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Cancer grid project crawls as key professionals exit entity

By RITURAJ BORTHAKUR
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GUWAHATI, May 8 - The much-hyped Rs 2000-crore cancer care grid project in the State � a collaboration between the Assam government and Tata Trusts leading to the Assam Cancer Care Foundation (ACCF) � which had an April 2020 target for operationalisation, has been a nonstarter, with key names associated with the project, including the country�s noted oncologist Dr Tapan Saikia, exiting the Foundation allegedly due to loss of respect and dignity.

Lack of coordination between the two entities in the collaboration, remote control from Mumbai, corporate governance issues and refusal to take into confidence local expert advice have been cited among the reasons for the work on the grid progressing at a snail�s pace.

On May 21, 2018, Health Minister Himanta Biswa Sarma had said the three-tier network of hospitals would be operationalised in two years� time. Official sources, however, said that work on the hospitals had begun just a few months back, and the progress so far has been just a mere 20 to 30 per cent.

In the meantime, over the last few months, several top medical professionals roped in into the project have made their exit due to reasons that have shown the tie-up in poor light.

One of the key persons who left the project is Dr Saikia, who was brought in by Tata Trusts and assigned many responsibilities by the Assam government to steer the project and implement strategies to create an unparalleled model of cancer care and delivery across the State of Assam. He is one of the seniormost oncologists in the country with an experience of over 35 years in renowned apex institutions of the country, like Tata Memorial Centre and Prince Aly Khan Hospital in Mumbai.

When contacted, Dr Saikia admitted that �the progress has been slow for a number of reasons�.

�There is no clear understanding on the part of the Tata Trusts people how to go about the job. They are not taking experts in Assam into confidence. There is excellent expertise available in Assam. There are some very experienced and skilled people in Assam who have developed cancer centres in the State and elsewhere,� he said, without elaborating.

Dr Saikia said the project is not taking advantage of the State employees already roped in. �They are extremely committed as opposed to scratchy commitment of the Tata Trusts advisors,� Dr Saikia said, urging the State government to utilise the currently employed senior staff in the best possible way.

�They need freedom as they are no less experienced or committed than the Tata Trusts advisors. Respect is earned and loyalty is returned. We must take advantage of administrators and doctors of the State Cancer Institute (SCI) at GMCH. My feeling is that, in a much shorter time, they will be able to bring up a few very effective hospitals in Assam,� he said, asserting that blaming the monsoon for the development does not hold water.

People who have left the entity say at least two to three hospitals should have come up by now.

According to the project, of the proposed 19 facilities, 12 were to be comprehensive cancer care centres on the premises of government medical institutions in the State. Located at Barpeta, Dhubri, Diphu, Jorhat, Karimganj, Kokrajhar, Lakhimpur, Nagaon, Nalbari, Silchar, Tezpur, and Tinsukia, they would offer diagnosis and treatment of cancer cases. Another five will be adjacent to the district hospitals. Located at Darrang, Goalpara, Golaghat, Haflong, and Sivasagar, they will offer diagnostic and day care services, including chemotherapy. The Assam Medical College and Hospital (AMCH), Dibrugarh, will be upgraded to an apex cancer centre with education and public health research capabilities. The State Cancer Institute (SCI) at GMCH will be expanded to a 500-bed South Asia Research Centre, says the Tata Trusts website.

As far as progress on the ground is concerned, initiation of patient-centric services is still a far cry.

Among the big names who have exited are Dr Aarnie Purushotham, Medical Director�Tata Trusts Cancer Programme, Dr Tapan Saikia of the Board of Directors, ACCF, Elizabeth Prager, Director Strategy, CEO Vara Prasad Annam, and palliative care experts Dr Naveen Salins, Dr Nandini Vallath and Dr Gayatri Palat, etc. Also, Dr Nirmal Hazarika, Medical Advisor of ACCF, was not given extension of contract without citing any reasons.

�What was needed in ACCF is better administration and management at the local level, which were only found on paper. The people at Mumbai office of ACF (Alamelu Charitable Foundation, a branch of Tata Trusts) have been trying all the time to keep ACCF under remote control. Any decision made at ACCF have been rejected or just kept pending for months, or never taken to any constructive solution,� Dr Hazarika said when contacted.

In Assam, there are about 55,000 cancer patients at any given point of time. For these cancer patients, there are only two centres where government collaboration is involved � one at Dr B Borooah Cancer Institute (BBCI) and the other at the SCI at GMCH.

Under the ACCF project, construction has started in 10 sites from October 2019 but due Covid-19 and anti-CAA protests progress is further slow. Palliative care service has started in three places (AMCH-Dibrugarh, JMCH-Jorhat and SCI-GMCH), with one doctor and two-three nurses in each location. Chemo unit was to start in AMCH in mid-March this year but due to �some hitches� it is yet to take off.

Sources said a Section-8 company by the name of Alamelu Charitable Foundation was floated by Tata Trusts to initiate and implement its Cancer Care Program. Assam Cancer Care Foundation was started also as a Section-8 company (who work towards the objective of social welfare, without any intention to get any kind of profit). The Board of ACCF is represented by three chosen members of Tata Trusts (of which Dr Tapan Saikia was one member) and three others from the State government. Sources alleged that instructions from the two foundations were often contradictory and work-related orders that have created confusions for the staff to improve work efficiency and perform to their ability, resulting in poor execution.

The sources further alleged that there has been undue interference at microlevel execution of the planning making it difficult for ground level employees to work constructively.

�The hierarchy in the ACCF has been completely fractured due to misguidance from the top,� the sources alleged, calling the attention of the government which has allegedly been a mute spectator so far to the issues plaguing the project. Notably, the head of operations of ACCF has been camping at Delhi since the lockdown.

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Cancer grid project crawls as key professionals exit entity

GUWAHATI, May 8 - The much-hyped Rs 2000-crore cancer care grid project in the State � a collaboration between the Assam government and Tata Trusts leading to the Assam Cancer Care Foundation (ACCF) � which had an April 2020 target for operationalisation, has been a nonstarter, with key names associated with the project, including the country�s noted oncologist Dr Tapan Saikia, exiting the Foundation allegedly due to loss of respect and dignity.

Lack of coordination between the two entities in the collaboration, remote control from Mumbai, corporate governance issues and refusal to take into confidence local expert advice have been cited among the reasons for the work on the grid progressing at a snail�s pace.

On May 21, 2018, Health Minister Himanta Biswa Sarma had said the three-tier network of hospitals would be operationalised in two years� time. Official sources, however, said that work on the hospitals had begun just a few months back, and the progress so far has been just a mere 20 to 30 per cent.

In the meantime, over the last few months, several top medical professionals roped in into the project have made their exit due to reasons that have shown the tie-up in poor light.

One of the key persons who left the project is Dr Saikia, who was brought in by Tata Trusts and assigned many responsibilities by the Assam government to steer the project and implement strategies to create an unparalleled model of cancer care and delivery across the State of Assam. He is one of the seniormost oncologists in the country with an experience of over 35 years in renowned apex institutions of the country, like Tata Memorial Centre and Prince Aly Khan Hospital in Mumbai.

When contacted, Dr Saikia admitted that �the progress has been slow for a number of reasons�.

�There is no clear understanding on the part of the Tata Trusts people how to go about the job. They are not taking experts in Assam into confidence. There is excellent expertise available in Assam. There are some very experienced and skilled people in Assam who have developed cancer centres in the State and elsewhere,� he said, without elaborating.

Dr Saikia said the project is not taking advantage of the State employees already roped in. �They are extremely committed as opposed to scratchy commitment of the Tata Trusts advisors,� Dr Saikia said, urging the State government to utilise the currently employed senior staff in the best possible way.

�They need freedom as they are no less experienced or committed than the Tata Trusts advisors. Respect is earned and loyalty is returned. We must take advantage of administrators and doctors of the State Cancer Institute (SCI) at GMCH. My feeling is that, in a much shorter time, they will be able to bring up a few very effective hospitals in Assam,� he said, asserting that blaming the monsoon for the development does not hold water.

People who have left the entity say at least two to three hospitals should have come up by now.

According to the project, of the proposed 19 facilities, 12 were to be comprehensive cancer care centres on the premises of government medical institutions in the State. Located at Barpeta, Dhubri, Diphu, Jorhat, Karimganj, Kokrajhar, Lakhimpur, Nagaon, Nalbari, Silchar, Tezpur, and Tinsukia, they would offer diagnosis and treatment of cancer cases. Another five will be adjacent to the district hospitals. Located at Darrang, Goalpara, Golaghat, Haflong, and Sivasagar, they will offer diagnostic and day care services, including chemotherapy. The Assam Medical College and Hospital (AMCH), Dibrugarh, will be upgraded to an apex cancer centre with education and public health research capabilities. The State Cancer Institute (SCI) at GMCH will be expanded to a 500-bed South Asia Research Centre, says the Tata Trusts website.

As far as progress on the ground is concerned, initiation of patient-centric services is still a far cry.

Among the big names who have exited are Dr Aarnie Purushotham, Medical Director�Tata Trusts Cancer Programme, Dr Tapan Saikia of the Board of Directors, ACCF, Elizabeth Prager, Director Strategy, CEO Vara Prasad Annam, and palliative care experts Dr Naveen Salins, Dr Nandini Vallath and Dr Gayatri Palat, etc. Also, Dr Nirmal Hazarika, Medical Advisor of ACCF, was not given extension of contract without citing any reasons.

�What was needed in ACCF is better administration and management at the local level, which were only found on paper. The people at Mumbai office of ACF (Alamelu Charitable Foundation, a branch of Tata Trusts) have been trying all the time to keep ACCF under remote control. Any decision made at ACCF have been rejected or just kept pending for months, or never taken to any constructive solution,� Dr Hazarika said when contacted.

In Assam, there are about 55,000 cancer patients at any given point of time. For these cancer patients, there are only two centres where government collaboration is involved � one at Dr B Borooah Cancer Institute (BBCI) and the other at the SCI at GMCH.

Under the ACCF project, construction has started in 10 sites from October 2019 but due Covid-19 and anti-CAA protests progress is further slow. Palliative care service has started in three places (AMCH-Dibrugarh, JMCH-Jorhat and SCI-GMCH), with one doctor and two-three nurses in each location. Chemo unit was to start in AMCH in mid-March this year but due to �some hitches� it is yet to take off.

Sources said a Section-8 company by the name of Alamelu Charitable Foundation was floated by Tata Trusts to initiate and implement its Cancer Care Program. Assam Cancer Care Foundation was started also as a Section-8 company (who work towards the objective of social welfare, without any intention to get any kind of profit). The Board of ACCF is represented by three chosen members of Tata Trusts (of which Dr Tapan Saikia was one member) and three others from the State government. Sources alleged that instructions from the two foundations were often contradictory and work-related orders that have created confusions for the staff to improve work efficiency and perform to their ability, resulting in poor execution.

The sources further alleged that there has been undue interference at microlevel execution of the planning making it difficult for ground level employees to work constructively.

�The hierarchy in the ACCF has been completely fractured due to misguidance from the top,� the sources alleged, calling the attention of the government which has allegedly been a mute spectator so far to the issues plaguing the project. Notably, the head of operations of ACCF has been camping at Delhi since the lockdown.

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