Friday, April 24, 2009

Preventing Hospital Mishaps


The demonstrations against ADK Hospital following the tragic deaths of 37-year-old pre-school teacher Aishath Shaheen Mohamed and her unborn baby following a caesarian section on Monday brings to sharp focus yet again the increasing frequency of suspected cases of medical malpractice in the Maldives. The few cases that have gone up to the court, thanks to pro-bono lawyer Husnu Suood, such as those of Ali Zakhwan and Aishath Iyan are just the tip of the iceberg. Even those two cases are still pending in the court.

Shaheen, who had a past history of 2 caesarean deliveries, was admitted to ADK Hospital on 19th April. She was taken up for surgery the following day after her baby was diagnosed dead by hospital doctors. Her condition worsened following surgery and was referred to Indira Gandhi Memorial Hospital, where she died soon after.

The matter is under investigation by Maldives Police Services as well as ADK Hospital. Thus it is inappropriate to express any opinions here that would compromise the investigation. However, in the interest of preventing future mishaps certain points must be noted.

  • Is there an internal system in any Maldivian hospital to review complications and deaths proactively? Or is the system geared to hush up mishaps unless relatives complain or demonstrate?
  • So far we have only heard about Police and ADK investigations. Where is the Health Ministry investigation; and is the Medical Council sleeping?
  • One protester, Fathimath Shirmeela, is reported to have said it was imperative the government carried out comprehensive checks on foreign doctors and their qualifications. Is the Medical Council in a position to clear her doubts and concerns?
  • Another protestor, Hawwa Riyaza, said the purpose of the protest was to raise awareness about the poor service at the hospital. How accurate is her statement on quality? Is there an objective way to measure quality in ADK or any other hospital? Whose responsibility is it to ensure that each hospital has a system of quality assurance?
  • Is it left to Husnu Suood to single-handedly tackle the issue of medical malpractice in the country?


 


 

24 comments:

Anonymous said...

ADK must do a lot to regain lost reputation.

Anonymous said...

The hospital has fired two nurses saying they did not keep records of the care. if there is no record it must be assumed no care was given. how good is record keeping in our hospitals? what we get to see a few words jotted hurriedly by doctors and nurses. is that how records are kept in hospital?

Anonymous said...

Adk Hospital good Reputation is Loss.....only One thin is going Wrong, fuel off Doctor is Doing One Wrong thin........ Please dont do those off the thin.............

Anonymous said...

Yes, it is very easy for us to criticise others for negligence, but we have failed to realise that when we have shortage of doctors in the country, those who were trained for the purpose of fulfilling the shortage have distant themselves from the profession and they find time to write stuffs like this in blogs. Why not these people practice what they were trained for, then perhaps we maybe able to prevent this sort of deaths.

Anonymous said...

More hospitals and competition leads to better health care. Maldivians only recently had the option of choosing from 2 hospitals, and most people have no option but to seek medical attention from these alone. It is the governments duty to force bring health care services to par. So far I see no mechanism in place to give people confidence on the level of service. We are still beggars.

Faisal said...

This is a very sad turn of events and my prayers are with the family of Shaheen,
This demonstrates the urgency for all those involved in healthcare to call for and start an overhaul of the healthcare system in the country. We need to have more rigorous ways to control the quality of healthcare being given, and train more people in all areas, specially medical ethics and medical law, not to focus on medical negligence, but to establish and implement an ethically correct and legally just system of healthcare.
Perhaps this unfortunate event only has to happen to a family related to someone at the head of the government for them to take action?

Anonymous said...

Nashid got rich through hard earned money of the people. He has this large plot of land at low rent. We are not jealous of his fortune. But people must get good care from this valuable real estate.

Anonymous said...

Dr Waheed,

You were the head of the team that did the internal investigation of the Ali Zakhwan case at IGMH. Instead of asking the question whether hospitals have a system of internal investigation why don't you tell us how that particular case was handled by everyone, including you?

I'd be very interested in knowing what YOU did in that investigation. Whether it was, as you say, a Hush-Up affair.

My opinion on the other issues: Medical Council is NOT ready. It even does not have a true legal capacity. It is not independed. There are no medical malpractice laws. There is no health act.

There are no internal investigations unless there is a complaint. All cases must be investigated, but they are not. The system and apparatus is not in place for this to happen. We are relying on the very people who are alleged to have made the errors to investigate the case! That is indeed not right.

And Dr Waheed, why have we not had these systems, apparatus and mechanisms developed? Why do we still lack the legal frame work to protect the patients, the doctors and the services via a health act? You were an executive at the hospital and the ministry. Would you like to explain yourself?

GCD

Anonymous said...

@Anonymous 7:26AM
Why is that doctors can't write in blogs? They are people too and should be allowed to have personal time.

I disagree when you say they have distanced themselves from their profession. Try and see what good they have done, and you'll see it. Not all deaths are preventable - even doctors can't save each and everyone. Even so, I hope and trust they will do their best in saving people so that most will be saved and cured.

Abdullah Waheed's Blog said...

TO GCD:
The investigation of Ali Zakhwan's death is to this day the only such case that has been investigated fully, exposing the errors and shortcomings of IGMH. (This gives me the chance to claim that had I not volunteered, even that case would not have been investigated. I was not in the health sector even then.) The report was submitted to Health Ministry, which did not publish the report, but instead published its own press release taking some parts of the report.

Anonymous said...

I call on the government to launch an independent inquiry -perhaps a Presidential Commission

Anonymous said...

@ Anon, are you moron enough to beleive all medical problems in this country are caused by 2 or 3 doctors leaving the profession? they may have been good in their days, but today there are a large number of better trained specialists.

Hilath said...

Good questions. But as usual I don't think we are going to get any satisfactory answers.

By right, everyone should have access to the Zakhwan report. But do the public currently have a right to demand the government to disclose that report.

The media laws have to be amended to facilitate the right for people to demand such information from the government.

Anonymous said...

GCD has poinout the real problem. We lack legislature to protect the patients.

Anonymous said...

As anon 12:21 said we are not ready in many areas. another alarming issue is the acceptance of doctors trained in the former soviet republics. This issue is not really talked about as sons and daughters of health officials are [have] been trained there.
In India and Sri Lanka as I undertand they cannot practice without going through a special exam and internship.
yet in Maldives many Maldivians and forigners who has been trained there are recruited in to the health service and send to regional hospitals and health centers where no body monitors what they do.
I urge Ministry of health and F not to send students to russia and soviet republics as they will be no better than health workers and also explain your policy to the public.

Abdullah Waheed's Blog said...

To Anon 12.53... In many advanced countries no one qualified abroad is automatically accepted. They have to undergo an exam. Perhaps we can also think of something similar.

Anonymous said...

now now.. some one who has been practicing in the US needing to do an exam from Maldives to practice in Maldives? hmmmm...

nothing much to say except '''

just try wiping your own arses clean b4 you all talk about such.

Anonymous said...

I agree not all medical conditions are curable and docs a r no magicians.This tragic incident is culmination of the corruption that is prevailing in the Maldivian society.People have made recruitment of medical profession into a big time money making network.
There have been many instances where incompetent people were fired from IGMH.Unfortunately when we hear of an incident like this we find them surfacing up in another hiospital.Thanx to the network.
There are many issues.But blame it on Golhaa n keep a blind eye.U tell me one man did all this?

Anonymous said...

DMS needs to be revamped completely. Not that this incident is related to dms.

Anonymous said...

How many babies have died under similar circumstances?
How many cases were ever investigated. I still have to find out how I lost my baby at 9 months on the day caesarian was scheduled,..I had consulted the gynecologist just the previous night..was given an injection and sent home. How and why did my baby die?
How many Maldivian mothers who lost their baies have ever dared to ask this question?
I think it is time to raise the voice.

Anonymous said...

anon mother above me, i will have to say unfortunately you were a subject of a wide experiment. You are not the only one.

Anonymous said...

When the angel of death, Malakal Mauth decides to strike there is not a single doctor who can save the life. So just let it be.

Anonymous said...

President Gayoom was very kind to Nashid.

Anonymous said...

I guess Malakul Mauth committed untimely wrongful death this time. Hope Allah punishes him for disobedience.