Healthcare is broadly social and deeply personal, particularly with respect to a costly, high-mortality disease like cancer. Cancer can be emotionally and financially devastating for patients and their families, especially the poor. The problem is compounded in places like the North Eastern Region (NER) in India, a remote, “forgotten,” predominantly rural and agricultural border region where access to medical care is difficult. Even in the region’s leading state Assam, where cancer incidence is high amid a population of 35 million, the first cancer hospital was not opened until 1981. Later, a second, the Cachar Cancer Hospital and Research Centre (CCHRC) was established in 1996, it was the initiative of a non-profit society of local citizens, funded by public philanthropy on land provided by government.
CCHRC would, however, expand into an innovative, widely admired, full-service cancer care facility after Indian surgical oncologist Dr. Ravi Kannan R. became hospital director in 2007, the first formally-trained oncologist to fill the position. It surprised many that Kannan, who previously headed the surgical oncology department in Adyar Cancer Institute, a major cancer institute in Chennai, would exchange a position in a big city for a small hospital in a remote part of the country. Kannan had a simple answer. It was where he was most needed.
Under Kannan’s leadership, CCHRC became a full-fledged comprehensive cancer hospital and research center. From a hospital with limited facilities when he came on board, it now has twenty-eight departments covering oncology, pathology, radiology, microbiology, epidemiology, tumour registry and palliative care, and other services and specializations. From a staff of only twenty-three, the hospital now employs 451 people.
Kannan saw from the beginning that it was not just a matter of having state-of-the-art cancer facilities. Patient compliance rate to treatment was at 28%. Patients came but did not continue their treatment due to such reasons as the difficulties of traveling long distances, the cost (including the loss of income of family caregivers), and resignation to the belief that the patient would never be cured. Clearly, the underlying reason was poverty. Thus, the hospital introduced such pro-poor initiatives as free treatment, food and lodging, adhoc employment for caregivers, and a homecare program. Hospital team members would travel long distances to train family members in pain management and palliative care, as well as provide free medicines. As a result, patient compliance rates rose to 70%. CCHRC now provides free or subsidized cancer care treatments to an average of 5,000 new patients annually, catering to approximately 20,000 poor patients for treatments and follow-ups. Kannan says, “No one should be denied access to treatment due to want of money.”
The hospital states its vision in these words: “We aim to become a state-of-the-art cancer center that will ensure that no individual develops a cancer that can be prevented, that no patient is denied appropriate cancer treatment for want of resources, that no patient dies in agony and indignity and that no family suffers treatment induced poverty and grief.” It is a clear, bold statement that the hospital translates into actual practice.
Kannan, now fifty-nine-years-old, has served the hospital for nearly seventeen years. He is particularly proud of the people around him who share his vision for the hospital, many of them young professionals attracted and inspired by his leadership. Self-sacrificing and quietly heroic, Kannan lives with his family in Assam and in this remote region continues to work without expectation of public recognition. Reiterating his mission, he says, “To be able to deliver inclusive health care and inclusive cancer care, you must have care available. You must have care that is equitable, accessible, and affordable.”
In electing Ravi Kannan R. to receive the 2023 Ramon Magsaysay Award, the board of trustees recognizes his devotion to his profession’s highest ideals of public service, his combination of skill, commitment, and compassion in pushing the boundaries of people-centered, pro-poor health care and cancer care, and for having built, without expectation of reward, a beacon of hope for millions in the Indian state of Assam, thus setting a shining example for all.