Treating bone cancers for the last fifteen years has made me quite impervious to death, but there is a small problem with this subset of cancers that can still haunt- it affects young children. Healthy, happy children who were dancing, playing and running till the moment that weird knee or back pain makes their lives turn upside down!
It was a salubrious, pink, February afternoon when Bantu had hopped into my clinic, supported on the frail shoulders of his father. He was twelve years old and had a knee pain, which refused to go despite trying every known painkiller on the shelf. He had Osteosarcoma, the commonest bone cancer known to occur in this age group. He needed chemotherapy followed by surgery followed by another round of chemotherapy provided he survives the first round of toxic chemo and surgical assault. Besides the dangerous cancer, Bantu and the family were affected by one other disease- poverty. The father was a landless farmer from a village near Delhi. Complete treatment meant that there were some chances of the cancer getting cured but a definite possibility of the “other disease” getting escalated to dangerous levels. Anyway, funds were arranged, NGOs were pleaded and Bantu sailed through the first cycles of chemo. His complex surgery required multi-specialty skills and he requested that his leg be saved. I remember he telling me that he was afraid of an amputation, as his friends would taunt him and call him “langdha”. The leg was saved and he went for a second round of chemo that unfortunately opened new wounds on the operated leg, a common occurrence in children with poor nutrition. Exhaustive wound care meant further stay in Delhi and therefore a further intensification of the “other disease” as the father missed on kharif sowing! Convinced, that an amputation will bring an end to the misery unleashed by cancer, he reluctantly allowed us to remove the leg but not before I promised him that the amputated leg would be replaced by a high quality, artificial leg or prosthesis. Another NGO was roped in and measurements taken for a prosthesis. A beaming Bantu told me the other day that he could actually hop on his new leg and his friends from the village couldn’t make out which leg was amputated! He was waiting to start playing cricket. He was upset by the fact that he never got to bat. He was always asked to field in the game. His scans showed he was free of cancer.
When last evening his father called me, I thought the boy had started playing cricket and the father was excited to share the news. Instead, I was told that Bantu had died.
He died of Dengue!
I was numb for a few seconds. The twelve year old had defeated cancer but failed to defeat a disease, which shouldn’t have risen to such epidemic proportions in the first place; definitely not in the times of Swach Bharat! Bantu became a statistics in Delhi’s Dengue epidemic. His breath, his heartbeat and his courage were sacrificed at the altar of a nation that has recently started romanticizing with the idea of cleanliness! A disease, which has direct bearing to unhygienic, unclean surroundings, was to become the undoing of Bantu and those who loved him and that too at a time when we have a government, which talks of Swach Bharat and in the same breath slashes the expenditure on health by a cruel 20 percent in it’s first budget. India spends 1.3% of its GDP on health. Compare this to the health expenditures in some of the poorest nations on the planet, Afghanistan (1.7%), Ethiopia (3.1%) and Bhutan (2.7%). The numbers show the intent of policy makers more than a constant, nagging oratory of hope in a nasal tone! The audacity of policymakers in defending a cut in an already “sick” health budget is atrocious to say the least.
Corpses like those of Bantu are difficult to hide under the rhetoric of hope. India is a complex land where poverty, caste and illiteracy mix in poisonous proportions with disease. The urgency of providing healthcare cannot be overlooked. Clean India lies beyond the realms of rhetoric and chest thumping. Swach Bharat can wait, Bharat can’t!
By the way, did I tell you that Bantu was a dalit, a shudra? Well, precisely the reason why he wasn’t allowed to handle the cricket bat by the boys in the village!
Sorry Bantu! This happens only in India!
Shah Alam Khan
A renowned ortho surgeon with a premier ‘national’ medical facility expresses his anguish on the status of health care of poor and marginalized in a city/country where well-off/connected/VIPs can directly be flown through helicopters to hospitals. This is happening almost SEVEN DECADES after country became free. Please read it & pass on to friends.
Department of Orthopaedics
All India Institute of Medical Sciences
Ansari Nagar, New Delhi-110029
Associate Editor, Indian Journal of Orthopaedics