An institution of hope

The Shaukat Khanum Memorial Cancer Hospital believes in coming to the aid of the common man.

My grandmother was diagnosed with cancer in the eighties. She was only 50 at the time but the diagnosis came too late. In those years we'd spend our summer holidays with our grandparents at the foothills of the Himalayas in Pakistan. It was during one such summer that we became familiar with the dreaded C word — cancer.

I remember grown-ups discussing sending her medical reports and scans to specialised centres in the UK because they could not be diagnosed in Pakistan and she was too ill to travel. In those days the word cancer unequivocally spelt that the curtain was ready to fall — the prognosis was dismal.

I'm glad I was not there to witness the slow and inevitable shutting down of her system organ by organ. But the memories have been enough to help us empathise with cancer patients and their families.

In the same year at about the same time a young man learnt that his mother had also contracted the disease. He left no stone unturned to find a cure — she was treated in the UK at the best cancer hospitals — but she did not survive.

Finding a cure

After her demise the son vowed that he would do something in Pakistan to alleviate the suffering of the thousands of people who fell victim to this insinuous disease and who didn't have the means to seek better treatment.

Three decades hence, cancer does not sound that fatal ring of mortality that it did in Pakistan. One of the major catalysts for this change has been the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH) in Lahore, which was built with the donations of over a million individual donors ranging from school children donating their lunch money to well known celebrities.

The hospital that was built from Khanum's son's tireless fund-raising efforts has become a beacon of hope for thousands of cancer patients in Pakistan since it opened.

Although there are newly acquired radio therapy and chemotherapy facilities in some major hospitals in the country, SKMCH remains the only specialised centre for treatment in the country and one of the very few in the region.

The trust that runs the hospital has also set up a diagnostic centre in Lahore and two satellite clinics have recently started working in Peshawar and Karachi — two of the most populated cities in Pakistan. There are also over 40 laboratory collection centres nationwide.

Keeping in mind the great distances that sometimes become prohibitive for low income patients and their families, the trust recently opened a diagnostic centre in the port city of Karachi which is fully functional.

Patients need no longer budget the expense of initial travel for diagnostic purposes to Lahore. Given that remote areas of Sindh and Balochistan have little access to the hospital and that this usually means patients from the lower income bracket have no recourse to treatment, the trust aims to build a second hospital in Karachi.

However, at the moment, for treatment patients must still travel to the hospital in Lahore; which is not always an easy undertaking. Patients come from every strata of society, usually from remote parts of the country. Some have no means of transport and no place to stay — accompanying relatives have no accommodation that they can rent close to the hospital, which is located in the suburbs of Lahore.

Travelling to a city that you do not know (maybe even to a country that is not your own) and then trying to find accommodation and transport can be a daunting task. This is an area that can perhaps be built upon in the future as and when funds become available — perhaps a donor would wish to take on the project so that people can have some form of subsidised living space near the hospital whilst treatment takes place.

Financial aid

At the moment though the sole aim of the hospital and its requisite trust is to direct as much funding as possible for the treatment of cancer, especially in cases where patients have no alternative.

Some patients who have reached a terminal stage of the disease may not receive treatment at the hospital, but the hospital's dedicated team of doctors have to make this heart-wrenching decision so patients at an early stage of the disease could be saved. But the hospital and its staff sincerely is able to treat all who knock on its door.

Out of every 10 cases that are registered at the hospital seven cannot be treated due to lack of funds and about 70 per cent of the cases that are under treatment at the hospital are treated free of cost because they cannot afford to pay towards.

The most painful cases to handle, the doctors say, are those that involve paediatric cancer — the parents want to know why their child developed the disease — what the causes were so that they can prevent such a thing from ever happening again. There are no answers to such questions and the doctors know this. But relatives of the patients don't.

SKMCH is now a registered entity at the Dubai International Humanitarian City where the marketing representative for the Gulf region has an office. Says the representative: "There are currently two primary sources of funding for the hospital — fundraising and revenue generation. Fundraising involves donations, grants, zakat, sadqa etc. and constitutes approximately 50 per cent of the total budget — a telethon dinner is being planned for September. The remaining 50 per cent is accounted for by revenue generating activities such as paying patients and through laboratory collection centres and diagnostic centres."

SKMCH also directs its efforts towards research. "A dedicated research space (15,000 square feet) is available in the hospital and includes basic science laboratories as well as clinical research and data management departments, says the representative.

"At present, we have three PhD scientists working on various projects including work on BRCA 1 and 2 mutations in the Pakistani population and we have plans to hire additional staff as and when they become available. Collaborative work with international and national institutions is ongoing. Notable recent work includes that done with the DKFZ in Heidelberg, Germany.

"A clinical research office has been in operation for more than five years and helps steer various research projects via scientific and ethical review process in addition to coordinating pharmaceutical funded trials. Publications in peer reviewed literature are now appearing with regular frequency."

When asked about the trust's future plans, their representative said: "Future plans include enhancement of research endeavours, construction of a new clinical tower (which will double our present capacity), community and outreach services (including a population mammography project in collaboration with Cisco Systems) as well as a cancer hospital in Karachi.

"We are building a population based registry along with other partner institutions in Lahore."

Global scene

Cancer has, in the last few years, become one of the major causes of death worldwide. The World Health Organisation (WHO) states that in 2005, out of 58 million deaths worldwide, 7.6 million deaths were due to cancer. The number represents 13 per cent of global deaths.

Also, more than 70 per cent of all cancer deaths occur in low and middle income countries, where limited or no resources are available for prevention, diagnosis and treatment of the disease.

Seeing the dismal figures, Pakistan is fortunate indeed to have one specialised cancer treatment centre, but there is need for many more.

- For more details on Shaukat Khanum Memorial Cancer Hospital and Research Centre, visit: http://www.shaukatkhanum.org.pkor contact the Dubai representative by email: skmtdubai@gmail.com