Lying on a bench at the Bathinda railway station, sexagenarian Gurjant Singh waits to board the Abohar-Jodhpur passenger train. He, however, is not the only one waiting. As the train chugs into the platform, people rush to claim their seats. Those who are unsuccessful settle down on the floor. Soon, the train plunges into an eerie silence. For many of the passengers, it is another routine journey, wrought with hope and despair.
Welcome aboard the “cancer train”. The train commences from Abohar and leaves from the Bathinda station at 9:30 p.m. every day to reach Rajasthan's Bikaner, where patients undergo treatment at the Acharya Tulsi Regional Cancer Treatment and Research Centre (RCC). A majority of the patients are from the Malwa region of Punjab.
For want of money
RCC is a State government-funded cancer hospital and is supported by a private charity trust called the Acharya Tulsi Shanti Pratishthan. The hospital is fast becoming the only affordable option for the poor, who are driven into debts while meeting their treatment expenses.
“My father [Gurjant Singh] is suffering from esophageal cancer [cancer of the food pipe]. Since last December, I have been taking him to RCC for his monthly chemotheraphy sessions,” says Kushwinder Singh, who along with his uncle is accompanying Mr. Gurjant.
Mr. Kushwinder points out that he spent nearly ₹30,000 on his father’s treatment at private hospitals in Bathinda. Now, he is under a debt of over ₹1 lakh.
“Treatment is expensive. I divide my time between farming and taking care of my father. My younger brother, who goes to school, is also my responsibility...All this is not easy,” says Mr. Kushwinder.
Facing similar hardships is the family of Jagpreet Singh (13), who was diagnosed with blood cancer two years ago.
“We spent over ₹1 lakh at local private hospitals, and then gave up. RCC was the only option for us,” says Jagpreet’s father Guradeeta Singh (47), a farmer from Kot Shamir village. He adds that he incurred a debt of nearly ₹5 lakh while funding his son’s treatment.
Agro-chemicals
Experts say this “cancer train” symbolises the adverse impact of the Green Revolution on public health in Punjab. The rise in cancer cases in the region can be attributed to the indiscriminate use of agro-chemicals.
Lakhwinder Singh, a professor of economics and coordinator at the Centre for Development Economics and Innovation Studies at Punjabi University, Patiala, says, “Punjab is the leading State in terms of consumption of fertilisers and insecticides. This is leading to various diseases, especially in the cotton belt of Malwa.”
According to a survey conducted by the government, cancer claimed 33,318 lives in the State between 2008 and 2012, out of which 14,682 were in the Malwa region alone. Research has revealed that the soil in this belt is high in Persistent Organic Pollutants (POPs), nitrates, phosphates and uranium, which gradually make way to agricultural produce.
Agro-chemicals also affect fertility and can lead to mental disorders in infants.
“Pesticides lead to neural tube defects, and can cause stunted growth and mental disorders in infants. There have been reports of reduced sperm counts, spontaneous abortions and premature deliveries from some belts in the State,” points out Shantanu Nevrekar, a visiting scholar at Punjabi University.
Umendra Dutt, a member of NGO Kheti Virasat Mission, says drinking water crisis and depletion in the groundwater levels are also leading to health problems in the State.
Dr. M.K. Mahajan, Director, Advanced Cancer Diagnostic, Treatment and Research Institute, Bathinda, attributes changes in lifestyle and food habits as the other leading causes of cancer. “Smoking and tobacco consumption, which cause cancer, are rampant in this region,” he says.
Mr. Lakhwinder points out that the State government is not providing enough support to patients.
‘Lack of govt support’
“The government should not only provide financial support to patients but also look after their food, health and educational needs,” he says.
At present, the Punjab government runs the Cancer Rahat Kosh (Chief Minister Cancer Relief Fund) scheme, which provides free treatment and medicines up to ₹1.5 lakh.
Data show that 36,788 people have applied for the scheme since 2012.
Dr. Mahajan asserts that ever since the scheme was launched, fewer people have been visiting RCC.
Further, with the opening of the Advanced Cancer Diagnostic, Treatment and Research Institute in Bathinda and other cancer hospitals in the State, the demand for RCC has reportedly gone down.
“There are not as many passengers on the cancer train as it used to be a few years ago,” says Lal Meena, the Travelling Ticket Inspector who has been serving on this route for nearly three years.
Poor patients, however, feel that the amount provided under the cancer scheme is too less.
“Treatment expenses usually cross the ₹1.5-lakh limit. What do we do then?” asks Harnek Singh (44), another passenger on the train.
“I quit my job as a daily wage farmer after I got diagnosed with mouth cancer. My wife now works as a domestic to meet my treatment expenses,” says Mr. Harnek, as he breaks into tears.
