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Ganga Prem Hospice Patients

 

 


INDIA, Haridwar, 24th April 2016
A Cervix Cancer Patient in Poverty
Thirty eight year old Anjanavati came to the Ganga Prem Hospice cancer clinic in Haridwar in April 2016, and waited patiently for her turn to see the doctor. She was one of the first patients to be seen.


Radiation Oncologist Dr SK Sharma, suspecting, that her gynae cancer may have spread, requested an ultrasound. The Hospice sponsored the test and the investigation report showed that the cervix malignancy had indeed spread through the pelvic region. Ganga Prem Hospice counsellors spoke to the Anjanavai at length about her prognosis. Coming to understand the difficulties that her condition would entail, she was understandably quite upset.
Nani Ma and Dr Aditi discuss how to help Anjana
Nani Ma and Dr Aditi discuss how to help Anjana

 

A small woman and underweight, Anjanavati has four children. Her husband is the only earning member of the family with a small salary of five thousand rupees a month. He had not accompanied her to the clinic as they could not afford the loss of wages that taking one day off would entail. When asked by the counsellor if her husband cared for her, she quietly answered, “Yes,” before breaking into tears and sobbing helplessly.

   
Sister Philomena at Anjana’s home
Sister Philomena at Anjana’s home
On the day after the clinic, her pain and other symptoms were again extreme and she phoned repeatedly on the Ganga Prem Hospice help line. She had forgotten which of the medicines were the tablets for pain. The home care team already had her on their priority visit agenda and two GPH nurses visited her on the 26th of April in her home, which is in one of the farthest places Ganga Prem has visited. She lives a total of fifty-five kilometres from the Rishikesh office and thirty kilometres out of Haridwar.  


On Wednesday 27th April, Anjana was taken by the Ganga Prem Hospice to the nearest cancer hospital in Dehradun to see if any palliative treatment can help her to stay well enough to continue caring for her children.

Anjanavati lives in a one room house which is shared by the five other members of her family. There being no toilet in the house, she has to go to the wooded area near her colony every time she wants to go to the toilet. Feeling a frequent urge to go to the lavatory, Anjana drains her cancer-racked body of all strength running out to the jungle several times a day.

Patients like Anjana, who live in such difficult conditions, make the hospice team long for the day when the GPH residential hospice will be completed and open for service.

 
     

 

 


India, Rishikesh, March, 2016
A Pre-school Child with Leukemia
Five-year old Navya dislikes going to doctors and hospitals as the visits invariably entail an injection. She is too young to understand that she is undergoing treatment for leukemia which was diagnosed two months ago.

When the little child visited the Ganga Prem Hospice cancer clinic for a second time in March 2016, the oncologist cleverly offered her a packet of biscuits, which she cheerfully accepted. She nibbled on a biscuit as her mother and aunt spoke to the doctors and the hospice team about her condition. The clinical examination for any swelling behind the ears was also done gently and tactfully so that the child did not withdraw from the doctor’s touch.

 
   
Navya enjoys her biscuit
Navya enjoys her biscuit
The two sisters with Dr Sharma
The two sisters with Dr Sharma

 

Navya is one of two siblings, the other being younger by a year, a four-year old sister who looks more like her twin. Being only twelve months apart, the two sisters play together, share food and treats, and also their infections. Navya needs great care and caution to be exercised around her so that she does not fall ill but keeping the older patient apart from the younger child is a challenge for the family and the children.

The parents had come with their daughter to the Ganga Prem Hospice clinic for the first time in January 2016, with Navya’s test reports and history of dengue fever. They had been referred to a cancer hospital earlier, which had advised bone marrow aspiration for the child. At the Ganga Prem Hospice cancer clinic, surgical oncologist Dr. AK Dewan advised the same. The parents seemed reluctant but soon got the test done. The reports turned out positive for Acute Lymphoblastic Leukemia. At the Hospice clinic, the mother and aunt asked questions about how long the treatment would last, if the child would be cured, and what kind of diet is to be followed.  After the oncological consultation, the Ayurvedic practitioner spoke to the family at some length, advising them on foods that might help the child recover quickly.

Navya's parents are natives of Rishikesh, with the father running a small shop in the local market. The child lives among her parents, grandparents and other extended family members. Fortunately, she seems to have supportive parents, which multiplies her chances of getting a curative treatment.

 



India, Rishikesh, October, 2015
Patient with Cervical Cancer Loses Her Home
Saumya’s eyes are red and swollen, tears course endlessly down her cheeks. She weeps quietly and without complaint seemingly  bracing herself for whatever blow will  fall  next, yet her sweet face is quick to break into shy smiles of trust and gratitude for those who try to help her.

One month after her second marriage Saumya found she had unusual bleeding. After confiding in her husband the rounds of expensive tests and medical treatment began. She was finally diagnosed as having cervical cancer. As the medical expenses involved in her treatment rose her welcome in her new home decreased. It seemed to the members of her new family that she had just come there to create a financial burden. With the exception of her husband the family gradually turned against her. Finally they accused her of knowing about the cancer before her marriage and of using the marriage as a means of getting herself treatment. As she became weaker and unable to help in the house the hostility grew.

Saumya’s husband brought her to the Ganga Prem Hospice for a second opinion and it was confirmed that her cancer was advancing and she needed treatment urgently. This news was not received with any sympathy by Saumya’s in-laws and her husband was given an ultimatum demanding she be sent back to her native village immediately. Despite GPH counseling and promises of help, Saumya was put on a bus with a monetary gift from her husband and sent back to her childhood home.

Saumaya’s parents had long since passed away and her only brother has been missing from his home for the past nine years. Saumya’s sister in law, struggling to bring up her own family, could not offer much help to the sick and heartbroken woman but did take her to the local hospitals and tried to find medical help for her. Saumya was turned away from the hospitals near to her village where they said that they did not have the facilities to treat a cancer patient. In pain and desperate, Saumya phoned her husband and the GPH team pleading to be able to come back to Rishikesh. Her husband, sick with grief and torn between his wife and his family called her home.

When the family flatly refused to keep her in the house, Ganga Prem Hospice arranged for her stay at an ashram which supports the project and advised and encouraged her husband  that he look after her. At present Saumya’s husband has found the strength to take his wife home and is facing his family’s wrath. With her spirit and body broken by sorrow, fear of desertion and the inexorable advance of the cancer, Saumya has taken emotional refuge with the Hospice team. Hospice counsellors are giving her and her husband their full support but the wasted time when Saumya was sent away has taken its toll and the latest reports show that the cancer has spread to the rectum and bladder and she may now be too weak for active treatment.

Saumya passed away at 1.00 am on 20th November 2015
Saumya had developed a swollen abdomen indicating imminent renal failure which could have been averted by a simple operation. Her drunken husband however decided to send her back to the village again as he said he  felt stressed by the situation and needed a break. Despite the pleas of the GPH team to let her have the operation before she went, Saumya, afraid to go against her husband’s will, left Rishikesh once again. The GPH team kept in touch with her by phone and tried to arrange help for her from a town near to her far off village but it was too late and Saumya passed away on the 20th November at the age of thirty-five.



India, Haridwar, September, 2015
Reaching Patients on the Far Outskirts of Haridwar
Some of the Ganga Prem Hospice home care patients live a very long way from the Hospice base in Rishikesh, even so the team try to reach as many far off patients as possible without compromising the number of patients served in more accessible areas.

The Ganga Prem Hospice home care team vehicle drove a long distance from the busy centre of Haridwar city and, as the traffic thinned out and fields became visible, one could see that the very outskirts of the city had been reached.Turning into a narrow lane of houses, the Hospice team of the palliative care doctor and nurse made their way into a small house, where a young man of thirty-five was lying down in the room.  His elderly father opened the door to the team and then called to his wife, saying, "The doctor has come."

The patient, Pradeep Kumar, suffering from cancer of the buccal mucosa, was until very recently, the only earning member of the family of four. Working as a driver, he managed to earn a few thousand rupees a month. A few months ago, cancer developed on his left cheek. He came to the Ganga Prem Hospice cancer clinic for the first time in June, where the hospice team, recognizing his great need, shortlisted him as a patient who needed to be supported with medical treatment and the hospice home care service.


   
Dr Aditi speaks with Pradeep about his condition
Dr Aditi speaks with Pradeep about his condition
Philomena does Pradeeps dressing
Philomena does Pradeep's dressing
   

As the Hospice driver gave the family a bag of food supplies,donated by a GPH supporter, Dr Aditi Chaturvedi spoke to the patient at length, taking stock of his symptoms and his pain medication. Pradeep’s father and mother were present, asking the doctor questions at times. As nurse Philomina cleaned and dressed the patient's feeding tube area, Dr Aditi taught the patient how to keep the area clean to avoid infection. The patient showed some the team his small boxes, stored under his bed, which contained his dressing material and medicines as he changed his dressing himself. An enquiry about whether the patient was still chewing tobacco followed and advice given.


   
Pradeep’s father takes medicines from the GPH ambulance
Pradeep’s father takes medicines from the ambulance
Dr Aditi explained to the patient gently that at the stage that his cancer was, it could only be kept under check and that the chances of a full recovery were unlikely. The team observed that the family appeared unable to grasp the significanceof the prognosis. Their simplicity seemed to protect them from an immediate feeling of despair. 



As the hospice team left, the patient's father came to the hospice vehicle and was given some medicines for Pradeep.

On the way back, the hospice team travelled the distance of a kilometer to enquire about a patient who lives another thirty kilometers away. The team usually leave medicines for him at his sister’s shop. As it was a festival day, the shops were closed and unfortunately both the patient and his sister’s phones were unreachable. The team was concerned about the patient, another young man with advanced cancer and in need of care and so when contact was made he was called to the clinic to see the oncologist.

Update March 2016


Pradeep Kumar is possibly living (and suffering) through the last days of his life. His inflamed facial wound has spread across his left cheek and constantly oozes pus. Not being able to eat or drink, and at present not agreeing to a feeding tube, the young man is all skin and bones. The Ganga Prem Hospice home care team visits him every day to dress his wound. Every day a nurse travels thirty five kilometres to reach his home, sanitises her hands, removes the old medical dressing and applies a new one.
Nurse Mamta cleans Pradeeps facial wounds
Nurse Mamta cleans Pradeeps facial wounds


 

Pradeep holds a hand-mirror and watches his wound being dressed. His speech is very muffled. Sometimes he just writhes in pain or restlessness.

On one such visit by the Hospice nurse on March 26th, he was lying in bed in a room darkened during the daytime. The light was turned on when the nurse arrived. Pradeep and his younger brother were alone in the very small room where the family lives. An iron tray with clean water was put on the floor under the bed to serve as a spittoon. A little distance away on the floor were jugs, glasses, a flask, and a mortar and pestle to grind tablets into powder. The family was trying to give as much material comfort to him as their impoverished state could allow.

Soon the patient's father, two uncles, and his mother came to the room. Each one of them was innocent in their own way. One of the uncles who was very vocal insisted that Pradeep be given some medicine so that he would regain his appetite immediately. The other uncle was introduced to the GPH team, but he politely stayed in the background saying that he was hard of hearing, so he didn't want the visitors to waste their time speaking to him. When the mother joined them, she seemed happy to see the team. During the conversation, sometimes she would express worry about how much pus was coming out of her son’s tumour, and on other occasions, she would show the flask of warm water that was put there for her son to drink. In a poor household, even warm water in a thermos is a kind of a luxury. The nurse repeatedly advised the patient and his family not to use just any cloth for wiping saliva or any other fluid near the wound. The bottle of antiseptic that the GPH team had left during a previous visit was ferreted out. As the cloth washing technique was being explained, the mother understood, and added, "I am the only one (to do all this work.”) For a frail elderly woman with a bent back and a dying son, to do all the washing, cleaning and cooking everyday, must not be easy.

As the GPH team was about to leave, Pradeep said a couple of times that he would come to the clinic the next day. It was going to be a long journey for his wisp of a body, but he wanted to come to see the rest of the team whom he had come to love so much.



India, Rishikesh, August, 2015
Casual Labourer Loses Livelihood
A patient with cancer with so few resources that, when asked for his phone number, said he would get a neighbour’s number should Ganga Prem Hospice needed to contact him. When asked how we could locate him, he gave the name of a shop keeper in his locality from whom he bought supplies, and who would direct visitors to his dwelling.

Sixty year old Ramesh Tiwari came to Rishikesh nineteen years ago from Lucknow for a holiday with his uncle, who was then the railway station master in Rishikesh. Ramesh did not have any education or a job and his uncle got him small jobs as a casual labourer. Having no family as his wife had passed away and having no children, Ramesh then settled in Rishikesh, setting up home in modest accommodation in the Krishna Nagar area.

 

   
Ramesh receiving free medicines at the clinic
Ramesh receiving free medicines at the clinic
A year ago, Ramesh developed signs of cancer with a growth showing on the left side of his face. A simple man who could not afford medical treatment anyway, he pinched the growth to make it disappear. "It only spread more after that", says the patient.

     

 

 

"Employers have stopped giving me any work as they say that I should get rid of my facial deformity first." says Ramesh who is jobless now. With no family or support, he is confronted with a bleak future. Ramesh came to the Ganga Prem Hospice cancer clinic on August 30, 2015, in Rishikesh, where surgical oncologist Dr AK Dewan advised a biopsy and then surgery to cut the cancer out. As the Ganga Prem Hospice counsellors spoke to him, he seemed unable to comprehend the situation and gave up his fate to whatever the circumstances would decide for him.

The Hospice team persuaded him that he should make a visit to the hospital and if he decides to go ahead with his treatment, the Hospice would try to have his cancer treatment sponsored.

Update October 10th 2015
 
Ramesh Tiwari was admitted into hospital on the 30th September and after a successful operation sponsored by Ganga Prem Hospice he was discharged on the 10th October. GPH looked after Ramesh’s expenses in the hospital and will continue to provide him with basic rations until he is able to return to work. Ramesh is overjoyed at the result of the operation and looking forward to a normal life again without his ugly sore. He says that he is very much thankful to Ganga Prem Hospice.

 

 


 

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PATIENT'S STORIES
Cancer patients and their loved ones are invited to write to us about their views, thoughts and feelings. We will include as many letters, articles and stories as is possible in these web pages.

Please send your article to Nani Ma at nanima@gangapremhospice.org.

 
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