Afiya's cancer journey a testament to why Maldives desperately needs a cancer hospital

Thousands of Maldivians seek treatment for cancer in the country on a regular basis. Yet the country only has three doctors who specialise in the field. Despite having an onco-centre in Hulhumalé operated in collaboration with India's Amrita Hospital, patients do not have access to regular and consistent treatment locally.

This results in irreversible and adverse consequences suffered by patients. This time, it was Fathimath Afiya Bridgden, founder of Care Society - a local NGO that serves persons with disabilities in the country - who went through the hardships of trying to get treatment for her cancer in her home country.

Sharing her experience on Facebook, Afiya explained how delays in vital and expensive tests she attempted to get done from Indira Gandhi Memorial Hospital (IGMH), ADK and Tree Top Hospital in Malé resulted in the spread of her cancer.

"My breast cancer spread to my underarm axilla [armpit] because it took time to get expensive tests done from IGMH, ADK and privately from Tree Top Hospital throughout the course of one and half months," she revealed.

She detailed that by the time she got approval for Aasandha (the national health insurance scheme for locals in Maldives) and traveled to HCG Hospital in India, tests revealed that her cancer had spread to three lymph nodes under her arms.

Reflecting on her experience, she expressed the importance of timely care for cancer patients and highlighted that time is critical in delaying the progression of disease and even saving the lives of patients diagnosed with the disease.

"Everyday cancer patients have to wait in the long duration it takes for [their] tests to be done in Maldives is [a day that] endangers their lives. But [they] might have to wait one and half months or even longer," she wrote.

Illustrating the gravity of the situation, Afiya recalled how she made her appointment for an oncologist consultation during last March, only to be able to consult during the first week of May. She revealed how patients are put on waiting queues when the specialist doctors go on medical leaves and vacations.

"My situation also worsened from first stage to second stage because treatment was delayed. Initially it was to be treated with radiation therapy alone. However, cancer spread and [I] ended up having to undergo cycles of chemotherapy for 12 months. Seven chemotherapy cycles still remain," she wrote about her condition.

Based on her experience the former Deputy Gender Minister called onto expand the level of treatment available for cancer patients within the country.

"Its important to build a specialised cancer hospital to treat cancer patients in the Maldives. IGMH currently offers few services for cancer patients. A recently established oncologist department is [also] there. Hulhumalé Hospital also offers chemotherapy. This is progress compared to before. But there are no specialist doctors. No specialist services," Afiya expressed her frustrations about the healthcare system.

Owing to the lack of available treatments, Afiya went to Bangalore for her treatment where she stayed for seven months and returned to the Maldives on March 15th after eight cycles of chemotherapy and 17 cycles of radiation therapy which is unavailable locally.

With Bangalore being an expensive city and not an easy place to live in, Afiya wants to receive treatment in Maldives, if possible, she expressed.

However, cost of treatment is also another challenge for patients like Afiya. While Aasandha paid USD 1038 (MVR 16,016) for a PET scan at ADK Hospital, the national insurance scheme only covered USD 150 (MVR 2313) for the second PET scan she ended up needing while in Bangalore, despite the scan costing USD 540 (MVR 8236). The balance had to be covered by the patient, Afiya said.

"I was supposed to travel to Bangalore for a doctor's review two months back. Doctors here [in Bangalore] asked for additional tests. Although Aasandha was arranged last year, [I] dont know what will happen this year. So [I] have decided to discontinue treatment and return back to Maldives," Afiya announced.

"A cancer hospital dedicated to cancer patients is needs to be built very soon. These services being available in Maldives is important. Being able to receive treatment for cancer in Maldives would surely reduce the [expenses from] state budget, expenses from citizens [pockets], amount spent by the government on foreign hospital and would also bring more comfort to cancer patients," she added.

According to Aasandha, more than 10,000 Maldivians received treatment for cancer last year alone. This includes those who were suspected to have cancer and those who sought treatment for it.

Data suggests that the most number of people sought treatment for cancer in the country in the year 2021, which was 30,096 patients while 23,500 people received treatment for the invasive disease in 2022.

With the number of people diagnosed for cancer on the rise in the tiny island nation, the previous government of Maldives made the decision to establish a specialised cancer hospital in the country. However, before the work commenced on the hospital which was due to be built in Gan island of Laamu Atoll, a decision was made to change the location to the Malé City.

Work on this project is yet to commence.