Issue 01 Vol 01 August 2020 OnChronicleC AN EXCLUSIVE NEWSLETTER OF ALAMELU CHARITABLE FOUNDATION, SUPPORTED BY TATA TRUSTS 1 Assam Cancer Care Foundation, a joint initiative of Government of Assam and Tata Trusts, is the Welcome most significant arm of the programme – with 10 under-construction hospitals and multiple operational projects, some of which are first of Note their kind. The state of Assam, which reports 32,000 new Dear Reader cancer cases every year, of which 70% of cases are reported in later stages, needed a structured We are delighted to bring you the first volume and early detection and screening programme. issue of ONCHRONICLE, the exclusive newsletter Through an MOU with National Health Mission of Alamelu Charitable Foundation (ACF), (NHM), capacity building, screening for early supported by Tata Trusts. detection and awareness programme has been launched in 8 districts. Opportunistic screening ACF was conceived and conceptualised by the kiosks have been opened up in 4 Medical College Tata Trusts in 2017, to mitigate the problems that Hospitals. ail cancer care in India. Since then it has been fighting against the lack of infrastructure and We have also entered into an understanding with trained workforce, deficient diagnostic and NHM in Maharashtra, Jharkhand, Andhra therapeutic medical equipment, limited financial Pradesh and Odisha and the capacity building, access, lack of cancer and palliative awareness, early detection and screening programmes are absence of quality care and more, while being rolled out in respective catchments. encouraging detection of cancer in its early stages. To provide the ease of access to cancer patients Content for chemotherapy and radiotherapy facilities, we To address these issues, the team is working at have introduced novel Day Care Centres. Two of multiple levels and collaborating with them are already operational at Dibrugarh and 1. Welcome Note like-minded state governments and Tirupati, and two more are under way 2. Distributed Model of organisations, who could join us in achieving the Cancer Care mission of transforming cancer-care in the With the pandemic of COVID-19 hitting the country. country in the first quarter of 2020, impacting 3. Swasth Assam almost everyone and everything in each sphere 4. Day Care Centres We have built and transferred to the Department of life, the programme also received its blows. of Atomic Energy, a 352-bedded facility – However, the ambitious and focused team 5. Outreach at Mahamana Pandit Madan Mohan Malviya Cancer quickly adopted the new way of life and started Tea Gardens Centre at Varanasi, to run under the aegis of TMC. functioning accordingly. As on date, most of our The infrastructure and facilities have been 6. Tobacco-control projects are back on track and making Initiatives enhanced at the Indian Railway Cancer Institute consistent progress. and Research Centre, Varanasi (rechristened as 7. Nursing Fellowship Homi Bhabha Cancer Hospital) and Meherbai Tata In this issue, we have highlighted some Programme Memorial Hospital, Jamshedpur. interesting updates of Cancer Care Programme. 8. Highlight - Chandrapur Cancer Care Foundation To ensure access to high-quality cancer Hereafter, we will aim to bring you the salient pathological diagnostic services to cancer highlights of the programme, quarter on quarter. 9. Byline - Quality patients across the country and to address the Improvement demand and supply gap of pathologists Happy Reading! specialising in cancer diagnosis, Centre for Oncopathology (COP) has been set up in Mumbai. 2 Vol 01, Issue 01, August 2020 The fourth pillar focuses on and a broader cross-section of affordable care. Efforts are the population and increasing Distributed Model on to empanel all centres package rates under both under National and respective state and central insurance of Cancer Care State Government's health coverages. insurance schemes for When fully operational, we are cashless treatment of all expecting to achieve an eligible patients. In addition, to appreciable increase in early ensure that no cancer patient diagnosis and reported cases, leaves treatment mid-way due a substantial reduction in to the lack of funds, we are travel and treatment time, trying to leverage various reduction in treatment public schemes, and voluntary expenses and a strong cadre donations from NGOs, of trained oncology philanthropists, etc. In parallel, professionals. policy advocacy work is being done for the inclusion of a larger number of procedures Distributed Model of Cancer Care is the response of Cancer Care Programme team of the Trusts to tackle the burgeoning issue of cancer in India. The innovative model which will be 3 Swasth Assam – implemented by ACF, has been put in place, taking into kiosks for opportunistic consideration the unique cancer care issues of the country. The model has four pillars, and each of these pillars addresses screening and health awareness the wide array of cancer care problems. Enhanced access pillar is our response to the lack of cancer care infrastructure and trained workforce to treat and manage cancer patients. Following a step-down approach, different levels of hospitals (L1, L2, L3 – differentiated by capacity, and services offered) are being constructed in various parts of the country, that will ensure cancer treatment is available within a few hours of reach. At present, construction work is on for a network of 10 hospitals in Assam, one hospital each in Tirupati, Allahabad, Ranchi, Chandrapur, Mangalore, and 5 hospitals in Odisha. Capacity is being enhanced for yet another hospital in Cachar in Assam. To make sure that standardised quality treatment is provided to patients across hospitals, a Digital Nerve Centre (DiNC) is being While Assam Cancer Care check-up (including BMI), Foundation (ACCF) has taken screening for hypertension, put in place. All the hospitals will be linked to DiNC, reducing multiple initiatives to diabetes and oral, breast and turn-around time for cancer care and bringing treatment closer propagate regular screening cervical cancers. Awareness is to patients by synergising people, processes, platforms, and and awareness, in a also provided on lifestyle, networks. Thus, technology and standard operating one-of-its-kind effort, ACCF nutrition and varied procedures form the second pillar. collaborated with Medical health-related topics, in local College Hospitals of Assam languages that are easy to One of the key concern issues of cancer in India is late stage through Directorate of Medical understand. Education, and developed a detection in over 70% of the cases. To tackle the problem an novel concept called Introduced in January 2020, 'Awareness, Screening, Early Detection and Palliative Care' 'Swasth Assam.' the team has since launched pillar has been put in place. The team is working both at 'Swasth Assam' kiosks at four advocacy and implementation level to reverse the current 30:70 The 'Swasth Assam' are Medical College Hospitals in kiosks providing opportunistic Assam – Guwahati, Barpeta, ratios of early to late detection to 70:30 over a period of time. screening and Tezpur and Dibrugarh. Kiosks health awareness. at other locations are under way. On a daily average, a 'Swasth Assam' kiosks are kiosk has 60 to 80 bright and attractive centers, beneficiaries visiting and set up in heavy footfall areas of availing the services. select Government Medical College Hospitals for Going by the success of conducting health check-up of 'Swasth Assam' model, the family members and relatives Cancer Care Programme team accompanying the patients and is soon introducing such patients' visitors. The services kiosks in Chandrapur, Ranchi include: general health and Tirupati. 4 Vol 01, Issue 01, August 2020 While the main units are under way, support, an e-helpdesk has been Cancer Care to strengthen cancer care delivery in put in place, complemented by an short term, ACF is setting up Day onsite patient navigator. The Care Centres at all L2 cancer centre patient navigator helps the Delivery locations. OPD services, day care patients in filling out required chemotherapy and radiation forms and guides them through in short term services will be provided at these doctor consultations and tests, etc. day care centres. At Tirupati, while the main unit is Two Day Care Centres are already under way, the centre has a tie-up operational, one at Assam Medical with select hospitals for all other College and Hospital, Dibrugarh and cancer care services. The the second at SVICCAR (Sri e-helpdesk at the centre is actively Venkateswara Institute of Cancer engaged in managing patient Care and Advanced Research), solutions. Tirupati. Three more day care centres are For supportive disciplines and under way at Diphu, Barpeta and surgical oncology requirements at Silchar. Assam, partnership with the medical college is being leveraged, providing comprehensive cancer care to patients. To provide the required navigation and counselling 5 The screening work at tea gardens, Eorts to which was stalled for a while due to COVID-19 pandemic restrictions reach has been reinitiated. The team is now spreading awareness and the last person adopting preventive measures of COVID-19 along with other lifestyle possible modifications. An increased focus is on tobacco control activities, as tobacco consumption in any form There are 21 To ensure early A referral program for the increases serious complications Amalgamated detection and timely treatment of suspected cases has from COVID-19. Stationed in the Plantations Pvt. Ltd. treatment of been put in place, making sure that tea garden itself, the outreach (APPL) tea gardens Non-Communicable the entire screening and treatment team of ACCF, has been conducting loop is completed. Suspected cases its activities as before. This, in the state of Diseases (NCDs) of hypertension and diabetes are on completion, would perhaps be Assam with a total including easily referred to Referral Hospital and one-of-its-kind population-based estimated captive identifiable cancers Research Centre. Those suspected cancer registry in North East India. population of around and an eventual for oral, breast, and cervical 86,000.