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ANNUAL REPORT 2011-2012

Cancer Clinics
Ganga Prem Hospice organised 18 charitable cancer clinics in the year 2011-12, the highest number of clinics in a year as compared to any other previous year. Each clinic saw 90 patients on average. Almost every third patient at the clinics was a cancer patient while 10% of the patients coming to the clinic had advanced stage cancer. 60 different cancer types among the patients were seen by Ganga Prem Hospice in 2011-12.

The Ganga Prem Hospice charitable cancer clinic services in 2011-12 saw an increase of 81% in the number of patients seen as compared to the previous year. The number of cancer patients and terminally ill cancer patients visiting the clinic also went up by 25% and 20% respectively. One of the reasons behind the increase in the number of patients was that the Ganga Prem Hospice cancer clinics and screening camps expanded to towns beyond our base, Rishikesh. Haridwar, Dehradun, New Tehri and Uttarkashi were the towns covered in a 200-kilometre radius.

The year also saw eleven medical practitioners give their consultations to patients at the monthly cancer clinics. These specialistssurgical oncologists, general surgeons, gynaecologists, general physicians and ayurvedacharyasgave their time and services free of charge, both to the patients and to Ganga Prem Hospice. They took time off their hospital duties, travelled long distances from Delhi to the clinic locations, and were always ready to give further advice over the phone.

Breast cancer was by far the most common cancer found in patients, with buccal mucosa as the second most common malignancy.

The cancer clinics also doubled up as screening camps, especially in the mountain areas where patients otherwise do not have access to medical experts. Diagnostic and screenings tests like the Pap smear, biopsies, ultrasounds, X-rays, CT scans, endoscopies and MRI scans were sponsored for poor patients, as were laboratory tests like sputum, urine and other tests.

Sarojini counselling an underprivileged patient
Ganga Prem Hospice strived to provide all-around support to patients attending the cancer clinics—not just a consultation and a prescription. The counselling service was of great value to the patients as after the doctor's consultation, patients could get information about where to go and what to do from the counsellor, who spoke to the patients and their families at length.

Patients who were found to be terminally ill at the cancer clinic were offered the Ganga Prem Hospice home care service. Those who were under-privileged were helped with sponsorship of their palliative treatment.

The larger number of clinics also served to introduce Ganga Prem Hospice to the residents of Uttarakhand and has led to a significant increase in the number of cancer patients seeking support from the Hospice. It has also led to an increase in volunteer support in the areas of clinic outreach, particularly in the Uttarkashi district.

The Home Care Programme
In the West, terminally ill patients may choose to die at home. In India, due to the absence of hospices, under-privileged patients have no option other than to die at home. Cramped living conditions at home, no medical support—not even basic medical care equipment for toileting—no breathing support, and poor nutrition make dying a far worse experience than it should be.

The Ganga Prem Hospice home care service works towards making the last days of cancer patients more bearable. The only full-time charitable service of its kind in the state of Uttarakhand, the home care team of a nurse, sometimes accompanied by a doctor, and a masseuse, travelled to Dehradun, Haridwar and Rishikesh six days a week throughout the year. Each patient received one or two visits every week.



The year 2010-11, which was the second year of full-time home care service for terminally ill cancer patients, saw the work get firmly established in Haridwar and Dehradun, as well as the Ganga Prem Hospice home city of Rishikesh. Early in the year, the number of home care patients in Rishikesh was always far more than the Haridwar or Dehradun ones, but as time progressed there was almost an equal number of patients in each of the three cities at any given time.

Of the 108 cancer patients who were served during the twelve months of 2011-12, breast cancer was the single most common cancer found. If we categorise the cancers according to their sites, then gastrointestinal cancers had struck 30% of the home care patients, with head and neck cancers being the second most prevalent category of cancer after gastrointestinal.

At the beginning of the year in April 2011, Ganga Prem Hospice was serving 30 cancer patients a month, and a year later in March 2012, the number had grown to 41 patients being provided with nursing service.

The division of patients according to gender was almost equal, with female patients being slightly more in number: 55 females against 53 males, three of the males being children.

The elderly continued to be the majority recipients of the home care service, as 51% of the 108 home care patients were above the age of 61.



The fact that the Ganga Prem Hospice service facilities are utilized mainly by the economically weaker sections of society was evident from the fact that only 29% of the 108 home care patients the Hospice served came from financially secure backgrounds. The rest of the patients were under-privileged and unable to access the medical care that they so much needed in their last days.

It was a taxing time for the home care team as they saw 58 of their 108 patients die during the year. Some of these patients were like family as they had been with the Hospice for a long time. Some were without any support, like a cervix cancer patient who was shunned by her adult step-sons and had to live in a make-shift room in one corner of the courtyard of her husband's house. She eventually died in hospital, her hospitalization expense having been paid for by Ganga Prem Hospice.

The home care team not only provided nursing care such as dressing of tumours, changing of catheters, monitoring of vital statistics and dispensing of medicines, but also carried food supplies, clothes, and medical accessories to the patients, not to mention the emotional support which was given to them and their families on every visit.

While the nurse and the ambulance driver, sometimes accompanied by a doctor and therapist, were the front-end of the home care service, the Ganga Prem Hospice counsellor, manager and others worked behind the scenes, arranging for medicines and food supplies, sending patients' reports to oncologists, raising funds for the home care service and the hospitalisation of patients, and entering each and every home care visit report and its details into a database designed specifically to monitor the daily medical care given by Ganga Prem Hospice come rain, cold or heat wave.

Support a Cancer Patient Scheme
During 2011-2012, Ganga Prem Hospice provided free home care services to terminally ill cancer patients as well as free consultations from senior oncologists and counsellors at the monthly cancer clinics. Almost all poor patients who came to the Hospice clinics were provided with free medicines and also guided to diagnostic centres that give Ganga Prem Hospice patients reduced rates for tests. Some tests such as Pap smears, blood sugar, blood, etc, were also done free of charge at the cancer clinics themselves. Nutritional supplements were distributed to those who needed them and, from time to time, fruit juices, tea and snacks were also given to patients at the clinic and on home care visits.

As well as the above mentioned support, the Hospice also provided other forms of support to underprivileged cancer patients during the year 2011-2012. This support included sponsorship for diagnostic tests, surgery, chemo and radiotherapy, regular supplies of medicines, hospital stays, travel expenses, food rations, clothing, and emotional and spiritual support.

Although Ganga Prem Hospice predominantly sponsors patients who are terminally ill, in certain cases patients in earlier stages of cancer are also given help for their needs. On these occasions the Hospice steps in, in a timely manner, and pays up front for the necessary treatment and care. At the same time the Hospice social workers look for financial sponsors for the unfortunate patients or help them apply for the government funds available in such cases. Hospice supporters and local Rotary clubs are often approached for financial help and sponsorship is generally forthcoming.

In the year 2011-2012, 23 poor cancer patients availed of the Hospice Support a Cancer Patient Scheme, 12 of these being male and 11 female. Most of the beneficiaries fell within the 41-50 age group and came from Rishikesh, although patients from the Dehradun, Haridwar and Chamoli district were also given support under the Hospice scheme. More than half of the sponsored patients had advanced stage cancer and 10 died within the same year.

Ramjeet at a Ganga Prem Hospice cancer clinic
Among the underprivileged patients who received help under the Support a Cancer patient scheme, there were many who were very poor and some who belonged to scheduled castes. One of the Hospice's long term patients was a 44-year old leukemia victim called Ramjeet Yadav. Quiet and appreciative of all that was done for him, Ramjeet regularly attended the monthly cancer clinics.

He had come from a town far away from Rishikesh to earn his living as a labourer. Whatever money came from his efforts was sent home to feed his wife and four children. There was certainly nothing left over in his pocket for leukemia medicines and the nutritious foods he needed to help them work. Ganga Prem Hospice counsellor Sarojini Murthy always took special care to see that the reticent Ramjeet had all that he needed, reminding him when it was time to have his regular blood tests and sending him to hospital in the Hospice ambulance. Sarojini Ji saw to it that Ramjeet was provided with payment of his tests, leukemia medicine, nutritional supplements, fruit, vegetables and milk, as well as warm clothes for the winter. When it came time for Ramjeet's eldest daughter to be married, Sarojini Ji spoke to local Hospice supporters and ensured that Ramjeet had some simple household gifts to take home for his daughter's wedding.

Stories of some of the other cancer patients who were sponsored under the Ganga Prem Hospice Support a Cancer Patient Scheme in 2011-2012 can be seen in the Patients' Stories section of the Ganga Prem Hospice website and include the stories of Sarla Devi, Usha Devi, Asadi Devi, Aarti and Kripa Ram.


PREVIOUS ANNUAL REPORTS

ANNUAL REPORT 2010-2011

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ANNUAL REPORT 2009-2010

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ANNUAL REPORT 2008-2009

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ANNUAL REPORT 2007-2008

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