Even as it ushers its 25th year, the Care India Medical Society (Pune), the brainchild of army veteran Col. N. S. Nyayapathi, is a monument to the steadfastness of goal and clarity of vision possessed by both him and the CIMS team—that of providing cancer palliative care for the poor and underprivileged sections. Having reached out to over 35,000 patients so far, CIMS with its various projects Satseva, Matruseva, Vishranti and Cantreat, hopes to take the message of detection, diagnosis and humane treatment of cancer patients far and wide. After all, a good quality of life prolonged, helps save a family
You beat cancer by how you live, why you live
—Stuart Scott
It is precisely this simple, yet powerful mission that motivates the team behind the Care India Medical Society of Pune, CIMS, to go out there and do its best—day after day—in face of several odds.
A public charitable trust working in the field of cancer palliative care for the poor and underprivileged sections of society since 1993, the growth trajectory of CIMS is evident through various need-based projects that have evolved over the years, namely Satseva, Matruseva, Vishranti and Cantreat.
Like several endeavours of lasting value, the origins of CIMS are rooted in understanding and personal experience, given that Col. Nyayapathi watched his beloved mother succumb to the advanced stages of kidney cancer in 1989. Her pain and suffering left a lasting impact on him, and along with his anesthesist wife Dr Madhuri Kavoori, he decided to take humane, thoughtful and scientific care to the sections of society that needed it the most. Being an army veteran, he has been able to rope in the Armed Forces Medical College to carry out surgeries free of cost.
The backdrop is grim enough: the socioeconomic scenario in India is such that most patients either ignore the symptoms (despite sensing that something is wrong), or worse, cannot afford treatment even after being informed of its implications. In both cases, they forfeit their best chances of cure if their ailment turns out to be malignant. The figures say it all: about 80 per cent of the new cases of cancer per 1 million are diagnosed in advanced stages and less than 4% of them have access to palliative care. It is estimated that in India the total number of people who need palliative care is a whopping 5.4 million/year. Naturally, this makes the role of palliative care critical.
To further explain, the World Health Organization comprehensively defines palliative care as: “An approach that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness through prevention and relief of suffering by means of early identification, assessment and treatment of pain and other problems—physical, psychological and spiritual.”
On her part, Fatima Lilani, Director, Project Monitoring, would like to stress that palliative care, contrary to popular perception, does not only mean end-of-life care. “That is a very limiting—and limited definition,” she asserts. “End-of-life is but one aspect of palliative care, representing the entire journey from the point of diagnosis to treatment and cure. It also recognises the fact that cancer is not just one person’s journey—but one that involves assorted stakeholders, especially their family.”
To that end, the CIMS objectives include, organising cancer awareness and establishing early detection facilities, promoting cancer research and establishing cancer care centres for the terminally ill, as well as free diagnostic and therapeutic services to the lower socioeconomic sections of society.
"Chemotherapy costs that are usually around Rs.3 to 4 lakh are provided to the needy free of cost. It would be nice if society, as well as the Corporate Social Responsibility activities of companies, stepped in too"
—Col. N. S. Nyayapathi
Col. Nyayapathi believes in taking cancer care to the poorest sections of society.“But women tend to either neglect their health, or shy away from any health-related queries on their reproductive organs, no matter how pertinent. Hence, the move to name this programme Matruseva was a deliberate and well-thought-out one, emphasising the motherhood of these women— which makes it both a priority and responsibility to care for themselves,” he shares.
“There are a few things, though, that you won’t find here,” says Col. Nyaypathi. “No reception or billing counter—no hospital odour and no dirt. In fact, it has a very cheerful, positive and clean ambience—the cleanest you can find,” he asserts. “After all, it is clean surroundings that best nurture the spirit of life.”
Palliative care, contrary to popular perception, does not only mean end-of-life care. That is a very limiting—and limited definition. End-of-life is but one aspect of palliative care, representing the entire journey from the point of diagnosis to treatment and cure. It also recognises the fact that cancer is not just one person’s journey—but one that involves assorted stakeholders, especially their family
—Fatima Lilani, Director, Project Monitoring, CIMS
The team at CIMS. After all, both quality and longevity of life matter.Plans are now afoot to reach out to rural areas, where awareness levels are low. “Given our vast experience, we are planning to start a rural outreach project by establishing nodal points like Kolhapur, Satara, Sangli on one axis and Akola, Baramati, Nagpur on the other, and perhaps Solapur and Daund on the third axis. It’s a sad fact of life that most of these people don’t know that there are organisations that help relieve cancer patients of their pain. Even a simple thing like morphine is unknown to them. We plan to organise trained staff to cover these areas and reach out to the villages around these places to provide at least basic pain management,” says Col. Nyayapathi. “Once there, we will study the requirements of the place, and form a team with our staff, plus a local doctor.”
Despite their financial constraints, the goodwill for CIMS is immense and has spread word by mouth. “Our biggest achievement is that we have evolved into a one-stop social support system to the community over the entire spectrum of palliative care in its true sense—prevention by creating awareness, early detection through periodic screening, treatment and end-of-life care aspects.
Despite the great strides achieved thus far, there’s a long way to go before society wakes up to the full implications of what cancer represents—one of India’s fastest-growing diseases. With new cancer cases or its incidence in India estimated to grow by 25% by 2020 (according to the cancer registry released by the Indian Council of Medical Research), cancer has become one of the major causes of death occurring in the country.
“Changing lifestyles and rising levels of pollution are major contributors, surely, but it is our observation that stress is the numero uno killer. Almost all patients undergoing chemotherapy have been dealing with stress for several years now. Stress manifests itself in ways big and small, and really ruins an individual’s health,” he says. “Apart from this, it is also a matter of tremendous concern the way tobacco is destroying people and families, giving rise to oral cancers. And no, cancer does not restrict itself to any one strata of society—its tentacles spread far and wide, sparing none. Correct and timely diagnosis are the first steps for better prognosis in cancer treatment.”
Incidences of breast cancer that are on the rise as well reflect lifestyle changes too. “There is a need for further research on how diet impacts health. Every diet is relevant to a certain geography and context, and it is important to recognise that fact. Similarly, there are certain groups of people that are more vulnerable to a disease. For example, when the European migrants travelled to Australia in large numbers, its harsh and extreme climate led to a spike in cases of skin cancer, simply because their light skin tones that had evolved for thousands of years in the cold climes of Europe, were unable to cope!” he says.
To mark its silver jubilee year, CIMS organised a ‘CIMS Run for Cancer’ event to create awareness about cancer. The marathon, which was jointly organised by the Run-buddies Club, was held for 3, 5 and 10 km, respectively, starting from Shri Mahavir Vidyalaya, next to BMCC College, Pune, received an enthusiastic response from citizens. And thus, the CIMS continues, onward and forward with its mission to alleviate pain and suffering.
By Kalyani Sardesai
