Mohammad Kaleem is eight years old
but his life has been ruined by a cruel and isolating condition.
His hands are 13 inches long.
They weight 5.5lb each
and they're still growing.
Some even believe he's cursed.
Kaleem is excluded from school and rejected by his community.
Unable to dress or feed himself,
Kaleem is entirely dependent on his parents.
But there is hope for Kaleem and his family.
Pioneering surgeon Dr Raja Sabapathy
believes he can stop the boy's hands growing.
He's convinced he can improve the function in Kaleem's hands.
It will involve intricate, complicated and painful surgery
but it's the only chance for Kaleem to live a normal life.
Bokaro, eastern India.
Here, there is only the most basic medical care.
Born into poverty,
Kaleem's abnormal growth has been undiagnosed and untreated.
His condition, known as macrodactyly, or local gigantism,
is usually treated at birth.
Now weighing 5.5lb each, Kaleem's hands are almost useless.
His mother Haleema, who has two other children untouched by the condition,
can only watch as his hands continue to grow.
Shamim, Kaleem's father, earns less than £15 a month
and can't afford medical care.
Local doctors have been unable to diagnose Kaleem's rare condition.
In his village,
Kaleem's condition has also exposed more worrying fears...
..even from his family.
Branded as the devil's child,
Kaleem is regularly the victim of village bullies.
While his elder sister Nasira attends school, Kaleem must stay at home.
The headmaster won't allow Kaleem in the classroom.
Excluded from school, Kaleem faces a future of illiteracy and poverty.
But his extreme condition has caught the attention of the world's media.
And now leading microsurgeon Dr Raja Sabapathy
is offering him the chance of a more normal life.
As Kaleem is such an exceptional case,
Dr Sabapathy will treat him as part of his charity work.
Can medical science free Kaleem from his reputation as the devil's child?
Eight-year-old Kaleem suffers from macrodactyly, or local gigantism.
His already-huge hands continue to grow.
After learning about his extreme condition,
leading reconstructive surgeon Dr Raja Sabapathy
has offered to treat Kaleem.
His hospital in Coimbatore in South India
will take on Kaleem as a charity case.
(SQUEALS)
Kaleem and his family set off on an extraordinary journey.
It's the first time they have travelled
more than a few miles from home.
They're heading a thousand miles south,
with hope that Kaleem can at last be helped.
(HORNS HONK)
Ganga Hospital in Coimbatore is built around Dr Sabapathy's expertise.
Reconstructive microsurgery.
The pioneering surgeon would normally operate on infants,
well before local gigantism has been allowed to develop.
As an eight-year-old, Kaleem has the most advanced case
that this specialist centre has ever seen.
Good boy. Good, good, good.
Dr Sabapathy's priority
is to increase the function in Kaleem's hands
and try to reduce their size.
Kaleem is left-handed.
Treatment will focus first on the hand he uses least.
The plan is for Kaleem to undergo two rounds of complex surgery.
Now he faces weeks of intensive assessment.
Dr Amit Patil also will be working closely on his case.
First, he needs to take a detailed medical history.
In his first week,
Kaleem undergoes extensive clinical testing and examinations.
Blood tests and chest X-rays will determine
if he will be able to undergo hours of anaesthesia.
The initial tests reveal that Kaleem is malnourished
due to intestinal worms.
He's mostly skin and bones.
Any excess weight is in his abnormal growth.
10% of his bodyweight is in his right arm alone...
.. and he's very weak.
Kaleem now needs to build up his strength with the hospital food
to cope with the rigours of surgery.
After one week in hospital, Kaleem is getting stronger.
Week two.
Next, it's physiotherapy tests on the boy's reflexes.
With the first procedure days away,
the team complete testing and perform a full body scan.
These reveal fatty tissue in Kaleem's arms, hands and chest.
After two weeks in hospital, the time has come.
The team are confident that Kaleem is strong enough to withstand surgery.
It's time to prepare for his first operation.
His right hand has six fingers, one of them completely useless.
In this first phase of surgery,
the size and weight of Kaleem's right forearm will be reduced
to lighten the strain on his weakened body.
As Kaleem faces hours of intricate and complex surgery,
his family face the agony of waiting.
First, the blood supply to the arm is cut off.
Now, the team assess the tendons, nerves and veins in Kaleem's forearm.
The tendons in his forearm are buried in dense, fatty tissue.
The medical team must cut with precision.
A mistake here would be disastrous.
Kaleem has been in theatre for almost four hours.
So far, his parents have been given no news.
To protect the existing mechanical functions of Kaleem's hand,
Dr Sabapathy has to avoid
cutting essential nerves, tendons, arteries and muscles.
The nurse applies a small electric charge
to track the main nerve running through Kaleem's arm.
The nerve at Kaleem's wrist has grown to around four times its normal size.
After freeing the tendons trapped in fat,
Dr Sabapathy makes a startling discovery.
It's good news for Kaleem.
Finding Kaleem's finger joints are still flexible
means that much of his hand movement may be restored
by stripping out the excess fat.
Having identified all the essential parts of the arm,
the bulky fat tissue and excess skin is removed.
They're working against the clock,
because if the blood supply is cut off for too long,
the hand and arm will start to die.
The last stage is to deal with Kaleem's sixth finger.
With the sixth finger removed, the surgery is over.
As Kaleem's wounds are closed up, now is a crucial time.
The first operation will indicate how effective surgery can be
for this rare condition.
With this final stage complete, the next surgery will attempt
to reconfigure and remodel Kaleem's giant hand.
(GROANS)
After a long and anxious wait,
Kaleem's parents can at last be reunited with their son.
Now the operation is over,
the concern is that Kaleem's abnormally large hand
may not heal properly.
It's two days later.
The bandages can be removed
and everyone can see how his hand looks after the operation.
The first operation looks like a success
but more surgery lies ahead.
Dr Sabapathy's next operation is critical
to stop Kaleem's hands from growing further,
cutting into his extended bones.
Eight-year-old Mohammed Kaleem
suffers from macrodactyly, or local gigantism.
In his remote Indian village,
he's been literally demonised and excluded from school.
But eminent surgeon Raja Sabapathy has decided to help him.
Yes. Good.
Two months after the first operation on his right forearm,
Kaleem has returned for further surgery
to reshape the bones in his right hand.
But Dr Sabapathy warns he can't work miracles.
Today's surgery will be more invasive than the first operation
and the outcome is crucial for Kaleem's future.
For this second stage of surgery, Dr Sabapathy's objective
is to decrease the size of the hand and fingers
and prevent them growing further.
He plans to operate on the joint of the fingers
and cut the growth plates,
the cartilage that makes children's bones grow.
(WAILS)
It's a complex operation,
but Kaleem's parents have put all their faith
in Dr Sabapathy's pioneering methods.
The time has come.
This reconstructive surgery will be tough
but it's Kaleem's best hope for a better life.
His giant hands are unique,
the most advanced case of gigantism ever seen at this hospital.
The boy's right hand alone weighs 5.5lb
and without treatment, it will keep growing.
Dr Sabapathy plans to work on the two large middle fingers.
He begins with his right ring finger.
The aim is to reduce both their size and weight
to try to develop grip in the right hand.
The team must preserve the blood supply
and be careful not to damage the tendons and nerves in the fingers.
Removing the fatty tissue will make the first finger lighter and slimmer.
Next, the bone must be cut.
As a result, Kaleem's ring finger is reduced by an inch and a half.
Dr Sabapathy can now review his work,
before moving on to the second finger.
It's a stressful time for the boy's father.
With the ring finger trimmed,
next the team turn to Kaleem's even larger middle finger.
It's a vital time in the operation.
Now Dr Sabapathy must remove the growth plate
to prevent the finger getting longer.
Finally, he inserts a metal rod, a K-wire, to hold the bones in place.
With the growth plates removed,
Kaleem's fingers will not continue to grow.
With the work on the fingers complete,
Dr Sabapathy turns his attention to the huge palm.
It's intricate surgery,
dangerously close to the boy's essential tendons.
To increase the grip and mobility in Kaleem's hand,
the tendons, blood vessels and nerves must be freed from a mass of fat.
By 8pm, after almost five hours,
the surgery is finally over.
For Kaleem's parents, it's been a long and anxious wait.
A drowsy Kaleem has come through well.
His right hand has been re-sculpted, trimmed,
his middle fingers are shorter and thinner
and his palm has a hollow for the first time.
Now his surgery is finished, Kaleem can begin his lengthy recovery.
And, at last, his parents can be reunited with their son.
The next 48 hours will reveal if the procedure has been successful.
The operation is a success.
With the growth plates removed,
Kaleem's giant fingers will now stop growing.
But it could take months
before he will feel the benefit of the lengthy surgery
and use his hand.
As the wounds heal and the swelling reduces,
the next stage will be prolonged physiotherapy.
With the two rounds of surgery completed successfully,
there's renewed hope for Kaleem's parents.
Now Kaleem and his family can prepare to return to their village in Bokaro.
But back home, the boy was seen by many as the devil's child.
He's been excluded from school.
But what will the villagers and the rest of his family make of him now?
Mohammad Kaleem has been through two rounds of intensive surgery
on his gigantic hands.
Eminent surgeon Dr Sabapathy
is helping the boy as part of his charity work.
With such advanced gigantism,
Kaleem's hands will always be abnormal.
The priority is to improve their function,
rather than their appearance.
The operation was risky,
so the team focused on the right hand, the one he uses the least.
After surgery, Kaleem has returned home
and is almost three months into his recovery.
Today, one of the surgical team, Dr Amit Patil,
has travelled a thousand miles to visit Kaleem
for a post-operative checkup.
He's here to assess how well Kaleem is coping at home since his surgery.
During his operation,
metal wires were inserted into each of Kaleem's fingers
to keep the bones straight.
But one has fallen out.
Dr Patil has to assess the situation
and calls Dr Sabapathy for advice.
After conferring with Dr Sabapathy,
Dr Patil decides to remove the remaining wire
left in Kaleem's finger.
This will help to reduce the post-operative swelling.
Dr Patil now tests Kaleem's manual dexterity.
Exercises using both his hands is the key to Kaleem's rehabilitation.
His recovery will be a long process.
He'll need intensive physiotherapy for a year.
But more urgently, Dr Patil needs to address the local slur
that Kaleem is the devil's child.
Kaleem's uncle is an influential village elder
and believes the boy is cursed.
Convincing him it's a medical condition
may quell these rumours once and for all.
Such superstitions are deep-seated
but Dr Patil hopes he's made some progress.
Dr Patil leaves Kaleem's family with the medical advice they need
to continue his recovery.
Kaleem wants to live a normal life like the other boys in his village...
..but doesn't go to school with his friends.
Now Kaleem is home, his father wants to confront
the school headmaster's prejudice against his son.
It's good news.
At last, Kaleem has a place at school.
Because his condition is so advanced,
Kaleem will always be different from the other boys.
But since his surgery,
Kaleem is more comfortable and the function in his hand is improving.
With a place at school and greater acceptance in the community,
there's now hope for a better life for Kaleem.
subtitles by Deluxe