A young boy with an ultra-rare genetic condition that makes him look like an old man has defied doctors to celebrate his 15th birthday.
Nihal Bitla, who lives on the outskirts of Mumbai, India, has Hutchinson-Gilford progeria syndrome (HGPS), which ages his body eight times faster than normal.
The condition leaves Nihal bald, with heavy wrinkles and severely weakened limbs.
The average life expectancy for children with progeria is 14, with many dying from a heart condition called arteriosclerosis, which usually affects adults over 60. As a result, children with progeria are prone to heart attacks and strokes aged 10 or under.
But Nihal blew out the candles on his 15th birthday cake in January 2016, making him the oldest living child diagnosed with progeria in India.
And despite the challenges posed by the syndrome, the teenager remains positive about his future.
‘I have never felt that this is a disease, because I’m a special child. This is like a God’s gift to me,’ says Nihal.
His dad Srinivas Bitla, who owns a mobile phone repair shop, says his son started developing marks on his body at an early age.
‘Nihal wasn’t like this since birth. A couple of months into his life, he started developing spots,’ explains Srinivas. ‘We thought those were blemishes on his skin probably. Then we thought it was a genetic problem. However, after visiting a lot of doctors, we were told that this was a case of progeria.’
Dr Parag Tamhankar, a medical geneticist and paediatrician at the Genetic Research Centre in Mumbai, finally diagnosed Nihal with progeria five years ago.
‘When I met Nihal in 2011, I heard the family’s complaints that Nihal has started looking like an old man, right in his childhood.
‘At that time he was a 10-year-old kid and he had started looking like a 60-year-old. I knew it was something like progeria.’
As well as the visible symptoms of accelerated ageing, Nihal also suffers a variety of health issues as a result of his condition.
Dr Tamhankar adds: ‘Nihal has a lot of physical problems. His joints are stiff and his stamina has decreased over the years.
‘He had a few episodes where his joints got dislocated spontaneously, including his shoulders. Even while changing his clothes, he fears that his joints can get dislocated.’
The brave youngster was initially able to attend school, but was eventually forced out by bullies.
Now Nihal spends his days playing with toy robots, surfing the Internet and painting, while his 11-year-old sister Vaishnavi helps him with studies.
‘I go out with my sister, I play with her, she looks out for me. If someone calls me names, she beats them up,’ says Nihal.
And while his body shows the signs of rapid ageing, Nihal has the mental age of a regular 14-year-old.
While Progeria is incurable, the Progeria Research Foundation in Boston has been pioneering a drug treatment to combat the heart problems.
Nihal travelled to Boston, America, in December 2014 for free treatment – which appears to be having a major impact.
‘There have been a lot of visible changes in Nihal’s health – for example, his body flexibility,’ says his dad Srinivas.
‘Earlier, he was not able to bend or stoop. But now he is able to do that.’
As well as assisting with treatment, the Progeria Research Foundation and their media partners are also trying to raise awareness of the condition, especially in India where they hope to find and help more children with progeria.
Nihal has been at the heart of a social media campaign – and is determined to help others with his condition.
‘There are many more in India who are like me. It’s my wish that all of them should get quality treatment, says Nihal.