Fuvahmulah Hospital denies negligence in stillbirth and soldier’s death

Fuvahmulah Atoll Hospital has denied allegations of negligence in a series of medical incidents including a case of stillbirth and the recent death of a soldier on the island.

The hospital’s statement came in response to comments by Fuvahmulah Atoll Councilor Hussain Saeed, in which he blamed the hospital’s management and Health Minister Dr Mariyam Shakeela for “worsening conditions” at the hospital.

On May 31, a gynecologist at Fuvahmulah Atoll Hospital suspended a caesarean on a pregnant woman halfway through the surgery. That same night, the gynecologist refused to perform a caesarean on another pregnant woman after the fetus died in the womb. The patient’s family said the doctor had cited lack of obstetric gel to ease birth.

The following day, a soldier died of a heart attack while playing football on Fuvahmulah. Then on June 3, the family of a three-year-old told local media that doctors at the Fuvahmulah Hospital had given the child a wrong injection.

However, Fuvahmulah Hospital has denied any wrongdoing in the four cases and condemned the council’s comments saying they are “deeply saddened to note that the Fuvahmulah Atoll Council’s press conference on these incidents spread falsehoods and incited fear among the public.”

At a press conference at the President’s Office today, officials from the Health Ministry also defended the Fuvahmulah Hospital, but said investigations were underway to see if any negligence had occurred.

Negligence

Speaking to the press in Malé yesterday, Saeed and five other councilors from the opposition Maldivian Democratic Party (MDP) expressed concern over lack of doctors and medical supplies, and the quality of medical care at the hospital.

“We previously thought the Fuvahmulah Hospital was not cooperating with the Health Minister in implementing the government’s health policies. But when things at the Fuvahmulah Atoll Hospital drop to this level, it shows Health Minister Shakeela has been negligent in implementing President Yameen’s health policies,” Saeed said.

Councillors said there were 123 pregnant women on Fuvahmulah at present. The island has a population of 13,000, of which 700 are children.

Although a neonatal ICU has been opened on the island, the facility does not have a pediatrician, Saeed said.

He noted a lack of medical equipment and supplied on the island stating: “There are only two thermometers in the hospital. Doctors and nurses only have two machines to check blood pressure.”

“Doctors [told us] when they ask the management for chemicals, the management told them to make do with what is available,” he continued.

Doctors also said the management shut down any initiative to improve facilities, Saeed said.

“When Fuvahmulah doctors take initiatives to improve facilities at the hospital, Fuvahmulah hospital’s administrative officer threatens doctors and tell them not to speak about the hospital. [Doctors said] they are made to work overtime, but overtime remuneration is cut from their salaries,” Saeed said.

Procedures followed

In a statement today, the Fuvahmulah Hospital explained that the first pregnant woman had arrived at the hospital for a routine check up, but was hospitalised when the doctor noticed the fetus’ heartbeat was too fast.

The gynecologist scheduled a caesarean with the family’s consent, but suspended the surgery after making an incision. A pediatrician and a second gynecologist were brought from neighboring Addu City hospital to complete the surgery.

The operation was completed successfully and no harm was caused to either the mother or child, the hospital said.

Speaking to the press at the President’s Office today, gynecologist Dr Hawwa Hana said the Fuvahmulah doctor followed the correct procedures.

“From our observations it appears [the doctor] during the surgery noticed issues that could endanger the mother that they had not noticed before,” she said.

“The placenta was at an unusually low position, and because of this there were changes to the mother’s veins, and the doctor suspected it may cause complications such as excessive bleeding. They decided not to remove the baby and wait for additional help from another team from Addu,” she said.

The Fuvahmulah Hospital said they also had not detected any negligence in the stillbirth case.

The pregnant woman had been hospitalised at 10:30pm on May 31 when the gynecologist noticed the baby’s pulse declining during a checkup. The fetus died in the womb, and the doctor opted for a natural birth.

When the baby was delivered at dawn the next day, doctors found the umbilical cord wrapped around the baby’s neck, the hospital said.

Hana went into further detail stating that the doctor did not have the opportunity to save the baby before the pulse dropped.

“With the baby’s death, the highest priority is the mother’s life. And so instead of a surgery, a normal delivery was recommended,” she said.

Soldier’s death

Fuvahmulah Atoll Councilor Hussain Saeed said Maldives National Defense Forces (MNDF) Corporal Abdulla Nazmee had not received any emergency care when he collapsed while playing football. The hospital’s ambulance arrived on the scene with just a driver and no emergency care facilities, he said.

The Fuvahmulah Hospital, however, said the doctor had not detected a pulse when Nazmee was brought to the hospital.

“But this hospital’s doctors and nurses tried to see another way. We would like to note emergency response injections and facilities are available at this hospital,” the statement read.

The hospital also said the three-year-old who is said to have received the wrong injection in fact received an antibiotics injection. The child’s condition did not decline because of the injection, the hospital said, adding that the child is now doing well.

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Gan Council fears “health disaster” after severe sewage spill

Laamu Atoll Gan Island Council has raised fears of an imminent “health disaster” following a severe sewage spill on the island.

The spill was caused by damage to pumps and septic tanks in the sewage treatment facility. Recent rains have spread the sewage throughout the island, Gan Council President Ahmed Salah told Minivan News today.

The council is trying to contain the sewage, but have received no help from any government office, Salah said.

“The pumps in the system are not working, and the [septic] tank is also damaged. So when sewage effluent gathers in the tank it overflows and spills out. But this has got worse with the rainy season, the waste is being carried across the island through the puddles. And sometimes it is overflowing from the toilets, leaving houses and rooms filled with waste,” he said.

The spill poses “enormous health risks,” Salah said. Exposure to sewage can cause several infections including gastroenteritis of the stomach and hepatitis.

“We have asked the hospital to be on alert for a medical situation, and we have also informed the Ministry of Health and other authorities. We told them we are facing great health risks here and we have asked them to take action,” he said.

According to the council similar incidents have occurred on the island during the rainy season. The 5,500 strong population is among the biggest in south central Maldives.

“It was the first thing we discussed in the new council as well. We informed the ministries, we even went to Malé to bring this to their attention. We wrote to the disaster management center, but no action has been taken yet,” Salah said.

The sewage system at fault is located at the new settlement of tsunami-displaced population that moved to Gan from Mundoo and Kalhaidhoo Islands in 2007.

The sewerage project was funded and implemented by the International Federation of Red Cross Societies (IFRC) as part of their tsunami recovery work. After the project was completed, it was handed over to the government of Maldives.

Salah said no one has taken ownership of the system since it was handed over and said he believed the spill had taken place due to lack of maintenance.

“No one took the responsibility for managing it. The council doesn’t have the financial capacity to handle it, and without any ownership and repair it eventually broke down. We have discussed the issue with Fenaka [state-owned utility corporation] as well, but they won’t take charge until the system fully repaired. Their estimated cost for repairing it is above MVR1 million (US$ 64,850),” he said.

The council is now trying to manage the situation by using a mobile tank called bowser to drain the waste into the sea. The bowser was donated as part of the sewage system.

“It [the bowser] has a very small tank, even with 20-30 rounds we are unable to drain it to a level where people can use the toilet. We are trying to find a way to control the situation even if it is by pumping it all in to the sea,” he said noting that some households are not using the toilet.

When the council approached the National Disaster Management Centre (NDMC) for a solution, the office said they could not offer any help as the sewage spill cannot be considered a disaster.

Speaking to Minivan News today, an NDMC official confirmed that the situation cannot be considered a disaster as it had developed gradually. The NDMC said the sewage project was the responsibility of the Ministry of Housing.

However, the Housing Ministry has said the Ministry of Environment and Energy was responsible for the project. The Environment Ministry was unable to comment on the issue at the time of publication.

MVR85 million sanitation facility is being built on Gan Island for areas that do not have a sewage system with assistance from the French government.

Salah said the council has proposed to join the old and new systems, but experts have said the task is impossible as the two systems are incompatible.

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Malé City Council turns to private donations for mosque repair

Malé City Council has turned to private donations to repair mosques for the Islamic month of Ramadan after the Islamic Ministry’s failed to release funds.

Deputy Mayor Shifa Mohamed told the press on Tuesday many mosques in Malé are badly in need of repair. With just three months remaining for Ramadan, the council has decided to “do what can be done” from the council’s budget and private donations.

The Islamic Ministry has failed to respond to a two month old request for a MVR 1.5 million (US$ 97,087) to paint and renovate mosques, the council said.

The permanent secretary of the Islamic Ministry told the council that a decision will be made on consultation with Minister of Islamic Affairs Sheikh Mohamed Shaheem Ali Saeed.

“We have already met the Islamic ministry and reminded them that Ramadan is approaching, and at that meeting the Islamic Ministry permanent secretary said a decision would be made after consulting with the minister. Again, last week the mayor [Mohamed Shihab] went to the meet the Islamic minister and brought these issues to his attention. [The minister] has said that some assistance would be provided this week. So we are hoping now,” Shifa said.

Malé City Councillor Zaidul Ameen said businesses are now sponsoring some of the repairs and said the council had recently received paint from a shop in Malé.

Responsibility for the maintenance and management of mosques was transferred from the Islamic Ministry to local councils by the landmark Decentralisation Act of 2010. However, following an amendment to the the Religious Unity Act enacted in April 2013, all mosques will be under the jurisdiction of the Islamic ministry starting 13 July 2014.

An Islamic Ministry official told Minivan News today that it had received a total of MVR10 million (US$648,508) from state budget to repair mosques around the country, and the amounts necessary for mosque renovation would be transferred to the councils as soon as requests are submitted.

“We have now released a circular [June 1] requesting all councils to submit the amounts they require [for mosque renovation],” the official said. According to the official, this amount is from the state budget and does not include any funds from the Islamic Ministry’s mosque ‘Waqf’ fund.

The ministry has already announced plans to build new mosques and “broaden the role of mosques” in the future in a more sustainable manner.

In July 2012, the Islamic Ministry collected more than MVR15 million (US$974,000) million as donations from members of the public for the “mosque fund” established in 2010. At the time Shaheem said that he decided to ask for funds from the people of Maldives as the state budget could not provide it.

After an Algerian businessman donated MVR3.1 million ($US200,000) to the fund, Shameem announced plans to construct a ten storey building ”Darul Iman” (House of Faith) to sustain the Waqf fund. Shaheem said he expected Darul Iman to generate MVR1.8 million (US$116,731) annually, which would then be used to construct and renovate mosques.

Shaheem also requested more funds from Kuwait, Qatar, Saudi Arabia, the UAE, Malaysia, and Brunei. In March this year, he handed over the construction project to state owned Maldives Transport and Contracting Company (MTCC) for MVR24.9 million (US$1.6 million).

In February, the ministry announced plans to construct 40 new mosques within  the year. The ministry said 14 are already under construction with MVR72.6 million (US$4.7 million) from the state budget.

A total of MVR65.2 million (US$4.2 million) was allocated in the 2013 state budget for the construction of 17 mosques.

Saudi Arabia has also agreed to donate funds to construct seven mosques within the year. The ministry said it has received MVR 28.8 million (US$ 1.8 million) for six of these mosques.

The Crown Prince of Saudi Arabia, Salman bin Abdulaziz has also donated US$1million to the ministry when Shameem brought up the renovation of mosques in a meeting with leaders of the Indian Muslim community,

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Select committee decides composition of ‘241’ security services committees

The composition of parliament’s ‘241’ security services committee has been determined today by a five-member select committee chosen at Monday’s sitting.

Article 241 of the constitution states, “A committee of the People’s Majlis shall be established to exercise continuing oversight of the operations of the security services. The committee shall include representation from all the different political parties within the People’s Majlis.”

Parliamentary rules dictate proportional representation in standing committees for political parties based on the number of MPs in each party.

The select committee decided to allocate four seats for the ruling Progressive Party of Maldives (PPM), three seats for the opposition Maldivian Democratic Party (MDP), two seats for the Jumhooree Party (JP), and one seat each for the Maldives Development Alliance (MDA) and the Adhaalath Party (AP).

Along with Independent MP Muaz Mohamed Rasheed, the committee will consist of 12 MPs.

The select committee decided the number of seats to allocate for each party in the other 12 standing committees during meetings yesterday.

The PPM with 38 MPs will have five seats each from 11 committees and four seats from one committee while the MDP with 25 MPs will have four seats from nine committees and one seat from three committees.

The JP with 15 MPs will have two seats each from 11 committees and one seat from one committee.

The MDA with its five MPs will have one seat from eight committees while Adhaalath Party MP Anara Naeem and Independent MP Muaz will each sit in two committees.

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Environment Minister Thoriq signs for PPM

Minister of Environment and Energy Thoriq Ibrahim signed for the ruling Progressive Party of Maldives (PPM) today.

Thoriq had been filling a slot assigned for the Jumhooree Party (JP) under the coalition agreement formed with the PPM during last year’s presidential election.

Following the dissolution of the coalition agreement between the JP and PPM last week, nine political appointees belonging to the JP – including Transport Minister Ameen Ibrahim – were dismissed by President Abdulla Yameen, prompting speculation in the media that the three ministers remaining in JP slots would join the ruling party to retain their posts.

Speaking to press after signing his membership form at a ceremony in Muleeage this afternoon, Thoriq said he decided to sign for the PPM to complete the work begun by his ministry after the current administration took office in November last year.

The environment minister assured the public that he would “sincerely” remain behind President Yameen for the next five years and endeavour to develop the country.

Thoriq also denied coming under “any kind of pressure” to sign for the ruling party in the wake of the coalition’s breakup.

In his remarks at the ceremony, President Abdulla Yameen meanwhile praised Thoriq as an “active” and “resourceful person,” welcoming the minister to the party on behalf of PPM Leader Maumoon Abdul Gayoom, the party’s council, parliamentary group and members.

“Welcome to the team. God willing, we are beginning a long-haul journey so welcome aboard,” he said.

Aside from Thoriq, Home Minister Umar Naseer and Economic Development Minister Mohamed Saeed were also appointed to the cabinet as JP political appointees. The pair have however yet to sign for the PPM.

The PPM severed its coalition agreement with the JP following a dispute over the speaker’s post, which was contested by JP Leader Gasim Ibrahim after President Yameen urged the business tycoon to withdraw his candidacy and support a PPM candidate.

President Yameen however told reporters on Sunday (June 1) that the PPM was still willing to work with the former coalition partner and professed “respect” for Gasim.

Yameen noted that three cabinet ministers as well as board members of state-owned enterprises occupying JP slots remained in the government.

He also denied pressuring the JP members to sign for the ruling party to retain their government jobs, adding that it was “up to them to decide” how best to serve the nation.

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Kulhudhuffushi airport may displace 130 households

An estimated 130 households may have to relocate for the construction of an airport on northern Kulhudhuffushi Island.

Blueprints shared with the Kulhudhffushi Island Council show 80 plots of land will be seized for construction. But Council President Ali Mohamed said they expect to relocate an additional 50 households, as buildings cannot be constructed to heights desired by homeowners in plots adjacent to the airport.

Establishing an airport on the most populous island in the north was a key campaign pledge of President Abdulla Yameen, although with a regional airport on Hanimadhoo Island – just 16.5 km or a 30 minute dhoni ride from Kulhudhuffushi, critics have questioned the feasibility and economic viability of the venture.

Environmental groups have also called the project unconstitutional, as it requires the dredging of the island’s only remaining mangrove.

The site was declared protected after the island’s second mangrove was dredged in a reclamation project in 2010. The government in February amended environmental regulations to allow dredging in protected areas.

Mohamed said islanders remains divided over the project, with supporters believing it would usher in socioeconomic development while opponents have called for affordable and reliable transport links between Kulhuduffushi and Hanimadhoo.

“Regardless, the Kulhudhuffushi Council will not obstruct the government’s plans. We have cooperated with the Housing Ministry. We will pressure the government to fulfill its pledges, and we will criticize them if they don’t build it,” he said.

However, relocating 130 households would be difficult, with families already stating they would only move with comparable compensation, he said.

According to Mohamed, people have been living on these plots for 30 years, and have invested in their homes and have started businesses including shops and carpentries on their land.

“Also, these households are on plots of land that are approximately 3,000 square feet. But new plots are only 1,400 square feet,” he said.

A possible solution would be to relocate households to the 28-hectare land that was reclaimed in 2010, but such a move would disrupt existing plans for the area, he said.

The reclaimed “New Kulhudhuffushi” is to be developed into a commercial zone with an international ferry terminal, business hubs, city hotels, a mosque and a football field, Mohamed said.

The only remaining option would be to dredge the entire mangrove to make space for the displaced households, but such a move raises further environmental implications, he said.

Approximately 10,000 people are living in 1600 households in Kulhudhuffushi, Mohamed said.

The government has said four parties have expressed interest in building the Kulhudhuffushi airport. Developers will be given a contract of 25 years and will be awarded an island for resort development for 50 years in order to subsidise the airport.

Mohamed said he expects the venture to cost at least US$25 million.

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