Five weeks from hope

The sun hung low over the dusty path as Rafiya trudged forward, the weight of the sack digging into her shoulder. Her breath came in short gasps, each step heavier than the last. Just as she reached the bend near the old pine tree, a sharp, searing pain tore through her abdomen. She staggered, her vision blurring, and with a strangled cry, collapsed onto the ground. The sack tumbled beside her, spilling grain into the dirt, but Rafiya could only clutch her stomach, a wail escaping her lips as the world spun around her.

Rafiya, a 38-year-old woman, lived with her husband and four children on the outskirts of Anantnag district, where life moved with the rhythm of hardship and quiet endurance. She had never known ease. Her husband, Salim, worked odd jobs; hauling bricks or running errands for wealthier villagers. Their small home had known no facilities, and only one working bulb powered by a solar panel donated by a local NGO. They lived mostly on rice, lentils, and the few vegetables they could grow in their patch of land.

The pain started as a dull ache in her lower abdomen. She ignored it at first. She had to. There were children to feed, floors to sweep, and firewood to gather. But the pain grew, and soon, it took her breath away when she stood too long. Unexplained and frequent.

Her husband borrowed 900 rupees, two days’ wages, to take her on a bus to the nearest government hospital, 40 kilometres away.

The doctor listened quietly as Rafiya recounted her symptoms, her voice strained with fatigue. After a brief five-minute examination, his brow furrowed. Without wasting time, he ordered a battery of tests — bloodwork, ultrasounds, and finally, a CT scan. The results were troubling: a mass in her stomach, its contour irregular and ominous. He treated her pain symptomatically, gave her a moment’s relief, and then scheduled a biopsy. “Come back in a week,” he said gently. “We’ll know more then.”

But a week was too long.

The pain returned, sharper and deeper than before. One evening, as she bent to rinse utensils in the courtyard, a bitter taste rose in her throat. It was blood. She collapsed again. Her husband rushed her to the hospital, where the doctors found her haemoglobin low. Blood transfusions followed; bags of crimson hung beside her fragile frame. When the biopsy results finally arrived, the diagnosis crushed the thin wall of hope they had clung to: stomach cancer. And it was already bleeding. The word hung in the air like smoke.

“She needs to go to Srinagar hospital,” the doctor said grimly, not meeting her husband’s eyes. “She needs radiotherapy for the bleeding or she will die.”

The hospital in Srinagar was nearly 100 kilometres away from their home. The bus fare would cost more than they had in their home. Salim sold his two sheep and a goat, clutching the modest wad of notes in his calloused hand, the only wealth he had left to trade for hop. and took Rafiya to Srinagar.

The hospital was overcrowded. People spilled into corridors. It smelled of iodine, sweat, and despair. After hours of waiting, Rafiya was seen. They needed rescans, a detailed biopsy review, blood work. The doctor’s tone was clinical: It looks like advanced-stage stomach cancer.

The doctor prescribed radiotherapy to control the bleeding and advised them to return for a full five-week course, with sessions scheduled five days a week. Though the treatment itself was free, the logistics posed a harsh dilemma: either rent a place near the hospital or brave the long, gruelling commute each day. For a family already stretched to its limits, both options felt nearly impossible.

“Is there a place near home where I can get treated?” Rafiya asked.

The nurse looked at her kindly. “No. There’s nothing close by. You’ll have to keep coming here.”

They left in silence. On the bus back, Rafiya leaned against the window, biting her lip until it bled.

Over the next month, her pain worsened. She stopped eating. Her belly swelled. There was no money left for painkillers, let alone another trip to Srinagar. They could only manage to visit the nearby hospital, which, though kind and well-meaning, could offer only temporary relief. The bleeding would subside for a while, but the pain always returned. It was a grim reminder that the real treatment lay beyond their reach.

She began to sleep on the floor, curled up in pain. The children, two still under ten, watched her with wide, terrified eyes; too young to understand the illness, but old enough to sense that something was very wrong. Their playful chatter had faded into silence, replaced by whispered questions and restless nights. The house, once full of noise and life, had grown heavy with fear. A local herbalist offered roots and powders. They tried it. Nothing helped. Salim begged for money from whoever he could. Most had nothing to spare. Then came the monsoon. Flooded roads. No buses. And the closest help still hours away.

Rafiya died one humid night in July, her breathing shallow, skin pale, eyes clouded in pain. She had never received a single dose of curative radiotherapy. Not one scan. Not one treatment. She died never truly knowing what she had. Never having the chance to fight it. Never being seen beyond the label of “too far” and “too poor.”

Six months later, the children still ask about their mother. Salim works two jobs now, and sometimes looks toward the hills and whispers, “We were just too far away.”

Let this be more than a story:

J&K is witnessing a consistent uptick in cancer cases, with over 12,000 to 13,000 new diagnoses annually. Between 2019 and 2022 alone, the region reported 51,577 new cancer cases, highlighting a growing public health concern. Despite the rising burden, J&K’s healthcare infrastructure struggles to meet the demand. Essential procedures like PET scans have extended waiting periods, sometimes spanning months. Radiotherapy facilities in Kashmir remain severely limited, with the only two centers concentrated in Srinagar. For thousands living in remote areas, access to timely cancer treatment becomes a logistical and financial nightmare. This centralization not only delays care but often forces patients to abandon treatment altogether due to cost, distance, or lack of accommodation. The disparity highlights an urgent need for decentralizing cancer care and expanding oncology services to district-level hospitals across the valley.

This story is adapted from true events, with names and details changed to protect the family’s privacy.

Peerzada Faizan Gul, Radiation Therapist, GMC Anantnag