Human error or criminal negligence?
A PRIVATE television channel reported on Friday that the doctors have contended that it was a “human error” that caused Shahzadi Shahida Sultana, 35, to lose her life, in the complications that surfaced when she was operated for removing the forceps which were left in her abdomen in an earlier surgery. And the doctors were quoted as saying that they would be protesting further if the action taken against the concerned doctors was not withdrawn.
It is indeed shocking what has happened and brings into agonizing, painful focus the much heard lament, and frustration that the quality of medical care in our hospitals is declining, despite the technology that is being inducted into the healthcare system.
About the best of doctors there are complaints and grievances, at many of an individual nature, which reflect the overall attitude that most doctors have towards their patients. About the best of hospitals and the quality of the health care, they trumpet about and exorbitantly charge their patients there are disgusting stories of inefficiency, indifference, and even over billing. The sad death of this young woman in Hyderabad, which has angered the public and compelled one to once again contemplate the ugly reality that many times characterizes the medical system of this country.
This defensive argument that the Hyderabad doctors have taken about “human error” is baffling. It mirrors a certain insensitivity and lack of compassion on the part of a professional community whose job entails being kind and considerate, besides being competent.
This plea about “human error” is, by the way, something that most incompetent or erratic men and women put forward in other spheres of life too. And with this information technology expansion in our lives, another defence argument for harassing citizens is to say: “The system is down”. One feels like saying that for the common man, it appears that the system is always down. Or there is no system at all. It is, despite all the rhetoric and the policy making, the absence of a system or its abject failure that stands out. The solution to problems in public dealing departments and domains is still what comes within the purview of “personal contact”.
In this tragic case of Shahzadi Shahida Sultana, details carried in Dawn on March 8 (which was the International Women’s Day), it is said that the deceased woman carried a pair of forceps in her abdomen for almost a year and during this period she suffered severe pain and vomiting.
Apparently the forceps were left in the stomach in February last year, when she gave birth to a baby girl on 13th of the month. Her brother is quoted as saying that it was on 18th February this year that the forceps related pains surfaced. And subsequent events, investigations and two major surgeries were carried out for removal of the surgical instrument. But her condition did not improve and she died.
The family of the deceased woman has lodged a criminal case against five lady doctors and the in charge of the gynaecology unit 111 at the Liaquat University of Medical and Health Sciences, Civil Hospital Hyderabad.
Making one contemplate, the sadness of the case is that the woman’s husband is a rickshaw driver and could not afford private medical care for his wife in pain, spread over a year. Private hospitals or clinics can be no better at times. Patients pay fabulous fees for what many citizens regard as “sheer fleecing” by doctors, who of course have their own points of view.
A colleague of mine took his eight year son, Taimoor, to an eye specialist. For the child, it was a first ever experience of facing a doctor for an eye test. The doctor was intimidating, abrupt, dismissive and his little patient was terrified. With the result when the prescription came, the parents were dissatisfied and they went for a second opinion, naturally. They said: “An eye specialist should have been polite and kind with his eight-year-old patient.” This experience relates to a private clinic.
But look at these two examples that another colleague emailed to me about two experiences that took place recently at a posh large private hospital. The irony is that we all have to live with these doctors, these hospitals, these situations. In the first instance, a leading gastro-enterologist “banged on the table, and threw out a file of a patient as soon as she found out that she had got a CT scan done on the advice of a relative.” Then he told the patient that she should leave, as he had no treatment for her, now. He was evidently unhappy about a second opinion she had gone in for. Keep in mind that the patient was suffering because of an undiagnosed medical problem. The doctor concerned for all his experience and stature did not understand the vulnerability, sensitivity, and emotional state of the patient, and her family. There is much to think about such interactions that sound so familiar.
Or take this instance from another leading private hospital, a senior pulmonologist reportedly misdiagnosed a cancer patient and began treatment for tuberculosis. And he was adamant that TB it was, if it wasn’t cancer!! A biopsy report confirmed cancer, and the patient, who could afford to do so, took the first flight to get treatment abroad.
Let’s face it. If one looks at this doctor-patient relationship, complaints and grievances are long standing. Were one to generalize, it is obvious that anyone in authority in this society, ill treats the man in a lower position and assumes that he (the stronger man) is always right. That strength could be in matters material or moral.
Returning to the case of this woman who died following the surgery for removal of forceps, there is much more to mourn here. The doctors of the hospital concerned, all the paramedical staff and just about everybody has gone on strike, says a report and “hundreds of patients suffer” as a result. They are all protesting about the case that has been registered against the six lady doctors. Isn’t that strange? But then who is to protest about the death of Shahzadi Shahida Sultana, only her husband? Is it not expected of society to protest?
Let me end with an observation that came from a woman this week when she read this sad story. She said it was disappointing that though this case surfaced on International Women’s Day, there was virtually no mention of this story by any of the speakers, in the country. For that matter, in Karachi, I haven’t heard anyone take real notice of this incident.
All is not lost
THE people of Lahore have shown by their action that nothing can dampen their fun-loving spirit, even if the Punjab government may have accomplished what the right wing elements could not for the last 50 years: banning kite-flying. Basant is being celebrated today all over the city, with all other activities, including the joyous singing and dancing going on as usual. What if no kites fly in the sky, they remain very much a part of the city’s skyline. One need only to look at the hundreds of poles along the main arteries.
This is no marathon, nor another imported gimmick that can win a government ready to buckle under pressure, exerted by a handful of killjoys, any brownie points on its obsession with a ‘soft image’. The MMA may be right in thinking that it has settled the marathon score with the government by forcing it to ban kite-flying, but it has been proved wrong if it thought it could cow the hearty bunch that is Lahoris into toeing its narrow-minded line on merrymaking. The city nazim’s gloating over his victory regarding the ban he was seeking long before the mullahs caught on with him was also short-lived. Lahoris are dancing in the street, in the open spaces, to the beat of drums like they do every year on Basant, as the festivities continue.
But back to the ban. It is an open secret that the metal-coated ‘killer’ twine is the most expensive kind of threads that only a few rich can afford, which it should not have been hard for the authorities to crack down on. Ordinary kite-flyers use the traditional variety that can only ‘cut’ a kite and not people’s throats. You may ask why they are being deprived of a popular sport which they have enjoyed since at least the time of Shah Husain, who was a contemporary of Emperor Akbar and who thus sang eloquently of kite-flying in this city:
Sajan de hath dore assadi, mein sajan di guddi
Nau-taar di dore lae ke mein assmaaneen uddi
What is next on the government’s agenda, you wonder. A ban on Mela Charaghan, for the killjoy extremists have also been opposing that popular annual festival tooth and nail all these years?
If they had their way they would stop Pappu Dholli and the likes performing at the Baba Shah Jamal and other shrines in the city. A ‘soft image’ of a people has to come from within; it is either there or not there. The way the people have taken the ban imposed on kite-flying in their stride and carried on with the rest of the festivities proves that a ‘soft image’ is already there at the popular level. Inducting foreign-educated ladies in government service as advisors who speak with a heavy American accent is as fake an indication of a ‘soft image’ as the officials’ contrived speech, which does not gel in with the government’s real image that the people have of it etched on their minds. It was the government’s unsolicited patronage, and greed to make money on the part of commercial establishments that put a spin on the sport; it over-commercialised it to the point where elitism and exclusivity set in. You could have controlled the menace of metal and razor-sharp twine and brought any number of foreigners to Lahore to partake in the sport, as is the case in Ahmedabad in India which has its own kite-flying festival but no casualties are caused during the activity. The visitors would have gone back carrying a good image of the country, as was happening in the preceding years, but harsh and extreme tactics adopted by the government to placate a handful of killjoys and depriving the people of their most cherished pastime will only embolden the forces of extremism.
The failure of the government to prevent deaths by razor-sharp twine can be likened to its failure on February 14 when goons were given a free run of the city and they went on rampage, killing three people and torching property worth millions. When was the last time the city burnt the way it did on that day? Ask an octogenarian and he will tell you it reminded him not of the 1977 PNA riots but of the gutting of Shah-Alami on the eve of partition. Why was there no public outcry over the security lapse that resulted in deaths and damage then? Were the three lives lost and millions burnt to ashes worth any less than the lives lost in kite-flying? Go to the DHA’s Khyaban-i-Iqbal on a Sunday and watch the spoilt brats of the rich play dodgem cars on the wide boulevard, racing their imported cars. Bikers doing ‘wheelies’ are no less a threat to public safety. Many have died in the stunts and continue to do so, unchecked. Why are they of no concern to our guardians of faith, and consequently, to the self-righteous city and Punjab governments? If a ban is needed it should be imposed on the Independence Day celebrations in Lahore, when rash driving claims many lives every year, but that is if saving lives is a valid argument for banning kite-flying.
Basant has long been the bane of those who, in their ignorance, see it as a pagan festival. The challenge thrown in the Punjab assembly by the provincial law minister at the MMA MPAs demanding a ban on kite-flying the other day, when he dared them to stop Basant reportedly against the wishes of President Musharraf, seemed to have jolted this very unsure government. The minister seemed to have taken the president’s expressed interest in Basant festivities literally. He got a snub from the presidency the next day, which paved the way for the provincial government to buckle under right wing pressure. A political dispensation in which the president himself has to decide whether a cricket match can be aired or a kite can be flown leaves one startled.
The battle lines drawn by the MMA against kite-flying had little to do with saving lives, as many will be ready to argue. It had more to do with stopping the people from having fun and to bring the government down on its knees. That the present rulers handed the right wing elements their longed-for victory on a platter is the real shame. If that indeed is not the case, let the government again backtrack on its decision, now that we are told it has seized miles of the ‘killer’ twine. Let Lahoris have a kite-flying Sunday.
VETERAN poet and critic Ahmed Nadim Qasmi has written about the plan of some members of the Pakistan Foundation to illegally construct a mosque on a piece of land on The Mall, adjacent to a five-star hotel, that he says does not belong to the foundation. He has pleaded with religious scholars to give expert opinion as to whether such a construction is permissible under Islamic precepts.
What evades all logic is that the government should turn a blind eye to such a move on such a conspicuous spot. But as someone remarked the other day, the plan might be to have another Masjid-i-Shuhada so that this portion of The Mall is also blocked when another protest call is given. If true, the government should consider relocating the hotel next door to make more space available for the like activities on The Mall, and save regular hotel guests, among them foreign cricket teams, the trouble of being caught in a riot. That would really work wonders for projecting a good image of Pakistan abroad. —OBSERVER
Lot of the Pakistani worker
DURING the past year there have been widespread reports in newspapers here of the poor treatment of labourers working on the UAE’s mega construction projects, but it appears that most Pakistani workers seem to suffer in silence when things go wrong.
There are reckoned to be more than 500,000 Pakistani expatriates in the UAE. This figure includes those who are here illegally, either on visas that have expired or who managed to smuggle themselves into the country and never had a visa in the first place.
Most are from Punjab and the north and, according to the Pakistani consulate in Dubai, about 75 per cent are labourers or blue-collar workers.
Mohammed Waseem, who is in charge of welfare matters at the consulate, told the Evening Post newspaper that, despite the numerous reports about labourers being treated badly, the consulate only receives about three or four complaints a week.
He reckons that the workers stay silent and compromise with poor conditions because of job insecurity and their need to keep earning to send money home.
The complaints that are received are usually about non-payment of wages, often for many months, and in these cases the consulate asks the UAE ministry of labour to help sort things out. The Dubai authorities are currently being quite positive in such cases and send officials to the construction sites to pressure employers to pay their workers.
It is not, however, always a case of companies deliberately not paying, but being unable to do so because of cash flow problems caused by not receiving money for work completed. I know from talking to acquaintances in the construction industry that payments are frequently delayed by clients and some of the worst payers can be government departments. Well down the line of contractors, sub-contractors, sub-sub and so on, it is the poor labourers who are at the bottom of the pile.
DRIVING to Abu Dhabi this week I reflected on what a fabulous road system we have here in the Emirates. The federal capital of the UAE is about 130 kilometres from Dubai and the two cities are linked by a highway that, even at its narrowest, has four lanes in each direction.
Once over the border into Abu Dhabi emirate, I motored along at the current permissible limit of 160kph and reached the outskirts of Abu Dhabi city in less than an hour.
With crash barriers in the centre and along the sides, and fencing to stop pedestrians or camels wandering onto the road, I felt safe and certainly not a danger to other road users.
On such a highway, accidents should not happen but the mangled and twisted barriers every few kilometres bear witness to the frequent crashes that take place. Most are caused purely by speed, and the driver who overtook me as though I was standing still — I reckon he was doing more than 240kph — was an accident waiting to happen.
The problem is that the roads, designed to the highest possible standards, are so good that people drive too fast, beyond their capabilities and lose control of their vehicles.
The death toll is rising. On average, somebody is currently dying on Dubai’s roads every day and last week the man in charge of the city’s traffic police likened the situation to a war zone.
Some experts say that one of the problems in Dubai is that the drivers come from all over the world and all have different driving mentalities but one of the most telling statistics indicates that, per capita, it is UAE nationals who are more likely to be involved in accidents and kill themselves (and others), with most crashes caused simply by reckless driving.
Within Dubai city accidents are mostly minor shunts, which is not surprising since the congestion means that vehicles spend lots of time crawling along.
Major road improvements are now taking place and there are plenty of promises about new roads and bridges over the Creek that divides Dubai into two parts but the population is expanding so rapidly that most people believe it will be almost impossible to cope with the increased traffic.
Now there are hints that the queues will be getting even longer before there is any chance of the situation improving.
Work has now started on building the city’s metro rail, which will be part overhead and part underground, and last week the roads authority said that drivers will have to show patience during the construction phase. You have a feeling that such a carefully worded pronouncement means that we are facing absolute chaos for the next three or four years. The city is already grinding to a halt and building stations in some of the most congested downtown areas is obviously not going to help in the short term.
Dubai does, however, have a knack of coming up with spectacular and futuristic schemes and there are currently rumours floating around of a dramatic announcement concerning transportation that will be made shortly.
I have no idea what it is likely to be, but I am currently passing the time in the endless road queues imagining what I would do to get the traffic moving again. I haven’t come up with a solution yet.