Sikh refugee's plea to Delhi government for free treatment to save his son

CourtThe Delhi High Court Friday issued notice to the central and Delhi governments and AIIMS on a plea filed by Afghan refugee parents of a four-year-old boy suffering from aplastic anaemia, a life-threatening disorder.

Justice Manmohan sought response from the governments and hospital July 24. The kid, Kulraj is in dire and immediate need of bone-marrow transplant to save his life, which would cost around Rs.10 lakh, as per the estimate given by AIIMS, advocate Ashok Agarwal appearing for the parents told the court. The plea said that as per the last examination, his platelets have come down to 2,000 and are dwindling, against a minimum normal of 150,000.

Since the kid's parents are not in a position to afford the cost of the treatment, AIIMS, the central and Delhi governments, jointly as well as severally, have a constitutional obligation under article 21 to bear the entire cost of the treatment of the patient in order to save his life, argued Agarwal.
The kid's health has been deteriorating and the doctors have warned that he is not responding well to the current treatment. The boy has lesions appearing all over his body, particularly in the mouth and he has stopped eating for the last two days, the plea stated.

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Kulraj's father, Sujan Singh is a Sikh refugee from Afghanistan. His family had come to India in 1992 and settled here. He works as a salesman and earns around Rs.8,000 a month. Unable to afford the hefty cost of treatment of his son, he approached the court, submitted the plea. (Read: Anemia causes, symptoms, diagnosis and treatment)

What is aplastic anemia?

Blood cells develop from stem cells found in bone marrow. Diseases of the bone marrow like leukaemia, myelodysplasia, etc. can affect blood production and cause anemia. In aplastic anemia there is marked reduction or absence of stem cells due to infections, autoimmune diseases or drugs. This decreases the production of red blood cells causing anemia. Health conditions like cancer, advanced kidney disease, diabetes, hypothyroidism, etc. can decrease hormones needed for production of red blood cell and cause anemia.

What is bone marrow transplant?

Bone marrow transplant is done to restore stem cells that have been destroyed by high doses of chemotherapy and/or radiation therapy. It is also used to treat certain cancers like multiple myeloma, leukaemia, lymphoma, neuroblastoma, etc. and blood disorders like sickle cell anaemia, thalassemia, aplastic anaemia, etc.

There are three different types of bone marrow transplants. When a patient's own bone marrow is used for transplant it is called autologous transplant. In allogenic transplant bone marrow from a donor is used and in syngeneic transplant bone marrow from a patient's identical twin sibling is used. Under general anaesthesia the stem cells are harvested from a large bone of the donor/donor site, usually the pelvis bone, through a large needle.

The transplant is a failure if the transplanted cells fail to produce stem cells. Patients may experience varying degrees of complications. Transplant from a donor carries a risk of an immune reaction (graft versus host disease). According to a finding, vorinostat combined with standard drugs given after transplant, can halve the risk of developing this deadly side-effect. After the transplant procedure there is also a risk of infection, anaemia and bleeding. Because of the high doses of chemotherapy involved, bone marrow transplants nearly always cause infertility. But patients, mostly the young, are now often given the choice of fertility preservation before they start treatment.

With inputs from IANS

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