Many Bhutanese citizens would know of one or more family members, relatives or even friends who have been afflicted with cancer.
Medical records show that Cancer is fast becoming Bhutan’s deadliest Non Communicable Disease with 3,301 cases and 382 deaths from 2008-2012.
However, common sense would dictate that the figure is a gross underestimation as some people in remote areas don’t seek treatment and richer folk in urban areas get their condition diagnosed and treated abroad.
Except for cancer deaths that take place in the hospital most cancer related deaths which take place outside the hospital are not reported. So it can be surmised that even the death rates are far higher from cancer then what official hospital figures can ever capture.
Cancer is essentially when a damaged cell or cells in the body goes rogue and multiplies so much that it overwhelms healthy cells. It is not a disease that can be transmitted.
Medical specialists in Bhutan and medical literature from abroad have listed out some specific causes of cancer. These include diet, environment, exercise and healthy lifestyle, addictive habits like smoking, alcohol and chewing tobacco or Doma and stress and well being.
In the case of Bhutan, given that we have a generally clean environment, diet and lifestyle seem to be among the major causes of cancer.
This is also borne out in the fact that the highest cases of cancer in Bhutan are stomach cancer followed by other types like throat etc.
In the case of diet, international research has shown a strong and unmistakable link between high consumption of animal protein and animal products and the increased chances of getting cancer. The particularly harmful ones seem to be red meat and fatty meat which are still the central diet of most Bhutanese.
Though there is no conclusive research yet our higher than normal consumption of chilli which is known to cause ulcer may also not be helping.
Research has shown that the popular ‘Nake’ of wild fern is carcinogenic and even wild animals avoid eating it.
International studies have also shown that junk food like soft drinks, packaged food products and etc can cause cancer in two ways. First it makes you vulnerable by making you obese due to the high sugar, salt and fat content. Secondly the various preservatives and processing techniques make the product carcinogenic.
Salt is also the latest entrant with research showing higher than normal consumption of salt being linked to cancer. Most Bhutanese consume twice the level of salt than what is normal.
The impact of tobacco including second smoke, tobacco chewing, alcohol and Doma chewing is like adding fuel to fire when it comes to cancer. The research and evidences on this are beyond dispute.
Another major cause seems to be an unhealthy lifestyle with no exercise as obese and overweight people are also more vulnerable to cancer then people who are fit and exercise regularly.
Environmental pollution in the air and water through chemical and toxic fumes are also known causes. This may require more detailed studies by the Ministry of Health and National Environment Commission on the co-relation between various industrial and mining activities and the health of nearby residents.
Extreme stress and tension on a continuous basis can also make a person more receptive to get cancer.
Some people are more genetically prone to get cancer but they can avoid getting it by adopting a healthy lifestyle and diet.
In short, the modern Bhutanese lifestyle makes many people susceptible to getting cancer.
Most people today consume more red meat and animal products, junk food, alcohol, tobacco, salt etc than at any point in our history due to increased disposable incomes.
Given the demands of a modern economy we have very less time for exercise and instead endure more stress than ever.
Though the government and health system has started to focus more on cancer a much bigger and more comprehensive effort is needed from multiple agencies and stakeholders.
Aggressive and large scale advocacy by multiple government agencies would be a start as prevention is better than cure. Our government policies must encourage people to also eat healthy and get adequate avenues for exercise. There must be more stringent checks and studies on what Bhutanese people are eating. There are plenty of international agencies that the government can seek help from.
The unique thing about a disease like cancer is that it consumes a lot of time, resources and energy of both families and the state.
It is high time now that we recognize the danger posed by this NCD and work towards addressing it.
“You can see a person’s whole life in the cancer they get.”