Ramon Magsaysay Award recipient Dr. R. Ravi Kannan's Healing Touch
How an oncologist brought life-saving cancer care to remote Silchar, Assam with a pro-poor, people-first approach
“I never wanted to choose surgery for a profession,” recalls Dr R. Ravi Kannan, a surgical oncologist at the Cachar Cancer Care Hospital and Research Centre (CCHRC) in Silchar, Assam. Nor was it his plan to move his family from their home in Chennai where he led the surgical oncology department at the Adyar Cancer Institute. But like most best-laid plans, life had a way of taking its own course, and in Kannan’s case, it was one that led him to a part of the country where his skills were needed most.
A specialization in surgery may have been an afterthought, but the jovial 59-year-old was certain about pursuing medicine. His passion for the field came from his mother, in whose eyes medicine was the ultimate career and her village physicians the ideal doctors. “She would see them going house to house delivering healthcare, having a cup of coffee, attending weddings and funerals—becoming part of the family. For her, a doctor was the epitome of everything that is gracious,” he says.
Having completed his MBBS from the Kilpauk Medical College, Chennai, Kannan went on to do his MS from Maulana Azad Medical College, New Delhi and further, his MCh in surgical oncology from The Cancer Institute, Adyar in Chennai. It was during his tenure at the Cancer Institute that Kannan met Dr Chinmoy Choudhury, then the Director of CCHRC, only the second cancer hospital to open in Assam, a state that grapples with ...
“I never wanted to choose surgery for a profession,” recalls Dr R. Ravi Kannan, a surgical oncologist at the Cachar Cancer Care Hospital and Research Centre (CCHRC) in Silchar, Assam. Nor was it his plan to move his family from their home in Chennai where he led the surgical oncology department at the Adyar Cancer Institute. But like most best-laid plans, life had a way of taking its own course, and in Kannan’s case, it was one that led him to a part of the country where his skills were needed most.
A specialization in surgery may have been an afterthought, but the jovial 59-year-old was certain about pursuing medicine. His passion for the field came from his mother, in whose eyes medicine was the ultimate career and her village physicians the ideal doctors. “She would see them going house to house delivering healthcare, having a cup of coffee, attending weddings and funerals—becoming part of the family. For her, a doctor was the epitome of everything that is gracious,” he says.
Having completed his MBBS from the Kilpauk Medical College, Chennai, Kannan went on to do his MS from Maulana Azad Medical College, New Delhi and further, his MCh in surgical oncology from The Cancer Institute, Adyar in Chennai. It was during his tenure at the Cancer Institute that Kannan met Dr Chinmoy Choudhury, then the Director of CCHRC, only the second cancer hospital to open in Assam, a state that grapples with a relatively high incidence of the disease. In 2007, Kannan, by then no longer at Adyar, decided to visit Silchar with his family at the behest of Dr Choudhury, who wanted Kannan to take charge of the facility. While he spent time at the hospital, his wife Seetha, then the Regional Officer at the United States Educational Foundation in India, visited and engaged with the local community.
What they learnt there about the state of cancer-affected patients was distressing. Apart from CCHRC, the only cancer hospital serving the region was in Guwahati, around 300 kms away from Silchar, which meant time and financial costs that many patients could not afford.
“Cancer treatment itself is expensive and long drawn,” admits Kannan. “Most people would die in their homes because they couldn’t avail of treatment.” Before returning, Seetha told her husband, “Let’s move here. There’s a lot of need, and this is what we should be doing.”
The challenges Kannan confronted in those early days were far greater than he expected. The facilities at CCHRC—set up by the tireless efforts of Dr Choudhury with the help of like-minded individuals who shared his vision and raised funds and support—were limited. Much of the necessary equipment and infrastructure were lacking.
“I just landed up thinking, Okay, I’m here to perform surgeries. In reality, we suddenly found ourselves out of a very established setup and into a place where there was nothing.” Kannan says. Basic utilities, such as stable power, were a luxury, so resourcefulness was key.
“We would often be operating when a power cut would occur. There were no generators, so we built large windows and performed surgeries in the day, keeping consultation hours after dark.
A professor of mine used to say, ‘It’s a poor craftsman who blames his tools for a job badly done’,” he quips. Besides the logistical challenges, there remained a much larger hurdle: fostering acceptance of treatment and ensuring compliance among patients. Data from a registry established in the hospital in 2008 did not gloss over the truth.
“In 2011, we realized that nearly 60 per cent of patients were not coming back. And out of those who did, only 28 per cent were completing treatment. What we were doing wasn’t helping anyone. Eighty percent of our patients are daily-wage labourers. Return visits meant they would lose a day’s pay and soon their families would be out on the street,” explains Kannan.
With his task clearly cut out, CCHRC began providing low cost and free treatment as well as boarding and lodging facilities for patients and caregivers who came from far off places. To compensate for lost wages, caregivers are also offered ad hoc employment during the course of the treatment. Over the next few years, more measures were instituted in an organic fashion—quicker investigations, no waiting lists, satellite clinics, a free home-care programme and so on. As a result, CCHRC now sees a compliance rate of nearly 70 per cent.
Beyond the hospital, there’s also much being done to increase awareness about available treatment options and educating the community on the importance of self screening. Kannan is a firm believer that “in poorer economies, prevention and early detection is a must.” Outreach efforts such as training ASHA workers to conduct triage assessments all contribute to achieving this and reducing the fear and stigma surrounding the disease. In Dholai, for example, an early-detection campaign the centre organized reached out to 50,000 people of which 45,000 complied with the programme.
Everything the centre does is carried out with a philosophy that puts people first: No patient will be denied appropriate cancer treatment for want of resources; no patient will die in agony and indignity; and no family will suffer treatment-induced poverty and grief. “As Dr S. Krishnamurthi said, ‘If the fruits of science don’t reach the last man in the queue then that science is of no value,’” Kannan says, citing the legendary oncologist who interviewed him when he applied for a position at Adyar. Kannan’s work has led to him receiving numerous awards including the Padma Shri in 2020 and the prestigious 65th Ramon Magsaysay Award in 2023.
“The recognition has certainly helped. When we ask for help, people listen and bring attention to the work. I hope more attention is also given to the core philosophy that drives the organization. One of the big challenges that we now face is: how do we attract more people to this philosophy?”
Looking back, Kannan counts many teachers, mentors and colleagues as instrumental in shaping his convictions and pushing him to do better, but he counts his wife, Seetha and his father as the most important ones. “I never got to tell him this, but he was my biggest inspiration, Kannan muses. “The way he viewed life and people was special. He would tell me ‘Never judge someone harshly. You must have faith in people and the goodness in them. There’s such enormous goodness around us.’”