Coping with a deadly duo

The main new block of the Cancer Institute, Adyar. - K.GAJENDRAN

Chennai has systems in place to cope with the challenges posed by HIV-AIDS and cancer.

THERE is life after cancer and HIV infection. To give patients and their families this hope is the mission of many of Chennai's doctors.

There was a time when cancer was seen as a terminal disease. But thanks to sustained research and development efforts in pharmacology and diagnostics and interventional advances, most forms of cancer are curable now, especially if they are detected early. The Cancer Institute in Chennai functioning under the guidance of Dr. V. Shanta, a pioneer in the treatment of cancer in Asia, has achieved a 75 per cent cure rate, including in the case of paediatric leukaemia. Dr. Shanta in fact says that there can be a hundred per cent cure if the disease is detected and treated early.

However, there has been a significant increase in the incidence of the disease: the numbers have doubled in the past decade. In India, about 10 lakh people develop cancer every year, half of them because of tobacco use. Tobacco use leads to oral (mouth), pharyngal (throat), laryngal (voice box), oesophageal (food passage) and lung cancers. It is estimated that just by curbing tobacco use the share of oral cancer in the incidence of all of forms of cancers can be reduced from 29 per cent to 4 per cent.

The Cancer Institute, which caters mainly to the weaker sections, has state-of-the-art facilities. Apart from radiation therapy, chemotherapy and surgery, it offers facilities for intra-operational radiation and 3-D conformal therapy. Multimodal therapy for the sake of organ conservation, and optimisation methods to salvage limbs, apart from surgical programmes, including of the brain, are the strengths of the Institute. Its bone marrow and paediatric oncology departments are among the best in the country. The Hereditary Clinic, a first in the country, studies the genetics of the disease. Its tobacco cessation clinic is one of its kind in India. In 1969 it was along with the Cancer Institute that the World Health Organisation set up the first international Cancer Control Programme in the developing world.

At the Institute the emphasis is on preventive oncology, which has two components - prevention and early detection. The Cancer Institute seeks to be sensitive to the patient's emotional needs, for which it has a specialised support group, named Sanctuary.

The Institute's financial needs are great. A novel fund-raising campaign, "iruvadhu varai iruvadhu" (20 till 20) is under way. The idea is to collect Rs.20 from each person who can afford the sum to raise Rs.20 crores. Says Dr. Shanta: "This is not just about collecting money, but a way of creating awareness and generating hope and positive action among people about cancer."

Besides the Cancer Institute, the multi-speciality hospitals involved in oncological diagnosis and treatment are Apollo Speciality Hospital, Sri Ramachandra Medical College and Research Institute and the Rai Memorial Hospital.

THE scourge of HIV/AIDS has replaced cancer as the biggest medical concern. The first case of HIV (human immunodeficiency virus) infection in the country was detected at the Madras Medical College Hospital by Dr. Suniti Solomon. Since then, this Professor of Microbiology has been actively working on the clinical aspects of the disease, including in the areas of research, training and management. In 1993, Dr. Suniti Solomon set up a charitable trust, YRGCare. Apart from creating awareness about AIDS (Acquired Immune Deficiency Syndrome) and training AIDS prevention educators, the centre provides medical care to economically disadvantaged HIV patients. It is one of the few centres in the country that is equipped and willing to admit readily patients who are HIV-positive.

The centre now functions on the premises of Voluntary Health Services, with a 16-bed in-patient facility, and also has the country's first intensive-care unit for such patients, apart from creating a consortium of consultants to treat HIV-infected persons.

According to WHO estimates, India has the largest number of HIV-infected persons for any country and over half of all HIV-positive persons in South-East Asia. Tamil Nadu, with a third of the country's identified HIV-infected persons, woke up to the problem early and created the country's first AIDS prevention agency, the Tamil Nadu State AIDS Control Society (TANSACS). Realising the role of the community in the task, district-level societies were formed under the District Collectors. The government also involved in the task non-governmental organisations - most of them trusts and charity organisations, realising that they could constitute the most effective route to reach the people.

TANSACS, along with the AIDS Prevention and Control Programme (APAC) which is housed at the Voluntary Health Services and is funded by USAID, the United States Agency for International Development, finances over 70 such NGOs in the State. Among the better-known NGOs working in the field in Chennai are the South India AIDS Action Programme (started in 1988), the Community Health Education Society (1997) and the Indian Community Welfare Organisation (1994). The Government Hospital for Thoracic Medicine, located at Tambaram on the outskirts of Chennai, handles the largest number of HIV-positive in-patients in any one medical facility in Asia. Started some decades ago as a sanatorium for tuberculosis patients, the hospital has become a sanctuary for the HIV-positive, particularly those from the poorer sections. About 50 per cent of its 1,000 in-patients are HIV-positive.

Providing a link with life is what Chennai's well-equipped hospitals, doctors and other medical professionals and NGOs do for the lakhs of people who come to the city with hopes of a cure for their ills.