Two years ago, when Dr Priti Ingle Jadhav’s husband Vinod lay gasping for breath after a road accident in rural Akola in Maharashtra’s Vidarbha, all he could say was ‘save me’. Despite Priti making frantic calls to ambulances, doctors and friends and trying to flag down vehicles, Vinod did not survive. In his final moments, she kept telling him: “Saans roko mat (Don’t stop breathing).”
After 10 years of devoting their lives to treating tribals in rural areas of Malsur and Babulgaon in Akola, the couple were looking forward to city life, and had started working together at the district’s largest women’s hospital, popularly called Lady Hardinge hospital.
After losing Vinod, a pathologist, Priti, a paediatrician, eventually got back to work, at first mechanically. But a challenging case involving a five-day-old baby of farmers, which doctors had termed “hopeless” and too expensive, gave her fresh purpose.
“The infant was dying. The blood urea and serum creatinine levels were extremely high. There was no urine output and the father, an alcoholic, did not seem concerned,” says 30-year-old Priti, who consulted Medical Superintendent Dr Arati Kulwal and urged authorities to let her treat the infant.
“I don’t know what happened. Perhaps I saw the hopelessness of the situation, and felt similar pangs of despair like when Vinod could not be saved. I decided to come out of my mourning and start saving such babies,” Priti says.
The baby had stopped taking feeds or passing urine five days after he was born. With the cost of treatment at private hospitals estimated at Rs 4 lakh, the infant’s 20-year-old mother Pooja Rathod, who hails from a farmer’s family in Mangrulpir, decided to admit him to Lady Hardinge hospital.
Peritoneal dialysis (PD) is often used in cases of end-stage renal failure — except this hospital had no PD kit to treat infants.
Funding for such advanced healthcare is limited and lack of trained personnel, especially in rural areas, is a challenge government health authorities have to deal with when faced with complicated cases. “The workload is immense here. The Lady Hardinge hospital has the largest 48 Special Nursing Care Unit in Maharashtra that handles sick babies. Every year, at least 3,000-3,500 sick babies are admitted here and the case fatality rate has been brought down to 8/1000 live births,” says Kulwal.
While team effort is crucial, Priti has been personally involved in saving at least nine highly critical babies, Kulwal said.
To save the five-day-old, Priti, who did her MD paediatrics from Government Medical College at Miraj, eventually started scouting around for the kit, which includes a trocar, catheter and scalpel blade, and costs Rs 600. PD is a type of dialysis used to remove excess fluid and toxins. She got the kit, started the PD cycle and monitored the infant every hour. “I timed each cycle and did not sleep for two nights,” Priti recalls. At the 48th PD cycle, the baby’s urine output was 6ml. Gradually, it showed significant improvement — enough to be discharged.
At one point, saving the baby seemed impossible. But eight months later, when Pooja got her boy Ayush for a follow-up visit, Priti’s eyes lit up. “Yes, I could save this baby,” she says, with a smile.
As with Ayush, Priti used quick thinking to save eight other critically ill infants. Five had severe problems, including jaundice due to RH incompatibility. The critically ill newborn recuperated after exchange blood transfusion — a procedure that takes four-five hours and has to be monitored closely.
In another case, where triplets born at a private hospital were admitted to the special newborn care unit, one of them had convulsions while two others had respiratory distress syndrome. “I involved the mother and trained her how to monitor her baby,” says Priti.