Tuesday, January 7, 2014

The financial burden of having a child with cancer

Many of the families who I work with have an income of less than $2/day (per person).  Having a child diagnosed with cancer means a huge financial burden for them.  Not only do they have to pay for all of their child's medications, but often the family must travel long distances to the hospital.  Even if it only costs $3 to take the bus each time, the family must often make this trip multiple times per week, and one parent's income is often reduced or lost as a results of having to accompany their child to the hospital for all of these visits.  Families are often forced to sell all the land that they own or ask relatives to lend them money to afford to continue to treat their child.

The hidden cost of their child's illness adds up in other ways as well; who will care for the family's other young children when one parent must stay in hospital with the sick child?  For the mother, who stays with her child in the hospital, how will she afford food?  At BSMMU only mothers (or other female relatives such as sisters, aunts, grandmothers) are able to stay overnight when their child is hospitalized because there are no washroom (toilet) facilities for male relatives.  While the child and mother stay in hospital, the mother must find a way to prepare food and clean the clothes.  Often families arrive at the hospital with almost nothing after travelling long distances.

Cost add up further the longer a chid is hospitalized.  All IV fluids, needles, syringes, blood tests, x-rays and even bandages must be purchased by the family.  After receiving intensive chemotherapy, the child may become immunocompromised and develop a life-threatening infection, further adding to the costs for a family.  They must purchase more IV equipment as well as IV antibiotics to treat the infection.  

Transfusions of blood and platelets are also needed for children with cancer as their body's ability to make red blood cells and platelets is impaired by chemotherapy. When this happens a family has to frantically make calls trying to find an available relative or friend who has the correct blood type and can to go to the transfusion department to donate blood.  Even with a donation from a relative, the cost of a transfusion is substantial.  If the family can't find someone, then there may be a chance to purchase blood but the cost is almost 10 times as high, is often unavailable, and could be contaminated with hepatitis, HIV or another infection.  There is no blood bank system in Bangladesh the way there is in Canada.  

A mother and her children on the children's cancer ward in Malawi
In Malawi, World Child Cancer has started distributing weekly 'welcome packs' to all mothers when their child is admitted to hospital.  The kit contains essentials such as cooking oil, soap, sugar, toilet paper, tea, matches, toothpaste and a bundle of firewood.  The pack costs less than $5 to provide, but has proved effective as more families continue treatment since hospitalization are now slightly more affordable.  This article describes the situation in Malawi where WCC is also working:

In Bangladesh, there are no cooking facilities for the ward. Mothers often prepare the food on a piece of newspaper on the floor, cooking it in an electric rice cooker.  A more hygienic cooking environment, away from the bedside with proper places to wash cooking utensils would improve the safety of the food that the children are eating.  

What about the food the hospital supplies?  It is not clean and because it is spicy the children will not eat it.  Lunch and dinner is the exact same thing every day.  Not all that appetizing....

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