On a chilly morning of November 16, 2019, Mir Zakir Hussain, 38, from Shelwath, a village to the north of Bandipore district of the Kashmir valley, observed a painless underarm lump. Hussain called his elder brother who, in turn, sought help from one of his acquaintances who knew a technologist in the radiology department of the SKIMS hospital at Soura. The matter was referred to the oncology department. It didn't take too long for the doctors to establish that the growth was an indicator of multiple myeloma, a form of cancer, and the patient required chemotherapy and then a stem cell transplant.
Misguidance complicated the issue
The doctors devised a treatment plan and the patient was immediately put on a standard induction protocol. Meanwhile, desperate and without proper guidance, the family decided to take the patient to the Tata Memorial Hospital (TMH), Mumbai. At the TMH, the waiting for the transplant was nine months which the family could ill afford. The TMH offered another option— Sir Ganga Ram Hospital, New Delhi. The hospital authorities agreed for the transplant but after a month. The tentative cost of the procedure was put at fifteen lakhs rupees. Before the family could think of arranging the money, the pandemic caused by the Corona virus dashed all their plans.
This reporter got in touch with the Director SKIMS, Dr A.G. Ahangar, who advised against taking the patient outside the valley for a treatment that could easily be performed at his hospital.
“Our oncology department is fully equipped to undertake the stem cell transplant and it is a regular exercise at the SKIMS,” Dr Ahangar informed. “Under Rashtriya Arogya Nidhi (RAN), patients are also entitled for a free treatment.”
The family, despite these assurances, insisted on having the transplant performed outside the valley and instead of going to Delhi landed at some hospital in Chandigarh. The worsening Covid situation, however, left the family in lurch and they had to beat a hasty retreat to the valley. SKIMS was the only option left.
Back to the square one
“It is only after being pushed from pillar to post that we finally come to appreciate our own institutions,” Prof Gull Mohammad Bhat, who heads the oncology department at SKIMS, said. “Our hospital is among the best in India for such emergencies.”
Prof Bhat is a trained Oncology expert from AIIMS New Delhi.
The SKIMS not only welcomed the patient but decided to bear the expenses also. On December 18, 2020, an amount of rupees six lakh was sanctioned in favour of the patient and the transplant date was fixed on December 26.
A team of doctors and paramedics including faculty members namely Dr Syed Nisar Ahmad, Dr Mir Mohmad Hussain, Dr Faisal Guru, Dr Saquib Zaffar Banday, senior residents and nurses under the supervision of Prof. Gull Mohammad Bhat laid out the plan and transplant was performed in January 2021. The patient was retained in the hospital for a month and finally discharged in a healthy condition. He is currently on a follow up and is doing good.
A decade of selfless service
Hussain’s successful transplant is a result of the hard work and perseverance of the SKIMS’ oncology department that has tirelessly been working for well over a decade now.
Stem cell and bone marrow transplants are transforming medicine and with it the lives of increasing numbers of patients with life threatening illnesses are saved daily.
“It is now nearly 10 years since the first successful stem cell transplant was performed at SKIMS.” Prof Bhat informed. “A 52 year old male patient from south Kashmir’s Anantnag District required a transplant for a type of relapsed cancer called multiple myeloma.”
A retired bank employee, the patient is hale and hearty cherishing his life to the fullest after his superannuation.
The department has successfully performed similar transplants in more than seventy patients involving different cancers like multiple myeloma, non Hodgkins lymphomas, Hodgkins lymphoma, Acute leukemia, neuroblastoma etc. Both autologous and allogenic transplants are performed at SKIMS with highly satisfied success rates.
The department has the distinction of performing the first haploidentical transplant in a case of relapsed acute myeloid leukmia which is performed at few designated centers in India.
The department is, however, grappling with many issues that impede its smooth functioning in more than one way.
“The incumbent director, Prof Ahangar, has been keen to see the department run as per the required standards,” Prof Bhat said. “The department is still struggling with arranging finances and has many logistical issues to tackle.”
One of the most pressing issues, Prof Bhat said, was providing a separate and fully equipped unit for the stem cell and bone marrow transplant under the medical oncology in the state cancer institute.
“We’re in a dire need of doctors, nurses, technicians and laboratory technicians besides providing the facility for HLA matching, cryopreservation, liquid nitrogen and other requirements,” Prof Bhat added.
A centrally funded project by the GOI for SKIMS, the state cancer institute has a separate BMT Unit under the Oncology department with fixed budgetary allocations.
“We request the administration to designate a separate unit of stem cell and bone marrow transplant under the department of medical oncology as per the GOI guidelines for the cancer institute,” Prof Bhat said.
Note: The name of the patient in the story has been changed to preserve his identity.
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