Seven-Year-Old Sangeeta

Poverty and sickness go together, that we all know, but here is a situation, which would be hard to believe where it costs a dollar and 10 cents to get an X-ray and take the next step.

Poverty and sickness go together, that we all know, but here is a situation, which would be hard to believe where it costs a dollar and 10 cents to get an X-ray and take the next step.The hospital here at Mungeli has seen a strange transition in the past two years.  The number of late and neglected cases are many and getting less but some continue to absolutely amaze anyone in the field of medicine.  

During a very busy morning as patients had crowded around.  There was a small meek and shy little girl who was scared and hiding but in obvious severe respiratory distress which you could hear as she got closer.  She was fighting for each breath as her little chest got sucked in with each breath she took.

She had turned a shade of blue and was immediately rushed for an X-ray of the chest and neck.  On the X-ray, we could see a coin (the size of a dollar) stuck at the level of the upper chest, behind the level of the sternum.

On learning more about the history, the mother said that 7-year-old Sangeeta had swallowed a coin about 10 months ago.  Since then, she had had difficulty with breathing and now was having trouble with swallowing as well as lost considerable weight.  

We explained to them that this was a very major condition and the mother went in search of the father of course taking the child and the X-ray with her.  

We did not see them and knew that they were scared as they were poor and scared.  I did not know if my reassurance of help and support had convinced them.

I thought they would not be back, but soon they came with the father and a whole crowd of relatives.

We took the little girl into the OR and explained the grave situation to them all.

They of course were very poor and cost was something that had been the reason for them not to show the little girl to the doctor or get an X-ray.  The father works as a laborer and the mother also works for daily wages in the fields.

Being the simple and not  so well equipped hospital that we are, we had no access to a bronchoscope, which is the ideal thing.  But we had some graspers, which had been used to take
out foreign objects from the esophagus.  

We knew that no other hospital in the city or the vicinity would ever take care of Sangeeta without money and gathered up my courage along with a small prayer.  

Under anesthesia, we could reach the coin, visualize it under X-ray vision and hold it, but it was deeply wedged between the trachea and the esophagus.  We were then forced to do a
tracheotomy.  During this time, we had to lay open the front of the chest of the little girl to reach the coin.  

It was a difficult job and there was a hole in the trachea that we had to leave behind in which we left a tracheotomy tube through which the child could breathe and recover.

Today, Sangeeta is doing well, the tracheotomy tube is removed but she is still on nasogastric feeds till we are sure that the esophagus is also healed.  

It is unbelievable what we can do with so little.  Truly I believe God gives us the strength to take the next step boldly.  I know that with the best of equipment we would still have a big job on our hands, but with the little we had, we were still able to save little Sangeeta.

Blessings,

Anil Henry

Anil works with the Synodical Board of Health Services of the Church of North India.  He serves as
Acting Director at Christian Hospital, Mungeli along with his wife as Senior Medical Officer.