India’s Public Health System Fails Yet Again: The case of Runa Begum with Hydrocephalus

You have already seen the news about Runa Begum, a 17 month old baby girl from Agartala, Tripuara who suffers from Hydrocephalus, medical condition in which fluid accumulates in the brain leading to an abnormally large head circumference. It is reportedly a serious but largely correctable medical condition.  The short story is that Runa, was born with this condition and only after recently her story along with pictures, circulated globally via media and online social networks, now she is being treated at an elite private hospital in  Delhi, some 2000 kms from her hometown. This has been made possible only by private charity. However, cases such as these raise several questions on the state of our public health system.

Given that her head has swelled to 3 times the normal size, presumably the condition manifested at birth or even before. So why did it take 17 months of worsening complications and media reports for the family to receive medical attention? And that too by the private sector and/or charity.

News reports say that the family was denied treatment at the Government Medical College at Tripura as they could not produce documentation that they were ultra poor and such a surgery costs a lot of money. Moreover a ‘rare’ condition such as this required advanced medical care that was perhaps beyond the expertise of  the Agartala hospital.

First, hydrocephalus although uncommon, is not really a rare disease as it affects 1 in 500 children born. Second, Agartala is not a village but the largest city in one of  India’s 28 states. The Government medical college at Agartala there has a multi specialty hospital with clinics in Pediatrics  Surgery and Neurology, all three specialties required for such a case. Moreover they are linked to many other hospitals through telemedicine, precisely to seek consultation on cases they are unable to handle.  Despite all this neither were they able to treat a child with a potentially fatal condition for 17 months nor arrange treatment elsewhere? They merely let fluid accumulate in her head, which has now swelled to 90 cm, much larger than what is usually documented for this condition ( Images revealed by web search show much smaller heads)

Thankfully for Ranu, the visually stunning nature of hydrocephalus , caught the media’s eye and subsequent support poured in. However there may be thousands other less fortunate poor kids whose parents may not have documents to claim abject poverty, yet may be poor enough to not be able to afford any private hospital.

While we hope for Ranu’s recovery. the minimum I demand from the Health Ministry is to conduct an inquiry into why exactly was this case not treated by the hospital, which claims its vision as “To provide best Health Care facilities to the people of North-Eastern Region”!


Author: harshT

Assistant Professor

8 thoughts on “India’s Public Health System Fails Yet Again: The case of Runa Begum with Hydrocephalus”

  1. Thanks for a very nice write up highlighting issue of a “Case” mismanagement, and “Poor” ‘s suffering. Also thanks for drawing my attention to “Telemedicine” @GMC.Agartala. Other than that my recommendation do visit my Blog sometime @[ ] here I have attempted to build a discourse on the process of Institutionalization taking place, stemming from my personal story. Though after reading your writing style and use of WordPress, with some really cool News on latest Media research, I feel that I got to have an eye out for you.. 🙂 also note I am loving whats happening in the NorthWestern 🙂 great going.. do note “Shirvardhan” better be on the Radar..!! 🙂

    1. “Shrivardhan” { } is OPEN!! and “Revolution has Come” though please note that Shrivardhan community is laden with NCPsympathizers. Despite Corruption charges in Open Knowledge even @GrassRoots.. also note “India Against Corruption” team has some real Savvy Social Media outlet managers 🙂 here is a strategic appeal { } to Throw Out each and every one of those Corrupt Entity { including their BOSS } , with Grass-root Mobilization, Planning and Campaigning.. 🙂 Please pay careful attention the “Media Flow Dynamics” as they unfold.. 🙂

  2. If card was the hurdle how was the mother in the hospital for cesarean section delivery?
    Was the baby supposed to be born with separate BPL card tag? Its a shame , no measures can help the insensitive ones !

  3. Your concerns are very genuine and I as a medico ,am ashamed of my colleagues.
    This baby was born of C section ,which puts it in high risk category where follow up in well baby clinic is advised every fortnightly. This is to ensure proper growth and development. Head circumference is most essential serial measurement as any aberration in it demands prompt action
    to prevent brain damage and mental retardation.
    Every child comes in contact with a doctor at least 6 times in first year during vaccinations when all
    growth and development issues are checked. Pulse polio is done 5 times in first year where baby
    comes in contact with ANMs even in villages.
    If health system was in order and even slightly vigilant the head would not have been allowed to reach these dimensions.
    Irony is this that inspite of reaching the hospital at such a critical state BPL card becomes a hurdle?
    Its shameful that none of the doctors could act responsible to atleast do a ventricular tap to drain the fluid and start medical management. Cheap and best Upadhyay shunt was invented several years ago to help poor people,s hydrocephalus surgically..Why should the medical community not be punished for pushing this high risk precious baby of poor parents into blindness and irreversible mental damage. i am afraid if developmental retardation and blindness could ever be reversed in this little one now. The brain growth is maximum in first 6 months of life thats why head measurements are important. In this baby the unnecessary fluid accumulation hampered the brain growth. its a shame on the system.
    I am reminded of a baby of a soldier which i came across while I was an army doctor in a field hospital in sikkim in 1978.I suspected hydrocephalus during serial measurements. I immediately contacted the commanding officer of father of the baby who was posted far off and got his leave and advance salary sanctioned and referred the baby to Command hospital calcutta. The neurosurgeon intervened early , my vigilance and proactive approach was appreciated and baby was on my follow up till he excelled to enter postgraduate studies.
    I wish at least doctors the cream of society remember their duties towards society and hippocratic oath !

  4. Do you think if Aadhaar or UIDAI were to be properly implemented, we would be able to help solve this problem? Or corruption because of human intervention would still come into play.

    1. Himanshu, Surely the denial on grounds such us not having a BPL card can be addressed due to Aadhar. But can the attitudes of people change? I think if we have the right attitudes in place, we can anyway overcome bureaucratic hurdles. But yes at least systems such as Aadhar would ensure that even if some people within the system have the right attitude, they can more easily see to it that others don’t push people around

      1. well when one speaks of “Aadhar” one sounds like technology can solve socio-economico-environmental problems!! well well well.. can they.. is the Aadhar implementation so smooth.. are the people rushing to get Aadhar numbers!! Do you have one is the question..!! Do they have the number.. is another question..!! 🙂

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