Women urge drastic action from president on drugs

A women’s group campaigning against drug abuse has handed the government a petition urging President Abdulla Yameen to prioritise the Maldives’ drug crisis.

The Society for Women Against Drugs collected 359 signatures calling on the president to improve the quality of drug rehabilitation care, and to launch medical care for addicts suffering from withdrawal symptoms in police custody.

“Successive governments have attempted to address the problem of drugs, but they are not doing enough and we don’t see politicians prioritizing the issue,” said the group’s chairperson Fathimath Afiya after handing over the petition last week.

According to a 2012 UN report, there are 7,496 drug addicts in the Maldives. However, critics say the true figure is much higher.

Meanwhile, health advocacy groups have expressed concern over a high risk of HIV spreading among an unmonitored population of injecting drug users.

President Yameen in February acknowledged that changes were needed in the drug rehabilitation system, but the cabinet in March discussed mechanisms to decrease state expenditure on drug care centres.

Home Minister Umar Naseer last year pledged to prioritize drug trafficking and last month brought in a sniffer dog squad.

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IGMH HIV transfusion case sent back to PG

The Criminal Court has returned to the prosecutor general the case of the IGMH lab technician charged with responsibility for transferring HIV infected blood to a pregnant Maldivian patient.

Court officials told Sun Online that the investigation was incomplete, but that the prosecution of an Indian national – charged under Article 88 of the Penal Code – would be resubmitted after further investigation.

After the transfusion of infected blood occurred in February last year, the Indian lab technician was said to have admitted culpability in the incident.

The technician had been working at the hospital for seven years and had received an award for his performance prior to the incident.

Source: Sun Online

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Health sector unprepared for potential HIV outbreak, warns HRCM

The health sector is unprepared for a potential outbreak of HIV in the Maldives in the absence of prevention programmes and specialised care for population groups at risk, the Human Rights Commission of Maldives (HRCM) has warned.

“[The Health Protection Agency] mandated with HIV/AIDS prevention/control is not adequately funded and lacks capacity to lay down such a system,” reads the HRCM’s submission for the UN Human Rights Council’s Universal Periodic Review.

“There are no prevention services for high risk groups, increasing the risk of spreading HIV. High risk factors including sharing of needles to inject drugs, high sexual activity among adolescents and youth could contribute to an increased prevalence of HIV/AIDS. It is alarming that there is no screening system for HIV/AIDS and STI in the prison system; considering some of the identified HIV patients go in and out of prison as repeated offenders.”

In May, the health ministry issued new guidelines on preventing the transfer of HIV from mother to child while the Health Protection Agency warned of an HIV “time bomb.”

A series of protests over regional healthcare services occurred earlier this year after it was revealed that the state-run Indira Gandhi Memorial Hospital (IGMH) had transfused HIV positive blood to a patient in February due to an alleged technical error.

The HRCM report also noted that health services were “not easily accessible and available in atolls and lack healthcare professionals such as gynaecologists and paediatricians.”

“Public has no trust in the healthcare system due to many avoidable health incidents and sensitive medical information of patients being leaked,” the report stated.

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Health Ministry seeks to protect mothers and infants from HIV “time bomb”

New guidelines on preventing the transfer of HIV from mother to child will come into effect from Wednesday (May 7 2014), Ministry of Health and Gender has said.

The national guideline on prevention of mother to child transmission of HIV is underpinned by a need to equip the Maldives for what the Health Protection Agency has termed an HIV “time bomb.”

Programme Coordinator for the Reproductive Health Unit Naseera Nazeed has urged all pregnant women to get tested in their first semester.

“There is very high chance of saving the baby – 90% – if they are checked,” she said.

The guidelines aim to protect women of childbearing age from HIV, advise women with HIV against pregnancy, protect HIV positive mothers from infecting their children and providing support to HIV positive mothers and their families.

The Maldives identified the first infant with HIV in 2012. In February this year, the Indhira Gandhi Memorial Hospital (IGMH) transfused a pregnant women with HIV positive blood due to a technical error. Meanwhile, local media have alleged a 19-year-old HIV patient had given birth at IGMH in early April.

Programme Manager for the National HIV AIDS programme Abdul Hameed said the spate of HIV incidents this year had raised awareness on HIV and provided a boost to healthcare efforts.

“We are sending out the public a clear message, always to be sure of their status. HIV is everywhere, you don’t have to give your name, you just have to go and get tested. The result will be in 10 minutes,” he urged.

Not prepared

Lack of prevention programmes and specialized care for population groups at risk facilitate an HIV outbreak in the Maldives, Hameed said. Sex workers, gay men and intravenous drug users are particularly at risk, he said.

“We are sitting on a time bomb. We know those key populations exist [in Maldives],” stated Hameed. “At any time it can explode.”

The Maldives does not offer prevention services for gay men or sex workers, he said.

HIV patients prefer treatment abroad due to high levels of stigma and discrimination, he said, adding: “Even in the healthcare system itself there is ingrained discriminations.”

The healthcare system is ready for an outbreak, Hameed claimed, but said there are deficiencies that could hinder response to a crisis.

“The health system is ready, but we don’t have the civil society or organization networks. We may not be prepared,” he said.

A prevention workshop—the second of its kind—is underway from Tuesday to Wednesday (May 4 to May 6) to train health professionals on the new guidelines. A total of 31 participants from regional hospitals, populous atolls, Malé, Villimalé and Hulhumalé are taking part.

The Ministry also plans to hold a series of phone conferences to all atolls to further disseminate the information.

Former Minister of Health Dr Ahmed Jamsheed Mohamed said it was only through “incredible luck” the HIV virus had not spread throughout the country.

“All the habits that may lead to the spread of HIV is excessively in practice,” he claimed referring to sexual promiscuity and intravenous drug use in the Maldives.

Since the first case of HIV was detected in the country in 1991, 19 cases of HIV have been reported among Maldivians. However, the Health Ministry estimates numbers of HIV positive persons could be between 70 and 100.

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19 year-old Maldivian HIV patient gives birth

A 19 year-old woman with HIV has given birth to a child last week at the Indira Gandi Memorial Hospital (IGMH), local media have reported

According to online newspaper ‘MV Youth’ the patient was allegedly involved in a sexual relationship with a man with HIV when she was 15 years of age.

The website reported that the man who she had sex with was found guilty of having sex with the girl and sentenced to 19 lashes in 2010 by the Criminal Court. It was not confirmed whether the baby was tested positive to HIV.

Speaking to Minivan News today IGMH Spokesperson Zeenath Ali said that she had not heard of the incident.

‘’Some other news agencies had contacted me today and asked about it but I told them that only the concerned authorities such as Health Ministry and concerned persons from IGMH will have that kind of information,’’ she said.

She said she cannot confirm whether or not the information was true.

On February 27, an expatriate lab technician working at IGMH who was allegedly responsible for the transfusion of HIV positive blood to a pregnant Maldivian patient was taken into police custody.

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, after which the blood test report was reviewed.

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

In October 2012, the then Minister of Health Dr Ahmed Jamsheed Mohamed claimed it was only through “incredible luck” that HIV had not spread across the Maldives, considering the prolific levels of unprotected sex and intravenous drug use.

Jamsheed at the time spoke of the risks of promiscuity in the society, referring to the 2010 case where police arrested an HIV positive prostitute. He stated that the same prostitute had been identified in the Maldives as being HIV positive in the year 2009 as well.

Since the first case of HIV in 1991, 19 cases of HIV have been reported among Maldivians, while the estimations of HIV positive persons are as high as 70 – 100.

The Health Ministry has previously warned about a possible explosion of HIV/AIDS in the country, with high risk behavior such as drug use and numerous sexual partners a concern.

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Voice of Women fears further discrimination for IGMH scandal victims

Maldivian NGO Voice of Women has expressed concern that the victims of the recent HIV scandal at Indira Ghandi Memorial Hospital (IGMH) will suffer from further discrimination.

“Our foremost concern is that the mother and child will be subject to unfair and unfounded discrimination based on societal myths and misinformation about the disease,” said the women’s rights NGO.

Despite acknowledgements that the Maldives as a society exhibits a number of high risk behaviors for transmission of HIV, the number of people reported to be living with the illness is less than 100.

The incident, in which HIV positive blood was given to a female patient – whom local media has reported to be pregnant – became public last week.

Following similar calls from the Human Rights Commission, Voice of Women has called for the protection of the patient’s identity as well as urging concerned parties to initiate public awareness campaigns.

The opposition Maldivian Democratic Party (MDP) has accused the government of hiding the news – first discovered 8 days prior to the public announcement – until the conclusion of celebrations marking its policy achievements since assuming power.

Health Minister Dr Mariyam Shakeela has rejected calls for her resignation, arguing that the incident was  a one off. She did, however, inform a Majlis committee last week that the health sector was severely underfunded.

An Indian expatriate – allegedly responsible for incorrectly marking the blood test – is currently being held in police custody. IGMH Deputy CEO Dr Mohamed Habeeb told MPs on the government oversight committee that the Indian national had admitted his culpability in the incident.

Voice of Women have been critical of the tone taken by Dr Shakeela in the aftermath of the incident, suggesting she had failed to take responsibility for the systemic failures that led to the incident – instead blaming a single individual.

“We are concerned by repeated calls by the Minister for harsh and criminal punishment for an individual. The punishments should be relevant and take into consideration the failure of the system (if that is the case) rather than laying responsibility solely on an individual,” read the group’s press release.

The NGO also questioned the police’s ability to conduct what it suggests ought to be a medical inquiry.

Further incidents and president’s response

Local media yesterday reported that a similar incident had occurred in nearby Hulhumalé Hospital, with a male patient attempting suicide after mistakenly being told he had hepatitis B.

CNM reported that hospital staff had advised the man to separate from his wife before discovering that the test results were in fact those of another patient. After taking a knife and some rope to the local football pitch, locals dissuaded the man from killing himself. The family are reportedly planning to submit a complaint to the Health Ministry.

Director General of Health Services Dr Sheeza Ali was not responding to calls at the time of press, while Permanent Secretary at the Health Ministry Geela Ali denied any knowledge of the incident.

After being criticised for failing to mention the incident during yesterday’s state address at the opening of the Majlis, President Yameen last night commented on the IGMH incident for the first time.

During a campaign event for Henveiru Dhekunu constituency PPM candidate Mohamed Riyaz, the president was reported as saying that the incident ought not to have happened under any circumstances.

Yameen went on to note that overcrowding at IGMH – which he described as being “busier than the fishmarket” – was a problem that needed resolving urgently.

“If we look at the health minister’s statements at the People’s Majlis committee, there are clinics in Malé. There is a land and building given at a cheap rate – free –  called ADK,” Haveeru quoted Yameen as saying.

The privately-run ADK hospital is the capital’s second largest, and is run by the ADK Group. The group is chaired by the Maldivian Democratic Party candidate for the Komandoo Dhaairaa constituency, Ahmed Nashid.

Vice President Dr Mohamed Jameel Ahmed met today with representative of the World Health Organisation (WHO), though the President’s Office did not report the IGMH incident as having been discussed.

Shakeela has said that she sought the assistance and advice of the WHO upon learning of the incident on February 19.

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Week in review: February 22– 28

A tragic incident at the country’s main public hospital – IGMH – caused outrage this week as it was revealed that HIV infected blood had been given to a patient.

Profuse apologies from the Home Minister were not enough for the opposition Maldivian Democratic Party (MDP) who accused the government of hiding the news for eight days in order to complete the celebrations of its first 100 days in power.

Earlier in the week, Minivan News was informed that certain operations at the hospital had been suspended owing to the lack of the necessary staff safety equipment. The week had begun with Indian Foreign Minister Salman Khurshid pledging US$10 million for the renovation of the Indian-built facility.

The introduction of unlimited health insurance had already been announced earlier in the week. The ambitious pledge is soon to be followed by larger pensions, both of which are set to be sustained through the issuance of government debt.

Promises for completion of the long-awaited Malé-Hulhulé bridge within two years were also given, though development of the central atolls appeared to be coming at the expense of the Addu – the country’s second-city.

High priority is being given to the housing situation of police officers, while the fisheries minister launched a training scheme for long-line fishing, arguing that deviation from the country’s traditional pole-and-line approach was important to utilise all fishing grounds.

The Supreme Court’s decision to prosecute the Elections Commission (EC) on contempt of court charges prompted alarm this week from both representatives of the EU and Maldivian civil society, who demanded the court “earn the respect of the people”.

The EU called upon the government to ensure the EC’s independence in the run up to the March 22 parliamentary elections. Despite the government’s financial restrictions on EC spending, the commission has assured that polls will be unaffected.

While on the campaign trail, the MDP’s Mohamed Nasheed warned that the people of the country would not tolerate further electoral interference, labelling the ongoing court case “unjust”.

While Nasheed assured that his party does not intend to obstruct the government should it win a majority, President Yameen remained unconvinced, assuring voters that the MDP would attempt to remove him.

Yameen also rounded on the current members of the country’s legislature, arguing that the public had lost confidence in the institution. The recently jailed MP Abdulla Jabir was this week cleared of further cannabis possession charges – his lawyers have suggested his earlier conviction violated his constitutional rights.

The Criminal Court’s running feud with the Prosecutor General’s Office continued this week, with the PG’s Office accusing the court of overstepping its authority when introducing new time limits for the forwarding of cases.

In the Civil Court, a dispute over an oil trade agreement between the State Trading Organisation and Villufushi constituency MP Riyaz Rasheed was thrown out after the former’s legal team failed to show up.

Further agreements on oil trade could be on their way, however, as the the national oil company announced it was searching for outside assistance for further exploration projects.

Though well-qualified to discuss oil, Saudi Prince Salman bin Abdulaziz was reported to be visiting the Maldives in order to talk about potential investments in tourism, transport, and Islamic affairs, as well the provision of a soft loans to the Maldives.

One avenue of Saudi investment into the country was confirmed this week, with a prominent investment firm from the kingdom making plans for a US$100 million resort in Laamu atoll.

Maldivians seeking to travel in the other way may have to delay their plans, however, after both the Civil Court and the Anti Corruption Commission ordered the Islamic Ministry to halt the awarding of contracts for Hajj trips pending investigations into the bidding process.

Elsewhere this week, the second case of forced child prostitution in the country’s southern atolls, while an inmate at Maafushi jail suffered severe head injuries during a fight with other inmates.

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Health minister apologises over HIV transfusion as investigations launched

Minister of Health and Gender Dr Mariyam Shakeela has apologised for the transfusion of HIV positive blood to a patient at the Indira Gandhi Memorial Hospital (IGMH), in a press statement issued almost fifteen hours after the incident was made public.

The statement said that “as it happened due to the negligence of a staff working at IGMH” the minister and the ministry “apologised with deep grief” to the patient, the patient’s family, and all citizens of the Maldives.

“Given the modern technological resources and tools established at IGMH to prevent such an incident, the ministry accepts that this incident should not have taken place and this sad incident shouldnt be acceptable for anyone. Today is a sad day unlike any other day this ministry and IGMH has ever seen.”

The ministry said that an investigation was launched as soon as it came to the attention of the government and the hospital, and that the employee found to be negligent was relieved of their duties immediately.

“The ministry assures that, after completing the investigation, strict action will be taken against everyone who is found to have been negligent in this,” read the statement.

Stating that “changing the sorrowful result of this incident is not in the power of this ministry”, assurance were given that all necessary steps are now being taken to prevent such an incident in the future.

Concluding the statement, the ministry requested all health service providers to “learn from the incident” and to be more attentive, kind, and dedicated in providing their services.

Speaking to crowds gathered outside IGMH this evening, local media have reported Maldivian Democratic Party (MDP) Chairperson ‘Reeko’ Moosa Manik has pledged to introduce a no-confidence motion against Dr Shakeela in the Majlis.

The MDP earlier accused the government of delaying the news of the incident – first discovered eight days ago – to allow for celebrations of the government’s first 100 day achievements.

Investigations

Maldives Police Service has confirmed that an investigation in to the incident is being carried out in coordination with the Ministry of Health.

The parliament’s government accountability committee will begin it’s own investigation tonight at 8:00pm,  and will  later summon the minister of health and other senior members of the ministry and the hospital.

Human Rights Commission of the Maldives (HRCM) has also announced the launch of an investigation as well as expressing condemnation and grief over the incident.

“This commission calls upon the state to provide special protection and care in accordance to international standards for the person who sustained an irrevocable loss in this incident, and to provide health care of the highest standard for the person,” read a press release this afternoon.

The commission noted that the right to life and right to security and safety of the person of the victim have been violated and requests the government and state to ensure the victim and family are provided with their rightful social protection and are not discriminated against in any way.

Requesting that legal action be taken against all responsible parties, the HRCM also demanded the strengthening of regulations and procedures in accordance with international best practices.

In a separate ‘public appeal’ statement today, the commission called on the media and members of the public to respect the grief and privacy of the victim and family, and to refrain from any action liable to cause further harm and distress by willfully imparting false information.

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IGMH transfuses HIV positive blood to patient

Indira Gandhi Memorial Hospital (IGMH) has transfused HIV positive blood to a patient due to a technical error in the laboratory, the hospital and Ministry of Health and Gender revealed last night.

According to the hospital, the incident took place on February 3, with discovery of the error not made until February 19. The failure to reveal the incident earlier was, according to IGMH, due to a delay in receiving an internal report on the case.

Conversely, the opposition Maldivian Democratic Party (MDP) had accused the government of covering up the incident so as not to overshadow the government’s celebrations of its first 100 days in office.

At a joint press conference held last night, IGMH Deputy CEO Dr Mohamed Habeeb and Director General at the Ministry of Health and Gender Dr Sheeza Ali apologised for the incident.

Describing it as the “saddest incident in the eighteen year history of IGMH”, Dr Habeeb sad he was sharing the news with “grief and shame” and that he “apologised to the patient, the patient’s family, and all citizens of the Maldives”.

Reassuring that the services provided at the public hospital are safe, Dr Habeeb said the hospital has “state of the art” laboratory equipment and that the incident was caused by the “negligence of an individual”.

After investigating the case it was found that the lab technician was aware that the blood was infected even at the time it was taken, continued Habeeb, adding that the technician had subsequently reported the blood to be clean.

The technician in question has been suspended and the case reported to Maldives Police Service.  According to the hospital, no acts of negligence had been noticed from the technician in his previous seven years of employment.

Speaking at the press conference, Habeeb said the incident had brought some issues within the hospital to light. He assured that those issues would be addressed and all arrangements would be made to prevent any future incidents.

Just yesterday it was revealed that the hospital had been forced to suspend certain surgical procedures after it had been unable to procure the necessary safety equipment.

According to the ministry, immediate treatment has been started for the patient by the government as per WHO guidelines. As all information regarding HIV patients are held as confidential by the state – in accordance to WHO guidelines – no details of the patient or the donor were revealed.

However, local media outlet Haveeru has suggested that the patient is a Maldivian woman and also that she is pregnant.

Cover up and negligence

The MDP has promptly accused the government of a cover up, with a press release issued today accusing authorities of deliberately hiding the issue until the administration’s first hundred day celebrations were over.

“They deliberately kept the news from the public in order to show that those hundred days are not dark and terrifying days”.

The party has compared the cover-up to the murder of prisoner Evan Naseem in 2003, the fallout from which accelerate the country’s democratic reforms.

Condemning the incident, the MDP described it as as a reflection of the current status of health sector in the Maldives, accusing the government of neglecting the health affairs of the people and destroying public trust in the sector.

The party stated that blaming a single individual for the incident was a matter of concern and that the heads of the health sector had not taken responsibility. Despite repeated attempts, at the time of press Minivan News had been unable to get a response from senior figures in the Health Ministry or IGMH, including Minister of Health Dr Mariyam Shakeela.

MDP MP Mohamed ‘Shippe’ Shifaz – a member of the parliament’s government accountability committee – today said  that the Health Ministry would be summoned to the committee regarding the matter.

State minister for Fuwad Gasim said the ministry was trying  very hard to manage the situation and bring about necessary changes.

“Of course we are very much saddened and it shouldn’t happen..but unfortunately it has happened and we will take the necessary action regarding the people involved in it,” he said.

Fuwad also noted the importance of having medical negligence act, saying that – as there is no such law currently in force –  that  medical professionals should be careful.

A medical negligence bill was drafted by MP Rozaina Adam in 2011, though she today explained that the legislation is currently stalled in the Health Ministry.

“I sent it for their comments and it has been with the ministry since then. Another issue was, when it was discussed with medical professionals, they suggested that it should come with another bill related to administration and the health services bill. But that bill was drafted by the ministry,” Rozaina said.

With or without the comments of the ministry, stated Rozaina, the bill will now be sent to the parliament for discussion as soon it returns from recess.

Since the first case of HIV in 1991, 19 cases of HIV have been reported among Maldivians, while the estimations of HIV positive persons are as high as 70 – 100.

The Health Ministry has previously warned about a possible explosion of HIV/AIDS in the country, with high risk behaviour such as drug use and numerous sexual partners a concern.

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