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MUMBAI, Maharashtra (AFP) – With just a patchwork of colourful plastic sheets to shield patients from the heavy monsoon rains, a Mumbai street acts as an unofficial ward to one of India's top cancer treatment centres.
Every year, the Tata Memorial Hospital draws tens of thousands of cancer sufferers thanks to its heavily subsidised medical care. But the city's steep hotel and rental prices force scores to sleep on nearby pavements.
"There's rats, mosquitoes and dirt," said farmer Suresh Patidar, who stays with his wife Leela, 55, as she undergoes treatment for breast cancer.
"We tried to settle on the other side of the street but the police didn't allow it.
"A hotel is very costly. It's impossible," he told AFP.
With their home in the central state of Madhya Pradesh at least 12 hours away by train, the Patidars' cheapest option has been to sleep on the roadside for the past month, despite the regular torrential downpours.
The bandages and surgical masks worn by others on the street betray their common suffering.
The Tata centre offers some free or cheap rooms around the city to poor outpatients, and more are being added, but numbers are difficult to manage as Indian cancer cases increase.
"There will always be more people," said hospital spokesman S.H. Jafri. "Many NGOs give them food and things on the footpath, so because of that they tend to stay there."
The pavements have offered such patients and their families a temporary home for years, but there are signs that local residents are growing impatient over their sick neighbours.
At the nearby police station, Senior Inspector Sunil Tondwalkar said he had written to Mumbai's municipal authorities asking them to move the sick street-dwellers to more suitable lodgings.
Locals have complained they are blocking the pathways, and that "they're eating and going to the toilet on the footpath and the streets. It's not hygienic," Tondwalkar said.
He also wants the streets cleared because he says hospitals can be a "soft target for terrorists", while "anti-social elements", such as thieves or beggars, can infiltrate the patients.
Despite their uncomfortable lodgings, the families for now have little alternative.
Few Indian hospitals offer the range of cancer care and cheap costs of the Tata centre, where 60 percent of about 50,000 yearly patients are subsidised and 14 percent are treated for free, according to Jafri.
Those on the street said they were contributing to their medical costs, and had sold their land or livestock to help fund their treatment.
"People living on the streets are people who earn daily, eat daily, so they aren't people with long-term savings," said H.K. Savla, founder of the Jeevan Jyot Cancer Relief and Care Trust.
His charity feeds 600 patients and their families in Mumbai twice a day, and he said 150 to 200 people were usually camped outside the Tata hospital.
"They have to save whatever they have to manage their treatment," he explained. A hotel is an extra cost that could be more effectively spent.
Now a government-run centre, the Tata hospital began life in 1941 as a philanthropic venture by the industrialist Tata family after a relative died of cancer, despite going to Britain for expensive treatment.
"They said, what about the poor patients in India? So they started this," said Jafri.
The need for such services is only set to grow in the huge nation, where more than half a million people died of cancer in 2010, according to a study published in The Lancet medical journal last year.
Pankaj Chaturvedi, a professor and a head and neck surgeon at the Tata hospital, said cancer is a rising blight as Indian society becomes more affluent.
While breast and cervical cancers are the most common among women, lung and mouth cancers are the biggest killers for men owing to the widespread use of tobacco -- especially chewing tobacco -- across the country.
"Increasing tobacco and alcohol use, unsafe food and lack of exercise -- these are the four factors that lead to an increase in non-communicable diseases of which cancer is a top one," he said.
On top of these factors, improvements in medical science mean people are living longer, and "the longer you live, the higher the chance of cancer".
For some however, it still strikes early.
Ponmuth Rajaram Haridas, 22, has been camping outside the Tata centre for four months with his parents while he is treated for blood cancer, having sold off all the sheep on their farm and taken out a loan.
On doctors' orders that he eats home-cooked food, his small and spritely mother makes him simple meals of rice, dahl and vegetables on a tiny stove in a corner of their makeshift tent.
Speaking through a surgical mask to keep out the germs, he said he hopes to return to their village in another couple of months after he finishes two more sessions of chemotherapy.
"I can't get to sleep here. The atmosphere is much better at home," he said.