Cancer used to be so rare in Nepal that there is no word for it in the Nepali language. But Hariban could be a microcosm of the cancer sweeping the country. Cancer is now the fifth leading cause of death in Nepal, with lung, breast, cervix, stomach and colorectal cancers being the most common.
Approximately 28,000 new carcinoma cases are diagnosed every year in Nepal with mortality at 20,000, both at an increasing rate as per the Global Cancer Observatory estimates. But many more cases go undiagnosed due to lack of resources and insufficient screening.
The ongoing Covid-19 pandemic has added to the crisis. There were five times more funerals at the Pashupati cremation site in December 2020 compared the previous year. While some could be people who died from the coronavirus, many others are thought to be patients with cancer or other chronic disease who could not get timely treatment.
Lockdowns and restrictions as well as fear of contracting SARS-CoV-2 had affected patients of many chronic illnesses such as cancer due to reduced treatment and screening facilities. This in turn has likely resulted in more fatalities, say health experts.
Back in Hariban, Sah is now doing well after treatment. She says: “I’m lucky because my family could afford the treatment. I now plan to study science, be a nurse and care for patients like me. I want to help the poor and provide them treatment without cost.”
Rafi Miya also lives in the neighbourhood and can barely survive on income from farm. Now, in addition to poverty, the family is burdened with cost of cancer treatment for himself and his son.
Miya was diagnosed with throat cancer after a biopsy in Bharatpur Cancer Hospital. “They operated on me and took the growth out, but my voice is hoarse now. We cannot get the medication here, and it is expensive.”
His son Lipla Miya’s cancer has affected his bowel and bladder functions. His treatment has already cost Rs200,000.
Phekini Devi Mahato Sundi also lives nearby, and started getting skin rashes, and suspects the lump in her breast is cancer. She cannot even afford to travel to get a checkup. Her husband Sinai has asthma, and is despondent that he does not have the money for her treatment.