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Journalism of Courage
Priyanka Chettry, a 22-year-old political science graduate from Dhemaji in Assam, has finally learnt to smile and savour the food cooked by her mother. Having suffered a facial injury in childhood that froze her jaws and deformed her face, she had been on a liquid diet for as long as she can remember. Now, doctors at the Government Dental College in Ahmedabad have given her a new lease of life by performing a complex and restorative surgery free.
This state government hospital holds out hope for many like her who cannot afford such surgeries in a private hospital. Most state public hospitals, too, do not have specialists or resources to conduct them because of the high costs concerned. Priyanka’s jaw condition, called TM Joint Ankylosis, demands a highly sophisticated surgery, the instruments and prosthetics for which can cost upwards of Rs 3 lakh alone.
The Ayushman Bharat scheme is of no help in such reconstructive surgeries, offering only Rs 15,000 for a procedure on one side of the face and Rs 30,000 for paired organs. Having braved stigma for most of her early years, Priyanka did not want to miss her only shot at a normal life, travelling five days to reach Ahmedabad by both bus and train.
Doctors use donor funds for corrective surgeries and are proactive in raising resources, reaching out to potential sponsors. “Such surgeries are usually done at big public hospitals. But at the dental college, we can do so as donors help us a lot with surgical instruments and apparatus,” said Dr Sonal Anchlia, the head of Oral and Maxillofacial Surgery, who met Priyanka during a medical conference in Guwahati. “Since no government hospital in Assam does such surgeries, I asked her to come to us. Now we get almost two patients every month from across India,” she added.
Over the last year, the dental college has done 14 such facial reconstructive surgeries, and nine more are lined up next year. Dr Anchlia is now planning to approach the Gujarat CSR authority for funds. “A majority of our patients come from Uttar Pradesh, Madhya Pradesh, Rajasthan and Gujarat. There have been more girls than boys,” she said.
Although Priyanka had TM Joint Ankylosis after a facial injury and trauma, this condition can also develop after an infection, rheumatoid arthritis or be present from birth. It can affect one or both sides of the face. “We deal with several kinds of malformed jaws or jaw joint fractures that need replacement. Some of these children have not just had distorted faces but have had difficulty breathing due to constriction of the windpipe, slurred speech and difficulty eating or swallowing,” said Dr Anchlia.
Priyanka had asymmetrical stunted growth on both sides of her lower jaw. “Her mouth did not open at all. So her airways got constricted leading to breathing issues and Obstructive Sleep Apnea (OSA),” said Dr Anchlia. She and her team performed an intricate procedure, separating two bone fragments to lengthen and reshape her lower jaw with a special device. This created space, allowing new bone tissue to grow.
“We use elastic bands in the mouth to direct the growth of the bone. The most irregular bone structure can be corrected using this method. Her teeth had also grown in a very haphazard manner due to the stunted growth of her face. So we had to correct that as well,” said Dr Anchlia.
Part of the reason that public hospitals stay away from facial surgeries is because of the long preparatory time and a series of procedures they entail. Priyanka has just been out of her first surgery. “Planning takes about 25 days. Then we conduct the first surgery to implant the device in the jaw. A week later, we begin turning the screws to lengthen the lower jaw and allow the soft tissue to fill up. At 1 mm per day, we go up to 25-30 mm in total. This can take about 1.5 months of stay in the ward,” said Dr Anchlia.
With her facial scars just healing after her implants, Priyanka says she no longer feels ashamed of going outdoors. “My family never ate in front of me so that wouldn’t feel left out. I can look at myself in the mirror without negativity and am finally excited about my future,” she said.
Priyanka is the eldest of three siblings and hopes to support her family who never left her side. Before she returns to Ahmedabad for the second phase of her treatment, she will be applying for job interviews in Guwahati. “The soft bone takes six to eight months to grow and consolidate. After this, we will do a mouth and chin surgery. We will replace the jaw joint with a 3D-printed titanium prosthetic which will be fitted there to mimic the natural joint,” said Dr Anchlia. Priyanka will then be completely out of her childhood trauma.
