One of RMF’s guiding principles is that we approach our work “one child at a time”, focusing on individuals, real impacts and tangible results even as we implement large-scale, projects affecting millions of people. This approach, while effective, is never easy. We get attached. This past month, I’ve been reminded of how rewarding one child at a time can be and also of how painful.
I met Abishek, aged 7, one night last December at Real Medicine’s office in Jhabua. I was cranky for spending a late-night in the office sorting through expenses when Jimmy, our project coordinator, brought in a boy and his father who had heard about RMF and wanted to see if we could help them. Even in the dim light I could tell that Abishek was not well. His bony hand clung around his father’s neck as his father told me about Abishek’s battle with cancer and hospitals and the family’s battle with debt and mistreatment. Abishek had been diagnosed with a Wilms tumor, a form of cancer not necessarily fatal in the West, if caught early, but which was already in the late stages because of the poor rural medical system in Jhabua. As Abishek started to get really sick and his stomach began to swell drastically, he and his family were bounced around from hospital to hospital, his treatment being ever referred, deferred, by doctors unable to tell the seriousness of his condition. He finally ended up at a private hospital in Indore where the hospital charged his family obscene amounts of money (which they had to borrow from money lenders to cover) and performed a surgery that another later doctor told me was a butcher’s job. It is suspected, and highly probably given this hospital’s reputation, that the surgeon purposely did not remove the entire tumor so that there would be more to remove later, for another surgery fee. Further, we learned that Abishek was only beingadministered 3 of the 5 recommended chemotherapy agents he required. He went through all of the side-effects of chemo, but with little benefit. Sounds unimaginable, but sometimes medicine as a business overrides the Hippocratic Oath.
Things were not looking good for Abishek when we met him, but every child deserves a chance. I called on a friend whose father is the chief of surgery at the best pediatric hospital in Ahmadabad, 10 hours away and he immediately agreed to see Abishek, free of cost. The doctors, while warning us of the worst, said Abishek had a small chance of surviving and started him right away on the correct chemo. We took Abishek and his family back and forth to the hospital in Ahmadabad, pestering doctors for quicker results, bothering nurses for extra blankets, and even donating blood to Abishek.
While most of the Abishek’s doctors, neighbors, and family members had given up hope of his survival, we stubbornly, continued to consult with experts, continued to look for better chemotherapy agents, and showered Abishek with his favorite chocolates and juice boxes. Ever y visit to Abishek’s house was heartbreaking as we watched Abishek waste away, cancer ravaging his body, and imagining that this all could have been avoided if Abishek’s cancer was detected earlier and if this criminal hospital in Indore hadn’t put greed over medicine.
While going through the heartbreaking journey with Abishek, my spirits and hopes were also lifted by another one of our special cases, Sachini, in Sri Lanka.
Jimmy also left the students wide-eyed as he gave them an impassioned talk about how HIV can happen to anyone if we do not take the right precautions. By giving the students examples from real-life cases of people their age contracting HIV, Jimmy certainly woke up the audience and then hit home with practical advice on how they can take precautions against HIV and where to go get testing.
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