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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: Relatives and a patient wait for their turn behind the shadow of a banner where late Nepali Primer Minister Sushil Koirala is seen while receiving treatment for his cancer at the Bhaktapur Cancer Hospital (left) and the hospital staff with Late Princess Jayanti Rajya Laxmi Devi Shah on February 02, 2015 in Bhaktapur, Nepal. Established in April 1999 by the Nepal Cancer Relief Society (NCRS), the government of Nepal, Rotary International and others, Bhaktapur Cancer Hospital is a non-profit and community-oriented hospital. It has 72 beds and employs 140 technical, ancillary and administrative staff. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A patient holds a folder with her cancer diagnosis while other patients queue at the reception of the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 20,000 people die every year from cancer with almost 30,000 new cases of cancer a year, with cervical cancer being the leading cause of cancer-related deaths among women and lung cancer among men in Nepal. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A woman stands by a closed door with a banner creating awareness about cancer inside the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 20,000 people die every year from cancer in Nepal, with almost 30,000 new cases a year. The NCRS conducts primary intervention activities such as cancer and tobacco awareness classes in schools, colleges, hospitals and rehabilitation centers. It also holds conferences for communities and policymakers. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A nurse closes the door of one of the consultation rooms at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 5,000 patients are treated in Bhaktapur Cancer Hospital each year. The hospital’s ‘tumor board’ is staffed by Nepal’s top oncologists, pathologists, gynecologists, and radiologists, and was established by the NCRS to ensure the best treatment is provided to patients through a collaborative process. Cancer patients can register their illness through the NCRS to be considered by the board. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A patient affected by stomach cancer lays on a hospital bed while a nurse cuts the stitches of his surgery during a consultation at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 5,000 patients are treated in Bhaktapur Cancer Hospital each year. The hospital’s ‘tumor board’ is staffed by Nepal’s top oncologists, pathologists, gynecologists, and radiologists, and was established by the NCRS to ensure the best treatment is provided to patients through a collaborative process. Cancer patients can register their illness through the NCRS to be considered by the board. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A nurse examines body samples inside the laboratory at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 20,000 people die every year from cancer with almost 30,000 new cases of cancer a year, with cervical cancer being the leading cause of cancer-related deaths among women and lung cancer among men in Nepal. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: Body samples affected by cancer are left on a table to be studied by doctors inside the laboratory at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. The prevalence of non-communicable diseases (NCDs) – those that are non-infectious or non-transmissible – has increased significantly in Nepal, where they now account for more than 44% of deaths. The most common NCDs include chronic obstructive pulmonary diseases (43%), cardiovascular disease (40%), diabetes mellitus (12%) and cancer (5%). In addition to higher levels of alcohol and tobacco use, urbanization and changes in diets have contributed to this rise. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A patient affected by lung cancer lays on a surgical bed while nurses prepare the room for his surgery at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 20,000 people die every year from cancer in Nepal, with almost 30,000 new cases a year. The NCRS advocates for tobacco control programs and lobbies policymakers to pass the Tobacco Products Control and Regulatory Bill of 2010 as well as to ratify the World Health Organizations’ Framework Convention on Tobacco Control. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A patient affected by cervical cancer lays on a hospital bed while receiving chemotherapy at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 5,000 patients are treated in Bhaktapur Cancer Hospital each year. More than 1,100 women die from cervical cancer in Nepal each year, making it the most common cancer among women in the country. Despite being easily preventable, the lack of awareness around screening has made this form of cancer one of the most prevalent in the developing world. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: Doctors perform surgery on a patient affected by stomach cancer at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Although rates have increased, the exact prevalence of cancer in Nepal remains unknown due to the absence of a nationwide cancer registry. Only four cancer treatment centers with radiation therapy facilities exist in the country. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: The husband of a patient affected by cancer sits in front of his wife’s bed inside one of the rooms at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. One of the most significant challenges related to cancer in Nepal is the lack of awareness around the prognosis of the disease, as many patients, their families, and even healthcare professionals consider cancer to be an incurable disease at any stage. This results in significant delays in bringing patients to hospitals, and high rates of advanced-stage cancers and mortality. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A group of women affected by cancer lay on their bed inside one of the rooms at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. With a per capita income of only $600 (£420), the majority of Nepalis struggle to afford expensive cancer treatments, which individuals have to finance in the absence of a proper health insurance system. Often, people resort to selling property and valuables to pay for treatment. Bhaktapur Cancer Hospital has cut these costs drastically by offering low-cost treatment options. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A man affected by lung cancer lays on his bed inside one of the rooms at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. The establishment of Bhaktapur Cancer Hospital was one of the first steps in the fight against cancer in Nepal, but challenges remain. Experts say the next steps should include developing treatment centers throughout the country, establishing a national cancer research institute and rolling out a nationwide registry. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: Relatives of a patient affected by cancer help her to walk in one of the corridors inside the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. One of the most significant challenges related to cancer in Nepal is the lack of awareness around the prognosis of the disease, as many patients, their families, and even healthcare professionals consider cancer to be an incurable disease at any stage. This results in significant delays in bringing patients to hospitals, and high rates of advanced-stage cancers and mortality. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: The son of a patient affected by cancer sleeps beside his father inside one of the rooms at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. With a per capita income of only $600 (£420), the majority of Nepalis struggle to afford expensive cancer treatments, which individuals have to finance in the absence of a proper health insurance system. Often, people resort to selling property and valuables to pay for treatment. Bhaktapur Cancer Hospital has cut these costs drastically by offering low-cost treatment options. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: The daughter of a man affected by lung cancer sends a text message while sitting near her father’s bed inside one of the rooms at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 20,000 people die every year from cancer with almost 30,000 new cases of cancer a year, with cervical cancer being the leading cause of cancer-related deaths among women and lung cancer among men in Nepal. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: The sister of a patient affected by cancer places an ice bag on her sister’s arm inside one of the rooms at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. Around 20,000 people die every year from cancer with almost 30,000 new cases of cancer a year, with cervical cancer being the leading cause of cancer-related deaths among women and lung cancer among men in Nepal. Photo: © Omar Havana
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© 2021 Omar Havana
BHAKTAPUR, NEPAL- FEBRUARY 02: A woman hugs her husband affected by cancer before he undergoes surgery at the Bhaktapur Cancer Hospital on February 02, 2015 in Bhaktapur, Nepal. In most treatment facilities in Nepal, healthcare is provided in accordance with what the family is able to pay for, but at Bhaktapur Cancer Hospital a family’s financial resources – including support that might be provided by friends and relatives – are assessed with the help of a hospital counselor. Families can apply for charity care and receive about $600, although that is rarely enough to cover the treatment. As a non-profit organization, the hospital allocates some of the donations it receives towards helping patients pay for treatment. Photo: © Omar Havana
Public Story
The Big C
Credits:
omar havana
Date of Work:
02/02/15 - 02/03/15
Updated: 12/15/20
According to the World Health Organisation, 10 million people are affected by cancer every year worldwide, a number that is estimated to double within 10 years. In Nepal, the number of cancer cases is increasing day by day; around 20,000 people die every year from cancer with almost 30,000 new cases of cancer a year, with cervical cancer being the leading cause of cancer-related deaths among women and lung cancer among men. Nepal does not have a national population-based cancer registry, but it does have a hospital-based registry. The Bhaktapur Cancer Hospital was established by the Nepal Cancer Relief Society in 1992, becoming a model hospital with the first public-private partnership. Currently, the hospital has 62 beds with over 140 staff members, assisting over 30,000 patients a year, with the bed occupancy rate standing at more than 90%.
The major challenge observed in oncology service in Nepal is the high cost of treatment, in many cases due to a lack of insurance, and proper health policy. As a result, people have to bear all of the burdens by themselves, with most of the cases of cancer diagnosed at an advanced stage, indicating the long duration between disease onset and final diagnosis of the disease.
Photography: ©Omar Havana / All Rights are Reserved
