May 18, 1998

A determined foursome overcome disease and deprivation in a stirring story of survival.

By Binoo K John

One is for sorrow and two for joy, but what if it is four? Since October 1996, Rituraj and his wife Shakuntala have been wondering about the inexplicable working of this strange universe which left them holding four babies -- the country's first quadruplets in about a decade and possibly the only Indian quadruplets to have survived for more than a year. More important, it's the second case in the world when quadruplets gestated for an amazing 36 weeks.

When Rituraj saw four tiny pink mouths bawling at him, like newly hatched birds opening their beaks, his heart melted. Tinged with love was a sense of fear. "Four of them, what could I do? At that time, I was caught between fear and happiness," he says. Eighteen months later, happiness has clearly overcome apprehension as Rituraj sits with his clamouring brood -- two girls, Saloni and Sunaina, and two boys, Sani and Sachin.

Eighteen months is a long time to bring up quadruplets on a monthly budget of about Rs 3,000 which Rituraj earns as a cook at Delhi's exclusive India International Centre (IIC). Doubts and fears haunted the parents as, one after the other, the four had to be rushed to hospital to be treated for wheezing, indigestion and fever. Saloni ended up getting two attacks of pneumonia.

According to medical experts, the chances of triplets or quadruplets dying in infancy are 12 times more than for single babies. Even if they survive beyond infancy, the chances of kidney-related problems or cerebral palsy later on are quite high. Luckily for the quadruplets, they were all above 1 kg at birth and their gestation period was two weeks more than the minimum crucial 34 weeks for multiple pregnancies.

Three weeks after the quadruplets were born, Shakuntala had the bewildered look of an earthquake survivor. Her face flushed with exertion, she kept glancing anxiously at the faces of the puny foursome, huddled together on a camp cot against the biting cold. "My neighbours and friends help me," she had said then. Till the day the four were delivered at the All India Institute of Medical Sciences, Delhi, by Dr K.K. Roy through Caesarean section, Shakuntala was under the impression that she was bearing three babies -- an ultrasound in Shimla had showed her that. She had rushed in panic then to meet Roy, who had used in-vitro fertilisation to help her conceive. Roy's scan showed a fourth foetus hidden below, but he kept it from the parents. Normally, in such a situation, two or three embryos are selectively aborted to give at least one of them a chance. In this case, the four were perfectly positioned.

"She's a mountain girl. That's why she could take it," says Roy about his star patient. But mountain girls too need sleep. Neither Rituraj nor Shakuntala has managed to sleep a whole night at a stretch since the four were born. Sending Sani away to Rituraj's mother has not helped. When Saloni is sleeping, Sachin demands milk and high-pitched Sunaina wants to test out her potential as a tenor. The noise in the 10 ft by 6 ft room is like a symphony gone haywire. Sani, chubbier after a winter sojourn in a village near Shimla, can't get used to the blistering heat. Woken up from a sound afternoon slumber, he is crying without a break. He throws up and there is a scramble to set things right. In the midst of the continuous clatter, Shakuntala keeps her cool. She calmly picks up Sani and is caught once again in the whirl of her endless chores. Change soiled clothes, feed, sing a lullaby, a short nap, a piercing scream, water, a fresh set of clothes ... another day.

The early days were the most taxing, the days when, as Rituraj says, "one expensive milk tin lasted only two days". The Delhi quartet is now bubbly enough to sustain their symphony throughout the day. Rituraj holds Sachin and Saloni in a fatherly bear hug. Sunaina, her leg scalded by hot tea, is sitting with a pained expression as she tugs at her father's pants to get attention. But Rituraj's arms are full and Sunaina has to await her turn. Maybe he will carry her in his arms too just before he leaves for IIC after his three-hour evening break. And maybe one day he will rustle up for his brood the Chinese dishes at which he is an expert.

It is evening, the subdued quartet have shifted to a more sedate mode. The sun is dipping beyond the cluster of concrete houses and they are visibly happy with the evening breeze. At their father's command, "Jai, bolo", two of them fold their hands in a namaste as we climb down from the terrace. Their hands, full of gory red spots from mosquito bites, come together. As if in prayer.

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