Ravita Valvi doesn’t know it but she has wet the bed — again. The eight-year-old has a tear in the spinal cord, which has left her without sensation in the lower half of her body. And, doctors at the Gokuldas Tejpal (GT) hospital in Mumbai haven’t told her parents yet that their daughter may never walk again. Ravita’s fate will be clearer on Friday, when she undergoes the first of many surgeries to try and correct her condition. But her quest for treatment, spanning six hospitals and one month of travel across Maharashtra, is already a stinging indictment of the glaring gaps in healthcare delivery in one of the most developed states.
Over the last month, Rajya and Shanti, tribals from the Nandurbar district in Maharashtra, travelled 470 km to get their daughter treatment after she fell from a tree on September 29, fracturing her spine. Leaving their 10 other children at home in Khadkya village of Dhadgaon block, they tried their luck at five government hospitals between Nandurbar and Mumbai, finally carrying Ravita on a sari with its two ends tied to bamboo poles before getting her admitted at GT a fortnight ago.
Today, they still have those two bamboo poles, “if we need to carry our paralysed daughter to another hospital”.
The Valvis left home the day Ravita fell, heading first to the town at Dhadgaon. But with Nandurbar’s rural, district and civil hospitals lacking diagnostic and specialty services, the family decided to try centres in multiple districts. Even in Mumbai, they first visited the super-specialty KEM Hospital, run by the Brihanmumbai Municipal Corporation.
“We could not understand what the doctors said, and they could not understand us. We left at night, carrying Ravita on bamboo sticks,” says Shanti, who speaks Bhili and knows a smattering of Marathi.
Narrating their ordeal through a translator, Shanti says that on the night of October 17, they left KEM Hospital at 3 am, carrying Ravita on the makeshift stretcher. They walked 12 km from Parel to the Gateway of India, looking for another hospital, until a woman police officer spotted them five hours later. She took them to St George Hospital from where they were referred to GT Hospital. “We were told there is a hospital near the CST station, so we started walking in that direction,” says Shanti.
The Valvis own five acres of land on which they grow jowar and bajra. But when they left home with an injured Ravita, they had no money. “We thought she would be get treated in the rural hospital. We did not know we will have to travel this far,” says Rajya.
On the day Ravita fell, Rajya carried her on his shoulder, covering 4 km on foot, before finding a private vehicle to the rural hospital in Dhadgaon. But the lack of an x-ray facility forced the couple to travel 78 km to Nandurbar Civil Hospital, where she underwent primary treatment for a week.
But again, the lack of an MRI facility forced a referral to another district and the Valvis travelled to Dhule Civil Hospital, 96 km away, where doctors told them to visit Mumbai. The hospital ambulance dropped the family at KEM Hospital, their first ever visit to a city. “We have only seen hills and forests until now,” says Shanti.
KEM Dean Dr Avinash Supe says the hospital has no record of Ravita being admitted, though she was advised admission to Ward 29. The parents say the language barrier forced them to leave. “Nobody could understand us,” says Shanti.
At GT hospital, orthopaedic surgeon Dr Dhiraj Sonawane says Ravita has suffered a fracture on the L1 (lumbar) and D12 sections of the spinal cord. “On Friday, we will conduct a spine correction surgery to try and mend the fracture. We get one such case every month from rural and tribal regions. Studies show initiation of treatment may happen two to five months after the date of injury,” says Sonawane.
At the hospital, Ravita has been registered under the Mahatma Jyotiba Phule Jan Arogya Yojana for free surgery. A staff nurse and pharmacist from Nandurbar are around to help communicate.
“Even after spinal correction, we are not sure whether her nerve sensation will return. Even if her toe moves, I can give some hope. But there is zero movement now. She is passing urine and stools involuntarily,” says Sonawane. The post-surgery rehabilitation is a long road too, for Ravita will need catheterisation, physiotherapy and more.
Ravita’s parents say they spend around Rs 50 a day on food. They sleep on blankets laid out on the hospital floor. A few donors at the hospital gave them Rs 15,000 in cash, but the Valvis do not know where to spend that money.
Ravita is anaemic and highly malnourished, and is on multi vitamins and protein supplements. She is mostly quiet, only murmuring a few words to her mother who never leaves her side. “She used to play around a lot. She is disturbed now,” says Shanti.