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Disproportionate treatment facilities for cancer patients

465 beds against 12 lakh patients: study

Ahmed Shatil Alam

The facilities available for treatment of cancer in the country is widely disproportionate to the spread of the disease, say healthcare experts working in the field.
According to them, the country is heavily short on treatment centers, radiation facilities, doctors and physicists, leaving the approximately 12 to 13 lakh cancer patients, already burdened by high cost of treatment, in a lurch.
A recent study titled ‘Comprehensive update on cancer scenario of Bangladesh’, carried out by former BSMMU Oncology department chair Syed M Akram Hossain, published in the WHO South-East Asia Journal of Public Health  in October 2013, estimates that cancer treatment is only available in 19 hospitals in the country, which have a total of 465 beds.
Furthermore, there are only 27 radiation machines while there are 150 oncologists for the hundreds of thousands of patients, say experts.
There are nearly 35 public and private hospitals, including National Institute of Cancer Research and Hospital, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and Hospital, Khwaja Yunus Ali Medical College and Hospital in Sirajganj, who provide treatment to the cancer patients, say medical health professionals.
Hossain said the main victims of this situation are people from rural areas as most hospitals are based in Dhaka and a few other divisional cities like Chittagong, Rajshahi etc.
Furthermore, there are only 27 radiotherapy machines in the country. 
NICRH director Sk Golam Mostafa told New Age that nine government hospitals and four private hospitals in the country have the linear accelerator machines used for radiotherapy.
‘This is too inadequate as we need around 150 linear accelerator machines,’ he said.
BSMMU oncology department chair Sarwar Alam said there are only 14 telecobalt machines – another machine used for radiotherapy, which is also insufficient.
Sarwar said because of a shortage of equipments, most hospitals are restricted to providing patients with only medication support.
Meanwhile, the study states that Bangladesh has only 150 qualified clinical oncologists and 16 pediatric oncologists.
Syed M Akram Hossain, while speaking to New Age, roughly calculated the ratio of cancer patients to doctors in the country at 1:0.000137.
Besides, unavailability of trained medical physicists, who administer radiotherapy, creates further problems for patients. 
Sarwar speculates cancer is currently the second highest killer in Bangladesh, as well as the world, though there are only three government appointed physicists in Bangladesh who are working at BSMMU, while the total physicists might be around 30 to35.
The remainder are mostly working at private hospitals like KYAMCH, Square and United Hospital etc.
Besides the BSMMU, a few physicists are working contractually with the NICRH, informed NICRH officials.
Palliative care, which helps patients alleviate their suffering, is an essential part of cancer treatment all over the world, whereas in Bangladesh, there are only two state-owned palliative care centers at BSMMU and NICRH, besides a few more in the private sector, said Sarwar.
Meanwhile, the experts also said that the high cost of cancer treatment is leaving many poor, and eventually even middle class people, out of treatment.
Akram said a cancer patient need a minimum of Tk four to five lakh to get proper treatment, including surgery, chemotherapy and radiotherapy, which is beyond the reach of most people in the country.
He also said cancer medicines are costly for most patients.
According to pharmacists, a cycle of chemotherapy drugs ranges from Tk 24,000 to Tk 1, 66,000. At the moment, the price of medicines of a cycle produced by Sanofi Bangladesh Limited is Tk 1, 66,000, BEACON Pharmaceuticals Limited is Tk 28,000, Roche Bangladesh Ltd is Tk 32, 000 and Techno Drugs is Tk 24,000.
Added to this are a number of other supportive drugs required during treatment.
The experts urged the government to provide subsidy to cancer drugs and initiate a proper health insurance policy immediately to reduce the sufferings of underprivileged patients. 

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