Why Modicare isn’t making waves in Haryana’s “cancer village”

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PMJAY, Modicare, Mewat
Al Afia Civil Hospital, Mewat

In India’s most backward district, village with unusual number of cancer patients wonders if it will pay for treatment trips to Delhi and Jaipur

Nasru thinks he is seeing a doctor in Alwar for an inflammed jawbone. His family did not tell him that he has cancer.

For here, in Haryana’s “cancer village” almost every family has lost someone to the disease or has a cancer patient making long, painful and expensive trips to Alwar, Jaipur or Delhi for treatment. Villagers do not have access to statistics but say at any given point there are 200-250 cancer patients among the 1700 families in the village.

And though Haryana has emerged as something of a leader in the Pradhan Mantri Jan Arogya Yojana(PMJAY) – it has the country’s first PMJAY beneficiary – here in the cancer village interest in it is just about tepid. Because the scheme does not address the immediate concern patients and their families have – costs of the treatment day trips.

Launched by prime minister Narendra Modi last Sunday, PMJAY covers hospitalisation costs and drugs and diagnostics charges three days pre and 15 days post hospitalisation. The ceiling: Rs 5 lakh per family per year irrespective of the number of family members or pre-existing medical conditions.

“The hospitalisation costs were substantial. But it is the treatment for the last one and half years that is draining our family. We go to Rajasthan every three weeks and spend at least Rs 4000, per trip”

In Mewat, the average family size is 8. Nasru’s family of 17 took a Rs 1 lakh loan from the local bank to pay for his treatment expenses – it could be anything between Rs 200 to Rs 2000 per Jaipur trip. The cost varies according to whether his doctors at the government hospital who do not charge anything, ask him to get tests done from private diagnostic laboratories. The district has poor health infrastructure – a clutch of tottering CHCs and one secondary and one tertiery care hospital, both government. Locals prefer Delhi or Jaipur to these.

Ayushman Bharat kiosk
Ayushman Bharat Kiosk in Mewat

Lack of health facilities in the area and non coverage of day care treatment and conveyance expenses when travelling for treatment are practically deal breakers for Mewat – officially the most backward district in the country.

Mohammed Ilyas has been battling mouth cancer for 11 years now. He travels to Delhi for treatment but his last hospitalisation was some ten years ago. “Will they pay for my travel and lodgings in Delhi?” He asks eagerly.

“They” won’t.

Sarpanch Phoolchand says that at a recent camp for cancer detection – the village is used to medical teams coming from Delhi and elsewhere to understand the cancer phenomenon – of the 500 people screened, 20-25 cases of cancer were detected. There are no answers yet about why Sakras has such a high incidence of cancer.

“The hospitalisation costs were substantial. But it is the treatment for the last one and half years that is draining our family. We go to Rajasthan every three weeks and spend at least Rs 4000 per trip,” says Sahebuddin. His grandson Sehwan lost an eye to cancer and is currently on follow up treatment.

PMJAY is not offering him any answers. Yet.