Daily Times

She was in my English Literature class at college: vivacious, sparkling and bright. Her long, dark hair always tied in a braid, she exuded energy and enthusiasm. Always ready for a good laugh, she saw the funny side of life and was quick to dispel gloom and misery. She drove a parrot green ‘Dabba’ (minivan), in which we proudly roamed the streets of Lahore with her. She kept turtles in her bathtub — actually an entire tribe of them. She was Ayesha Haroon — one of my closest friends.

Ayesha, a well-known journalist and a dear friend, passed away earlier this week in New York, losing her battle with cancer. It was probably October 2008 when I called to chat with her and she sounded out of breath. Upon my query, she replied that she had climbed the stairs to her fourth storey office. I laughed, teasing her, as anyone who knew her could never imagine her being seriously ill, but just as a precautionary measure I asked her to get her haemoglobin (Hb) checked. A few days later, she told me that she had an Hb value of seven, but I was still not worried as I had been plagued with anaemia myself in the past. I chided her for giving up red meat completely and told her the fastest way to tackle this was to eat ‘liver’ and the easiest way was to sauté it lightly on the girdle and get it over with. Laughing, she told me that nothing would please her mother more than to feed her the gourmet delight! As days passed, her Hb refused to remain stable, and we thought maybe it was time to visit a doctor, but never in my wildest dreams did I ever think it was going to be anything scary.

My first introduction to cancer was through Indian, Pakistani and Hollywood movies, which I saw as a child; films like Anand, Milli, Mera Naam Hai Muhabbat and Love Story conveyed to me a feeling of utter doom. In my simple mind, it was guaranteed that if you got cancer, you had to die. Consequently, when my mother was diagnosed, I thought my world had ended. Cancer, such a scary word — and Blood Cancer — probably still the scariest. Ayesha was diagnosed with myelodysplasia, which is also known as preleukemia and was untreatable in Pakistan. As her haemoglobin kept on dropping, she had to be transfused with blood regularly. In early 2009, she had to undergo several blood transfusions in order to be stable enough to travel to the US for treatment. Ayesha was put on an experimental drug but, unfortunately, her myelodysplasia transformed into acute myelogenous leukemia (AML). She endured great pain and suffering as she underwent a bone marrow transplant and chemotherapy, but eventually started regaining her strength. She was writing again, appeared on talk shows, resumed her editing and started photography. As I looked at the pictures taken by her, I could not help but admire the beauty of it all. It was as if facing death had given her perspective, another way to look at her surroundings, to cherish and celebrate life itself. We prayed, hoping that she was finally out of the woods, but she suffered a relapse last June.

With the number of cancer patients increasing daily and several of my friends, family and acquaintances battling the disease, to me, it sometimes seems like cancer is the next common cold. Over a period of time, cancer has just ceased to be simply a health issue and has evolved into a multi-dimensional problem, which impacts us socially and economically, and should ideally be reflected in our governmental policies and regulations as it affects development and the right to life. Studies show that a number of behavioural and environmental factors play a significant role in causing cancer and it is thought that certain lifestyle changes may be able to reduce the risk of getting certain types of cancers. Behaviours that include smoking, low quality diet, lack of physical activity and exposure to the sun, and environmental factors such as being exposed to second hand smoke, pesticides, toxins, industrial waste and biological agents is all, and more, linked to cancer.

Every time I put a slice of luncheon meat in a sandwich, or pepperoni on a pizza or serve a sausage, or pan fry, or barbeque, I am exposing my loved ones and myself to an increased chance of getting cancer. The chicken we eat is reportedly injected with drugs of various sorts and the poultry feed has a number of toxins in it; the vegetables which enter our homes and then our bodies have been irrigated with industrial waste and toxic, polluted water. In 2011, the Lahore High Court took suo motu action on a report by the Environmental Protection Agency (EPA) that arsenic was found in the water being pumped from nearly 90 percent of the tube-wells belonging to the Water and Sanitation Agency in Lahore. The case was disposed off on the assurance of the Punjab government to install water filtration plants. Even the air that we breathe has high levels of lead and other toxins; in fact, statistics gathered by the Air Monitoring System of the EPA show that Lahore tops the list of the most polluted cities in Pakistan, with air pollutants being three times higher than the safe limit, followed by Peshawar and Islamabad. Recent studies show that non-smokers living in high air pollution areas are 20 percent more likely to die with lung cancer as compared to people who live and breathe in cleaner air environments; higher levels of soot and vehicle emissions are also linked to lung cancer. A study in China linked cancer to indoor air pollution from burning coal and wood for warmth. There are stories that common foods like burnt toast or low fat salad dressing cause cancer; however, a study by Harvard Medical School found that there was no significant statistical evidence to support or substantiate these linkages.

It is estimated that 55 percent of cancer deaths occur in the developing nations. World Health Organisation (WHO) urges countries to establish a well-conceived, well-managed National Cancer Control Programme. That “lowers cancer incidence and improves the life of cancer patients, no matter what resource constraints a country faces. It is a public health programme designed to reduce the number of cancer cases and deaths and improve the quality of life of cancer patients through the systematic and equitable implementation of evidence-based strategies for prevention, early detection, diagnosis, treatment, and palliation, making the best use of available resources. It evaluates the various ways to control disease and implements those that are the most cost-effective and beneficial for the largest part of the population; places emphasis on preventing cancers or detecting cases early so that they can be cured, and provide as much comfort as possible to patients with advanced disease.”

Ayesha lived on borrowed time; unlike many suffering cancer in poverty, she was lucky enough to receive the best possible treatment in one of the world’s best hospitals. She was blessed with a devoted husband, loving mother and exceptional brothers, who remained at her side throughout the ordeal. She maintained a healthy lifestyle but still got cancer; I do not know what caused it but I do know that we have lost a brilliant mind and a loving and compassionate human being to a lethal disease, and the loss is painful. As we grieve for her, we submit to God’s will, and accept the fact that we are all living on borrowed time.

The writer is an advocate of the High Court