It is customary for husbands and wives to argue, and to sometimes walk away in a huff. Except, when Aklu Ram, 28, did just that after a fight with his wife Sunita Devi, 26, she panicked. Lying in a hospital bed for over 150 days now, her body about 10 kg lighter, after both her perfectly healthy kidneys were removed ‘by mistake’ in a ‘clinic’ that had no licence to run, she thought her husband had left her for good.
“I was upset; that’s why I had left the hospital for some time, but I came back the same day,” says Mr. Ram, who has been by his wife’s side, taking care of their three children, as they navigate the hospital’s long and somewhat ageing corridors and doctors’ orders. They hope for a kidney donor, Mr. Ram’s not being a match for his wife.
“How can I desert my wife in such a condition? I have been with her like her shadow ever since the incident took place,” he says, his voice choking, as he sits outside the dialysis room of Sri Krishna Medical College and Hospital (SKMCH) in village Rasulpur Saidpur Bazid, Muzaffarpur district in Bihar.
Mr. Ram and Ms. Devi, who married in 2010, have a young family: an 11-year-old daughter, and two sons, 8 and 6. While Sonam Kumari helps her father, the boys have been sent back to their village, Mathurapur, where Mr. Ram’s parents are currently looking after them.
Sunita Devi, 26, who has lost both her kidneys when a quack took them out thinking they were tumours | Photo Credit: Nagendra Kumar Singh
As the dialysis is on, Ms. Devi asks the nurse to bring her husband to her bedside. She’s still nervous he may leave, never to come back. But father and daughter are preparing for a meal she must have after the dialysis, a thrice-a-week session that lasts four hours. “I hope someone donates a kidney so that I can survive and look after my three small children,” Ms. Devi says, perhaps conscious of the role reversal, with her daughter washing her clothes and running errands.
The Dalit family stays within the hospital, laying out a thin mattress next to Ms. Devi’s bed, as they wait for a kidney donor. It’s Guru Ravidas Jayanti and the family would have gone to a local mela to celebrate the life and teachings of the poet-preacher who was himself a part of what in the 15th and 16th centuries, was considered an untouchable community.
As a mason, Mr. Ram would earn ₹10,000 to ₹12,000 every month and with the little money they have saved, some that his brother sends, and some from a local not-for-profit, he is able to sustain the family.
But it’s not just about the money or that the children haven’t attended school for five months now, or even that his wife, for no fault of hers may die soon. It’s about a world-weary man who doesn’t know where to put his anger and grief at the loss: “Every passing day I am finding it difficult to survive,” he says.
He directs some anger at his mother-in-law, saying she forcefully took Ms. Devi to Subhakant Clinic to have her uterus removed. Then there’s hopelessness: “Do you think anybody will offer their kidney to poor people like us?” And desperation: “Can you get me any money from anywhere; you’re a journalist; you are influential.”
What went wrong
On September 3, 2022, Ms. Devi went to the Subhakant Clinic, 2 km from Baji Raut in Sakra block, where her parents live. Her mother, Tetri Devi, 63, had taken her for a consultation before, when Ms. Devi had complained of pain in the abdomen. They had met Pawan Kumar, who allegedly said her uterus needed to be removed.
About 24 hours after the operation, at home, Ms. Tetri suspected there was a problem, when her daughter did not urinate. She went back to meet Mr. Kumar, who gave her ₹5,000, booked a car, and accompanied them to Shree Ganga Ram Trauma Hospital, Patna. Thereafter, the family did not hear from him again.
At Shree Ganga Ram, several tests were conducted, and they were charged ₹42,000. The family then took a decision to transfer her to SKMCH, the biggest government hospital in Muzaffarpur. From here, they were referred to Patna Medical College and Hospital (PMCH) where it was found that both Ms. Devi’s kidneys were missing.
PMCH recommended that she be admitted at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, where she spent October 2022. However, once the Ayushman Bharat money of ₹50,000 was exhausted, they came back to SKMCH in November, and have been here ever since. Unfortunately, there are no nephrologists at SKMCH, nor does the facility have the capacity to do a kidney transplant in case a donor is found.
Now in SKMCH, Ms. Devi has developed chicken pox and so the hospital has taken her out of the ICU and put her into the dengue ward, since it is currently empty.
“I really don’t know how long my wife will survive without a kidney. She is in pain and only I can understand. The hospital authorities are saying that their only duty is to do the dialysis, and they are not responsible for finding a donor. If they don’t, who will?” Mr. Ram said.
Since the story has made the national news, the entire hospital is on alert for Ms. Devi. Mr. Ram says medicines, procedures, doctors’ fees, and food are all free. His only problem is that he is unable to earn.
SKMCH superintendent B.S. Jha doesn’t say what Ms. Devi’s chances of survival without a kidney and regular dialysis are though.
An FIR was lodged on September 9, in the Bariyarpur police station and then transferred to the Sakra police station for further investigation. Investigation Officer (IO) Saroj Kumar, who is station house officer of the Sakra police station said that during the investigation the police did not find any sign of a kidney racket.
“Pawan Kumar, the owner of the clinic has been arrested,” he said, adding that he had been hiding out at a friend’s house in Delhi. “During the investigation he accepted that it happened by mistake, assuming that the kidney was a tumour. They had shown the kidneys to Sunita’s mother as well, calling it a tumour,” he added. Later, they realised their mistake, and threw them into the medical waste dustbin. “During the interrogation, Pawan said he had not operated on Sunita, and it was Dr. R.K. Singh who had,” Mr. Kumar said.
The FIR names Pawan Kumar; Sangeeta Devi, his wife, who used to help him at the clinic; and Dr. R.K. Singh. He added that the so-called doctor’s name is not registered in the district civil surgeon’s office; neither was the clinic.
The ‘doctor’ has given a plea in court stating that from September 2 to 6, he was not in Muzaffarpur, and was in fact hospitalised in Patna with dengue. “As per the investigation, the main accused is Dr. R.K. Singh and the police are working on catching him,” the IO has stressed.
The case was lodged under the Transplantation of Human Organs and Tissues Act 1994 and the Scheduled Caste and Scheduled Tribes (Prevention of Atrocities), Act 1989. The State Human Rights Commission and the National Human Rights Commission have also issued notice to the State government seeking a reply in this case.
A senior official working with the health department said they were doing their best to provide all possible help to Ms. Devi, including finding a kidney donor. They also said that the department has instructed the Muzaffapur district administration to ensure that the people responsible for the heinous act be put behind bars.
The parents plead
Ms. Devi’s parents live a 20-km bumpy ride from SKMCH, and about 40 km away from where the couple and their children live. Their home is a kuccha structure with an asbestos roof, and can be accessed down a 200-metre dirt track. Ms. Tetri and Laldeo Ram, 71, sit on a khaat (rope cot) and cannot imagine what to do next. They have tried asking people in the village if anyone would donate a kidney, but no one has offered so far.
Tetri Devi, 63, and Laldeo Ram, 71, struggle to come to terms with their daughter’s loss | Photo Credit: Nagendra Kumar Singh
Even as Ms. Tetri opens her mouth to speak, her hands fold in a plea, almost begging anyone who will listen, to help. “He [the quack] has made my daughter’s life hell. She is counting her days lying on the hospital bed. Who will take care of her three children if anything happens to her?” she says.
As she speaks, the tears come quickly. She had fainted the day she came to know that her daughter’s kidneys had been removed. She says morosely, with some measure of guilt, that she was the one who had taken her to the clinic, as the nearest primary health centre is about 12 km away, and there’s no public transport to reach it. “The roads are in a poor condition, so it’s not easily accessible,” she added.
Despite the misery, Mr. Ram is supportive of his wife, saying that the decision to go to the private ‘clinic’ was because it was close to home, and most villagers used its services. It had opened two years ago in Bariyarpur. “Family and friends had also suggested we take her there,” he says.
Mr. Ram too breaks down, saying that if there had been a good hospital in the village, his daughter would not have been in this situation. He is a daily wage labourer, earning ₹5,000 to ₹7,000 a month. The couple had managed to save a little money despite their meagre earnings. That is gone now, and they are in debt.
“We took money on interest from the villagers and spent more than one lakh on my daughter’s treatment. I made many trips to Patna for better treatment, but at last she is being treated at SKMCH. We are left with no money and now struggling to get two meals a day. I have three grandsons with me, and they sometimes sleep on an empty stomach,” she says.
The couple have six children — two sons and four daughters. One daughter died last year, and the husband of another daughter had passed away a few years ago. Their sons stay with them and work in a brick kiln in the village. They earned too little for any financial support towards their parents or sister.
“Now, we have only one demand: to get a donor for my daughter apart from some financial help,” Mr. Ram said, never once alluding to the arrest or punishment of the perpetrators.
Bihar’s quack trap
The signboard of the unauthorised clinic has been removed and the premises sealed by the Bihar police after the incident. The clinic, a one-room outfit, is constructed in the middle of agricultural land, with just one gate to enter.
The people around the clinic were initially not ready to talk to the media, but soon opened up. A man who runs a sweet shop nearby said that on an average 20 to 30 villagers would visit, usually for first aid or to get medicine for pain relief. He seemed unaware that the clinic had also been performing operations, but said he’d seen Mr. Pawan sweeping the place.
Illegal operations by quacks are not new in Bihar. “There are about 5 lakh unlicensed medical practitioners commonly known as jhola-chhaap (quacks) in Bihar,” said Dr. L.B. Singh, Chairperson, State Advisory Committee for Vocational Training and Programme, Health Department, Bihar. “Out of 5 lakh only 50,000 are trained [by the State government] as rural medical officers who are responsible for primary health check-ups. To be a medical officer, a person should have passed the Class X exam.”
This is not the only bizarre case in Muzaffarpur district: in 2021, upto 13 people lost their eyesight after a cataract operation in a government hospital. In Khagaria district, 23 women were forced to undergo tubectomy without anaesthesia by a doctor at a primary health centre in November 2022.
While the government figures out an appropriate reaction, and the medical needs of its citizens overwhelm the State, there is the unheard voice of Sonam Kumari, Ms. Devi’s daughter. “I hope my mother can come home soon; unke bina man nahin lagta [without her, I feel disengaged],” she says.