Pro-government MPs reject Dr Shakeela’s re-nomination as health minister

Dr Mariyam Shakeela failed to secure parliamentary consent today after MPs of the ruling Progressive Party of Maldives (PPM) and ally Maldives Development Alliance (MDA) voted against approving her as Minister of Health.

Of the 73 MPs in attendance, 61 voted against endorsing her reappointment to the cabinet while 11 voted in favour and one abstained.

PPM reportedly issued a three-line whip against approving Shakeela following a secret ballot at a parliamentary group meeting this afternoon.

The health ministry has been under fire following a series of protests over regional healthcare services and mishaps in Malé.

The state-owned Indira Gandhi Memorial Hospital (IGMH) – long criticised for lack of qualified doctors and inadequate medical facilities – transfused HIV positive blood to a patient in February due to an alleged technical error.

In June, Fuvahmulah councillors called for Shakeela’s resignation after a case of stillbirth, an interrupted caesarean, and the death of a soldier on the island. A few weeks later, over 300 protestors demonstrated in Haa Dhaal Kulhudhuffushi over deteriorating conditions at the regional hospital.

Shakeela was up for parliamentary approval today for a second time after President Abdulla Yameen modified her initial portfolio as Minister of Health and Gender.

During a debate today on a report by the independent institutions committee – which narrowly recommended endorsing her appointment – PPM MP Mohamed Musthafa accused Shakeela of reversing a decision by the previous minister to raise wages for doctors under a 48-hour work week.

He claimed that Shakeela had reduced working hours to 45 hours and lowered salaries.

“The consequence was all specialists working at IGMH and doctors in hospitals in the atolls and health centres leaving the Maldives,” he said, adding that the health minister should bear responsibility for the alleged exodus.

Musthafa suggested that “circumstances have changed” since President Yameen nominated Shakeela for the post.

MPs of the opposition Maldivian Democratic Party (MDP) also voted against the health minister while Jumhooree Party (JP) MPs voted in favour.

MDP MP Rozaina Adam accused the health ministry of taking measures against health sector employees who provide information to opposition MPs. Such workers were threatened with dismissal and accused of “pestering” the government, she claimed.

Rozaina also strongly objected to the committee being unable to interview Shakeela due to a Supreme Court ruling.

JP MP Hussain Mohamed meanwhile noted that appointing cabinet ministers was a prerogative of the president, suggesting that the parliament’s confirmation role was a formality.

The party decided to endorse her as Shakeela’s reappointment implied that the president must have had confidence in her ability to implement his health policy, he said.

Health policy

Meanwhile, at a press conference yesterday, Shakeela said that the health sector had been strengthened despite “pressure” from elements within the government.

Shakeela insisted that she would not resign in the face of “obstacles and challenges” and said that President Yameen had not asked her to do so.

Shakeela contended that she had inherited a health sector “in ruins” with limited human resources and crumbling health centres and medical equipment.

She alleged that senior officials “within the system” were “obstructing” the ministry’s efforts.

Shakeela said she would “respect” the PPM MPs’ decision, but insisted that it would not be based on her performance.

Defending her track record, Shakeela said the ministry has formulated and submitted legislation to parliament on health services, health professionals, medical negligence, and medical devices.

The administrative framework of the health sector had been reviewed and revised, she said.

Shakeela said 70 percent of infrastructure had been damaged when the current administration took office, which has commenced repair work on 24 health centres at a cost of MVR14.1 million (US$914,397) while projects for repairing a further 49 centres were in the tendering process.

Contracts have been signed for constructing an 11-storey building for IGMH and upgrading the dialysis unit, she continued, adding that efforts were also underway to upgrade the Vilimalé health centre to a hospital.

Moreover, the ministry was purchasing equipment to upgrade the Hithadhoo and Kulhudhufushi regional hospitals to tertiary level, she said.

Among other ongoing projects were a quarantine facility and halfway house in Hulhumalé, a maternity waiting home in Kulhudhufushi, and newborn care centres.

A project to repair speedboats was also underway, Shakeela said, which has seen 13 out of 28 speedboats resume service. Four sea-ambulances have also been launched to fulfil a PPM campaign pledge, she noted.

While only 42 of 199 ambulances were functioning when she assumed office, Shakeela said 110 were now being used.

Noting that 80 percent of employees in the health sector were expatriates, Shakeela said the government was finding it hard to recruit professionals from overseas due to loss of confidence in the health sector by foreign workers.

A four-year long term plan for the health sector was being implemented, she noted.

Work has also begun on integrating a general practitioners service with the government’s ‘Aasandha’ health insurance scheme, Shakeela said.


Medical camp for heart diseases underway in Malé

Health Minister Dr Mariyam Shakeela inaugurated a three-day medical camp offering free treatment for heart diseases in the capital Malé on Saturday (August 9).

The medical camp with Dr Vivek Gupta, a specialist from the Asiri Surgical Hospital in Sri Lanka, is taking place at the Dhamana Veshi urban primary health centre in the Thalassemia centre on Majeedhee Magu.

The camp was jointly organised by government-run Dhamana Veshi and the Corona Sunrise International Pvt Ltd security firm.

Speaking at an opening ceremony, Dr Shakeela reportedly said that treatment of heart diseases was a “major challenge” facing the Maldives.

Two patients selected at the camp would be offered free treatment at the Asiri Surgical Hospital funded by Sunrise Corona, she added.

The health minister noted that the Maldives has the highest incidence of fatalities from non-contagious diseases in the South Asia region.

According to the health ministry, a survey conducted by the World Health Organisation from 2004 to 2012 found that 47 percent of Maldivians were overweight and 18.8 percent were smokers.

The most common heart diseases in the Maldives include blood pressure, diabetes, stroke, ischemic heart disease, and myocardial infarction or heart attacks.


PPM MPs reluctant to approve Dr Shakeela as health minister

Several MPs of the ruling Progressive Party of Maldives (PPM) are not in favour of approving Dr Mariyam Shakeela as health minister in an upcoming vote on parliamentary approval for her nomination, reports CNM.

An unnamed MP told the online news outlet that Majority Leader Ahmed Nihan organised an informal secret ballot at a PPM parliamentary group meeting last Wednesday (July 23).

“Most members were not that positive,” the PPM MP was quoted as saying.

CNM has meanwhile learned that Nihan has communicated the results to the government as well as Shakeela and sought her opinion on the possibility of resigning from the post.

PPM MPs were against approving her to the post because of her handling of several incidents in the health sector during the past few months, CNM claimed.

The President’s Office submitted Shakeela’s name for parliamentary consent earlier this month. She was reappointed to the cabinet after her ministry was renamed Ministry of Health from Ministry of Gender.

The department of gender was meanwhile transferred under the newly-created Ministry of Law and Gender.

The parliament’s government oversight committee narrowly approved the nomination at a meeting last week and forwarded the matter to the People’s Majlis floor for a vote.

As opposition Maldivian Democratic Party MPs and Jumhooree Party MPs voted against recommending the nominee for approval, Chair Riyaz Rasheed cast a tie-breaking vote.

Despite the PPM majority on the key oversight committee, the vote was tied 5-5 after PPM MP Abdul Latheef Mohamed abstained.

The MP for Haa Alif Dhidhoo had joined the ruling party after being elected as an independent.


Arrangements made to secure child support payments in three days

Arrangements have been made to secure child support payments through the family court for divorced mothers within three days, Health Minister Dr Mariyam Shakeela has said.

In her address on the occasion of International Women’s Day, Dr Shakeela said that the ministry has formed a council to promote economic empowerment of Maldivian women.

The minister also stressed the importance of protecting women in the workplace from discrimination and sexual harassment.

In March last year, parliament passed an amendment to the Family Act to increase child support payments to MVR2,000 (US$130) a month.


Resigning not the solution: Health Minister Dr Shakeela

Resigning in the wake of last week’s transfusion of HIV positive blood to a patient is not the solution to problems in the health sector, Health Minister Dr Mariyam Shakeela told MPs on the government oversight committee on Friday (February 28).

Dr Shakeela told the opposition-majority oversight committee that “human error” was to blame for the incident at the government-run Indira Gandhi Memorial Hospital (IGMH), as the lab technician reported the blood as negative despite the machine showing otherwise.

“My resignation isn’t going to solve this. I could resign if that is the case. My resignation is not going to solve it. That’s why I am saying, what is the solution? The solution is all of us cooperating and working together to improve the system,” she said.

Shakeela added that she had been receiving text messages calling for her resignation.

Asked by opposition Maldivian Democratic Party (MDP) MP Ahmed Hamza if she accepted “full responsibility without any excuses” for the incident, Shakeela replied that she accepts responsibility for “providing benefits” to whomever it was owed.

The ministry would attempt to explain to the public that the incident occurred due to “human error,” she stressed, adding that she did not think members of the public would stop visiting the government-run tertiary hospital.

As the donor was found by the patient, Shakeela stressed that the blood sample did not come from the hospital’s blood bank. The donor was not previously registered as an AIDs patient.

The government was ready to take whatever measures were necessary to restore public confidence, she added.

The minister also denied that there was a cover-up, or that the revelation to the media was prompted by leaked information.

Shakeela urged MPs to consider the mishap as “a one-off” incident caused by a mistake.

“Don’t think that this will keep happening to us all the time. We are taking steps for example to try and go to a fully automated system, to improve it and reduce human mistakes,” she said.

ISO standards

Upon learning of the incident on February 19, Shakeela said she informed the World Health Organisation (WHO), seeking advice and assistance following an emergency meeting with high-level officials at the Health Ministry.

The Health Ministry acted in line with international best practices, she said, and immediately launched independent inquiries.

The incident was revealed to the media shortly after receiving a draft report from an independent committee, she added, noting that further investigations were taking place to identify shortcomings at the hospital.

The machines at IGMH were state of the art whilst the standard operating procedures (SOPs) and protocols were at international standards, she noted.

Health Ministry Director General Dr Sheeza Ali meanwhile revealed that the laboratory was presently not “ISO certified”.

“But we are starting work during this year towards ISO certification. It is likely that we might not reach the latest [standards] as we might not be able to fulfil all the requirements,” she said.

Budget constraints

While the Health Ministry had asked for a “realistic budget” of MVR4 billion, Permanent Secretary Geela Ali said the budget approved by parliament had only MVR2.5 billion earmarked for the health sector.

Of the MVR2.5 billion annual budget, Geela noted that MVR1.8 billion was allocated for the National Social Protection Agency (NSPA).

Shakeela meanwhile told MPs that the health sector was in disarray, with crumbling infrastructure and facilities due to insufficient funds allocated in the state budget for many years.

“If we look at machinery, a screw comes loose from the machine and it falls on the head of the patient who is taken into the operating theatre,” she said.

Moreover, attracting qualified foreign doctors was “very difficult” as the salary of doctors in the Maldives has not kept pace with pay rises for doctors in the South Asian region, she explained.

Due to the budget constraints, Shakeela said the ministry was seeking foreign assistance, and that machinery and equipment were “on the way”.

In response to complaints regarding the budget, MDP MPs on the committee pointed out that health policy was formulated by the government while the state budget was proposed by the Finance Ministry, reviewed by a budget committee controlled by the ruling coalition, and approved by the government majority in parliament.


IGMH lab technician responsible for HIV blood transfusion in custody

An expatriate lab technician at the Indira Gandhi Memorial Hospital (IGMH) responsible for the transfusion of HIV positive blood to a pregnant Maldivian patient has been taken into police custody on Thursday night (February 27).

IGMH Deputy CEO Dr Mohamed Habeeb told MPs on the government oversight committee yesterday that the Indian national had admitted his culpability in the incident.

Local media has since revealed his identity and reported that the Criminal Court has extended pretrial detention to seven days.

Habeeb was summoned to the oversight committee along with Health Minister Dr Mariyam Shakeela and senior officials at the ministry.

Briefing MPs on the incident, Habeeb explained that the blood test was done on February 2 and the transfusion took place the next day.

The technician at fault reported the blood as negative despite the machine showing that it was positive for HIV.

The error was discovered when the patient came in for a routine checkup on February 18, he continued, after which the blood test report was reviewed.

A high-level meeting with senior officials from the Health Ministry was held immediately after the discovery and a three-member committee was formed to look into the incident, he said.

The committee comprised of an experienced doctor, senior nurse, and retired lab technician, he added – none of whom were employed by the hospital.

The incident was revealed to the media hours after the committee shared its findings, he said.

The blood sample was taken from a donor found by the patient and not from the hospital’s blood bank, Habeeb stressed. The donor was not previously registered as an HIV patient.

While there were normally two technicians at the lab, Habeeb noted that the Indian national was alone on the day in question as it was a public holiday.

Habeeb revealed that the technician left for India on the day of the incident and returned to the Maldives about two days later.

The technician had been working at the hospital for seven years and had recently received an award for his performance, Habeeb said.

However, Permanent Secretary at the Health Ministry Geela Ali revealed that the technician had been fired from his previous job in 2006.