One Doctor Is Quietly Building a World-Class Cancer Hospital for the Poor in Assam

Dr. Ravi Kannan’s vision has turned a small cancer centre into a full-fledged hospital in Assam’s Barak valley.
Barak Valley is a remote area on the Indo-Bangladesh border in Assam. For years, the people in the area had limited access to medical care. In fact, the nearest hospital was in Guwahati, which is 350 km away. This journey would often take 24 hours to complete, due to the difficult terrain as well as the threat of landslides.

The high incidence of cancer in the region, possibly due to extensive tobacco use, prompted citizens of the valley to come together and set up a hospital in 1996.

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The Cachar Cancer Hospital Society faced multiple challenges, including a severe financial crunch and lack of infrastructure, right from the start. In fact, the hospital got its first radiation unit only in 2006.
The first qualified nurse came on board in 2008. Though there were other trained personnel in the region, they were choosing to migrate to bigger cities in search of better employment.

The hospital continued to reel under all these problems till 2007, when it got a saviour in the form of Dr. Ravi Kannan.

“When I got the offer to come and work in Assam, my wife was hesitant. But after coaxing her, we came and spent some time here. I worked at the hospital and interacted with the patients. Meanwhile, my wife and daughter mingled with the members of the community. All of us realised that there was much work to be done here and this is where we should be,” he says.

So Dr. Kannan, who was a renowned oncologist at the Adyar Cancer Institute in Chennai, and his family, packed their bags and moved to Silchar.

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It was a big change for the family. For instance, his daughter, who studied in a school which didn’t have exams, had to take her first exam to get admission into Kendriya Vidyalya. The weather was different and so was the language. And life here was harder in comparison to their hometown of Chennai. However, slowly, they all settled into the new place and Dr. Kannan got to work.

“From day one, we just kept reacting to situations, whether they were related to finance or manpower or infrastructure,” says Dr. Kannan.

Over the years, this doctor and his incredible team managed to turn the place around.  There were only 23 staff members when he joined. Today, there is a 200-member strong team.

From 25 beds, the hospital now has 100 beds. And from 6, the number of nurses has grown to 102.

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“It is his selfless service and vision that have transformed this unknown cancer hospital into a comprehensive cancer centre that is providing free and heavily subsidised treatment to thousands of poor cancer patients every year,” says Rajeev Kumar, Dr. Kannan’s colleague.

In the early days, Dr. Kannan noticed that only a few patients who came for the initial check-up would come back again for a follow up. Every year, the hospital would conduct a review and find that most patients didn’t return a second time. Finally, it dawned on the administration that most people couldn’t afford the treatment.
Over 60% of the patients visiting the hospital have an income of Rs. 3,000 or less per month. As many as 80% are daily wage earners – labourers, tea garden workers and agricultural workers.

“We realised that most of them were the sole breadwinners of their families. They couldn’t afford to not work. The challenge was to figure out how to get them to undergo medical treatment, without taking away their daily bread,” he says.

This is how the hospital started home visits. The doctors started going to the villages to provide treatment to cancer patients. The patients do not have to pay for home-based care and follow up. Slowly, the hospital started satellite clinics for patients who are unable to travel long distances to visit the hospital. The doctors also provide phone consultations and stay in touch with patients who have returned home with prescriptions.

Dr. Kannan and his team discovered yet another way to get the patients to come in. They started employing those who come as attendants with the patients. These attendants help out in the garden or do other small tasks. Initially they were paid Rs. 30 but now they get about Rs. 100 per day for their work.

According to Dr. Kannan, because of the free food available at the hospital and the opportunity to work, some patients stay behind even after their treatment is completed.
The hospital has a desk in the outpatient department where the staff proactively assess the economic needs of the patients and assist them in getting treatment from the hospital at subsidised rates or for free.

They also provide patients with a better understanding of their treatment options.

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“We make efforts to offer the best treatment possible to all the patients, irrespective of their socio-economic status. No one should be denied access to treatment due to want of money,” Dr. Kannan says.
The hospital now has a strict follow up policy. The supervisors of each ward are given cell phones. They are required to call up people and find out why they have missed their appointments. They maintain contact with patients and their families and motivate them to complete their treatment as advised.

At present, the hospital has an annual inflow of 3,000 new and 14,000 follow-up patients. It also gets patients from other states, as well as from neighbouring Bangladesh.
For Dr. Kannan and his team, every day presents a new challenge.

“There have been times when my colleagues and I have conducted surgeries in fields we have not specialised in. The patients cannot always go rushing to Guwahati. How can we say no to someone who is critical? By taking up these surgeries, we have also been pushed out of our comfort zones,” he says.

The hospital runs on the funds it receives from various organisations and individuals. A grant from the Indo-American Cancer Association helped establish the Department of Pain and Palliative Care in the hospital in 2011. A Department of Dental Surgery has also been set up. The pharmacy offers medicines at highly discounted prices. An ICU was started from the contributions made by individuals and NGOs.

The hospital is now awaiting permission to set up a blood bank in the region.

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“The expenses just keep increasing. We rely on contributions to run this place and provide treatment to so many people. My amazing team has chosen to work here despite the fact that they would be better remunerated in bigger cities. The satisfaction we get from serving the community here is indescribable,” he says.

The Cachar Cancer Hospital Society is raising funds to support cancer patients. For more details visit its page on Ketto.
To get in touch with Dr. Ravi, mail him at [email protected]

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