UNDISCOVERED COUNTRY. The unkindest cut

Maybe it is my age, but it seems that I deal with diseases and hospitals far too much these days. For some odd reason, what I have been dealing with for the past month or so are tales of cancer. The first case I heard about was that of my wife’s aunt, who was diagnosed with a form of throat cancer. It was detected at an early stage and the treatment started soon after. The aunt is Kashmiri, her cousins and family have a number of doctors amongst them. She came to Delhi for tests, travelled to Chandigarh, and then suffered the rigours of chemotherapy in Kashmir itself. Through the massive floods of last year, the stark winter that is visually beautiful, but physically harsh, and then through the spring of this year when floodwaters rose again, she fought the disease and suffered the cure.

It showed me how deeply a woman — a wife and a mother — sits at the centre of traditional families here in South Asia, how her delicate health can bring the household to a standstill, and make a home into little more than a house as she withdraws from her functions. I visited the family in the aftermath of the floods, which had spared the old habitations and ravaged the newer buildings and neighbourhoods of Srinagar. She insisted that I be served fruit, and though she could not cut it herself, it was done to her specifications. She sat upon the carpeted floor and directed, even in her weakened state, the protocols of her house.

The second case was a little farther away. Our help’s brother-in-law was diagnosed with cancer. Luckily the patient’s wife worked with an understanding family, which asked favours on his behalf, and he is being treated. Our help does double duty at times, picking up the slack as her sister-in-law spends time in the hospital. My wife and I worry. How do they make ends meet? The costs are high, and of course they are not covered by any health insurance plans. The help will not take charity. She is a strong-willed person who, when she had slipped and fractured her foot two years ago, had resisted our efforts to pay her for the month that she was on bed rest. She refused help until we convinced her that she too, just like my wife and I, should get medical leave. Now we wonder if there is a way we can convince her to take a medical package. I work for a German company that offers an equivalent of three months’ pay as medical expenses when in need. Maybe we can adapt this to her family, but I do not know if she will accept. I cannot understand why I should have this privilege when she does not.

A third case was much closer to me. My closest cousin was diagnosed with leukaemia a month-and-a-half ago. We scrambled to figure out the treatment. I spent my nights at the hospital. His company made him go on paid leave for a month, rallied to offer him a substantial medical package, and found blood and platelet donors. In one of the finest private hospitals in India, I watched in trepidation as the bills rose. I cringed to think of those who do not have the privilege of wealth. Does poverty kill them? Does it ravage their households, leaving such high debts that their lives will be spent repaying them? Two-thirds of Indians live on less than ₹100 a day, and one day in the Intensive Care Unit costs more than ₹12,000 — this without tallying the costs of medicines and consultation.

And then, in the middle of his treatment, we found that a tailor, whose house and shop were destroyed in the Kashmir floods and who had stitched pherans and other garments round-the-clock to rebuild his life, was in Delhi to get his wife treated for breast cancer. While we pulled all strings to find them a bed at AIIMS, I thought how disease destroys us. It is not the illnesses, but the limited resources we have to deal with them. India spends about four per cent of its budget on health, among the lowest in the world, lower than Nepal, and two-thirds of medical expenses are out-of-pocket, as in not covered by the government. What happens to the millions whose diseases are not diagnosed because they cannot afford a doctor? What happens to those who cannot get admitted to a public hospital because there is none available, or the waiting list is too long? What happens to those who cannot afford the treatment to live? Can we truly, truly turn away from this?

( Omair Ahmad is an author. His last book was on Bhutan )

Follow Omair on Twitter @OmairTAhmad

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