Death, disease and compassionate policy

POLICY MATTERS

A VERY special friend of mine, Vijaya Lakshmi, passed away last week. She was first diagnosed with cancer about 16 years ago. After the usual treatment (surgery and chemotherapy) she was well, active and continued with her duties at Universiti Sains Malaysia.

In the last year or so, she had a relapse. The disease progressed; among other things it led to her ribs breaking. But that did not affect her spirit. She was always cheerful, not allowing what ailed her body or mind raise its hood and erode her positivity. Remarkable strength.

We would often have tea at USM, often accompanied by a mutual friend, a medical doctor with a passion for public health. When the doctor was with us the discussions would often veer towards healthcare, the economics of health and the political economy of the pharmaceutical industry. Viji, as we called her, would contribute enthusiastically to the conversation. She was a quiet activist of sorts. She used her editorial skills to sculpt academic health policy papers; she also volunteered at a free clinic. This gave her adequate familiarity with health issues.

She felt that accessibility to healthcare was a basic right. Viji was also aware that commercial interests get in the way of accessible healthcare and how the disadvantaged get doubly disadvantaged when their health is impaired.

Early this year I met another friend, a renunciate, with whom I had long shared communication before our meeting. This person, who is affectionately called Nani Ma, has been the driving force behind a hospice that has been established in Rishikesh, the Ganga Prem Hospice.

There is a curious link between Viji and Nani Ma. One was affected by cancer, the other sought to relieve the burden of those who were in the terminal stage of cancer. Nani Ma was struck by the physical and emotional pain that cancer patients undergo. In the villages of India, as in all developing countries,

palliative care is unheard of. The ravages of the disease, coupled with the dire economic circumstances that patients find themselves in leaves them in deplorable condition.

Nani Ma believes that those with cancer and whose lives are ending should be cared for with dignity, allowed to spend their last days within the arms of compassion, in a spiritually supportive environment. She welcomes all patients whatever their religious beliefs might be.

I would normally have discussed with Viji my visit to Rishikesh and the long conversation I had with Nani Ma. But the months after February were difficult for Viji. I was not sure if it would be appropriate to talk about Nani Ma’s work. I did not.

The passing away of one friend who succumbed to cancer and the continuing work of another to bring solace to those with the disease bring to mind several things. In the face of death, the impermanence of life is a stark and undeniable reality. Care and compassion are just about all one can extend when one’s life is gradually but surely fading, when pain discomfort and helplessness triumph over one’s sense of clarity.

If only those in power (ie politicians and policymakers) would be open to the pain and suffering of the sick and the dying they would realise the necessity of easy access to healthcare. The more disadvantaged one is the further access recedes from one’s grasp.

It is acceptable to place healthcare within the realm of the market system. That works for some. But for the large majority the government is all they can turn to. And the government cannot shirk its obligation to the people of the country. A rakyat-centred government must be a compassionate one. A caring society presupposes a caring government.

Viji was always generous with her time and kindness. Like her, I hope those in power will find it in their hearts to be compassionate to the sick, the dying, and by extension, to express it in the healthcare policies of

the country.

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