Cancer on the rise among children in underprivileged areas of Pakistan

Karachi: An increasing number of cancer cases are being reported among children from low-income localities of Pakistan, as per a study conducted by paediatric oncologists at the National Institute of Child Health (NICH), Karachi, which cites adverse environmental conditions, unhygienic living conditions, consumption of unsafe drinking water and malnourishment as possible causes. 

“Poor quality of life due to deteriorating environmental conditions and unhygienic lifestyle is causing frequent infections to a vast majority of Pakistani children. Combined with the malnourishment, these infections are resulting in causing various types of cancers to children,” said Professor Nizam-ul-Hassan, former director NICH and president of the Child Aid Foundation (CAA), a non-profit organisation which runs the cancer treatment at the NICH with doctors and philanthropists.

Talking to The News, he said there was no public sector cancer treatment facility in Karachi or even in the entire Sindh and Balochistan, and the whole burden of cancer treatment was borne by NGOs and associations like the CAA, the Children Cancer Hospital and some other private hospitals, including the Aga Khan University Hospital.

According to him, a group of Pakistani doctors, including NICH former director Prof Nizamul Hasan, started the cancer treatment at the Children Hospital Karachi in April 1999 and since then thousands of cancer patients have completely been cured by the qualified and trained oncologists and paramedics.

“Around 50 to 60 children suffering from cancers are brought at our OPD everyday, of which 50 percent are new patients. Around 300 patients are receiving chemotherapy with various types of cancers, including Retinoblastomas, Acute Lymphoblastic Leukemias and Non-Hodgkin Lymphomas”, he claimed, adding that the inpatient capacity of the facility was just 14 patients due to space constraints.

While quoting pediatric oncologists, he said the worst environmental and hygienic conditions at low-income group localities in Pakistan were some of the major reasons behind frequent infections, including diarrhea and gastroenteritis among children, which was the leading cause of solid tumors or blood cancers to them.

Prof Nizam said although the study had yet to be published but the observations of the pediatric oncologists led to similar direction, saying childhood cancer was on the rise among children of low-income group people, who used to live in areas with extremely poor environmental and hygienic conditions, having no or low vaccination status and suffered infections on multiple occasions in a short span of time.

To a query, he said the centre had a team of pediatric oncologists, led by Dr Uzma Imam and paramedical staff, who had been trained by German pediatric oncologists and paramedics in 2005-06, adding that renowned Pakistani pediatric oncologists practicing in US and UK often visit their centre and offered their assistance and advice in treatment of patients.

‘Malnourished patients’      

“During the last several years, almost 40 percent children brought to the NICH with various types of cancers were malnourished and due to low immunity, their chances of having cancer increased”, Prof Nizam further said.

In addition to fighting cancer, he said, doctors and paramedics had to take care of the nutritional status of the patients so that their bodies could fight the lethal disease like cancers.

He further said malnourishment was on the rise among children of low-income segments and it was resulting in spreading cancer and other lethal infections.

“A group of German doctors and nurses, who trained our staff, emphasised on improving nutritional status of children with cancers, since a child could not fight cancer without having enough nutrition.”

The professor said the centre was providing highly enriched food supplements in addition to milk and dates to cancer patients as most of the patients suffering from cancers were highly fragile and underweight due to malnourishment.

‘Eye cancers on the rise’

Eye cancers, also known as retinoblastomas, are on the rise among Pakistani children being brought from rural parts of Sindh, Balochistan and lower Punjab, according to Prof Nizam claimed.

He said doctors were trying to understand the sudden rise in eye cancers which render the patient blind at an early age if not treated at the early stages.

He said the most common causes of the eye cancers were due to genetic reasons, but because of  sudden increase in the number of children with retinoblastomas, experts at the cancer treatment facility were worried and trying to understand the phenomenon.

‘Short of space at centre’

Despite spending Rs600 million annually, the cancer treatment facility at the NICH caters to only a few thousand patients annually as only 300 can be given chemotherapy, while only 14 can be admitted at the center at a time, according to Prof Nizam said.

“We are facing a shortage of space due to growing number of patients being brought to them from across the country.

“We are ready to generate double the amount we are spending currently on treatment of children if we are provided with ample space to admit more patients. A building at the NICH back was supposed to be given to us after its completion, but even after passage of a decade, it has not yet been constructed, even after the devolution process”, he said.

He urged the provincial government to release funds for the construction of the building at the NICH so that more patients with cancers could be treated.