Cancer: the toughest journey
For cancer patients in the North West, treatment involves a very long road trip. Some will travel 600km in a week to get to the nearest cancer care centre and back. Eoin Butler boards a charity cancer bus in Letterkenny and talks to patients bound for treatment in Galway
The Good and New cancer charity bus making its way through Barnesmore Gap between Ballybofey and Donegal Town during it's journey from Letterkenny to Galway. Photograph: Declan Doherty
William Farren and his wife Margaret. They had to make a 50km drive from their home in Greencastle to meet the bus in Letterkenny. Photograph: Declan Doherty
Patients and their partners set off on the long journey from Letterkenny to Galway Photograph: Declan Doherty
It’s 7.15am at the Dry Arch filling station in Letterkenny and a hard frost is down outside. A lorry driver bounds in from the darkness, rubs his hands together and orders a bowl of porridge at the hot food counter. In the corner, Sky News is reporting live from Los Angeles, where post-Oscar festivities are still in full swing.
But customers here don’t pay the TV much attention. It’s Monday morning, it’s -5°C and we’re a long way from Tinseltown.
Out on the forecourt, Eamon McDevitt is running through the names on today’s passenger list. A cancer survivor himself, he has been providing a free bus service for Donegal patients requiring radiation treatment at University College Hospital, Galway for more than three and a half years.
Two of his passengers, William and Margaret from Greencastle, have already been on the road for an hour and a half this morning, driving from their home on the Inishowen peninsula, to take their places on the coach today. In total, the round trip from Greencastle to Galway is more than 600km.
It seems incredible, on such a tiny island, that cancer patients should have to travel such distances to receive treatment. McDevitt agrees. “Imagine a map of Ireland, ” he says. “Draw a line from Galway in the west to Dublin in the east. There are eight cancer centres of excellence below that line [Waterford, Cork, Limerick, Galway and four in Dublin] and zero above it.”
“Surely to God, we deserve one in the northwest? Even if it was in Sligo. Driving up and down to Galway from Donegal just doesn’t make sense.”
Those who defend the present system point out that centralising cancer services at eight high-grade treatment centres around the country has resulted in an improvement in survival rates. They argue that the northwest does not have a sufficient population base to justify locating a centre there and that it is a mere quirk of history and geography that has left Donegal out on a limb like this.
Obviously, McDevitt doesn’t see things that way. “We’re either citizens or we’re not up here. It’s as simple as that, we’re either citizens or we’re not,” he says.
At 7.30am, McDevitt’s creaky, 22-seater coach pulls out onto the N13 with a half dozen people on board. William from Greencastle tells me he has 37 radiotherapy sessions scheduled over eight weeks to treat his prostate cancer. Fortunately, he has secured Monday-Friday accommodation at Inis Aoibhinn, a free residential care centre run by the Cancer Care West charity on the grounds of UCHG.
Like almost everyone I speak to today, he bemoans the lack of radiation oncology services in the northwest. But he cannot speak highly enough of the treatment he is receiving in Galway. He has his own room, a shower and tea-making facilities. His wife Margaret is welcome to stay and there’s always something on in the evenings.
At Kilross, there’s a parked car waiting for us on the roadside. A mother and daughter say their goodbyes. A few minutes later we reach our second pick-up point outside Ballybofay, where two more parked cars are waiting. McDevitt greets everyone warmly, welcomes them aboard and reminds us again to keep our seatbelts fastened. But what’s most notable is how effectively he manages to keep things moving.
The passengers are mostly older people. Some are travelling on the bus for the first time. They have loved ones to see off and baggage to stow. But delays are kept to a minimum. Everything proceeds with military precision.
When the Minister for Health cut subsidised bus services for Donegal cancer patients last year, he suggested public transport as a viable alternative. But the scheduled Bus Éireann service from Letterkenny to Galway takes five hours. Some cancer patients are obliged to drink three litres of water before receiving radiation treatment, meaning they would have to be nappied to make the journey without toilet stops.
The toilet issue won’t be as big a problem on the outbound journey today, McDevitt explains. But returning to Letterkenny after treatment on Friday morning, the bus will have to pull over nine or 10 times before it even reaches Tuam. “There are only two filling stations on that stretch of road. So most of the time passengers will have to go behind a well-sheltered tree, or a hedge on the side of the road. But at least we can facilitate that.”
Why not purchase a bus with a toilet onboard? He cites a lack of resources. “We’re a very small charity,” he says. “We don’t get a cent from the HSE or the Irish Cancer Charity. It’s a 24/7 battle for us even to exist.”