Dr. Dinesh Raj Neupane is a public health pharmacist. He obtained his degree in Public Health at Tribhuvan University, Institute of Medicine, Maharajgunj Medical Campus, in Kathmandu.

Dr. Dinesh Raj Neupane

Breast cancer care differs around the world, revealing urgent unmet needs: © stock.adobe.com.

A mother is not just someone who feeds her baby with milk. She is the heartbeat of the household. She is the caregiver, the emotional anchor, and often the quiet force holding everything together. Whether it is her child, her husband, or her extended family, everyone depends on her for nourishment, for strength, as well as for love.

A young mother, only 26 years old, notices that her breast milk has stopped flowing while nursing her baby. Worried and confused, she visits different doctors and is referred to the cancer care center in Kathmandu, the capital city of Nepal, as well as the largest city in the country. What she hears there will break her world apart.

She is diagnosed with stage IV breast cancer, and it has already metastasized.

Her husband, a military professional who died while serving the nation, left behind ex gratia payment, the only financial support the family had ever known. An ex gratia payment is a voluntary payment, made without any legal obligation or admission of liability, according to the Corporate Finance Institute website. The site goes on to say that this payment is most often offered following a loss or inconvenience, even if the payer isn't legally responsible. In this case, the military left behind this sum for his wife.

This payment is a small sum that she has been surviving on. However, it is not just her who has been surviving on this payment, but it is her children as well.

She has no siblings to turn to. No parents by her side. She walks this journey completely alone. The diagnosis is not just a medical crisis, but the beginning of a downward spiral. A life suddenly filled with financial burden, emotional pain, mental exhaustion, and social isolation.

She comes from a rural village, far from the capital, where treatment centers are located. Each hospital visit means another struggle not just for expensive medicines, but for bus fare, food, and a safe place to sleep.

She can no longer breastfeed. She cannot afford formula. She cannot afford nourishing food. Not for her baby. Not even for herself. The toxicity she faces is not only in her body. It has taken over her entire life.

 she endures pain, fatigue, and the side effects of cancer

 she lives with fear and anxiety, wondering what will happen to her child. Emotionally, she feels abandoned, lonely, and devastated. Her dreams are slipping away. Financially, she is drowning in a system that does not support her. The cost of treatment keeps rising, but her resources have run dry.

The government offers her one-time support of one lakh rupees, which translates to roughly $1,160 in the U.S. What does that cover? One or two doses of chemotherapy? A few tests? It is a drop in the bucket. It does not pay for survival. It does not give her the dignity or security she deserves.

This is not just her story. This is the story of many mothers across Nepal. Women who are battling not just cancer, but the deep unfairness of the system. We must ask ourselves whether access to care depends on where a woman lives and how much money she has. Does it depend on whether she is married or not? Because when a mother suffers, the whole family suffers.

When a mother dies, a child does not just lose a parent, in this environment. That child loses food, warmth, safety, and a future.

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Articles

Breast cancer care differs around the world, revealing urgent unmet needs in Nepal, where access, support, and treatment remain out of reach for many.

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