NEW DELHI - A 15-month-old Indian girl whose head has swollen to nearly double its normal size is "doing well", a doctor said Friday, but treatment could be complicated by the extreme nature of her case.
Roona Begum, who suffers from hydrocephalus, a rare disorder that causes fluid to build up on the brain, was discovered earlier this month living with her parents who are too poor to pay for life-saving treatment.
Roona was diagnosed with hydrocephalus just weeks after her birth in a government-run hospital in remote Tripura state in northeast India.
The swelling is putting pressure on her brain and has made it impossible for her to sit upright or crawl on the ground.
The publication of pictures taken by an AFP photographer in remote Tripura state in northeast India last week saw a top hospital in Delhi offer to examine the child and led well-wishers abroad to set up an online donation fund for her.
Roona's condition has resulted in her head swelling to a circumference of 94 centimetres (37 inches), putting pressure on her brain and making it impossible for her to sit upright or crawl.
Her father, Abdul Rahman, 18, who lives in a mud hut with his family in the village of Jirania Khola, had been praying for "a miracle" that would save his only child.
"Day by day, I saw her head growing too big after she was born," said the illiterate labourer who works in a brick-making factory.
And a miracle came when a top private Indian hospital offered to examine Roona - raising hope that she will get the life-saving surgery she urgently requires.
Her doctor, leading Indian neurosurgeon Sandeep Vaishya, who heads neurosurgery at the flagship hospital run by the private Fortis Healthcare group near New Delhi told AFP, "the child is doing well so far".
But he added: "Her case is very complex so we are currently considering options of how best to proceed."
The most common treatment involves the surgical insertion of a mechanism known as a shunt, which drains cerebrospinal fluid out of the brain and towards another part of the body where it can be absorbed easily into the bloodstream.
In Roona's case, however, the huge size of her head relative to the rest of her body complicates matters, according to Vaishya.
"Her head is several times larger than her abdomen, so we have to consider how that much fluid will be absorbed by her body if we put in a shunt," Vaishya said.
"I am also worried because she has developed a skin condition on the base of her head, suggesting that her scalp is quite delicate, so a shunt could pierce through and leak fluid through the skin, causing other problems," he added.
Local doctors had told Roona's parents to take the newborn to a private hospital in a big city but the costs were too high for her 18-year-old father, Abdul Rahman, an illiterate labourer who earns 150 rupees (S$3.40) a day.
Although the cost differs from case to case, a complex surgery like this one is estimated to cost about 125,000 rupees (S$2,868) and require a three-day hospital stay.
The US government's National Institute of Neurological Disorders and Stroke estimates about one in every 500 children suffers from hydrocephalus.
Cases like Roona's, where the head has doubled in size in a relatively short span of time, are extremely rare, according to Vaishya.
She has outlived an initial prognosis by doctors that she would survive only two months.
Vaishya said that surgeries to treat hydrocephalus cases are "not particularly risky."
"The child must be in a lot of pain because her head is so heavy. Still, in the images I could see that she was smiling sometimes, which makes me think that her cognitive functions might still be intact," Dr Vaishya said.
The website for donations to Roona can be viewed at www.mygoodact.com/collectiondetailperson.php?id=212. It has already raised more than US$34,000.