A patient arrived at the hospital with a broken femur and a huge pseudo tumour on his leg. For five years this twenty five year old man had been lying at home, in acute pain and unable to move. No-one was prepared to treat him. It was 1995 and the small centre had never operated on a haemophiliac. They put out an appeal for donations to fund the Factor necessary for the surgery, and Dr Garg succeeded in amputating the damaged leg. Within months, the young man, complete with a prosthetic leg, had opened a shop. When they last met, he told Dr Garg he was planning to get married. It is wonderful to see, the doctor said, this man is now so happy.
Some years later, a twenty year old patient crawled on all fours into Dr Garg’s office. His limbs had been so badly deformed by untreated bleeds he had no other way of moving around. It was, said Dr Garg, a pathetic sight to see. The man was admitted to the hospital. Their supplies of factor, again acquired through donations, were highly limited (they call it “treating conservatively” over here – which basically means they use absolutel
y minute quantities of factor incredibly sparingly). Injections were combined with a programme of traction and physiotherapy. After three months, the man walked out of the hospital on his own straightened legs.
The final story Dr Garg told is a contemporary one. They have a twenty-eight year old patient who needs a full hip replacement operation. But he has an inhibitor. He completed his education and wants to be a teacher. Instead he is lying at home unable to move and he has been there for the last year. The doctor told me that they have been trying to find donors – but the cost of inhibitor drugs is massive and they have been unsuccessful. Worse, he says, there is no prospect of the centre being able to fund surgery for him in the near future. I asked Dr Garg what will happen to the man without the surgery. “God knows,” he said.
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