JJ Hospital’s paediatric surgery department was once a revered super-specialty. But, it is now facing a decline and is on the brink of collapse.
The dean’s office at JJ Hospital, Byculla, recently requested the medical education department: they needed to borrow a paediatric surgeon from Pune’s BJ Medical College to perform a procedure on a 5-year-old girl, who had been raped. Allegedly, JJ’s paediatric surgeons were unwilling to handle the complex procedure themselves.
This request for outside help has revealed the dangerous status of JJ Hospital’s once-admired 57-year-old pediatric surgery department, a vital super-specialty branch that has steadily declined and is now on the brink of collapse. This situation illustrates the state’s complete failure to create employment and train doctors in super-specialty sectors.
Since the JJ department diverts most children needing surgery to BYL Nair or KEM Hospital, the situation is dire. At least two such cases arrive everyday, often from faraway districts. Only one patient was in the 18-bed pediatric surgical ward 41 on Friday. No JJ medical student chose any of the five paediatric surgery super-speciality seats this year. Less than half of the 1,100 surgery cases the department performed a decade ago are being performed.
JJ dean Dr. Pallavi Saple said they had to get a doctor from Pune’s medical college for a child’s severe case because their doctors wouldn’t. Commissioner of medical education Rajeev Nivatkar approved. Dr. Suryodhan Reddy, BJ Medical College, Pune pediatric surgery professor, traveled to Mumbai last week to do the treatment. He declined to comment but claimed the child was healing well.
A Navi Mumbai child admitted to JJ with serious genital injuries after her uncle sexually assaulted her after Diwali in November was the surgical case. Surgical specialists in pediatrics and gynecology performed thorough repairs. A colostomy was used to temporarily divert feces from the healed wound. A colostomy is usually closed after six weeks, but the department’s hesitation and Reddy’s transfer to Pune last year delayed its completion until last week.
Although the pediatric surgery unit has three full-time faculty members, clinicians from other departments said that it has been reluctant to handle challenging cases and constantly refers even simple ones to nearby hospitals. “From trauma, intestinal injuries, to pneumothorax, to surgical emergencies, almost all cases are being sent away,” a top doctor remarked. A Dongri resident who rushed his child to the emergency fled in frustration after causing a commotion without surgery doctors. Commissioner Nivatkar denied knowing about referrals. “I will investigate,” he responded.
Three of JJ’s four pediatric surgery professor positions are filled. The department hasn’t had a full-time professor since 2006, which is concerning as JJ is one of two government medical institutions in 25 that offers pediatric surgery. In addition, acting head Dr. Minakshi Bhosale goes “irregularly” to Mumbai from Pune. The other two doctors treat restricted cases.
Lack of a full-time professor, internal disagreements, and faculty shortages have stopped students from entering, leaving the department without junior resident doctors. “The faculty is hesitant to undertake cases as without residents there would be no one to provide post-operative care,” a member stated.
Dr. Bhosale maintained that her department was not responsible for decades of faculty and resident doctor shortages.
A paediatric surgeon could help one in 3,000 state-born newborns with congenital defects. Full-fledged neonatal ICUs with surgeons can save up to 10,000 infants, but Maharashtra has only one professor and one associate professor post till 2023, limiting faculty development in this vital area.
Conclusion
The once-revered super-specialty paediatric surgery department at JJ Hospital is declining and near collapse. The department sends most youngsters needing surgery to BYL Nair or KEM Hospital, which receives two daily. This year, the department’s paediatric surgery ward 41 has one patient, and no medical student has chosen one of the five super-specialty seats. Three of the department’s full-time faculty are full. The department has been without a full-time professor since 2006, a problem as JJ is one of two government medical colleges offering pediatric surgery out of 25. Without a full-time professor, internal disagreements, and faculty shortages, students have not joined, leaving the department without junior resident doctors. A paediatric surgeon could help one in 3,000 state-born newborns with congenital defects. There is just one professor and one associate professor post in Maharashtra until 2023, which hinders faculty development in this critical subject.
