A 18-month-old boy with an insect stuck in his respiratory tract had to travel nearly 400km from South Dinajpur to Calcutta amidst the lockdown to get it extracted after being referred by two government hospitals and allegedly refused admission in as many nursing homes.

Doctors at SSKM Hospital, where the insect was taken out, said Sampreet Ghosh had developed pneumonia because of an infection caused by the presence of a foreign object in the respiratory tract for nearly three days. He is now admitted in the paediatric critical care unit of the hospital.

The referral and alleged refusal happened days after Bengal chief secretary Rajiva Sinha had said on April 24 that private and government hospitals should not deny treatment to patients.

One of the two hospitals that could not treat the child was the Malda Medical College and Hospital.

Sampreet’s father Suman said the insect had entered the child’s mouth when he was playing on the terrace of their house on April 26 afternoon.

“We are not sure whether he had swallowed the insect or it somehow entered his respiratory tract. He came down and was shaking, unable to breathe. His face was turning black,” recounted Suman, a schoolteacher.

Suman drove Sampreet to the nearby Gangarampur Sub-divisional Hospital in South Dinajpur. The hospital authorities said they could not treat the boy and referred him to the Malda Medical College and Hospital, about 60km away (see chart). The boy was admitted to the medical college the same night.

“Doctors examined him but found nothing. He was vomiting and a small portion of the insect came out. ENT specialists at the hospital then examined him and said a big portion of the insect might still be stuck in the respiratory tract and that was causing the distress,” Suman said.

“The doctors referred my son to SSKM Hospital because they said he needed to undergo a procedure that could not be performed at the medical college. Sampreet was at the Malda medical college for two days. During that period, I called up two nursing homes, requesting them to admit my son. Both refused, saying they were not admitting patients because of the Covid-19 outbreak,” Suman alleged.

The family left Malda for Calcutta on the night of April 28.

“We had first thought of hiring an ambulance. But later I decided to drive to Calcutta in my car because of the Covid-19 fear. We reached Calcutta the next day after a 10-hour journey,” Suman said.

“We didn't face any problem on the road and fuel stations were open, too.”

At SSKM, Sampreet underwent bronchoscopy, a procedure that allows doctors to access the lungs and air passages for examination and therapeutic purposes. A thin tube or bronchoscope is passed through the nose or mouth, down to the throat and into the lungs.

“Whatever was left of the insect was taken out but because it had stayed in the respiratory tract for long, an infection developed and that led to pneumonia,” said Ankit Choudhary, an ENT surgeon at SSKM Hospital, who along with a team of doctors and anaesthetists performed the procedure.

In the Covid-19 season, many doctors are refusing to examine respiratory tracts of patients.

“In case of children, it’s more risky because of their tendency to cough in such situations. We were wearing personal protective equipment to perform the procedure. It is risky for anaesthetists, too,” said Choudhary.

Suman said they failed to find any place to stay in Calcutta because of the lockdown. He and brother-in-law Bhanu are spending the nights in the car. The ENT department has allowed his wife and mother to stay in the paediatric ward.

“Most beds are now vacant. So, we are allowing parents to stay here because the shelter for patients’ relatives is full,” said Choudhary.

Metro had on April 10 reported how a 16-month-old boy with a bone stuck in his respiratory tract had to travel almost 300km from Pakur in Jharkhand to SSKM Hospital to get it extracted.

“We have opened medical colleges and superspeciality hospitals in the districts but some crucial departments are not functional. Trained manpower is not available,” said a health department official.

Officials at the Malda Medical College and Hospital said they did not have the expertise to perform paediatric bronchoscopy.

“It is a specialised skill which we lack. So, we referred the patient to SSKM,” said Amit Dan, the medical superintendent-cum-vice-principal of the hospital.

The hospital at Gangarampur could not be contacted for comment.

Officials at Dishari Health Point, one of the two nursing homes that allegedly refused to admit Sampreet, said ENT doctors were not examining patients because of Covid-19.

“We are not turning away patients. But ENT doctors have not been available since the lockdown started. So, we can’t admit these patients,” said S.N. Sharma, the director of the nursing home.