Boundless woes afflict child cancer patients

Woes of 15-year-old Shakhwat Hossain Saikat all started when he discovered some serious illness in his body and all his family needed to take him to a Dhaka hospital to diagnose his disease.

The minor's mother Shirina Bibi, hailing from a remote village of northwestern Rajshahi city, rushed to Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka as Rajshahi Medical College Hospital or any other healthcare centre there did not have any equipment to identify Saikat's disease that got close to blood cancer.

As Saikat's father, a remittance earner living in Italy, could not return home immediately, his mother had to manage all his treatment singlehandedly.

"We needed Tk 200,000 as an initial spending to know if he was attacked with blood cancer and the stage of cancer. His father could not come to see him to meet the unlimited cost of cancer treatment," Shirin Bibi told the FE.

"We've already spent Tk5 million since he tested blood cancer in late 2018, apart from Tk 25,000 being spent every month," she added, saying, "A little financial assistance we got from the government and private organisations."

Despite BSMMU being a government facility, Bibi, 37, a mother of two, had to spend a big amount of money due to the costly treatment, medicine, and injections.

The situation gets critical mainly due to poor healthcare facilities and lack of advanced equipment and decentralisation of treatment services, experts told the FE.

They suggested advanced study and research on the child cancer situation to ensure advanced oncology services.

Despite child cancer in as much as 80 per cent cases being curable, patients in remote areas cannot come to Dhaka due to high cost of treatment and lack of awareness.

Experts said the cancer mortality rate is too high in Bangladesh compared to the developed countries. Therefore, early detection and mass screening are needed, they added.

Meanwhile, those who have financial ability mostly visit India and other countries to get advanced treatment which Bangladesh lacks.

According to the Indian Tourism Ministry, in the last three years until 2021, the rate of medical tourists from Bangladesh increased by 83 per cent; while 54 per cent of all foreign medical tourists were from Bangladesh.

Around 2.5 million Bangladeshis went to India for treatment and spent about US$500 million in 2020, it added.

World Child Cancer (WCC), a UK-based international children's charity, works with the government to improve the paediatric oncology services and build awareness.

Programme coordinator of WCC Jewel Ahmed while talking to the FE said Bangladesh does not have field research to know the real time data or actual figure of how many child cancer patients are there in the country.

"We estimate a figure that some 13-15 thousand children are diagnosed with cancer every year in Bangladesh. 50 per cent of child cancer cases of the figure are diagnosed and 30 per cent of them manage to take treatment," said Jewel Ahmed.

He, however, expressed the belief that child cancer screening and rate of taking treatment have improved in the country in the last couple of years, adding some 28 new posts of teachers have been created at the country's state-run medical hospitals and centres.

"Child cancer patients need 5-10 per cent radiotherapy while most need chemotherapy so treatment for them would be possible in the country if we decentralise the healthcare system," he added.

AKM Amirul Morshed, a child cancer expert and former head of the paediatric hematology and oncology department at Dhaka Medical College Hospital, also attributed the prevailing situation to shortage of medical professionals and Dhaka-based healthcare system.

He suggested stopping government registered physicians from doing practice in private hospitals or facilities by declaring government doctors to be 'non-practicing'.

"If we can make government doctors 'non-practicing', then the shortage of specialists in private facilities would be solved (more specialists will be generated within private facilities). Such practice is found in other countries like neighbouring India and they have got positive benefit of it," Prof Morshed added.

He advocated for introducing health tourism in the country to improve the situation.

Prof Dr Abul Bashar Md Jamal, additional director general Directorate General of Medical Education, told the FE, " Bangladesh has a severe shortage of child cancer specialists."

"Earlier, specialists for adult cancer mostly provided service for children as we did not have paediatric oncologists. Now we have some 20-25 paediatric oncologists which are still insufficient," he added.

And, most of the paediatric oncologists practise from Dhaka. Therefore, patients need to visit Dhaka for treatment, he explained.

"Meanwhile, we didn't have advanced equipment like re-agent to diagnose cancer and other diseases as those are costly. However, we have some of them now in some of our top hospitals in Dhaka," he continued.

The government has started establishing eight divisional cancer hospitals across the country and there will be extended service for children which would lower the costs of patients and decentralise the treatment, he hoped.

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