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Cancer plays the grim reaper in a remote Punjab village

Neena Chaudhary in Giana, (Bathinda)

Giana is a typical case of what often lies beneath the glittering surface in India. Punjab is touted as India's most prosperous state yet in villages like this it is one long tale of poverty, unhygienic living conditions, disease and above all official apathy towards the needs of the people. Giana, paradoxically, is a stone's throw away from where the state government's much acclaimed project -- a huge oil refinery -- is coming up.

While the state health authorities and the political leadership remain unconcerned, the people of this remote village bordering Haryana are trying to reconcile to the fact that cancer has taken on the form of an epidemic here.

The residents told rediff.com that as many as 70 persons have fallen prey to different forms of cancer. There has been 26 deaths in recent years. In the meantime medical assistance remains as distant as it has always been.

Preliminary inquires by the state health department, which was quite reluctant to accept the fact initially, have revealed that at least 17 per cent of the deaths caused by disease in this village in the last 10 years could be attributed to cancer of one kind or the other.

According to the report by a 15-member team headed by the Bathinda district health officer, which relied on the entries made in the village watchman's register, of the 128 deaths in the village since 1990, cancer accounted for as many as 22. Three others are currently undergoing treatment for the scourge. However, experts find it difficult to rely on the watchman's records, as it was not maintained scientifically or according to proper procedures.

Though the spread of the disease cannot be attributed to one particular reason, the villagers believe that it is caused by the brackish ground water with high levels of fluorine which they have been forced to drink due to inadequate supply of potable water for the last two decades. Others point towards the excessive use of chemicals in agricultural operations in this cotton belt situated in the south-western districts of Punjab, often referred to as the heartland of the Malwa region.

As it is, the villagers have to travel 150 kilometres to Ludhiana or 300 kilometres to Bikaner in Rajasthan for treatment. They point out that though the village dispensary was set up a few years ago, the health authorities have never bothered to post a doctor or para-medical staff here.

For the slightest emergency they have to travel at least six kilometres to village Malkana or Kalianwali Mandi in the neighbouring Sirsa district of Haryana. There are doctors posted in the government hospitals in the Raman Mandi and Talwandi Sabo towns, which again are 10 to 15 kilometres away.

Meanwhile, the Punjab government has decided to institute a detailed inquiry into the high incidence of cancer and will be associating senior professionals from the government, private organisations and research institutions to analyse the causes and suggest preventive measures.

The state government has also decided to undertake a census of the cancer patients in the state and grant them free travel facilities through the state-owned transport system. According to rough estimates, there are about 9,000 patients with various forms of malignant cancers in the state.

The figures in the Health Information of Punjab published by the Directorate of Health and Family Welfare, cancer was the fourth major killer, accounting for 3.8 percent of the deaths caused by disease all over the state. It followed heart attacks, malaria and respiratory disorders and ranked ahead of deaths by accidents and crime.

The first case of cancer in the village was reported in 1977-78, when Bachan Kaur succumbed to the killer disease while Jagir Kaur, who developed carcinoma of the ear, was the latest victim. Balbir Singh was the youngest victim of the disease and died of leukaemia at the age of 18, despite having received treatment at Bombay.

Jarnail Singh, who himself received treatment for a malignant lymphoma at Mohan Dai Oswal Cancer hospital in Ludhiana, says that his wife, Jagir Kaur and sister-in-law Jas Kaur, died about seven years ago, after they developed carcinoma of the cervix and tongue, respectively.

Hari Singh, a youth says that his mother died after a cancerous tumour was detected in her breast. Similarly, Bhura Singh says his wife also died of the same ailment, while Major Singh's mother died of a cancerous growth in the abdomen. Mohinder Singh says that his parents died of cancer.

Balbir Kaur and Gurdev Kaur, who have been operated upon for removal of cancerous tumours in their breasts still travel to Bikaner for follow-up treatment at the Sardar Patel medical college there. The 55-year-old Gian Kaur, revealed that the documents related to her treatment at Bikaner were taken away by a team of medical officials from the Bathinda civil hospital. However, she produces the railway pass which allows a cancer patient and at least one dependent to travel free for the purpose of treatment as evidence of her being afflicted by the disease.

Another youth, Gursewak Singh says that while most of the afflicted women suffered from cancer of the breast or the urino-genital system, among the men cancer took various forms. It was pointed out that Joga Singh of this village died a few years ago after he succumbed to carcinoma of the penis.

The disease has been equally prevalent among all the castes in the village. Malkiat Singh, a mechanic belonging to the scheduled caste lost his mother, Misri Singh, while Jagdish, who is a Brahmin, lost his wife to cancer.

To compound the problem, illiteracy and the lack of proper awareness has led to major misconceptions among the villagers. They believe that cancer is contagious and they burn everything that belongs to a dead patient. There were numerous cases, when even the documents related to the treatment of the patients were either burnt or buried.

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