Tag: IGMH

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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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.

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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.


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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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Orthopedic surgeries halted as IGMH fails to provide protective gowns

Read this article in Dhivehi

Indhira Gandhi Memorial Hospital (IGMH) has “temporarily delayed” some orthopedic surgeries after State Trading Organisation (STO) failed to supply lead gowns for medical staff, Deputy CEO Dr Mohamed Habeeb has said today.

He said the only surgeries affected by this would be those that require real-time X-ray monitoring, and that the hospital was expecting to receive the gowns very soon.

The lead gowns, like most other medical supplies for the hospital, are purchased through the STO, said Habeeb. The STO is a public company, with more than ninety two percent shares owned by the government.

“We have ordered replacements even last year. We might get them even by tonight. STO is working on it right now,” said Habeeb.

The purpose of lead gowns is to prevent the unnecessary and frequent exposure of medical staff to radiation which can cause cancer, infertility, and birth defects. While an estimated minimum of ten gowns are usually required for a surgery, the hospital currently has only two fit for use.

An IGMH nurse who often has to assist such surgeries told Minivan News that it has now been more than two years since they started requesting for new gowns. Letters have been written informing all relevant authorities of the situation, she added.

Orthopedic surgeries are done three days a week at the hospital, she explained, and on some days more than six of these surgeries require lead gowns.

“They [the remaining usable gowns] are usually taken by the doctors, saying they are closer to the source. Some staff have panicked after finding out they are pregnant. That risk is always there. And we are concerned about the patients as well. I have never seen any patient being offered a gown here,” she continued.

She stated that when patients need urgent attention, nurses cannot ignore and refuse to attend them even with the risks. Following a decision made by the department today, they will not be attending such surgeries until gowns are provided for them.

Head of the IGMH Orthopedic Department Dr Yoosuf Shan has told ‘Haveeru‘ that a memo highlighting the department’s decision has been sent to the heads of IGMH and the Health Minister.

“Radiation exposure could cause cancer. Most nurses assisting the surgeries are women. Without lead gowns their children could be born with birth defects. So as a precautionary measure we were forced to stop some of surgeries. They will continue only after we received lead gown,” Dr Shan was quoted as saying.

IGMH could not identify the exact reason for the delay in acquiring the gowns and the STO was unable to put Minivan News in touch with the relevant person.

Last November STO stopped supplying medicine to IGMH after it reached a set credit limit. At the time STO managing director Shahid Ali told local media that the Hospital had to pay approximately MVR 200 million to the organisation.

STO later resumed supples after raising the credit limit by MVR5 million in addition to the MVR411 million credit limit which includes payments going back to 2011.

Following the failure of other state owned company’s to pay almost US$40 million in bills owed to the STO, President Abdulla Yameen declared the organisation bankrupt last November. The company subsequently launched a campaign to cut operational costs by MVR50 million in 2014 (US$ 3,242,542).

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Police to oversee security at IGM Hospital

A special constabulary force is to oversee security at the state owned Indhira Gandhi Memorial Hospital (IGMH).

Assistant Commissioner of Police Hussein Adam and IGMH Project Director Ahmed Ali signed the MOU at a ceremony held this morning.

The arrangement was initially announced last month, with the force’s special constabulary being brought in to resolve ongoing security issues at the public hospital.

“Everyone agrees that IGMH is in dire need of stronger security. We had some thieves walk out with our fundbox, we had keys stolen, we have had our doctors threatened…we absolutely are in need of taking stronger security measures,” IGMH’s Deputy CEO Mohamed Habeeb told Minivan News in January.

Under the MOU, police will provide security around the clock, protect clients, stop thefts and muggings in the hospital premises and will take action against any individual who threatens hospital staff.

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Health Ministry increases salaries of doctors

The Ministry of Health and Gender has restructured and increased doctors’ pay in January.

Health Ministry’s Permanent Secretary Geela Ali said salaries had been restructured to level foreign and local doctors’ pay. Work hours had been increased along with the salary hike, and doctors will be allowed to see patients at private clinics, she said.

However, doctors have alleged that the revisions to the doctors’ salary structure had decreased pay by as much as MVR10,000 (US$ 648).

Doctors have held meetings with the management of the public Indhira Gandhi Memorial Hospital (IGMH) over low pay, local media has reported.

The World Bank and the International Monetary Fund (IMF) have previously expressed concern over the Maldives’ large wage bill.

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