First, the lack of X-ray and, later, the lack of an MRI facility forced an eight-year-old tribal girl to travel 467 km to Mumbai from the tribal belt of Nandurbar bordering north Maharashtra to seek treatment for a spinal injury that led to paralysis. Ravita Valvi’s case underlines the lack of health infrastructure in tribal regions of the state, forcing referrals to cities and overburdening tertiary-level hospitals for tests as basic as MRI and CT scan.
Bed-ridden Ravita now struggles at the state-run Gokuldas Tejpal (GT) Hospital in Mumbai with her parents afraid that she will never be able to walk again. A packet of biscuits lay by her side on a cot on Thursday that her father, Rajya Valvi, brought as the child silently stared, unable to feel or move her legs. Her mother, Shanti, kept touching her legs to check if Ravita could feel anything.
Around 4 pm on September 29, Ravita fell on her back from a tree in Khadkya village in Dhadgaon block of Nandurbar. Her parents carried her on bamboo sticks for 4 km, as no ambulance could reach the village. Then they took a private vehicle to Dhadgaon Rural Hospital. The hospital has an X-ray facility but no technician to conduct the test. The post for a medical superintendent is vacant. There are only two doctors at the hospital, both MBBS. Medical records from the hospital showed that the doctors dressed Ravita’s wound and administered painkillers. The girl suffered from swelling and a severe back injury.
The eight-year-old was then shifted 78 km away, after a two-hour-long journey, to Nandurbar civil hospital. Orthopaedic surgeon Dr Sanjay Gavit said Ravita suffered from vertebral fracture in L1 (lumbar) and D12 compression. “The fracture led to bone dislocation. The cord in the spinal bone got compressed leading to paralysis. She is paralysed waist down,” he said, adding that only primary treatment could be administered in the civil hospital.
Ravita remained admitted to the hospital for a week during which doctors could not continue treatment due to the absence of an MRI facility. According to Nandurbar civil surgeon Dr Raghunath Bhoe, lack of a super-speciality facility forced the child’s referral to another hospital. “We advised the parents to take her to either Surat or Mumbai,” he told The Indian Express.
Since September 29, the child has been taken to at least four hospitals but a CT scan and MRI are yet to be carried out.
After the village panchayat took up the matter, Ravita was transferred to Mumbai. On October 18, she was brought to GT hospital from St George hospital. “We will have to conduct a surgery on her fractured spine. The cord is compressed. We are not sure if, or when, the sensations in her legs will return,” said orthopedic surgeon Dr Swapnil
Officials at GT hospital claimed that there was further delay in her surgery and diagnostic tests as the girl had to be first enrolled under the Mahatma Jyotiba Phule Jan Arogya Yojana that provides free surgeries to orange and yellow card holders. The documentation has delayed her treatment.
Rajya, a farmer, neither has a mobile phone nor money. The couple speaks the local tribal language and has slept outside hospital on pavements not understanding what treatment the child is being administered with.
“We have been sent to several hospitals,” Ravita’s mother said in broken Marathi. The family from the Bhil community speaks Bhili, locally spoken in the hilly regions of the state.
According to the Medical Superintendent, Dr M B Tayade, a hospital staffer, fluent in Bhili, would be called as a translator to ease communication. Resident doctors claim that they have so far been unable to explain the patient’s treatment to her parents.
With most of the tribal population in the state residing in Nandurbar, the region has witnessed 467 deaths of children, aged less than six years, between April and September this year.
Mallinath Kalshetty, Collector of Nandurbar, met Ravita on Thursday. “I am personally following up the case. I have spoken to the district civil surgeon (at Nandurbar). We will ensure that X-ray and MRI facilities are restored,” he said.
The eight-year-old girl is malnourished and doctors will have to improve her nutrition and diet to make her medically strong to undergo a surgery.