Registered with the Registrar of Newspapers for India under R.N.I 53640/91
Vol. XXX No. No. 15, December 1-15, 2020
As a continuation of last issue’s feature on how non-profit healthcare institutions are coping with the pandemic, Madras Musings reached out to distinguished oncologist Dr. V. Shanta, Chairman of the Cancer Institute (WIA), Adyar.
The Cancer Institute is perhaps one of the city’s most notable medical charities. Dedicated to the cause of providing excellent, affordable care for cancer patients, the institute is equipped with more than 500 beds and a research division as well. Normally, the hospital allocates more than 50 per cent of its beds to the needy, who receive free boarding and lodging. In addition, 40 per cent of the patients are treated free of cost while the rest pay a nominal amount. When the pandemic emerged in March, the unprecedented public crisis posed new challenges to the hospital and patients alike.
“There was an increased need for psychosocial support,” explains Dr. Shanta. “The patient had to not only bear the fear and panic caused by cancer, but also the pandemic.” When the lockdown was enforced, the lack of public transport resulted in patients facing a delay in treatment stretching to as much as three or four months. This posed an ethical dilemma to the institute – on one hand, they had to shield the patients and their families from the pandemic, but on the other, they had to take a call on how long it is possible to defer treatment. “Early common cancers are curable,” said the doctor. “Advanced disease can be controlled and if untreated, will progress to the stage of palliation. Palliative care could not be denied.” With patients unable to reach the hospital in the early days of the pandemic, the institute’s income took a sharp dip as well – revenues that are crucial to the functioning of a charitable institution.
The situation has reportedly improved with the relaxation of lockdown norms and the availability of inter-state transport – between June and October, the institute has seen a steady pick-up in attendance in both the general and paying wards. But funding remains a challenge. The overall bed strength has gone down by 50 per cent in adherence to Covid guidelines affecting the income levels. Like other medical institutions, the reduction in income is accompanied by an increase in cost. “In general, treatment costs cover the cost of initial diagnosis, treatment type, radiation, chemotherapy, surgery or a combination of the above,” said Dr. Shanta, pointing out that cancer treatment is expensive on its own. This is only set to increase further, with the pandemic necessitating the use of RT-PCR testing, protective garments such as PPEs as well as intensive hygiene and sanitation practices prescribed for Covid control. “These may also need additional staff,” explained Dr. Shanta.
The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) is helpful in alleviating costs, though only to a certain extent – the scheme does not cover the full cost of cancer treatment. Further, the number of patients covered under other forms of medical insurance is also low. Public donations proved to be of great help to the institute in these times. “Support from the people and the families of survivors were of great help,” shared Dr. Shanta. The hospital also received generous help from service-oriented individuals, companies and organisations in procuring PPEs and implementing protective guidelines against the pandemic. “We cannot be adequately thankful to them,” said the doctor.
The institute has also taken steps to implement touch-free sanitisation devices. These, under the name of Sukhadaram, were from the Confederation of Indian Industry, Young Indians Group and Greater Chennai Corporation. These were installed at the institute in April. The device allows the foot to operate the soap dispenser and the tap, as well. “Similarly, around 50 foot-operated hand sanitizer stands were kept in strategic places all around the campus for patients, attenders, visitors and staff to disinfect their hands,” shared Dr. Shanta.
Speaking of the future, Dr. Shanta pointed out that the pandemic has imposed certain necessities that will change the institute’s style of functioning, including treatment. The doctor feels that cancer management can never be as ideal as it was before the pandemic, unless the virus is completely controlled. “We cannot predict how it will impact long-term results,” she said. “There will always be a need for compromise in treatment for some reason or the other.” Dr. Shanta also feels that the underprivileged will bear the burden more heavily than other sections of society and hopes that major philanthropic organisations and industries continue to participate in cancer control. “The struggle against cancer continues and Cancer Institute (WIA) will continue in its mission,” she concluded.