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Heart of Cancer Care: Dr. Gunjesh Kumar & Mr. Vivek Sharma | Jharkhand’s Battle Against Cancer

Heart of Cancer Care: Dr. Gunjesh Kumar & Mr. Vivek Sharma | Jharkhand’s Battle Against Cancer

Harbingers of Hope: Dr. Gunjesh Kumar and Mr. Vivek Sharma Paving the Way in Jharkhand’s Battle Against Cancer – The Heart of Cancer Care Unveiled

Vivek Sharma: My name is Vivek Sharma. I am an author, social worker, and advocate for cancer and mental health. Dealing with cancer is indeed a grave challenge, a significant issue. It also limits us to take help from the central government in every way due to restrictions of state subject matters. Today we will explore the challenges and issues faced in Cancer and How they can be tackled, especially in Jharkhand region.

With me today is Dr. Gunjesh Kumar, a very dynamic medical oncologist who practices in Jharkhand, Ranchi. Thank you so much for taking your valuable time. I will come straight to the point. Let’s dive right in. Jharkhand was formerly part of Bihar and has encountered numerous challenges in the past. However, from my understanding, it has evolved into a prosperous state, particularly in terms of modernized industrial sectors and mineral-rich zones. What are your thoughts on this transformation?

Dr. Gunjesh Kumar: In India, if you look beyond Maharashtra, the second revenue-generating state is Jharkhand because of all the minerals like coal, mica, bauxite, and iron, and everything is available in Jharkhand, but it needs to be utilized properly. 

Vivek Sharma: Ok. That is in terms of rich heritage and biodiversity. But today Let’s Talk about Jharkhand’s root problems in the battle against cancer.

Dr. Gunjesh Kumar: Examining the statistics reveals that there are approximately 100,000 new cancer cases annually. When you consider the geographical size, Jharkhand isn’t particularly large. With a population of about 40 million, around 100,000 individuals are diagnosed with cancer each year. It seems that in the past four or five years, the incidence has shown a notable increase.

Vivek Sharma: So, how one should get treated? 

Dr. Gunjesh Kumar: The primary issue lies in the lack of awareness among most patients regarding what cancer entails. Many individuals remain unaware until cancer reaches an advanced stage. Moreover, oral cancer and breast cancer are the most prevalent types. In East India, there is a notably high incidence of gall bladder carcinoma. It’s observed that one in every three cancer patients is diagnosed with gall bladder cancer, and this condition is particularly common in Uttar Pradesh, Bihar, East India, and Jharkhand.

Vivek Sharma: Today, we have individuals like you who are actively making a positive impact. Are the challenges faced by patients being effectively addressed? How are individuals coping with life while dealing with cancer?

Dr. Gunjesh Kumar: Even today, there is a prevailing mindset in Jharkhand that if someone is diagnosed with cancer, the only solution is to seek treatment in Mumbai or CMC, Vellore. However, the current scenario indicates a significant shift, with people now actively seeking medical treatments available in their local vicinity.

I currently operate in two to three different venues across Jharkhand. The first is my private hospital, where I offer personalized care. The second is a daycare center, where I extend cost-effective treatments to patients, including an additional 50% discount. Additionally, I am involved in practicing at a government hospital, where I conduct free OPDs and provide cancer treatments.

Even now, there is a mentality in Jharkhand that if something happens, go to Mumbai or CMC Vellore. This trend has been set. However, having practiced in Ranchi for the past two years, I’ve witnessed a shift. People now seek superior treatment options closer to home, and cost-effectiveness is a priority. Hence, I practice in two or three locations. The first is at my private hospital, where personalized care is a focus. The second is my own daycare center, where I offer treatments at a significantly reduced cost, accompanied by an additional fifty percent discount. Thirdly, I contribute to the government sector, dedicating two days to providing free OPDs for cancer patients.

Currently, I have been overseeing the care of approximately 15 to 20 patients with blood cancer over the last two or three months. They are receiving their treatments with ease, maintaining a comfortable routine of eating, drinking, and enjoying their time. It highlights the tailored setup designed for different categories of cancer.

Presently, the primary concern in healthcare is of middle-class population. Those with financial means often seek treatment outside their localities by traveling to cities like Delhi, Mumbai, or Hyderabad. Upon completing their treatment, they return home. However, for some middle-class individuals, neither the government schemes nor their limited financial resources cover the entire treatment cost, posing a significant challenge.

Few months ago, the Jharkhand government initiated a scheme known as the Gambhir Bimari Yojana, receiving funds ranging from 500,000 to 1 million. However, this scheme has now been discontinued, creating a significant concern. Presently, the Ayushman Bharat Yojana is the sole available option, having been transferred to the joint administration of the Central Government and State Government.

Under these schemes, all types of treatments are now viable. There is an ongoing debate, especially for treatments that people might find unaffordable under Ayushman Bharat or even in a large corporate hospital like mine. However, this landscape has certainly undergone a transformation in the past two years.

Vivek Sharma: You have provided extensive insights into the Ayushman Bharat scheme and the modular nature of treatment options in this particular region. With the presence of various government schemes, there are certain inclusions and exclusions. How is the transition from the Gambhir Bimari Yojana to the Ayushman Bharat Yojana affecting people? Is it influencing their access to treatment significantly?

Dr. Gunjesh Kumar: The Ayushman Bharat card has been an existing and is still active. The Gambhir Bimari Yojana, on the other hand, was an additional scheme provided by the Jharkhand government, offering extra treatment measures to those in need. The Ayushman Bharat card has proven highly beneficial, with 80 out of 100 patients having access to nearby cancer treatment services through this card. Without the card, these 80 patients would have faced challenges affording the necessary treatment. While the Ayushman card has assisted a significant portion of the population, it has limitations for certain treatments, such as major surgeries. For instance, extensive surgeries like gallbladder surgery are not covered in the Ayushman card package, posing challenges for both patients and hospitals.

If a hospital is in the negative, it cannot do business. This is a concern also present with Ayushman Bharat, which proves beneficial for non-serious illnesses. While Ayushman Bharat is offering treatment to certain patients in India, there is still room for improvement and expansion of its coverage.

Vivek Sharma: Doctor Sahab! When we discuss access to treatment, I often observe that the primary diagnosis or diagnosis-related challenges emerge because of Directly telling someone that their condition seems like cancer isn’t the approach. 

Dr. Gunjesh Kumar: Yes,  therefore we proceed with a biopsy, PET scan, and various procedures. Ayushman Bharat cannot encompass everything. The initial steps need to be taken by the patient. Until we have a diagnosis, we cannot include it in the Ayushman card. Let’s consider an example. To get approval for chemotherapy, the patient must submit their biopsy report, CT scan report, etc. Only then is it approved. The treatment is largely a self-initiated process for the patient. The patient has to manage it, and if they can’t, I arrange it through the government sector, either independently or by negotiating discounts. When someone is dealing with cancer, financial concerns arise. If the treatment costs range from 5,000 to 10,000 rupees or even 20,000 rupees, after the diagnosis, the remaining steps can be covered within Ayushman Bharat or in the government sector. It’s not that a patient comes to me and leaves without treatment. However, you have to take a few steps forward. Organizations like Tata Hospital also have NGOs. Many trusts suggest doing a little, and then we’ll do a little, and gradually, the government will also take some initiatives. Standing idle won’t bring about any change. Absolutely.

Vivek Sharma: Another question I have is that our channel is watched by many people, including policymakers patient care, and NGOs. Many people watch it, so I would like you to mention one or two difficulties that the government should solve or think about regarding patient care and NGOs. Tell us one or two things that will encourage patients or give confidence to the Care Giver for the Right to treatment.

Dr. Gunjesh Kumar: Whatever problems I have faced, I will speak on that basis. Number one, the Jharkhand government should think a little about the health sector. Regarding cancer patients a lot. The plan they had earlier was beneficial for serious illness a lot.

They were providing all treatments inside it. Surgeries were also being performed in these Gambhir Bimari Yojana. Surgeries were also being conducted in a corporate hospital. It’s commendable that the labor class can undergo major surgeries with government assistance in a corporate hospital. Access to better healthcare is a universal right, and people deserve quality care. There is a need to reconsider the implementation of the scheme for the betterment of healthcare services.

Many patients are refraining from seeking treatment due to financial constraints, unable to afford better healthcare. Another significant challenge within the state of Jharkhand is the issue of land. The Chotanagpur Act and the Good CN Act pose obstacles to acquiring land belonging to scheduled castes/scheduled tribes. Limited land is available if outright purchase is not feasible, hindering the initiation of new projects that require general land. Even my hospital is in search of land for a dedicated cancer hospital, but for the past one and a half years, acquiring suitable land has been elusive due to numerous land litigations. There is a pressing need for flexibility in this matter. If the government allows options like leasing or conversion for the greater good, it could address the scarcity of land and benefit the community. These are the two primary challenges I am currently navigating to enhance the well-being of the people.

Vivek Sharma: So, Doctor for those who still do not understand the impact of the Ayushman card, what message would you like to give to them about the PMJY scheme? Because Many times, there’s a tendency by people to avoid government initiatives, assuming they won’t be effective. However, based on my understanding, many things are indeed functioning well now.

Dr. Gunjesh Kumar: Ayushman Bharat has proven to be highly effective, benefiting 80 out of 100 individuals. It is a commendable scheme, yet there is room for improvement in its streamlining. Currently, the responsibility lies with the state government, particularly in managing the payments. The challenges arise when hospitals do not receive timely payments under the Ayushman scheme. For hospitals engaged in regular business, the absence of proper reporting results in financial losses, accumulated debts, and eventual closure. It is crucial for the government to recognize the importance of ensuring timely payments to hospitals as part of supporting the scheme. The successful progression of these initiatives hinges on addressing these issues. While I, as a practitioner, don’t have direct control over these matters, discussions in regular meetings underscore the potential discontinuation of the Ayushman card. However, the impact on countless individuals in need cannot be underestimated, making it imperative to find viable solutions for it.

Vivek Sharma: So, If you are a patient or a caregiver seeking quality treatment, and you happen to know someone in need, kindly inform them about the available resources. If there is an individual around you facing a health challenge, particularly in Jharkhand, encourage them to reach out. The doctor is easily accessible and visible to assist the patient. Should you encounter challenges or require additional support, consider reaching out to people or non-governmental organizations (NGOs). For those dealing with lung cancer, our organization, Lung Connect, is also available for assistance. Take the initiative, inquire, gather information, and facilitate the necessary steps for receiving proper treatment.

Dr. Gunjesh Kumar: And today many things are possible that were not there 10 years, 15 years, 20 years ago, and there is no need to go far for treatment. Now, in your state, whether you are from Jharkhand, Bihar, Uttar Pradesh, treatment is available at your local centers. Numerous hospitals and proficient doctors are readily available. It might be challenging to comprehend the medical jargon, but attend your check-ups and proceed with your treatment promptly. Valuable time is irretrievable, and chasing treatments may lead to a loss of crucial time. Therefore, for early-stage cancer, instead of traversing various locations for a month, seek opinions and allow the condition to progress by prioritizing swift treatment. Comprehensive treatments are viable at various locations, providing you the opportunity to receive quality care closer to home.

Vivek Shama: Fantastic, thank you so much. Dr. Sahab, you were listening to Dr. Gunjesh Kumar on cancer treatment With Vivek Sharma, a Social Entrepreneur. Stay Tuned!

 

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