January issue 2019
Care With a Difference
At the Liaquat National Hospital in Karachi, an unusual Oncology Support Service Centre provides not only counselling services to female cancer survivors, but also shows them how to groom themselves when in the throes of the often terrible after-effects of chemotherapy. The centre is the brainchild of Dr. Rufina Soomro, a Consultant Surgeon at the Liaquat National Hospital. After completing her Fellowship from the College of Physicians and Surgeons of Pakistan in 1991, Dr Soomro left for Ireland for training in Breast Surgery. On her return to Pakistan in 1994 she launched her breast cancer clinic at the Liaquat National Hospital.
Five-six years ago, during a breast cancer awareness month, L’Oreal approached Dr. Soomro with regards to a charity event the company wanted to hold for cancer patients. At this event, Dr. Soomro observed how, after the L’Oreal cosmetics team had applied lipstick on cancer patients and given them tips about nail care, they started feeling better. And so, instead of just a one-off event, Dr. Soomro thought why not make this a regular feature. She pitched the idea to the medical director at the Liaquat National Hospital Dr. Salman Fareed, who fully supported it. He immediately arranged for the hospital engineering team to convert a hospital basement into an Oncology Support Service Centre as per Dr. Soomro’s directions.
Patients who are undergoing chemotherapy invariably lose their hair and their eyebrows, while their nails turn black and brittle. For women already battling a life-threatening condition, the loss of their breast/s and hair adds to their trauma. Often they lose their self-confidence. Prosthesis help hide the breast loss, especially in a cover-up society such as ours, but hair loss is more difficult to hide.
Dr Soomro suggested to her own hairdresser and beautician, who was also a breast cancer survivor, to become a part of her initiative at the Liaquat National Hospital and she convinced Dr. Salman Fareed, to bring her on board. In 2014 – Dr. Soomro’s 20th anniversary at the medical facility – Liaquat National Hospital’s Oncology Support Service Centre became operational.
Aesthetics is one part of the Support Centre’s agenda. The other is counselling. Presently there are eight to 10 women counselling at the centre and they are all breast cancer survivors. Dr. Soomro speaks of the survivors’ group with great pride. Although they are all volunteers who are not on the hospital’s payroll, these women make it a point to inform her when they are going on leave, like regular employed staff.
“The first counselling session takes place when I break the bad news to newly-diagnosed cancer patients and inform them about the therapy and the surgery. Their response at times is cynical, because as patients they feel as a doctor I am only doing my job. However, advice from a counsellor who has been through the same experience as the patients, is different and has more meaning. Many of the volunteers at the Centre are able to convince patients to follow my advice as a doctor,” says Dr. Soomro.
She adds, “I know the value of their counselling because I have had cancer and been through the experience of chemotherapy, during which, I too, had lost my hair. When these women at the Centre give little tips to breast cancer survivors on how to look after themselves after chemotheraphy, their help is greatly appreciated. And advcse coming from five to 10-year survivors gives them hope.”
Dr. Soomro advises patients with long hair to cut it short before chemotherapy, and asks if they would like wigs till such time as their hair grows back. Most do not refuse the offer. Dr. Soomro explains, “People have a preference for wigs made from real hair. So we asked the women if, after their cuts they had enough hair to give to us, we could make wigs out of that for them. But to make a wig, hair collected from one person is not enough. So like blood donors, I have hair donors. There are a couple of women who donate their healthy hair for this project because their hair grows back within six months.” Patients’ hair invariably also grows back after chemotherapy, and after they are done using their wigs, they have them washed and donate them to the Centre for other patients.
“The counsellors, who have treaded this path themselves, also teach patients in the throes of chemo and hair loss the simple techniques of how to make their own eyebrows by creating a stencil shape out of plastic and using eyebrow pencil to fill it in.
“Given the positive results of this support initiative, gradually more items and services began to be added to the centre. For example, the hospital shop used to stock breast prostheses for those patients who had undergone mastectomies. But since the shopkeepers were all men, most female patients would not venture there. So we started keeping the prostheses at the Centre, and since these items are hospital property, keeping an account of the prostheses became my job, which I did not mind because I was doing it for charity. Counsellors meanwhile teach the cancer survivors how to wear the prostheses bras.
Among Dr. Soomro’s cancer survivors patients are two celebrities, Asma Nabeel, the famed scriptwriter of hit television dramas like Khuda Mera Bhi Hai, the record-breaking Khaani and Baandi; and recently Dr. Durdana Butt, veteran television artist since the 1960s.
Dr. Soomro observed that each time Asma Nabeel came to see her at the clinic, she would be wearing her scarf in a different style. That gave Dr Soomro the idea of making a booklet to show her patients how they could wear their head scarves in various ways that would enable them to cover their heads and still look smart. But because of Dr. Soomro’s hectic schedule – a clinic overflowing with patients, surgeries and teaching at the Liaquat National Medical College – that idea is yet to come to fruition. Meanwhile, Dr. Durdana Butt has become part of the Centre, receiving treatment as well counselling other patients.
Dr. Soomro recently celebrated her silver jubilee, completing 25 years of service. Every month she diagnoses a minimum of 45 to 50 patients with breast cancer. She examines them all, moving between the five cubicles in her clinic, each with a resident doctor who takes the patient’s history. She encourages all her new female cancer patients to visit the Oncology Support Service Centre for counselling.
Liaquat National Hospital gives the space, the counselling, and the services of hair-care and nail-care, for free. Poor patients are also given wigs which have been donated by patients after use. Through her own zakat collection Dr. Soomro personally subsidises the treatment of those patients who cannot afford surgeries, whereas the hospital pitches in with 15 per cent to 20 per cent discount. But the prosthetic bras, especially made by the Triumph company, are for sale. Once or twice a year, the company donates a box of free prosthesis. And most of the time they provide them to me at cost price when I give them the sizes I need for my patients.
Through word of mouth, the Oncology Support Service Centre has generated much interest. Now, not only patients of Liaquat National but also those from other hospitals come to the Centre, when they learn about it.
Additionally, through an arrangement, Dr. Soomro presently performs breast cancer surgeries for Shaukat Khanum Hospital in Karachi, until such time that they have the necessary set-up for these, and have a breast cancer surgeon. Shaukat Khanum Karachi breast cancer patients are sent to Dr. Soomro for examination, surgery and follow-ups, while they receive their chemotherapy from Shaukat Khanum Hospital.
The writer is working with the Newsline as Assistant Editor, she is a documentary filmmaker and activist.