KARACHI, Nov 15: A four-day appreciative inquiry conducted at Qatar Hospital in Orangi Town, with the help of Unicef, Sindh, has revealed that some of the maternal deaths in the hospital occurred because of power failure, non- functioning of generator and non-availability of electricians.
Operations were delayed because operation theatre lights were not working, or door was locked and key was not available, or oxygen cylinder was found empty before operation.
It was noticed that because of failure of ambulance service, emergency obstetrical care was delayed. On the days of general strikes, doctors and paramedical staff did not come to the hospital and patients suffered enormously. It also happened that serious patients needing intensive care were not transferred to a better hospital because of strike and non-availability of ambulance. Patients suffered because of non-availability of doctors, obstetricians, anaesthetists, nurses and midwives.
The inquiry highlighted that trained staff is a must for a centre where women in pregnancy can come anytime. The hospital cannot afford to be deprived of trained staff at anytime. A team of competent staff should be available round the clock for emergency obstetrical care. Maternal death is not acceptable because of deficiency in, or shortage of, staff at the time when they are needed.
Security in hospital is a very important issue as emergency services cannot be available if doctors and paramedical staff are terrorized. It is the duty of the community to protect and facilitate the working of medical staff and make sure that they provide emergency services without any fear and tension. It was also emphasized that the health department should create a sense of confidence in all healthcare staff and their rights be secured and protected.
The inquiry proposed that every maternal death and every mishap in relation to morbidity of patient should be discussed and responsibility be fixed/ identified. The situation surrounding a tragedy should be analyzed and intense efforts be made to improve conditions.
The inquiry into maternal deaths emphasized that medical record keeping has a very important role in the practice of good medical care. A good record keeping system is essential for proper running of a centre which provides emergency obstetrical care. The hospital management should review its medical information system and keep it up-to-date for analysis. All aspects of medical care should be recorded and be available anytime for review and analysis.
The inquiry concluded that maternal death is a tragedy for family, community and country. It should not occur and we must all work to save our women from dying at a young age. We must help the government and health department in our war against maternal death. Team work is needed to avoid maternal death. A missionary approach is needed to combat the tragedy of maternal death. This war cannot be fought by doctors alone, and every member of hospital team should work together to avoid this tragedy.
Porters and watchmen have a very special role to play in saving lives. The moment a woman in need of emergency care enters hospital, it is the duty of watchman and porter to see that she is examined by a qualified person as soon as possible.
Paramedical staff should also be available in the operation theatre, the blood bank, the laboratory and wards. It was noted that in some cases maternal deaths occurred because of the absence of paramedical staff. All paramedical staff promised that they would honestly try to improve their services at the hospital.
The programme, organized by the Women‘s Right to Life and Death Project, was facilitated by Dr Talat Rizvi, Dr Jamaluddin Shaikh, Dr Salman Kidwai and Dr Shershah Syed. It was attended by all of the hospital staff who are directly or indirectly involved with maternal care.—PPI
