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GPH Annual Report 2019-2020: Cancer Clinics Ganga Prem Hospice hosted eleven charitable cancer clinics in Rishikesh and one in Haridwar during the operational year April 2019- March 2020. A total of 765 patients received care at these clinics, with an average of 63 patients per clinic. The largest clinic (89 patients) were in May 2019 and the smallest (40 patients) was in the month of February 2020. |
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About 48% (368 patients) of the total patients were from Rishikesh, 18% (135 patients) from Dehradun, 12% (93 patients) from Haridwar, 13% (101 patients) from the plains and 8% (65 patients) from Himalayan hills. The male-female ratio of patients was 68:32. Ganga Prem Hospice patients are overwhelmingly Hindus (91%) which is a simple reflection of the demographics of the Uttarakhand Himalayan region. Other religions represented were Sikh, Muslim, Jain and Christian in numbers of descending order. |
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While the primary aim of the free Ganga Prem Hospice clinics is the diagnosis and follow-up care of patients with cancer, anyone with health concerns is granted a doctor’s consultation at the clinic. This year 66% of the total patients seen at the clinics were suffering from cancer, out of which 6% were terminally ill patients. An additional 2% 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 almost 56% of the total with 262 cases. The second most common category was breast cancer with 54 cases, followed by lung cancers (39), abdominal (19), reproductive organs (16), bones (12) and blood (7). Other miscellaneous cancers afflicted the remaining 56 patients. |
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The Ganga Prem Hospice clinic staff is augmented by a team of local and visiting doctors and volunteers. There were as many as eight doctors in attendance at one clinic, with an average of five doctors per clinic, including oncologists, palliative care specialists, oncology radiologist, gynaecologists, dentists, general practitioners/ physicians, Ayurveda and Homeopathic doctors. During the year, 3-10 volunteers helped at each clinic. In March 2020, the monthly clinic was cancelled due to the Covid-19 lockdown. |
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We were blessed to have young and enthusiastic Dr. Taranjit Singh, who was trained in palliative care at London and Adelaide, to head the daily medical proceedings as the Residential Medical Officer. He has been briefing and updating not just the medical team of the hospice, but also other medical institutions across the state at regular intervals. This year he has been actively attending conferences, conducting seminars and workshops, and training the nursing staff and volunteers.
As a result of increased outreach campaigns, this year we had 30 (27%) in-patients from other states alone. Among the remaining patients, 24 (22%) were from Haridwar; 29 (26%) from Dehradun and 11 (10%) from Rishikesh. And from the mountain regions we had 16 patients (15%). The incomparable, selfless service which Ganga Prem Hospice embodies, now has a powerful presence – not just throughout Uttrakhand – but in other states as well. |
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Out of 110 patients 58 male and 52 female patients were served. The majority (80 patients) were 40 years of age and above. 43 Patients were cared for by the committed team until they breathed their last, out of which four didn’t had any family with them. The majority of the patients were Hindus (105), the other five were Muslim, Sikh and Jain. The most common types of cancer seen were of lungs (15 cases), breast (9 cases), cervix (7 cases), tongue (6 cases), gall bladder (5 cases), ovary & stomach (4 cases each). The remaining 60 cases were of widely varying types of cancer.
In India, it will be observed that many hospice patents are often readmitted multiple times. Perhaps because of the strong family ties that are integral to the culture, patients frequently want to go home to be with their families. However, once at home, symptom management is often not possible, especially in the poorer sections of the community. As a result, patients often find themselves obliged to return to the hospice. Occasionally patients also leave the hospice for supportive hospital treatment and they return when it has been completed. In the year 2019-20 there were 34 patients readmitted to the hospice, some even as many as 3 or 4 times.
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Of the 325 home care patients, 51% (166) lived in Dehradun, 25% (81) resided in Rishikesh, while 23% (76) had their homes in Haridwar and Raiwala. The other 1% (2) were from various other villages in the area covered by the home care team.
On average, there were 307 visits per month, with variations in number depending on patient need and staff availability. When visiting medical professionals joined the team for a period of weeks or months, home visits naturally increased in number. Fluctuations in the numbers of staff available for home care often depends on holidays or the periodic engagement of staff in other GPH activities such as rural outreach, CME (Continued Medical Education) and patient oriented events at the inpatient facility. March 2020 had the most visits (394) and September 2019 had the least (236). |
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Categorizing the total data on the basis of age, the majority of the patients, i.e. 65% (212), were 51 years and above; 16% (22) were below 30 years of age; and the rest were between 31-50 years of age.
Breast cancer (37 cases) was the most common type of cancer found in the home care program. This was followed by lung cancer (31cases), cervical cancer (20 cases), gall-bladder cancer (14 cases), tongue cancer (13 cases), rectum cancer and buccal mucosa cancer (10 cases each), and oropharynx cancer and ovary cancer with 9 cases each. The remaining 182 patients suffered from 105 different types of cancer. Taken as a group, head and neck cancers were by far the most prevalent category with 64 cases (20%), followed by abdominal-intestinal cancers which numbered 52 (16%) cases. |
| After considering the financial status of patients, Ganga Prem Hospice helps the poorest families receive additional aid in the form of free food supplies, grants for hospital treatments, school fees, employment assistance, empowerment of women and so forth. Based on their income, most of the home care patients were categorized as lower-middle class (107), followed by poor (86) and then very poor (24). While 107 patients were classified as upper-middle class or well-off. |
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The religion of the patients mirrored the Hindu majority of the Himalayan region: 293(90%) patients were Hindu, with the remaining 10% following the Muslim, Sikh, Jain and Christian faiths. |
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A total of 6 doctors, 14 nurses, 2 assistant nurses, a masseuse, 2 social workers, 4 volunteers and 5 drivers joined the team at different times and for varying durations throughout the year to provide home care. |
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