For nearly 60 years, cancer treatment has seldom had a better address than Cancer Institute, Chennai.
An island in an era of corporatisation of health care, this is an institution that will not turn away patients, whether or not they have an appointment, whether or not they have money.
“The poor should be treated and supported, with the same facilities that those who can pay are able to afford. This was the ethos on which the Cancer Institute was built,” says V. Shanta, chairperson, Adyar Cancer Institute. Dr. Shanta however is more than chairperson. She joined the institution started in 1954 by Muthulakshmi Reddy, a doctor, and the first woman legislator in the country, along with Dr. Reddy’s son S. Krishnamurthy. The young duo worked hard at building the institution, setting in place systems that are still being followed and ensuring that patients felt cared for.
The world-renowned institution, which lies spread across two campuses in Adyar today, had a modest beginning in a small hut with 12 beds, with funds Dr. Reddy coaxed out of the Women’s Indian Association, to spend on cancer care. “At that time, we just had minimal diagnostic and therapeutic facilities,” Dr. Shanta recalls.
“Cancer is so different from other diseases — the panic and the fear are always there,” she goes on, weighing a lifetime of experiences behind that sentence. “We only believed that we should provide total satisfaction for the patient. They must feel they are being treated well.”
“If a life can be saved with our intervention, then we ensure that it is done. It does not matter if the patient cannot afford the procedure,” says T.G. Sagar, director of the Institute. Wherever you go in the Institute, you always run into an old-timer who will say just the same thing, sometimes differently and sometimes without a word out of place. So deeply is the message entrenched in those who serve here.
Twenty per cent of all patients, those who live below the poverty line, are treated free of cost. They even get free food and lodging at the Institute, Dr. Sagar explains. Another 40 per cent receives heavily subsidised care. In other words, they pay what they can. The remaining 40 per cent are patients who pay the tariff, many times lower than corresponding procedures in the private sector.
Dr. Sagar has been at the Institute for about 40 years now, and he is not the only old-timer. About 20 per cent of the staff who joined the institution in its early stages have stayed on, despite relatively low salaries, long work hours, minimal increments and having to lend a hand wherever needed — whether at the cash counter or registering a patient at reception. C.N. Janaki, the cheerful matron with dimpled cheeks, has been with the Cancer Institute since 1964, has done everything her job demands, and more. “None of us say ‘This is not my job’.”
“Working under Dr. Shanta has charted the course of my life. I have learnt much, and try to do as much as possible, especially emulate her attitude to patients,” Dr. Selvaluxmi says. She has recently taken charge of the radiation oncology department.
Tamil Nadu Chief Minister Jayalalithaa will shortly declare open a state-of-the-art accelerator for radiotherapy to mark the commencement of the 60th year of the Cancer Institute. She will also formally launch the Tamil Nadu Cancer Registry project and a 1.5 Tele MRI machine, according to A.V Lakshmanan, medical physicist and advisor at the Institute.
“We don’t stint on buying the latest equipment, whatever the cost. We find donors from corporates, individuals or governments,” says A. Vasanthan, Additional Director of the institute. “Everything else we reuse: envelopes, double side sheets and packing material for furniture.”
“We take pride in the fact that we are a state-of-the-art institution for cancer care that provides affordable and equitable treatment for all,” Dr. Shanta says. A statement Mangamma (name changed on request), sitting outside the radiation unit, her hair recently tonsured, easily attests to. Wife of a daily wage labourer who barely makes enough to put food on the table, she says she would have nowhere to go but for the Cancer Institute. “Thanks to Shanta Amma, I am here, and they say, I will be cured soon.”
Over the years, Dr. Shanta says, there have been phenomenal advances in treatment and pain management.
“Years ago, we could hear the screams of patients right across the road. Today, things are so much better for these poor people,” says Malar, who has been selling coconuts for years outside the Institute at Canal Bank road.
Undertaking community outreach awareness and screening programmes is a key component of the work the Institute does, along with hardcore scientific research.
But the centre piece is still the patient — who needs to be reassured that the doctor has no personal agenda, except perhaps satisfaction in a job well done. “Medical schools today teach the science, not the art, of medicine. The doctor-patient relationship is sacred and must be built on confidence and trust,” Dr. Shanta says.