|Year : 2021 | Volume
| Issue : 3 | Page : 321-323
Devastating impacts of COVID-19: An experience of abandoned child at a tertiary care hospital
Deepali Thakur1, Navneet Dhaliwal2, Sruti Sharma3, Anil Kumar Gupta4
1 Junior Resident, Department of Hospital Administration, Nehru Hospital, PGIMER, Chandigarh, India
2 Associate Professor, Department of Hospital Administration, Nehru Hospital, PGIMER, Chandigarh, India
3 Senior Resident, Department of Hospital Administration, Nehru Hospital, PGIMER, Chandigarh, India
4 Head of the Department Cum Medical Superintendent, Department of Hospital Administration, Nehru Hospital, PGIMER, Chandigarh, India
|Date of Submission||25-Feb-2021|
|Date of Decision||30-Mar-2021|
|Date of Acceptance||23-Jul-2021|
|Date of Web Publication||22-Sep-2021|
Control Room, Block D, Ground Floor, Department of Hospital Administration, Nehru Hospital, PGIMER, Sec-12, Chandigarh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
There were many challenges faced by both health-care workers and the common population during the COVID-19 pandemic. One such case was witnessed where a migrant worker abandoned his child in a tertiary care hospital, while he was undergoing treatment for acute liver disease and was reported COVID-19 positive. The child was treated for COVID-19 in the dedicated isolation facility of the hospital as per the guidelines. Later, when the child was declared COVID-19 negative and was ready to discharge, treating doctors found it difficult to hand over the child. The timely intervention and extraordinary efforts by the department of hospital administration and child welfare committee reunited the child with his family.
Keywords: Abandoned, COVID-19, impact, pandemic, stigma
|How to cite this article:|
Thakur D, Dhaliwal N, Sharma S, Gupta AK. Devastating impacts of COVID-19: An experience of abandoned child at a tertiary care hospital. Indian J Public Health 2021;65:321-3
|How to cite this URL:|
Thakur D, Dhaliwal N, Sharma S, Gupta AK. Devastating impacts of COVID-19: An experience of abandoned child at a tertiary care hospital. Indian J Public Health [serial online] 2021 [cited 2021 Dec 2];65:321-3. Available from: https://www.ijph.in/text.asp?2021/65/3/321/326389
| Introduction|| |
“Abandoned child” means a child deserted by his biological or adoptive parents or guardians, who has been declared as abandoned by the committee after due inquiry. A recent review of psychological sequelae has revealed numerous emotional outcomes, including stress, depression, irritability, insomnia, fear, confusion, anger, frustration, boredom, and stigma associated with quarantine, some of which persisted after the quarantine was lifted. One such finding was that the stigma of getting infected with COVID-19 positive can lead to the abandonment of kin because of the myth then circulating in parts of the Asian community that people admitted to hospital were never discharged alive.
| Case Report|| |
A 15-year-old boy was brought to emergency department of the institute on August 03, 2020, at 23:05 pm by his parents in a state of altered sensorium for the past 2 days, with a history of fever and jaundice for 7 days. His COVID-19 report was negative. Computed tomography scan was suggestive of cerebral edema and was provisionally diagnosed as a case of atypical illness (acute liver failure). The patient was shifted from Emergency to Liver intensive care unit (LICU) where he was intubated and was kept on ventilator support for 3 days.
As his condition was not improving generally, he was again tested for COVID-19 on the 9th day of his admission and was found to be positive. As per the protocol, the patient was shifted to COVID-19 hospital of the institute. Till the time patient was in LICU the parents and the relatives used to come and meet him regularly and were also taking care of him, but once the COVID-19 positive report came through, his parents and relatives abandoned him. They could not even be contacted telephonically.
After a period of 3 weeks, the patient became negative and was shifted to Male Medical Ward of Nehru Hospital on September 05. The patient was fully recovered and a discharge was planned but since he was not an adult, had to be handed over to the parents or guardians as per the child protection rules. The Resident Doctor counseled the child and asked him to provide alternate numbers or addresses of family members but without much success. The boy was not literate enough to share any details. Therefore, the hospital security and the lifeline nongovernment organization (NGO) associated with the Institute were informed. The security department informed the local police. The local police officers visited the patient in Male Medical Ward, but the patient was not really helpful. He was rather quiet, distressed, and looking helpless. The department of psychiatry was asked to intervene. The Psychiatry Doctor's advised supportive sessions and no medicine.
The Child Welfare Committee, Chandigarh, and District Child Protection Unit, Mohali, (DCPU) were informed by E-mail as well as telephonically regarding the abandoned child. The DCPU authorities asked a repeat COVID-19 test as the patient was to be shifted to a Juvenile shelter home where >50 boys of his age stay. The reverse transcription-polymerase chain reaction test for COVID-19 was sent which came out to be positive. The DCPU authorities were explained that the normal quarantine period required as per the Centers for Disease Control and Prevention and national guidelines had been adhered to and the test can stay positive for many days after that, but to no avail, they refused to take the boy to Juvenile shelter. The Hepatology Department under whom the patient was admitted shifted the boy back to isolation ward. Meanwhile, the resident kept pursuing the case for the restoration of the child with the family. The matter was finally brought to the notice of hospital administration, which further escalated the issue with the security department of the institute, the local police as well as the child welfare committee Chandigarh.
A search on the recorded address was started by the local police, but when asked about the patient's identity at that place every person of that area denied any knowledge and the telephone number of the patient registered on his visit to emergency was also untraceable. Due to lack of money to foot their medical expenses or in case of terminally ill or unconscious patients, families of patients at hospitals go untraceable later, but this was a strange case where a conscious 15-year-old boy not terminally ill, but poor and COVID-19 positive was abandoned.
On September 23, 2020, the third sample for COVID-19 was sent and it was negative. Therefore, the patient was shifted back to Male Medical Ward of Nehru hospital. The child Welfare Committee (CWC) was contacted telephonically and a fresh written communication was again sent through administrative offices. The CWC responded very quickly by E-mail on the very same day and deputed an officer to follow-up on the case. The Child Welfare Committee also asked the DCPU authorities of Mohali as the patient belonged to Mohali. The DCPU personnel along with police personnel took permission from the administration and they took the boy to mentioned address in the file. There they found the relative (Mother's sister) who though recognized the child but refused to take him back. She informed that his parents belong to Bihar and had gone back.
On September 28, patient custody was taken by the worker of DCPU, Mohali, Punjab. All hospital charges were waived off. The boy was still kept in quarantine for few days in a Juvenile home. Later, he was shifted to another suitable juvenile home of the state to which he belonged.
The CWC Authorities spoke to the relatives and parents and told them that the boy is fine, hale, and hearty and his COVID-19 test is negative. They also told the parents that all hospital dues have been waived off. Then, the child was finally reconciled with his parents on October 01, 2020, after almost 45 days.
| Discussion|| |
Unfortunately, since the onset of the coronavirus pandemic in India, the phenomenon of abandoning children has seen a sharp rise as stated in an article by a children's NGO such as one in Ahmedabad where a 6 month-old baby girl was abandoned by her parents after they were asked to get the COVID-19 test done after admission in hospital. Another case reported Cuttack wherein parents abandoned a year-old boy who died in SCB Medical College and Hospitals Isolation Ward in suspicion of COVID-19. Childhood is a critical period in any human's life, which marks the foundation of the personality and emotional resilience's capacity of any person. In this difficult time, attempts should be made by the administration to mitigate the effects of COVID-19 on those who deserve protection the most: The psycho-education, therefore of parents and caregivers, to support children in these difficult times and build their resilience is imperative. Department of Hospital Administration and Child Welfare Committee with their concerted efforts made the rehabilitation of a 15-year-old boy who was COVID-19 positive with his parents possible.
To conclude COVID-19 not only affected our health's but also our minds also. It has brought forth unexpected situations.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Government of India. The Juvenile Justice (Care and Protection of Children) Act, 2015. New Delhi: Government of India; 2015. p. 45.
Betty P, Carol N. Mental health and the Covid-19 pandemic. N Engl J Med 2020;386:510-2.