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Bhubaneswar/New Delhi: Separated conjoined twins from Odisha, Jaga and Balia, are "clinically" well and do not need ICU or specialised care, the Delhi-based All India Institute of Medical Sciences (AIIMS) has told the National Human Rights Commission (NHRC).
The AIIMS has also told the human rights panel that the twins medical requirements can be managed at any state-level hospital in Odisha having good nursing and pediatric support.
Jaga and Balia were craniopagus conjoined twins -- joined at the head -- which doctors had said was a very rare occurrence. They were successfully separated after a 21-hour-long surgery in October last year.
The NHRC had last month asked for an action-taken report from the All India Institute of Medical Sciences (AIIMS) over a petition that sought to prevent the shifting of the twins to a hospital in Odisha.
The petition was filed by Supreme Court advocate and human rights activist Radhakanta Tripathy, who claimed that the AIIMS' branch in Bhubaneswar did not have the essential infrastructure for the treatment and care of the twins.
The boys from Milipada Village in Odisha's Kandhamal region were likely to be sent back to the state in the second week of March, the petition stated.
In its reply to the NHRC, AIIMS authorities said the children were thoroughly evaluated by a team of doctors.
The team included pediatricians, pediatric neurologists, plastic surgeons, ENT surgeons, neuropsychologists and neurosurgeons, they said.
The team had concluded that after four months of surgery, risk to life is "very low" and they can be discharged and shifted back to Odisha for supportive and continued care, the authorities said.
"A team of senior doctors dealing with these children have met several times and feel that they can be managed at any state-level medical college or district hospital with good nursing and pediatric support near their hometown in Odisha.
"The team has reached a conclusion that after four months of surgery, risk to life is very low and there is no need for ICU or specialised care. Currently, they need good nutrition... and physiotherapy care for continued recovery," the AIIMS said in its reply.
It will be easier for the parents to nurse the children in their home state as "they have been away for over eight months now", the institute said.
"The constraint of beds in the neurosurgery department, CN centre, AIIMS, Delhi, can't be ignored and there is a more than two years waiting period for general neurosurgery ward admissions," the AIIMS said.
"We, at present, have more than two years waiting period for general neurosurgery ward admissions. Patients who can pay for admission to the private ward (cardio, neuro and CNT) have to wait for five to six months for routine admissions. We have been asked on humanitarian ground not to discharge Jaga for over three months now," the institute said.
"He has been kept in the hospital primarily because his parents come from a long distance (Odisha) and we wanted both kids to be ready to be discharged and sent back together with their parents," the response stated.
The reply mentioned that a team of five doctors from Odisha had visited AIIMS, Delhi, on February 26 and they examined the children and met the specialists dealing with the twins.
"It was explained to them that they do not need any special care at AIIMS, Delhi and that they needed nursing care and physiotherapy. The team from Odisha was convinced.
"Such care exists at any state/district level centre across country and in Odisha too," the AIIMS said.
The institute further informed the NHRC that even though the Odisha government had given Rs 1 crore financial support for these children, the premier institute had used only Rs 11.8 lakh.
The remaining money was transferred back to the Odisha government in December last year, it said.
"The entire stay at the hospital for both the children and their parents in two separate rooms over the last eight months and their logistics, and consumables (amounting to over Rs 25 lakh) was borne by AIIMS.
"Needless to say, a team of 35 consultants from various specialties, 40 doctors and 50 paramedical support team (nursing, technicians, physiotherapists) provided uninterrupted 24x7 care to these children as part of our clinical duty," the institute said.
The petition mentioned that the health condition of the twins, who have been staying at AIIMS since the operations along with their parents, needed to improve further before they could be sent to Odisha.
"Once they ... (are) sent back to Odisha, where the infrastructure and ancillary and incidental facilities are lacking, there shall be an imminent threat to their lives," it said.
"The facts and circumstances of the case also pose questions regarding the right to health and basic human rights of not only the children but of the entire family," Tripathy said adding that unless the NHRC intervenes, the "poor, uneducated ST family shall be deprived of justice".
The first phase of the surgery on the twins was performed on August 28 when the doctors created a venous bypass to separate the veins that return blood to the heart from the brain.
The final separation of the twin swas performed by a team of around 30 specialists on October 25.
