A man is undergoing treatment at the Indira Gandi Memorial Hospital (IGMH) after he was assaulted and suffered a deep head injury, reports Haveeru.
According to Haveeru, attackers used metal bars and such other objects to assault him.
Police have arrested two men in connection with the case, according to Haveeru.
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(0)The MTCC has announced that its ferry prices will be increased next month, reported SunFM.
SunFM reported that the Villingili ferry will cost Rf5 per ticket and Hulhumale’ ferry will cost Rf8 per ticket, starting from the 15th of next month.
Currently Villingili feryy costs Rf3 per ticket and Hulhumale’ ferry Rf5 per ticket.
(0)Dislikes(0)Rival factions of the main opposition Dhivehi Rayyithunge Party (DRP) have announced concurrent protest marches in Male’ tonight to demonstrate against the government’s decision to allow the rufiya to be traded within 20 percent of the pegged rate of Rf12.85 to the dollar.
Mohamed Hussein Shareef “Mundhu”, spokesman for former President Maumoon Abdul Gayoom, told press yesterday that the ‘Gayoom faction’ will choose a different route to DRP Leader Ahmed Thasmeen Ali’s faction to avoid possible clashes. The largest opposition party has been engulfed in factional strife following its dismissal of Deputy Leader Umar Naseer.
The march will begin at the tsunami memorial area at 9:00pm, “and we are consulting with police to determine the roads we’ll take,” Mundhu said.
At a rally last night to launch “DRP’s Main Office” near the artificial beach, dismissed Deputy Leader Umar Naseer echoed Mundhu’s appeal earlier in the day for opposition supporters not to join Thasmeen faction’s march.
Both Mundhu and Umar dismissed the rival faction’s planned protest as “a walk by Thasmeen’s family.”
Mundhu further claimed that Thasmeen had refused to authorise DRP protests in the past.
Unlike previous protests, said Umar, tonight’s “peaceful march” would not involve gathering outside presidential residence Muleeage or the Maldives National Defence Force (MNDF) headquarters, both restricted areas under freedom of assembly regulations and which have previously resulted in violent clashes between authorities and opposition supporters.
Rival rallies
Addressing supporters at last night’s rally, Umar accused the DRP Leader of splitting the party, claiming that DRP members were behind former President Gayoom and calling on “everyone working with Thasmeen to get behind Zaeem [Maumoon].”
If DRP members shun activities planned by the Thasmeen faction, Umar said that support for the embattled leader would “wither away.”
Deputy Leader Ilham Ahmed argued that if the party’s presidential candidate for 2013 had been chosen through a primary during the DRP’s third congress in March 2010 the current split could have been avoided.
“If it had been done through a primary we wouldn’t have this dissatisfaction among us,” said the Gemanafushi MP. “Therefore, I would say, even if some people are unhappy, we will have a primary. God willing, we will do that before too long.”
Vowing to “cut them down to size,” Ilham alleged that senior DRP members were “making secret deals with the government.”
Thasmeen and his allies should be “ashamed” to talk about the dollar shortage, said Ilham, as a deal had been stuck to raise the value of the dollar “inside [Speaker] Abdulla Shahid’s chambers” when the 2011 budget was passed.
Thasmeen faction’s concurrent rally was announced at press conference yesterday by Deputy Leader Ali Waheed.
While Gayoom factions members have been boycotting its meetings, the DRP Council reportedly passed a resolution last night to require the party’s secretariat approval before using the DRP logo or official seal.
However a defiant Ilham has since told local media that the council did not have the authority to ban a practice not explicitly forbidden in the party charter.
“I am a Deputy Leader elected by ordinary members of the party,” he said. “There is nothing in the party’s charter that says a Deputy Leader can’t use the party’s logo and seal.”
(0)Dislikes(0)Dhivehi Rayyithunge Party (DRP) MP Ahmed Mahlouf has submitted a resolution to the parliament to delay its recess until parliament concludes the Criminal Justice Procedure Bill, Evidence Bill, Parole Bill, Amendment to Children’s Act, Amendment to Gang Violence Act and Crime Prevention Bill.
Mahlouf told Minivan News that he presented the resolution in the hope that MPs will hasten their work and put more effort to pass those bills as soon as possible.
”The crimes occurring in the Maldives are now a very big concern for the citizens and they have expectations from the parliament,” Mahlouf said. ”I think the parliament should pass these bills before going to recess, which will play an important role to curb the gang violence and crime at the same time.”
The parliament is scheduled to go on recess on the first of next month, he said.
In parliament today Maldivian Democratic Party (MDP) Parliamentary Group leader MP ‘Reeko’ Moosa Manik presented the Criminal Justice Procedure Bill to the parliament.
The bill consisting of 229 articles and was drafted well, said Mahlouf.
”Although there might be some amendments that should be brought, I think the parliament should shorten the preliminary debate and pass it,” he said. ”Such bills often get politicised, but these are bills that need to be passed soon.”
He added that he fully supported any bills presented to the parliament if it will benefit the citizens, regardless of whether they were submitted by MDP.
Mahlouf recently resubmitted a resolution cutting a controversial Rf 20,000 committee allowance for MPs, which had originally been submitted by MDP Chairperson and MP Mariya Ahmed Didi. Mariya was forced to withdraw the amendment after the MDP Parliamentary Group voted that she do so.
(0)Dislikes(0)A team of retired Royal Air Force personnel are trying to raise money to help a small community in the Indian Ocean gain access to the vital healthcare they need to subsist. Inspired by this group’s determination to help this impoverished community in the Maldives – a land oft-associated with luxury – Donna Richardson travelled to the Addu region to uncover the real state of medical care on an island that used to enjoy free, first class medical care while the island was a Cold War staging post.
Because of its geography, it is easy to cover up the poverty-stricken side of the Maldives’s inhabited islands. The Maldives is seen as a luxury holiday resort destination, but in fact there is hardly a place where the contrasts between rich and poor are so pronounced. While millionaires sup their cocktails, the indigenous peoples barely scrape by on a dollar a day and many are priced out of the most basic medical care because of the rising cost of health.
The RAF have long left Addu Atoll (‘RAF Gan‘) in the Maldives where they were stationed during the 1970s, but for some servicemen such as Richard Houlston and Larry Dodds, Addu has remained close to his heart. Upon returning to the island during a memorial visit last March, he saw first hand how locals are suffering and denied access to even the most basic of medical care. He decided to see how he can help a community which he loves dearly. Along with a former colleague Phillip Small, they have been trying to establish a Gan Medical Fund to help to raise awareness of the issues the island faces, provide medical equipment, and eventually if there is enough funding when it takes off, to train the future generation of doctors.
When British Forces left the region, the hospital as well as the expertise and knowledge also vanished (allegedly the equipment all moved to Male), and with the establishment of a dictatorial government regime, Addu stepped ten steps back in terms of their medical facilities.
Based in the south of the country, Hithadhoo Regional Hospital (HRH) is the main public provincial health care facility providing curative public health services and is the only government hospital in the province. The hospital is located in the capital of the south atoll, in the furthest corner of Addu Atoll, and covers seven districts over two atolls. It serves 50,000 patients, including the inhabited islands of Hulhumeedhu and Fuvahmulah, but has only 50 beds.
Lack of funding, limited expertise and treatment for only those who can afford it – this is the picture of government health in Addu, but things are improving, according to the new director of the recently-formed Southern Healthcare Corporation Hussein Rasheed.
“The biggest challenges are most of all the lack of equipment, then patient load, then the quality of doctors, but we are changing things,” Hussein Rasheed said.
Now run under the 100 percent government-shared trust, the hospital also hopes to leverage revenue from the new national health insurance schemes to cover its costs and to help raise vital cash for the departments.
For some years now medical facilities for those living in Addu Atoll and its far-flung neighbour, Fuvahmulah, in Nyaviyani Atoll have been overstretched and in short supply. Many of the problems are hereditary. The aging 26-year-old hospital building is a relic of the Gayoom regime. It is in bad shape, with crumbling walls, unstable voltage, barely enough beds and no air-conditioning. Post operative patients swelter in temperatures akin to a sauna and the hospital is in desperate need of improvement. There are plans to build a new 100-bed hospital with a government loan and charity funding, but it will take a year to secure the funding and then to find a site.
Due to its previous funding constraints, HRH is currently understaffed and runs more like a general surgery practice found in most developed countries. Although it does have practically all the departments required to make it a hospital, most areas are understaffed and in need of vital equipment from donors and charities. As a public hospital it is appealing to charities and non governmental organisations to help it to serve its community and restore public confidence in its services.
At present there is still not enough basic equipment for the hospital to function. It was not even able to provide basic X-rays at the time we visited. Since the last one blew up due to faulty voltage in the building, a new X-ray machine was purchased but has stood in a box because of the risk of damaging the new equipment.
While HRH does have basic outpatient clinics including dental, ear nose and throat (ENT), gynecology, internal medicine, ophthalmology, orthopedics, paediatrics, reproductive health, diagnostics imaging services, and ultrasound scanning and physiotherapy services, there are not enough specialists to staff these departments or the right equipment to provide full services under these remits.
Previously most equipment was donated by NGOs and charities such as World Health Organisation, United Nations Children’s Fund, JICA and the Japanese as well as the Chinese and Australian governments. They have pledged to continue to work with the Ministry of Health and Family to procure equipment.
But the hospital urgently needs a CT scanner, MRI machine and incubators plus vital surgical instruments such a chest stapler and cannulas for performing tracheotomies. Each and every department needs more equipment.
Two rusty ambulances sit grounded on the parking lot. All gifted by various NGOs and nations, these vehicles need parts which are unavailable in the Maldives. One is a Japanese vehicle donated by the Japan Council of International Schools (JCIS) which requires expensive parts, and the other is a converted minibus with the seats relaxed to make room for stretchers.
Two more vehicles sit rusting in the garage. While these are in better shape they need parts and technicians to service them. The only functioning ambulance is an old ‘green goddess’ type vehicle gifted by the Australian government, which is used infrequently.
The Casualty and Accident and Emergency unit has just two beds. A serious road traffic victim was brought here just last week had to be transported to Male’ by Maldivian Air Taxi at his own cost. In cases such as this, if there are no seats, or medical insurance does not cover the patient, they simply cannot receive the vital care they need. It becomes a ‘pay and display’ system of healthcare.
Even the labour suite is ill-equipped for delivering babies. One small baby was fighting for his life in intensive care at the time of visiting. The infant’s parents said they could not afford the transportation to give birth in Male‘. The hospital urgently needs an incubator and does not even have a paediatric ventilator to aid distressed infants.
While the hospital does have an operating theatre with one operating room there are no specialist surgeons to perform vital operations and just two general surgeons.
Collectively this means that the hospital is unable to function to full capacity and the public is losing confidence in the medical care available in the atoll. While there is a surgical theatre, there are only two qualified general surgeons whose knowledge extends only to hernias and small operations.
These conditions and the need for basic equipment are urgent issues and the hospital is appealing for outside help and funding to solve these shortages.
A question of confidence
Another challenge the hospital faces isthe need to restore public confidence in its services. Facing huge waiting lists, patients with serious health conditions opt to travel to Male’ or India for treatment if they can afford it, and the hospital stays stuck in a rut. Yet these ‘health tourists’ face great perils amidst cases of organ trafficking and alleged substandard treatment in southern India.
A young girl from Hithadhoo told us how her family were forced to sell their car and personal possessions to pay for her mother to go to India for a leg operation. Her brother also has eye problems and needs to attend regular eye clinics, which the hospital does not yet have, although there are plans to introduce under the Madhana health scheme.
“My mother suffers from arthritis and rheumatism and needed to go to India for treatment,” she said.
“She was very ill and needed treatment and we have lost faith in the hospital here in Hithadhoo so we decided to go to India where the treatment is better value for money.”
Travelling for medical treatments is a costly business. Patients must pay for the airfare, accommodation and treatment, but people believe that the care they receive overseas is better and so the cycle of health tourism continues.
One of the ways that Hithadhoo Regional Hospital wants to counter this health tourism is to introduce ‘telemedicine’, whereby customers can be confident that their results will be seen by qualified medical specialists from around the world, and also to introduce visiting surgeons and hold specialist surgery days.
Rasheed admitted: “People are not happy with the level of care. Right now we don’t meet the basic requirements so many people decide to go to Male’ for treatment and when they don’t see any difference in services, they go to India.”
He warned of the dangers of travelling abroad to India for treatment. The practice of medical tourism there is not regulated and patients organise the travel plans themselves.
“While there are many good quality doctors in India, there are also huge problems with cheating in India, particularly in the south,” he said. “Someone recently went to India for surgery and ended up having a kidney removed. Health tourism is a very risky business,” he added.
Another patient told how his father in-law has been regularly travelling to India to receive palliative care for lung cancer. Put simply, there is no care of this type available in the Maldives.
Until now talk of cancer has been taboo, although cancer and heart disease are some of the biggest killers in the Maldives. But with no oncology or cardio department, or even an ECG machine, many people are forced to travel farther afield to receive treatment. In the past, limited information has been available about preventative measures so many people die earlier than they should.
There is no palliative care in the islands and only limited care for cancer patients even in Male’, and no facilities to perform open heart surgery or brain surgery.
Rasheed himself is interested in studying more about cancer and its causes to help to inspire health promotion campaigns and attract more doctors to the region.
In its favour, HRH does have an ISO-certified laboratory which is fairly advanced and offers some patient services including intensive care units and neonatal intensive care departments.
The hospital is also working on its health promotion, including child immunisation and growth monitoring, vector control, food hygiene and sanitation, disease surveillances and epidemic control, family planning, sexual transmitted disease clinic and turboculosis and leprosy control.
The hospitals’ three-year plan includes building a new hospital within a year, improving services in all areas, focusing on preventative health and education and introducing exchange programmes for doctors to visit the hospital and to partner with the private hospital in the region.
Rasheed said he has removed some of the ‘dead wood’ and de-motivated staff from HRH and replaced them with more high-energy staff. He hopes to turn the hospital’s reputation around in three years.
“When I took over the hospital here, we inherited a bad system, de-motivated staff and dated equipment,” he said. “In the past the doctors here were neglecting the needs of the patients. They knew they could do operations, but they were so de-motivated that they decided they could not do it and on many occasions we sent patients away,” he revealed.
These conditions and the need for basic equipment are urgent issues and the hospital is appealing for outside help and funding to solve these shortages.
There is also a need to distribute medicines for psychiatric patients, improving antenatal care and introducing an electronic record keeping system. At present patients with mental health issues are being released into the community without proper care and attention.
In addition, some elderly patients who have been abandoned by their families have taken up residence in the hospital.
However, things are starting to improve at the hospital after a change of management. Over the last three months since taking over the hospital trust, Rasheed has been making major strategic changes. In part this is due to a government reorganisation, which has placed all Maldivian hospitals under a new structure – which will operate more like a business, taking fees and charges from patients covered by the health insurance system.
“In the last couple of months we have managed to improve the level of confidence – for example, allocated a special day for general surgery where we have seen a couple of hernia patients, and we have been getting some good feedback. News spreads through word of mouth here,” he added.
With a limited budget to hire qualified doctors, the hospital is considering hiring visiting practitioners and surgeons. They are also appealing for the humanitarian services of voluntary, retired or semi-retired surgeons and specialist doctors to spend some time at the hospital in exchange for free accommodation, air fare and a share of commission from the profits gained from the operations they perform.
In the last month, the hospital hired a new Maldivian surgeon, a former classmate of Rasheed, who has performed basic operations. Just the other week they performed two hernia operations and feedback from the local community has been quite positive, according to Rasheed.
The two surgeons, Dr Fuammi Moustaffa and Abdulla Adsa, admitted that they were limited to small cases because of lack of equipment. Their remit includes appendicitis, hernia operations, cyst and gall bladder removal.
“We want to do more, but we don’t have the equipment or the specialists to perform other operations,” admitted Dr Moustaffa.
In January, the Israeli Eyes from Zion charity visited the hospital and removed cataracts from patients. There are plans for more visiting practitioners over the next few months.
Due to increasing demand for tertiary services in the provinces, with more funding it is planned to develop a specialised service centre for trauma treatment and the development of their service portfolio, as well as to improve provision of quality health care services.
The areas that they want to focus on include advanced diagnostic services such as MRI, telemedicine and treatment of kidney/renal conditions (including dialysis services) and establishing a provincial Emergency Medical Service (EMS) to international standards.
The hospital needs full time paramedics, fully-fledged ambulances, development of intensive care services and the development of a provincial medical emergency coordination centre.
Meanwhile, there is a private hospital called IDMC (run by the Simdi group) aimed at paying customers and those under the Madhana health scheme, such as civil servants. This hospital, run by Mariyam Shakeela, a former Hithadhoo resident, aims to provide first class medical care, but also requires more doctors to propel it to national standards. The hospital is currently campaigning to become an NGO called the Hawwa Trust to help alleviate some of HRH’s problems.
Eventually, once the basics are in place, Addu wants to develop medical tourism to attract patients to the Maldives. But for now this ambitious plan is limited until they come up to scratch on the other areas which are seriously lacking.
Donna Richardson is a freelance travel writer based in the Maldives.
For more information on Hithadhoo Regional Hospital visit www.shsc.com.mv
(0)Dislikes(0)The Maldives is battling a growing epidemic of dengue fever which is believed to have contributed to the deaths of at least five people this year.
More than 300 cases were reported in the first two months of 2011, compared with 737 cases and two fatalities reported last year. Many cases have been reported in Male’, although most of the fatalities have been islanders. One patient died during transit to Indira Gandhi Memorial Hospital (IGMH), and the more serious cases have disproportionately affected children.
Dr Ahmed Jamsheed, who until recently headed the Centre for Community Health and Disease Control (CCHDC), observed that 2011 had seen higher instances of dengue shock syndrome, where the mosquito-borne parasite causes blood pressure to drop so low that organs cannot function.
“Our initial theory was that this was a new strain of dengue,” he said. “There are four different strains, and strains one and three have been most prevalent. We took samples and sent them abroad but I had left the office by the time the results came back. I’m told out of the samples we sent a few tested positive for dengue one, which means no new strain.”
Instead of a new strain, Dr Jamsheed suggested that the growing number of dengue fatalities could be related to lapses in managing the disease, due to the high turnover of foreign doctors “particularly on the islands.”
“Usually dengue management in the Maldives is quite good, but new doctors are not very well orientated for dealing with dengue, and cases are being referred to Male’ quite late. It would be hard to say for sure at this point unless we did a case-by-case audit, to see where we’re going wrong,” he added.
IGMH Registrar Dr Fathimath Nadia noted that at least two of the fatalities this year involved children, “although these were quite complicated cases.”
Nadia said that health services had previously printed and issue a handbook on managing dengue to every incoming doctor and conducted briefings of incoming doctors, but was not sure if this was still carried out.
The CCHDC and the Maldives National Defence Force (MNDF) in February this year conducted spraying of mosquito breeding sites in Male’ and the surrounding islands, but reported difficulty obtaining access to residential and construction sites.
Minivan News also understands that a international mosquito expert brought in to exterminate breeding habitats at a resort had last month pinpointed the source of Male’s mosquito-breeding to pools of stagnant water in building sites across the city. However she was also reportedly unable to obtain the required permission to inspect the properties.
“The boom in the construction industry has created a huge number of mosquito breeding grounds,” Dr Jamsheed explained. “In Male’ when the Council gives planning permission it requires management of mosquito breeding grounds, but have so far failed to enforce it or conduct inspections. My experience in Male’ was that when our teams visited construction sites there was often nobody at the site to communicate with in Dhivehi or English.”
While the teams might be contact with the construction company responsible for the building, often those working at the site were employed under layers of subcontracting which made it difficult to place responsibility, he added.
Private and community rainwater tanks were also prime breeding grounds, he said, a particular problem on many islands.
“IGMH has a large underground water tank and we even found that full of mosquitoes,” he said. “They had not taken measures to make it airtight, although I think it’s been corrected now.”
Malaysia, which has had nearly 50,000 cases of dengue reported already this year, is currently working with France pharmaceutical company Sanofi-Aventis to develop a vaccine. The country has also launched a nationwide campaign to encourage people to destroy breeding grounds on their private property.
Early symptoms of dengue include fever, joint paint and a distinctive rash and headache, although it can be difficult to distinguish from the milder Chikungunya disease which can last for up to five days. However even healthy adults can be left immobile by dengue for several weeks while the disease runs its course.
(0)Dislikes(0)The Maldives Association for the Advancement of Science (MAAS) is hosting an event this evening (April 12) to celebrate the 50th anniversary of the first many in space.
“Fifty years ago a Russian by the name of Yuri Gagarin became the first human to escape the confines of Earth’s atmosphere and to enter into orbit around the Earth in space,” MAAS said in a statement.
“Human spaceflight became a reality 50 years ago with the launch of a bell-shaped capsule called ‘Vostok 1’ on April 12th, 1961. The capsule was carrying Soviet cosmonaut Yuri Gagarin, who took his place in history as the first human to leave the bounds of Earth and enter outer space.”
“MAAS will join the Global Astronomy Month’s global ‘Yuri’s Night’ celebrations with a local event to mark the occasion of this landmark human achievement. There will be electronic down-tempo music played live by a group of local musicians and the movie First Orbit will be screened as part of its global premier. MAAS invites everyone to join in the celebration.”
‘Yuri’s Night’ in the Maldives will take place at Seahouse in Male’ from 8:00pm to 11:00pm, April 12.
(0)Dislikes(0)The currency peg allowed the Maldives to have some of the highest living standards in South Asia by preventing excessive deficit spending, reports Lanka Business Online.
“Currency debasement and inflation are key to expanding the state at the expense of the larger society.
The Maldives also started active open market operations recently, ostensibly to mop up excess liquidity, but it can make it almost impossible to maintain a peg.
A well functioning open market operations system automatically sterilises interventions by a central bank (dollars sales by the monetary authority) with injections of local money forcing a balance of payments crisis, even in the absence of excessive deficit spending.
In 1997 many East Asian nations which had good fiscal management ran into currency crises due to sterilized interventions by central banks.
A fixed peg can only be maintained with unsterilized interventions and no deficit monetisation.
One of the triggers of Maldives current troubles was a large increase in the salaries of state workers. However the archipelago was also hit by a tsunami in 2004 and also suffered a downturn in tourism, a key source of state revenue, amid a global recession.”
(0)Dislikes(0)The Maldivian Democratic Party (MDP) has won four of the five seats of Kela Island Council while the Dhivehi Rayyithunge Party (DRP) has secured Kela’s two seats on the Haa Alif Atoll Council, after the Elections Commission repeated the election process.
The re-poll was ordered by the High Court which ruled that the original vote on February 5 was invalid, with public anger erupting after election officials turned away those who turned up to vote after the deadline.
Successful MDP candidates for Kela included Ali Shareef, Abdulla Zubair, Haulath Mahira and Hassan Mamdooh while Adam Asad was elected on a DRP ticket.
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