Child patients’ woes deepen amid poor cancer treatment in Bangladesh

By SM Najmus Sakib

DHAKA, Bangladesh (AA) – As the world marks International Childhood Cancer Day on Feb. 15, the hardships of child cancer patients in Bangladesh are deepening with a high mortality rate mainly due to poor health care and late detection.

Muhammad Salauddin, who hails from the eastern city of Comilla, recalled his family’s nightmare and a failed effort to save his two-and-a-half-year-old nephew.

Speaking to Anadolu Agency, he said doctors neither in his village nor in the city diagnosed cancer in its initial stage.

He said it took a week to diagnose his nephew’s blood cancer and another week to start treatment since he was admitted to Sir Salimullah Medical College Hospital in Dhaka in July 2020.

“Our nightmare had just begun. The hospital authority did not cooperate as needed. Trainee doctors administered treatment while the cancer specialist who supervised the medical team did not visit the patient for a second time despite repeated attempts (by the family to seek her consultation).”

“We couldn’t manage to obtain a bed in the intensive care unit despite our frantic efforts at hospitals in Dhaka since the boy developed a blood infection in his body due to the unhygienic hospital environment,” he said.

“His small body couldn’t endure the infection in the hospital, chemotherapy, hundreds of injections, and side effects of high-powered medicine, and he finally died on Aug. 7, 2020.”

Despite it being a government facility, they had to spend a lot of money on costly treatment, medicine, and injections, the uncle said.

- Poor government health care demotivates patients

World Child Cancer (WCC), a UK-based international children’s charity, works with government hospitals to improve pediatric oncology services in Bangladesh.

Jewel Ahmed, the WCC program coordinator in Bangladesh, told Anadolu Agency that the government health benefits hardly cover 4% to 5% of the total child cancer patients in Bangladesh.

“The poor situation remains as the healthcare facilities are mostly in Dhaka, even the major cities do not have cancer treatment or diagnostic facilities.

“Therefore, a patient who comes from the countryside could not continue the costly treatment, which caused the dropout rate to rise further, whereas as much as 90% of childhood cancer is curable,” he said.

If the cancer treatment sees discontinuation, the treatment needs to restart from the beginning, which many villagers do not understand, and take back their child as they are hit by the costly treatment, he said.

“Meanwhile, there is no national data or centralized information to know the actual number of child cancer patients and the mortality rate. But we can say the mortality rate is too high in Bangladesh compared to the developed countries,” Ahmed continued.

Dr. Md. Habibullah Talukder Ruskin, the head of the cancer epidemiology department at the National Institute of Cancer Research & Hospital in Bangladesh, stressed the need for early detection and proper diagnosis.

The physician, who stressed cancer screening as an early detection policy, suggested that a population-based cancer study be conducted to know the real scenario and official cancer data.

According to the Bangladesh Bureau of Statistics, 60.41% of Bangladeshis traveling abroad in 2019 visited India for medical purposes, a reflection of Bangladesh’s poor healthcare facilities.

“Not only the cutting-edge technology; we should also provide a cordial treatment environment for patients to upgrade our treatment culture,” Ruskin told Anadolu Agency.

- Shortage of health professionals, poor diagnosis

A K M Amirul Morshed, the head of the pediatric hematology and oncology department at Dhaka Medical College & Hospital, said around 15,000 new child cancer cases are diagnosed in Bangladesh every year.

“We have a shortage of medical professionals in the treatment. We could not provide health professionals at the government-run eight specialized hospitals for cancer treatment. Therefore, the treatment has remained Dhaka-based,” he said, adding, “we only could diagnose 25%-30% cases of childhood cancer.”

Morshed, who is also a government health official under the Ministry of Health and Family Welfare in Bangladesh, added: “Diagnosis is another major obstacle to address cancer in Bangladesh.

“If we can diagnose it at an early stage, 85% to 90% of child cancer cases are treatable. But sadly, except for a very few, most government hospitals do not have the diagnosis medicine or technology, which makes the diagnosis costlier. Meanwhile, very few companies manufacture cancer medicines locally, but those are costlier and low quality.

“We also have only 45 pediatrics in the country. But we are hopeful that in the next three years we would get 25 to 30 pediatrics in our local hospitals, as they are in the pipeline. There should be some child cancer support groups to help establish more child cancer hospitals.”

The government has started establishing eight divisional cancer hospitals while the project of opening child cancer units at all hospitals has been approved, he said.

“We need more investments in childhood cancer treatment. We need a central child cancer institute with standard diagnosing facilities in order to avoid faulty diagnosis and achieve early detection.”