Habit or crisis?

The comical mimicry of an average Karachi man notoriously involves a muffled, sibilant speech with a lot of rolled r's to replicate their manner of speaking as they chew on chhalia (betelnut) as part of their daily routine. The habit of consuming tobacco products has become so ingrained in society that, for a most part, it represents its culture. Similarly in the rest of Sindh, street corners and roadside kiosks almost always have people lingering – some holding a cigarette, others enjoying a paan. The morbid result of these practices is now starting to show in healthcare statistics as roughly a 25% increase in oral cancers throughout the province, particularly among young people.

According to healthcare professionals, the widespread use of gutka, mawa, paan, chhalia and other tobacco products is contributing to this increase - an emergency made all the more dire by the country's distinct lack of dedicated cancer hospitals. What currently exists in the province is a list of private-run or donation-based institutions and even they do not necessarily offer comprehensive cancer care. Some offer radiation therapy but lack the proper equipment and experience for chemotherapy or palliative care for all types of cancers under one roof.

This is despite the fact that 65,886 oral cancer cases were recorded in Sindh in the span of four years - just by the Karachi Cancer Registry. Thousands of patients every year struggle with footing private bills that disrupt their entire lives, and that is if they gain access to quality treatment in the first place.

Undoubtedly, the provincial government must address the root cause of the problem by increasing taxes on tobacco products and incentivising addiction treatment. But while this long-term plan springs into action, it first urgently needs to provide comprehensive cancer treatment that is affordable and accessible for people from all classes and social groups.