Rozina Aktar has lost all her luscious black hair from chemotherapy for her lung cancer. The sad-faced 30-year-old woman from Patuakhali has already had seven chemo sessions and is waiting for a few more. Then she will have surgery. She lives in the damp open backyard of the national cancer research hospital reeking of garbage scattered around, where other cancer patients have also managed to make space to stay for treatment.
Rozina has a paper-thin mat and a mosquito net to make her stay comfortable in that most inhospitable place. "I do not have the money to go home and come back again for treatment. So, I found a way to stay in the hospital backyard," she said. "Each chemotherapy sets me back Tk12,000-14,000 that I somehow manage from begging." Her husband had abandoned her after the unsettling diagnosis.
This is how the struggle of poor patients, who come to the National Institute of Cancer Research and Hospital in Dhaka, goes on day after day. Yet, they have no regrets, no complaints; rather they are happy as they have at least got some space to stay close to the hospital.
In the daytime, they go around begging for treatment money and at night, they sleep on their mats under mosquito nets.
They get chemotherapy or radiotherapy in an interval of seven or 21 days. But they neither can afford the money to travel costs to their village homes and return again, nor do they have the ability to rent a room in one of the most expensive cities in the world.
Rozina has been staying under the open sky for the last six months. If there was a need for emergency care, she could easily get a doctor's attention, she said.
Like her, many poor cancer patients get admitted to the national cancer hospital, have chemotherapy or radiotherapy and end up in the open space adjacent to the hospital.
The hapless patients not only fight the disease that has a high rate of fatality, they also have to endure the hot tropical sun, torrential monsoon rain and mosquitoes carrying deadly pathogens like dengue.
"We have no problem with the place we are now staying in. We are happy that we are at least getting treatment. We can't rent a house," Sirajul Islam, a farmer from Rangpur, who has brought his wife Hamida Begum to treat her brain cancer to the hospital for treatment.
Sirajul Islam has so far spent around Tk9 lakh for his wife's treatment in several private hospitals in Rangpur and Dhaka.
Radiotherapy and chemotherapy are not available in Rangpur Medical College, he said.
Gulzar Hossain Ujjal, haematology specialist at National Institute of Cancer Research and Hospital, told TBS that their hospital cannot accommodate more than 500 patients. On average, 50 patients get admitted here every day though the need is much higher.
The number of outpatients is around 1,000 per day, he added.
Everyday around 300-350 patients receive chemotherapy, while recipients of radiotherapy are 400, doctors at the hospital said.
It is not possible to house all patients at a time as there is a shortage of beds in the hospital, they also said, adding that they discharge stable patients after giving therapy and they continue regular outpatient visits staying anywhere on their own.
Some 1.56 lakh people are diagnosed with cancer in Bangladesh every year, according to a Globocan 2020 report.
According to WHO standards, a cancer centre is needed for every 10 lakh people. So, Bangladesh requires 160 cancer centres, but it has less than 20, which are located in the capital.
Moreover, the country needs 300 radiotherapy machines, but there are only 37 in public and private hospitals. Most of them remain out of order.
Patients complained that they have to wait 3-4 months for their turn to get radiotherapy.
Professor Dr Habibullah Talukder Raskin, cancer epidemiologist and preventive oncologist, said people's suffering will be lessened as cancer hospitals are being set up in eight divisional cities of the country.
But it is not enough to just set up a hospital and provide machines, skilled manpower is needed to handle them.
"We also need to emphasise preventing cancer alongside ensuring treatment," he noted.
Ismat Ara, 26, who was diagnosed with blood cancer, was left in Dhaka's national cancer hospital six months ago by her husband for treatment.
"We pay Tk20 per day to a nearby house to use their cooking stoves. We collect drinking water from the National Institute of Cardiovascular Diseases next-door," she said.
"We do not know how long we will be able to continue our treatment this way as security men guarding the hospital do not want us to stay in the hospital yard," Ismat concluded.