Five months old baby boy Sattar son of Allah Bachayo is a resident of village Umeed Ali lakho, Tehsil Sindhri, District MirpurKhas and is the youngest of the three siblings. Besides being born in a low-income family, the area of their dwelling is also deprived of basic health facilities, as a result of which, the couple could not have regular pre-natal checkups to monitor the pregnancy and evaluate the health of the anticipated family member. The pregnancy ran into complications and unfortunately in this case, the complications led to claiming the life of the mother after Abdul Sattar was born at a ‘private clinic’. Since birth, Abdul Sattar was unwell in his general health. He was born with an oversized head which kept increasing day by day after birth. The family continued treatment in MirpurKhas, without success.
Abdul Sattar was diagnosed with a condition called Hydrocephalus, which is a buildup of cerebrospinal fluid (CSF) in the brain. Under normal circumstances, the naturally produced protective CSF is drained from the skull. However, if there is a blockage in the drainage of CSF, fluid pressure builds up in the skull. Soft baby bones of skull area expand to ease the pressure resulting in a permanent deformity in the shape of an enlarged skull. If the condition goes further unchecked, it can lead to physical as well as mental disability, eyesight impairment and loss of life. The treatment of this condition involves implanting a shunt (a plastic channel) from the brain to the lining of the abdomen creating an alternate drainage path for CSF so that pressure in the skull can be eased and the patient’s brain can normally grow. The condition is treatable, but the plastic shunt is costly.
Abdus Sattar’s head steadily grew in size since birth and the family knew something was wrong. However, the poor family was gripped by panic when the right eye started protruding and the corresponding arm got paralyzed. The local doctor referred the patient to the Liaquat Hospital Neurosurgery unit in Jamshoro and Abdul Sattar was admitted on 8 Jan 2016. The cost of surgery dawned upon the family (Rs. 28,000 PKR). This was referred to as “catastrophic” by the family during their eligibility evaluation by Heartfile. The head of the household is an unskilled daily wager with a minuscule monthly income under 9,000 PKR a month. The family is very poor and belong to a remote area far from the city where access to treatment is a major issue. After demise of the patient’s mother, the father is the only caregiver of three children aged 4 and 2 years and the 5 months old patient. Attending to their care further dropped the family income since the father is the only earning member and attending to the kids restricts him from work and earning opportunities. The father and his three children live in a ‘kacha’ home and are deprived of even the most basic amenities. Over the course of Abdul Sattar’s treatment, the family has expended Rs. 60,000, largely borrowed. They do not own a vehicle, livestock or other cashable assets and are forced to travel 80KM away from home for the child’s treatment, which further adds to the catastrophic cost. They desperately awaited assistance for the lifesaving surgery for the boy. Luckily, the Neurosurgery department at Liaquat hospital is a registered Heartfile Health financing (HHF) facility and the focal doctor (Dr. Suhail Ahmed) requested financing for this patient on 27 Jan 2016 by sending a plain text SMS to HHF.
The patient was interviewed on his bedside (Bed # 30, Ward 16, LUH Jamshoro) by an HHF representative in Hyderabad on 29th of Jan 2016 and was found eligible for financing on the same day. On the same very day, a purchase order for the required shunt was dispatched to the registered vendor for the facility. Abdul Sattar was operated in the first week of February 2016. The latest follow up on the patient by the HHF program (dated 7 Apr 2016) reveal that Abdul Sattar is stable now and his condition has improved a lot since Jan 2016. The vendor who supplied the critical shunt for Abdul Sattar’s surgery billed the item to HHF. Abdul Sattar is the 140th Child whose Ventriculo-peritoneal shunt surgery has been supported through the Heartfile Health Financing program. He is one of the many living examples of the value this access to treatment initiative brings to the poorest of the poor.