Annual report 2018-19

Annual Report 2018-19:
GPH Annual Report 2018-19: Cancer Clinic
Ganga Prem Hospice hosted twelve charitable cancer clinics in Rishikesh and one in Haridwar during the April 2018-March 2019 operational year. A total of 1046 patients received care at these clinics, with an average for the year of 80 patients per clinic. The largest clinic (104 patients) was in March 2019, and the smallest (61 patients) was the Haridwar clinic in April 2018.

About 40% (431) of the total patients were from Rishikesh, down from 50% in 2017-18. 201 patients were from Dehradun, 149 from Haridwar, 178 from cities in the plains region, and 87 from towns or villages in the Himalayan hills. These numbers reveal an expanding geographical awareness of GPH services. The male-female ratio of patients was 61:39, almost exactly the same as in the previous year. GPH patients are overwhelmingly Hindu (90% at the 2018-19 clinics), which is a simple reflection of the larger demographics of the Uttarakhand Himalayan region. Other religions represented were Sikh, Muslim, and Jain in numbers of descending order.

While the primary aim of the free GPH clinics is the diagnosis and follow-up care of cancer, anyone with health concerns is granted a doctor’s consultation at the clinic. This year 56% of the total patients seen at the clinics were suffering from cancer, and amongst these 15% were terminally ill cancer patients. An additional 4% presented symptoms associated with cancer and these were sent for appropriate diagnostic testing as a first step in their continued care. As usual, head and neck cancers were by far the most prevalent cancers observed at the clinics, accounting for 45% of the total with 283 cases. The second most common category was breast cancer with 108 cases, followed by lung (41), abdominal (35), reproductive organs (28), blood (8), and bones (5). Other miscellaneous cancers afflicted the remaining 109 patients.

The GPH clinic staff is augmented by a team of local and visiting doctors and volunteers, with at least one oncologist at every clinic. There were as many as eight doctors in attendance at some clinics, with an average of six doctors per clinic, including oncologists, palliative care specialists, gynecologists, dentists, general practitioners and an onco-psychiatrist. Clinic operational activity benefited from the work of up to 14 volunteers (including volunteer doctors) every month. A few of these were international visitors who joined the local regulars in their monthly service, and all found meaning in helping others through the Ganga Prem Hospice charitable clinics.

GPH Annual Report 2018-19: Inpatient Facility

When it opened its doors in June 2018, the Ganga Prem Hospice inpatient facility became the headquarters for all GPH regional activities including administration, homecare, educational outreach and, of course, patient care. Within the first few months of operation an expanded staff and dedicated team of volunteers provided pain-relief, symptomatic care, healthy meals, and psychological and spiritual counselling and support to terminally ill cancer patients.

During the year Apr. 2018- Mar. 2019 the facility operated at near its 15-bed capacity with between seven and thirteen patients in residence at any given time. A total of 75 patients stayed at the hospice over the course of the year¬– nearly double the number of the previous year. Some stayed for a few days of respite care and symptomatic treatment, and some for several months at the end of life. Many of the patients were accompanied by family members, but there were also several destitute patients who were completely without support. In such cases, the hospice team acted as their guardians, providing them with company as well as care, and even making funeral arrangements according to the patient’s wishes. The hospice has its own crematory facility overlooking the sacred Ganga, as well as a beautiful temple, which was inaugurated in April of 2018. Regardless of financial status, hospice and palliative care services were provided free of charge to all.

There were fifteen deaths from end stage cancer at the hospice this year. Head and neck cancers were by far the most common malignancy overall, accounting for 25% percent of the 75 resident patients and primarily afflicting men. These included cancer of the buccal mucosa (12), tongue (4), and oropharynx (2). There were ten cases of lung cancer, seven of breast, and seven of the female reproductive organs.

Ganga Prem Hospice welcomes patients of all religions and socio-economic backgrounds. The majority (85%) of patients identified with the local Hindu majority population, and most (80%) were over the age of 41. Males outnumbered females by more than three to two and the hospice also cared for one child patient at the facility up until her death. About half of the total resident patients came from the tri-city area of Rishikesh-Haridwar-Dehradun, and the other half from distant towns in the Himalayas or plains regions. There are relatively very few inpatient hospice beds in all of India, so patients come from far and wide for this desperately needed service. Two foreigners who suffered from end stage cancer also chose to leave their bodies in the peaceful atmosphere that is provided at the facility.

Home Care Statistics Summary for 2018-19
During the GPH operational year from April 2018-March 2019, the home care team made a total of 2958 visits to 214 different patients. This represents a 30% increase in visits and a 15% increase in patients from the previous year. 98 patients are residents of Dehradun, 55 of Rishikesh, 56 of Haridwar (including Raiwala), and a few others are from more distant towns. These figures reflect the relative size of the three cities ¬– Dehradun is more than five times the size of Rishikesh.

On average, there were 247 visits per month, with some variation month to month depending on need and staff availability. April 2018 had the fewest visits (197) and March 2019 had the most visits (300).
Most (105 out of 214) of the home care patients were over the age of 50; fewest (18) were under the age of 30. This year breast cancer was the most common type of cancer treated in the home care program (27 cases), followed by ovary/cervix (22), lung (17), and tongue (13). However, taken as a group, head and neck cancers (60 cases) were again by far the most prevalent category relative to any other category of cancer, increasing by 3% in 2018-19, and primarily afflicting men. This unfortunate statistic is also reflected in the GPH cancer clinic and in-patient figures, and clearly linked to the prevalent use of tobacco and paan products.
The religious identity of GPH patients reflects the overwhelming Hindu majority of the Himalayan foothill region: 185 home care patients (86%) were Hindu, with the remaining fifteen percent following the Muslim, Sikh, Christian and Jain faiths.