Each day is a struggle between earning a meal and saving a life. For 38-year-old Tulasara Khadka of Botechaur in ward 9 of Gurbhakot Municipality, Surkhet, managing household expenses while arranging treatment for her cancer-stricken husband has become increasingly difficult.

With no money left for treatment, she now drives an auto-rickshaw in her locality to make ends meet.

“In my life, sorrow has outweighed happiness,” Tulasara said. “Perhaps this is my fate.” She works daily to arrange two meals while trying to manage treatment costs for her husband, who is battling bone marrow cancer. For her, saving his life comes first before everything else.

She has no regular income, and without daily labour, there is no income. She started driving an auto-rickshaw in October to raise money for the treatment of her husband, Ambar Bahadur, who had gone to Saudi Arabia for foreign employment to support the family.

Two years ago, he returned home after falling ill. Initially diagnosed with blood cancer, the money he brought back was spent during seven months of treatment at the Tribhuvan University Teaching Hospital in Kathmandu. His health improved slightly after that.

As staying home without income was not an option, Ambar, on doctors’ advice, bought an auto-rickshaw around one and a half years ago, spending Rs 750,000. He drove it for a few months, supporting the family, before becoming bedridden. Since then, Tulasara has taken over.

Further tests later confirmed bone marrow cancer. Doctors said he could only recover through a transplant. “Where can we find Rs 6 million needed for his treatment?” she said. “We had to return home without treatment because we could not arrange the money.”

Money collected by villagers, insurance payouts, foreign earnings, and Rs 3 million from selling 10 kattha of land in Bardiya have all been spent. More than Rs 5 million has already gone into treatment, she said, but his condition has worsened.

Financial constraints have also forced her to stop regular follow-ups for the past four months. Earlier, she used to take him to Sushil Koirala Prakhar Cancer Hospital in Banke for chemotherapy. “Each round of treatment started costing around Rs 100,000,” she said. “It has now become impossible.”

After her husband became bedridden, the responsibility of running the household fell entirely on her. Despite the emotional strain, she has not given up. She learned to drive an auto-rickshaw from a neighbour in just 15 days.

She now earns up to Rs 1,000 a day, making around Rs 10,000 to Rs 15,000 a month, barely enough for household expenses. Managing treatment costs has become nearly impossible.

After depleting all assets, her two sons, aged 16 and 19, have dropped out of school and gone to India for work. They are employed in hotels and send money home.

“I have not been able to treat my husband due to a lack of money,” she said. “The thought that he might recover if we manage treatment keeps troubling me.”