Presentation at the conference on “Science and Social Consciousness: Medicine in Rural India”
Joint Meeting of Indian Nuclear Society, Mumbai and International Cancer Center, Mahatma Gandhi Memorial Medical Trust
March 1, 2011 Bhimavaram, Andhra Pradesh
SUPPORT FOR THE INTERNATIONAL CANCER CENTER FROM THE U.S.
James Bradbury, Ph.D.
Oppenheimer Institute for Science and International Cooperation; Services and Relief for the Poor
The International Cancer Center (ICC) of the Mahatma Gandhi Memorial Medical Trust (MGMMT) has now achieved many of its initial goals which is a tribute to the Government of India, some supporting activities in the U.S., and, most importantly, the dedication and perseverance of M.R. Raju and his wife, Devi, who conceived, created, nurtured, and brought the ICC to its present state of maturity. The mission of the MGMMT is to provide medical and educational services to a rural, underserved, relatively poor region in Andhra Pradesh, the ancestral home of the Raju family. Most of the people in this district cannot afford to go to major health centers in distant cities. Medical services offered through MGMMT include radiation and chemotherapy treatments for a variety of common cancers, gynecological evaluations and treatments, and ophthalmologic care. More than 2000 patients have been treated and there are more than 1000 patients in the facility cancer registry. The ICC has a well-developed infrastructure, ample space and treatment facilities, and a highly competent staff that soon will soon need augmentation. In addition to medical treatments the MGMMT provides education through a formal preschool program and through awareness programs in the vicinity that emphasize early detection and prevention of health problems.
Core support of the MGMMT comes from the Raju family; additional, direct assistance from America for the MGMMT has included modest financial contributions through the non-profit organization “Services and Relief for the Poor”, equipment donations, and more than 30 teaching interns, physicians, and engineers who have provided volunteer services in India for extended periods. More support can and should be made available. It is estimated that to better serve regional needs in providing affordable health care there should be a factor of at least two increase in patients enrolled and a dramatic expansion in the prevention/early detection arm of the program. Further, it is time to develop a plan for appropriate replication of this rural treatment center in other parts of India. Some specific components of a vision for the way forward are listed below. It is hoped that resources from the U.S. can help with the implementation of many of these activities.
*Staff and equipment to permit accessing more patients: Four additional staff members (surgeon, pathologist, diagnostic radiologist, medical physicist) are needed to double the number of patients treated. Addressing additional cancer sites requires obtaining an 8-MeV electron accelerator, a more powerful Cobalt source, and improved brachytherapy equipment; equipped rooms are already available for all of these appliances.
* Other clinic capabilities: In addition to cancer treatments, the MGMMT facility offers ophthalmological help, gynecological services, and maxillo-facial surgery. New directions could include providing dermatological services and taking steps to ease the endemic tuberculosis problem. TB is the leading cause of death for the Indian age group 15-45. Relatively inexpensive DNA analysis equipment can be used to distinguish between latent and active TB and thus determine the most effective course of action for individuals. This analysis and follow-up treatment could be performed in a rural clinic.
*Health education and awareness: New educational and motivational techniques can be instituted in the region to build health awareness, disease prevention, early detection of problems, and general good health practices including nutrition and hygiene. Targeting children will pay huge dividends downstream. Motivational technologies include child-accessible computer-based games, contests, health education programs, and individual handheld biomedical sensors. Children could obtain and record their health data, remain strongly coupled to feedback and assessment activities, and enroll in study groups supported by the parents and schools. Not only is long-term health improved but the children are introduced to the information age. The village residents should assist in designing activities and participating in feedback and modifications and, at an appropriate time, take ownership of the program.
* Monitoring and tracking regional health parameters: Satellite data, surveys, and existing records can be used to determine geographical parameters such as the regional demographics, socioeconomic characteristics, health status, clusters of disease incidence, communication/transportation infrastructure, access to medical health care, clean water availability, pollution and waste sites, etc. These data can be used to establish baselines, rate of health improvement, and the region-specific health projects that cost-effectively satisfy community needs.
* Replication of the rural health clinic: The MGMMT will document its activities in terms of approach, problems encountered, and successes. Replication of this rural clinic in other parts of India, with facilities tailored to meet the particular regional needs, should be supported by local and national government and through community involvement and widespread volunteer effort. The overall aim is to treat, on a region- by- region basis, existing health issues and create sustainable programs for achieving changes in behavior, health literacy, and health advocacy that will lead to demonstrably improved health in rural areas for the long term.
The above suggestions are all underpinned by science and technology. Good science and good scientific judgment are essential ingredients for developing solutions to the many daunting global issues such as health, environment, clean water, food production, climate change, and reduction of weapons of mass destruction. However, individual and collective social consciousness will be the attribute that drives the application of science to improving the condition of this needy planet. Since national and international security are at some level dependent upon the well-being of the population there is a pragmatic component to dealing with the global issues. But there is also an altruistic component that modern research has shown to be embedded in our genes and leads to selfless-ness and compassion, a wish to give to others with no thought of compensation. This compassion and aid-giving is a major quality of being human. The Raju team, husband/wife and their family, for the past two decades have devoted their time, energy, medical skills, and scientific wisdom to making this rural medical clinic a successful reality. They embody social consciousness in the highest manner.