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Respected surgeon gives docs rap on the knuckles
Much respected retired Professor of Surgery A. H. Sheriffdeen has questioned the failure on the part of the Lady Ridgeway to promptly treat a 10-year-old, boy with a ruptured appendix due to the non-availability of a senior surgeon at the premier paediatric hospital in the country.
The incident took place on Aug 22. Dr Sheriffdeen has brought the incident to the notice of the President, College of Surgeons of Sri Lanka, requesting the outfit to inquire into the incident.
The following is the text of the letter addressed to the CSSL President: “I write this letter following a bout of acute depression and a sense of hopelessness following an incident that occurred on Saturday 22nd August 2020.
I saw a 10-year-old boy at Ratnam’s Private Hospital around 11 am with an obvious clinical diagnosis of acute obstructive Appendicitis. The mother said that she could not afford treatment at a private hospital, so I gave her a letter to the Lady Ridgeway Hospital, assuring her that the boy would get the best possible care. The grandmother was screaming that she would pawn all her jewellery and take prefer treatment at a private hospital, but I again reassured her that I had faith in our trainees and doctors.
On the same day, at about 8.30 pm, I got a call from the boy’s father to say that the junior doctors had told the family that the appendix had ruptured, that the boy needed major surgery by a Consultant and there was no Consultant available. No solution was offered. They were desperate and agitated.
I told them that I did not do emergency surgery at night and suggested a few names and Private Hospitals they could go to.
That was when the depression hit me. Why, I asked myself repeatedly, why am I wasting my time? Why am I wasting my time talking about professionalism and ethics? Why did I waste my time chairing the Committee that produced the Book “Professionalism and Ethics in Surgical Practice” where in Chapter 2 on “Total Patient Care” this scenario is dealt with? Do not these doctors or their near relatives have 10-year-old sons whom they care about? How would they feel if this incident occurs to them?
Why are we wasting time talking about modern techniques, recent advances, updates, laparoscopic and robotic surgery, mentoring programmes, Scientific Sessions, workshops and so on when a 10 year old is left to die from a ruptured appendix due to non-availability of a senior surgeon at the premier Paediatric Hospital in the Country – in the whole of Sri Lanka?.
Professor Milroy Paul was my Professor of Surgery. This was in the early 1960s. He had a surgical Ward in the Lady Ridgeway Hospital. I have seen him driving his old Riley car in black trousers and white dinner jacket with a black bow tie arriving at the hospital at 10 pm to do a tracheostomy in a child with Diphtheria and stridor. He obviously had been at a dinner dance. Mind you, there were no pagers, mobile phones. He always left a contact land line number in the ward and if this method failed to contact him, the registrar was expected to go to the hotel by car or taxi to summon him. He always came promptly. The patient mattered more to him than that dinner, than that dance.
The government gives duty free cars to our doctors just for this purpose. Mobile phones are freely available. Contactability is not an issue. But something is lacking, is it not? All the fancy cars, all the fancy mobile phones did not help this child in an hour of need.
That is because we lack commitment- a commitment to care, treat and cure regardless of day or time-a commitment not to betray the trust – betray the trust that mothers, fathers, grandparents, brothers, sisters, children place in you.
There will be the usual explanations but they will only serve to compound the issue as trying to get explanations or hold an enquiry is usually an attempt at cover up. It needs a change of culture, a paradigm shift.
The child may have survived, but that is totally irrelevant to the issue at hand.
More ruptured appendices, acute abdomens, general, orthopedic, neurosurgical, urological, cardiothoracic, vascular etc. emergencies – more excuses; will they not end?
I am writing this as therapy for my depression. The foul taste will not go away. As a Medical administrator once said, “Patients will die, it cannot be helped!”
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PCoI on Easter Sunday attacks:
By Shamindra Ferdinando
Attorney General Dappula de Livera, PC is not bound by recommendations made by the Presidential Commission of Inquiry (P CoI) into the 2019 Easter Sunday carnage, or presidential directives in that regard, according to authoritative sources.
They said that the AG couldn’t under any circumstances initiate legal proceedings until he had received the full PCoI report.
President Gotabaya Rajapaksa received the PCoI report on Feb 1. The President’s Office delivered a set of PCoI reports to Speaker Mahinda Yapa Abeywardena on Feb 23, a day after the report was presented to the cabinet of ministers. The Island raised the matter with relevant authorities in the wake of a section of the media reporting the PCoI recommending punitive measures against former President Maithripala Sirisena, Defence Secretary Hemasiri Fernando, IGP Pujitha Jayasundera, Chief of State Intelligence Senior DIG Nilantha Jayawardena, Chief of National Intelligence retired DIG Sisira Mendis and All Ceylon Makkal Congress (ACMC) leader and Samagi Jana Balavegaya MP Rishad Bathiudeen et al over the Easter Sunday carnage.
Sources pointed out that due to the inordinate delay in sharing the PCoI report with the AG, the department hadn’t been able to take preliminary measures required to initiate the proceedings. Sources said that a team of officers would take at least six weeks or more to examine the report before tangible measures could be taken.
With the AG scheduled to retire on May 24, 2021, even if the AG Department received the P CoI it would be quite a tough task to initiate proceedings ahead of retirement, sources said. However, in terms of the 20th Amendment to the Constitution enacted in last October, both the AG and the IGP could receive extensions beyond 60 at the President’s discretion.
Dappula de Livera received an Acting appointment as the AG a week after the Easter Sunday carnage whereas his predecessor Jayantha Jayasuriya, PC, was elevated to Chief Justice.
Responding to another query, sources said that the Attorney General two weeks ago requested Secretary to the President for a copy of the P CoI. However, the AG was yet to receive one, sources said. In spite of the AG not receiving a P CoI copy, the AG had instructed the IGP to obtain a copy of the report when he requested the police to complete investigations into the Easter Sunday carnage. The AG issued specific instructions after having examined police files pertaining to the investigations.
The IGP, too, hadn’t received a copy so far though some sections of the report were in the public domain.
Agriculture Minister Mahindananda Aluthgamage displayed at a live political programme on Derana a copy of the P CoI report he received at the cabinet meeting earlier in the day.
Sources said that the Attorney General’s Department couldn’t decide on a course of action in respect of the Easter carnage on the basis of a section of the report. In terms of the Commission of Inquiry Act (Section 24), the AG enjoyed significant powers/authority in respect of investigations; sources said adding that the Department urgently required both the P CoI report and police investigations report. The Attorney General’s Department has raised the delay in receiving a P CoI report amidst the Catholic Church attacking the government over the same issue.
Sources said that ministerial committee appointed to study the P CoI report couldn’t decide on how to proceed with the recommendations and the matter was entirely in the hands of the AG. Sources pointed out that the delay on the part of the government to release the report had received the attention of sections of the international media, including the New York Times. Public Security Minister retired Rear Admiral Sarath Weerasekera having met Malcolm Cardinal Ranjith at the Bishop’s House on Dec 8, 2020 said that the AG would get a copy of the P CoI report once the President received it. Minister Weerasekera said that the CID had handed over the relevant files after having completed investigations into eight blasts. Referring to the Parliamentary Select Committee (PSC) report on the Easter Sunday carnage, the former Navy Chief of Staff said that all such documents would have to be brought to one place and considered before initiating legal proceedings. Acknowledging that there could be delays, lawmaker Weerasekera said that on the instructions of the Attorney General a 12-member team of lawyers was working on the case. The minister vowed to expose the mastermind behind the Easter Sunday attacks. Investigations continued while some of those wanted were overseas, the minister said.
The minister acknowledged that the Attorney General couldn’t proceed without the P CoI report. Minister Weerasekera reiterated that once the President received the P CoI report, it would be sent to the Attorney General. The minister said that there were documents two to three feet high that needed scrutiny. The minister assured comprehensive investigation. The minister said that investigations pertaining to eight blasts had been completed and the reports handed over to the AG. However, the Attorney General had found shortcomings in those investigations.
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By Saman Indrajith
The Presidential Commission of Inquiry on the Easter Sunday bombings had failed to identify the mastermind of , the JVP said yesterday.
Addressing the media at the party headquarters in Pelawatte, JVP Propaganda Secretary MP Vijitha Herath said that the PCoI report had levelled accusations against former President Maithripala Sirisena, former IGP and head of intelligence for their dereliction of duty, shirking of responsibilities and not taking action to prevent the attacks and negligence. There were reference to the causes of the terror attacks and actions to be taken to avoid such attacks and the influence of extremist organisations. “However, there is no mention of the mastermind of the attacks, the handlers of the attackers and those whose interests the carnage served. It is also not mentioned whether there has been any foreign or local organisation behind those attacks. As per the PCoI report the attack took place as a result of culmination of extremism.
“According to the PCoI the extremist activities were a result of the prevailing political situation then. The entire nation was waiting to see who was responsible and who masterminded those attacks. The PCoI has failed to identify the true culprits responsible for the terror attacks. The report says that the leader of the suicide cadres killed himself in the attacks and it was a puzzle. That means those who are actually responsible for the attacks are still at large. The report does not provide exact details of the sources of the attacks. The PCoI had sittings for one year and five months. It summoned various persons and got their statements but it has failed to shed any light on the terror attacks. Everybody knows that the top leaders of the government and heads of security and intelligence establishments failed in their duties. Ranil Wickremesinghe was the second in command and he too is bound by the responsibility but the PCoI report fails to identify him as one of the persons against whom legal action should be instituted. The PCoI has treated Wickremesinghe and former President Maithripala Sirisena differently. We are not telling that this report is a total failure but we cannot accept this as a complete report. The PCoI handed over its report to the President on Feb 1. After 23 days it was sent to Parliament. Now, a copy of the report is there in the parliamentary library for the perusal of MPs.”
Herath said that the PCoI did not have powers to take punitive action. “It only has powers to name those responsible and recommend action to be taken against those named.
