Cancer: Kashmir’s Silent Crisis
YAWAR HUSSAIN
As Kashmir society witnesses unprecedented rise in Cancer cases, the government continues to hibernate amid alarm bells around the lack of infrastructure, shortage of professionals, and the non-existent testing facilities for foods and medicines, reports Yawar Hussain.
Srinagar: Mukhtar Ahmad (name changed), a retired government employee, sits melancholic in his two-storied house, overlooking the Jhelum River in Pampore, as his relatives and friends come to show solidarity since he was diagnosed with rectal cancer three months back. His loss of surroundings doesn’t stem from his disease but from the history that he lost his wife Rubeena to the same disease two years back.
He remembers picnicking with his wife and two daughters in the saffron fields during the harvesting season.
“After Rubeena passed away, I used to go to these Saffron fields with my two daughters and son-in-law to remember yesteryears. But now I think I won’t make it to the next harvesting season,” Ahmad said.
He said that his wife’s stomach cancer was detected in the third stage, leaving him devastated but hopeful.
“I believed we could save her, but as time progressed, my hopes gradually shattered. I felt helpless as her eyes spoke to me that she was losing the fight.”
While losing the “closet” one was irreparable for Ahmad, he also had to endure a huge financial toll.
He said that he spent close to ten lakh rupees on his wife’s treatment, but then couldn’t afford to take her to better health facilities outside, which are renowned for cancer treatment.
“Life is up to God, but I still have that itch that I couldn’t take her outside. I think maybe she could have been saved, but alas, I didn’t have the resources as I was the only earning hand,” he said.
He said that following the treatment costs for his wife, he had to get one of his daughters married, leading to a further financial burden on his family.
He said that with his disease now being detected, he is lost, as he doesn’t know where the money would come from.
“The government facilities aren’t readily available. There is a huge rush of cancer patients. I have to go to a Srinagar-based private facility, which is very expensive,” Ahmad said.
He divulges that for close to four months, he was losing blood but didn’t tell his 24-year-old younger daughter about it.
“I lost weight, and I also started to look frail. I used to get IV (Intravenous) fluids administered through a local quack,” Ahmad said, adding that he didn’t want to incur more financial burden on himself.
It was only after he was found unconscious by his younger daughter that his sister and extended family made him see a doctor, leading to the diagnosis of cancer in his rectum.
Ahmad’s younger daughter, Madiha (name changed), said that she was hoping against hope that her father would be fine, but deep down, the fear from her mother’s days lurked in her thoughts.
“My elder sister and I used to tell each other that he (their father) is going to be fine, but somewhere we both knew that we were just trying not to address the elephant in the room,” Madiha said.
She said that they both wanted to take their father outside to Tata Memorial Hospital in Mumbai, where their mother couldn’t go, but the huge financial prospect related to it has devastated their hopes again.
“The government claims there are good facilities here in the Valley, but it is so difficult to get the basic PET (Positron Emission Tomography) scan done in a government facility,” Madiha said.
Poor Govt Facilities
With cancer cases on the uptick in the Valley, coupled with high costs in private facilities, the whole of Kashmir Valley has just one PET scan machine — located at the Regional Cancer Centre of Sher-e-Kashmir Institute of Medical Sciences (SKIMS), Soura. The PET scan machine is vital for staging, diagnosis, and monitoring of the disease.
The Valley’s other crucial health facility, Government Medical College (GMC) Srinagar, has one PET scan machine installed but not made operational yet. The lack of a PET scan machine means a longer waiting period and delayed diagnoses of the disease, in which time is crucial.
Comparatively, the Jammu division is slightly better placed, though not adequate, in terms of cancer facilities than Kashmir. A state-of-the-art State Cancer Institute at Government Medical College, Jammu is being built with 100 beds, three operation theatres and an Intensive Care Unit. While SKIMS also has a similar institute, the All-India Institute of Medical Sciences (AIIMS) Jammu has also started a chemotherapy facility with specialists hired for the job.
Also, the American Oncology Institute (AOI) operates a full-fledged cancer hospital at a private health facility in Jammu.
While the lack of infrastructure facilities in the Valley has been a major impediment in fighting cancers, the Cancer Treatment and Management Fund for the Poor (CTMFFP)—financial assistance for cancer treatment for families with income below Rs 20000 per month—has also been dwindling since last year.
A government doctor, wishing anonymity, said that since the last financial year, the patients have been complaining of delays in assistance under the scheme.
“The majority of patients seeking treatment for cancers fall under the eligibility criteria of the scheme, and they really need money. But the government seems deaf,” the doctor said.
Lawmaker from Kulgam assembly segment Muhammad Yusuf Tarigami, who had raised the issue, said that it was strange that, abruptly, the CTMFFP funds were halted and still the issue lingers on.
“For many of the poor, the CTMFFP is a lifeline. Since July 2024, this lifeline has been halted. I had appealed to the chief minister for early clearance of pending cases, but complaints are still coming,” Tarigami said.
The inadequate cancer facilities often force patients towards greener health pastures, but at an added financial and emotional cost.
A cancer patient from north Kashmir’s Kupwara district said that he had to wait for over a month for his PET scan, leading to his children taking him to Delhi.
“They forced me because they said that when a PET scan is this much delayed, what treatment would they further administer to you?” the patient said, adding that he, however, had to go without his wailing wife because of the associated financial costs it would have incurred.
The Oncology department of Government Medical College (GMC) Srinagar and the newly established GMCs in Baramulla and Anantnag have a serious shortage of manpower, coupled with a lack of infrastructure.
The majority of rural hospitals in the Valley lack even radiotherapy facilities, which then leads to an added burden on the tertiary care hospitals in Srinagar.
From the north and south regions of the Kashmir valley, the calls for the setting up of Regional Cancer Centres (RCC) have been voiced vociferously.
The GMC Anantnag and GMC Baramulla cater to more than half the population of the Valley and even beyond to the regions of the Chenab valley of Jammu division.
Health Minister Sakeena Itoo recently announced that Rs 124.83 crore has been allocated for major upgrades in J&K’s healthcare infrastructure. The plan includes a PET-CT at GMC Srinagar, MRI machines at GMC Baramulla, Kathua, and Rajouri, a Cath Lab at GMC Doda, and enhanced telemedicine facilities across 80 units.
Dr Gazanfar Ali, a physician, said that the lack of cancer facilities in Kashmir can be gauged from the fact that PET technology, which is indispensable in modern oncology, is so severely limited in Kashmir.
“SKIMS is overburdened with its single PET scan machine. It caters to thousands of patients. This leads to longer waiting time, which in the case of cancer is very detrimental,” Dr Ali said.
He said a PET scan plays the most important role in the initial diagnosis, treatment planning, prognosis, and follow-up of cancer patients.
Alarming Figures
As per official data, Jammu and Kashmir recorded over 64,000 cases since 2018, with the Kashmir Valley alone accounting for more than 50,000, nearly four times the number in Jammu. Last year alone, over 7,000 new cases were registered.
Data from the Union Health Ministry reveals that 51,577 new cancer cases were reported in Jammu & Kashmir between 2019 and 2022. In the same period, 35,623 people lost their lives to the disease.
Since 2013, SKIMS Soura has recorded around 50,000 new cancer cases, while GMC Srinagar has registered around 8,000 since 2017.
The SKIMS reported over 28,457 cancer cases from 2019 to 2024. Annual case numbers include 4,337 in 2019, 3,814 in 2020, 4,727 in 2021, 5,271 in 2022, 5,108 in 2023, and over 5,200 in 2024.
In 2012, the SKIMS study identified “dietary practices and high salt consumption” as the main reasons behind the rising cancers of the stomach and oesophagus in the Valley.
Specialists opine that dietary habits, lifestyle changes, genetic predispositions, and delayed diagnoses, owing to a lack of medical infrastructure, are among the major reasons behind the uptick.
Dr Gazanfar Ali said the most prevalent cancers in Kashmir are gastrointestinal (GI) cancer, breast cancer, lung cancer and colon cancer.
He said that more oily and salty foods are the main reasons behind the gastric and abdominal-related cancers in the Valley, while the quality of spices and condiments is completely unchecked.
He said the recent controversy around the quality of meat and poultry consumed in the Valley is in itself an answer to why there is an increase in cancer cases.
“The most sub-standard medicines normally reach the Valley. Similarly, the foods and other eatables are of the lowest quality,” he said.
Dr Mohsin Bashir said that while there are lifestyle-related reasons behind the rising cancer cases, the government’s failure to set up monitoring and testing centres for the quality of foods, meat, poultry and spices, along with vegetables, is a more pressing issue.
“There is no filter. Common people can’t filter what is filthy and what is alright to eat. Even if one stops to eat outside, what about the spices, medicines and meat one brings home,” Dr Bashir said.
He said urbanisation has brought in a sedentary lifestyle, which has led to obesity and hypertension. “These problems have led to higher infertility rates in women in Kashmir and also led to a rise in breast cancers. Late marriages, due to the rising cost of marriages, also lead to breast cancer.”
Dr Gazanfar Ali said that there has also been a huge surge in lung and colon cancers in the Valley. “While lung cancer is mostly the product of active smoking, passive smokers are also around 40 per cent of the cases. Colon cancer rates have increased. Lifestyle and dietary habits contribute to it as well.”
