Photography and writing by Chuck Russell
Chuck Russell documents travelling for a day with the Life at Your Doorstep (LYD) home-visit palliative care team, from the Mehdi Nawaj Jung Institute of Oncology and Regional Cancer Hospital (MNJ) in Hyderabad, India. Early in 2013, a second home visit team has been sonsored by an organization in Andrha Pradesh.
Anuradah balances her mobile phone and the patient logbook on her knee as our driver Chenni deftly maneuvers the van through Secunderabad’s side streets avoiding the congestion snarling the main roads.
Anuradah, nurses Shoba and Hepsiba and healthcare volunteer Professor Priya Kumari are crowded in the back seat as I take up the front passenger seat alongside Chenni for the day. I marvel at his knowledge of the sidestreets of Secunderbad and Hyderabad. GPS free, he naviagtes the LYD team to patients’ homes.
Anuradah says they rely on Chenni to convey them safely around the adjacent cities of almost seven million in Andhra Pradesh. For six years, the team has visited 5-6 patients and their families, six days a week, 52 weeks a year. The team is accessible by Anuradah’s mobile phone 24 hours a day. Initially sponsored by a pharmaceutical company, the LYD team has been funded by Two Worlds Cancer Collaboration since the start of 2012. The team provides home-based palliative and end-of-life care for patients unable to visit MNJ – all free of charge. The success of the LYD team inspired an India-based NGO to fund a second home-visit team in the spring of 2013.
"The impact is humbling to witness. In a country where a cancer diagnosis too often comes when the cancer is severely advanced..."
where a diagnosis often means abandonment by family and friends (as the misnomer persists in India, and much of Asia, that cancer is contagious), and where a diagnosis invariably leads to severe financial hardship for the patient’s family.
Twenty minutes later after a couple of detours, including reversing back down a narrow alley to avoid a dump truck, we arrive at the next family’s house. It’s not until later that I recognize the significance of the moment as the two nurses and social worker wait quietly in the shadow of a wall beside the house.
It’s their first visit to the family after the family’s patriarch has passed - a husband, father and grandfather to a now bereaved family. The team sits quietly listening as the family unburdens their grief.
Later when we are back in the van Anuradah speaks fondly of their former patient who used to address the team as “daughters”. At the end of the day, as Chenni guides us through the streets back to MNJ, the team talks of their work - work that is personally rewarding and simultaneously taxiing.
As with the pediatric and adult in-patient and out-patient departments at MNJ, the LYD team is overwhelmed by the volume of patients and their needs. It comes in the recurring dreams and it comes with the start that the ring of Anurudah‘s mobile brings in the middle of the night. But it’s clearly evident from their dedication and gentle, uncompromising care that they are very good at what they do.