Senior figures at Male’s two major hospitals have claimed the institutions could “run into difficulties” supplying certain medicines and services if the current currency crisis in the country continues, although stocks are currently sufficient.
Amidst a controversial government decision to devalue the rufiya against the US dollar in order to address the black market dealings for foreign money, businesses such as flight providers have also claimed to be facing difficulties in providing their services.
In this market place, ADK Hospital Managing Director Ahmed Afaal said that ADK Enterpises, the hospital’s parent company, had raised concerns about the availability of dollars to purchase certain medicines for its pharmacy operations.
“At the moment, the hospital has stock for our needs. Yet if we cannot get enough because of a lack of dollars we may run into difficulties in the future,” he said. “For the time being, we have enough medicines to treat patients, although some medicines may become difficult to find at our pharmacies.”
Cathy Waters, Chief Executive of Indira Gandhi Memorial Hospital (IGMH), agreed that concerns over the availability of dollars may hamper the hospital’s efforts to purchase medical goods and services in the short to medium-term, though she believed payment of the expatriate workers vital to running health centres was a greater problem at present.
“My biggest concern is how [this financial situation] may impact our ability to employ expatriate workers, as well as pay for certain goods,” she said. “We are particularly dependent on an expatriate workforce at the hospital and these workers are particularly aware of the dollar situation in the Maldives.”
According to Waters, expat staff had already raised concerns about difficulties they have experienced in sending dollars abroad to support their families – a key reason many initially accepted work in the Maldives.
Waters said she believed the hospital could also face ongoing problems in covering the costs of imported medicines and other services, despite supplies currently meeting needs.
Requests had been made to national health authorities to try to find ways to alleviate possible short-term and medium-term supply and payment issues, she added, although she said she had not yet been informed as to what measures might be taken.
The Ministry of Health was not responding to Minivan News at time of press.
However Dr Jorge Mario Luna, World Health Organisation (WHO) representative to the Maldives, told Minivan News that at present there had not been any requests from health service providers in the country concerning possible procurement problems as a result of a shortage of US dollars.
Dr Luna said that the WHO itself did not procure drugs or treatments outside of public health medicines for certain illnesses like tuberculosis or filariasis, yet it was ready to assist health services if required.
“As of today, we have not received any request for emergency medicines due to a procurement problem,” he said. “In case we receive a request, we stand ready to assist.
The government has meanwhile claimed that fluctuations caused by the managed float of the rufiya will stabilise in three months as the market adjusts.
The body of a newborn baby boy discovered in a park in Hulhumale’ this morning was found with underwear tied tightly around his neck.
Spokesperson for Hulhumale’ Hospital Dr Ahmed Ashraf said the baby may have died from asphyxiation.
‘’When the baby was found the knot was a bit loose, but the marks on its neck shows that it was tied tightly around the neck,’’ Dr Ashraf said.
Dr Ashraf said the baby was dead when discovered, and was first brought to Hulhumale’ hospital before the police took the body for forensic investigation.
Police Sub-Inspector Ahmed Shiyam said the baby was male and appeared to have competed nine months gestation.
The dead baby is the third to have been found abandoned in the last few weeks. On Friday the corpse of a three-month premature infant was discovered in a Coast Milk tin in Villingili, while on May 5 another premature baby was found in a plastic bag in Male’s swimming track area. A medical examination later concluded that the baby had sustained cuts, bruises and other wounds.
Police have since arrested two women in connection to the discovery of the infant found in the tin, including a 30 year old suspected of being the mother and a 24 year old woman police said had confessed to helping the first deliver the baby prematurely.
In November last year another abandoned newborn was discovered alive in some bushes near the Wataniya telecommunications tower in Hulhumale’. The child was put in the care of foster parents.
Birth out of wedlock remains heavily stigmatised in the Maldives. An unreleased 2007 study by the International Planned Parenthood Federation (IPPF) found that the stigma of having a child out of wedlock compels Maldivian women and girls to opt for abortions, and while a taboo subject, the practice was found to be widespread.
Some of those interviewed for the study said they knew of girls as young as 12 who had undergone abortions, and each knew at least one person who had terminated a pregnancy.
Abortion is illegal in the Maldives except to save a mother’s life, or if a child suffers from a congenital defect such as thalassemia. Many women unable to travel to Sri Lanka resort to illegal abortions performed by unskilled individuals in unhygienic settings, or even induce abdonminal trauma or insert objects into their uterus.
Other studies focusing on HIV have identified associated risk factors contributing to unplanned pregnancy including high levels of promiscuity and limited use of contraception.
Correction: An earlier version of this article stated that the infant was a nine-month old baby. This was a confusing translation and has been clarified as the infant was a newborn.
Cathy Waters is the new Chief Executive of Indira Gandhi Memorial Hospital (IGMH), the main hospital in the Maldives. She is one of three foreign medical experts brought out by the UK-based Friends of Maldives NGO and the Maldives High Commission to improve the country’s standard of medical treatment, alongside Medical Director Dr Rob Primhak and Nursing Director Liz Ambler.
JJ Robinson: How did your role at IGMH come about?
Cathy Waters: I’ve been on holiday to the Maldives many times, but it’s been a very different experience living and working here, compared to the sanitised version [of the country] you get at the resorts.
I knew nothing about Friends of Maldives – instead a friend of mine sent me an advert in the Health Services Journal, and said “This is the job for you.” I thought it was interesting, was interviewed in December and found myself out here very quickly, in February.
My background is 28 years working in the UK’s National Health Service (NHS), starting as a clinical nurse and working my way up. For the last 15 years I’ve been working in management, and the last eight as Chief Executive of a primary care trust, which commissions health care services.
I’ve had lot of exposure training and working in hospitals, as well as the broader healthcare system. I left the NHS three years ago and worked in a small management consultancy in the UK, which involved going into companies that were facing problems, and working with them to solve those and bring about change.
My last big contract involved working with big local authority in London than needed a transformational change. In reality it meant making significant savings – we had to make 80 people redundant.
JJR: What was your understanding and knowledge of what the position involved before you arrived?
CW: I understood that IGMH is one of five entities that comes under the umbrella of the Male’ Heath services Corporation (MHSC), IGMH being the largest entity, at about 90 percent.
I knew they needed to make significant changes to patient care, and the overall environment for patients. I knew IGMH needed change, which was part of attraction for me as it was somewhere I could utilise all the skills I had to bring about that change.
I also knew it was a hospital that people care passionately about. There’s a real sense that it belongs to the community and that we should be providing high quality services.
One of the things I noticed early on was that staff morale was very low, and people were unsure about what was happening with the organisation and had all sorts of concerns about the future. One of the things I did when I started was observe what going on and try to be very visible as a chief executive, spending time with the doctors and in the labour ward.
A new executive nurse director Liz Ambler is already here, and a Medical Director Dr Rob Primhak will be joining in July, so together we want to be able to demonstrate importance of management staff and clinical teams working closely together. We need to break down some of those barriers and reduce the divide between management and clinical services.
JJR: You arrived three months ago on the tail end of the collapse of the Apollo deal, a 15 year agreement signed in January 2010 with India’s Apollo Hospital Group to manage IGMH. What actually happened?
CW: I did read about Apollo. My understanding was that they wanted to bring about significant change but they wanted significant resources to do that, and that wasn’t an option. One of the things I’m very clear about is that we need to bring about significant change, but within the existing budget. That might involve reviewing everything we do as an organisation.
Unless we can find resources elsewhere we have to work within the budget we’ve got. That’s quite a challenge, because previously there may not have been the same budgetary controls [there are now]. We have to be careful how we utilise our very precious resources.
JJR: What parallels have there been so far with your earlier experience?
CW: Working in an organisation where there are significant financial challenges, and working in an organisation where patient needs are very clearly evident. The population is very vocal about what they want and need – some of that is about manging expectations.
One of the things I know we need address is that people can’t access doctors as quickly as they want. We need to increase outpatient appointments. At the same time there is no system of triage, or prioritisation of the emergency room, which we are now developing.
JJR: It’s true that many people claim the quickest way to get an appointment is to have the mobile number of a friendly doctor.
CW: We have a Maldivian ER consultant in training who is coming back to develop a triage system and ensure those patients who need to be urgently seen are seen straight away, or that those with minor ailments are seen by someone else, or not as quickly.
From what I understand there isn’t a word in Dhivehi that translates into ‘urgent’. We have quite a lot of work to do to make sure patients get to the right place at the right time.
One thing common to people working in the NHS and IGMH is that staff are passionate about what they do. We have to channel that in a positive way. We need to engage staff in decisions rather than it being a top-down management style.
This means helping them to be part of the decision making process, which can be difficult to get your head around. The key groups are patients and staff – happy patients mean staff are pleased they are doing a good job, equally, happy staff are more likely to perform well.
Sometimes it’s very simple stuff – such as saying ‘Thank you, well done.’ I don’t think that’s happened here very often. It doesn’t take a lot to say thank you.
The work that went into planning for mass causalities for the Friday of the recent protests was great. It was a really great example of working as a team and getting everything ready for an influx of casualties.
I recognised the hard work that had gone in so I made sure I came in on the Friday and was part of what was going on, so staff felt supported, and afterwards I wrote a thank you memo. Simple stuff like that makes people feel valued for what they are doing.
IGMH was gifted to the Maldives by the Indian government
JJR: What have been some of the key cultural challenges?
CW: There is a very, very different work ethic to the UK. Some of the things I’ve found very different and very frustrating are about how people manage their time, and motivating people to work. That’s a huge issue.
Getting people to plan ahead and put processes together is challenging. One exciting project is expanding the intensive care unit – I said we need a proper process and justification of the expansion, a proper plan about how we are going to do this. For me there’s a discipline to this, but it’s not always the way things have been done.
Also different and very distinct to IGMH is the lack of use of email – staff still attempt to use memos. I’m trying to encourage the use of email, and encourage people to think ahead and write agendas for meetings.
JJR: On other side of the cultural question, what has been the reaction among staff to a foreigner coming in as a top-level manager?
CW: Inevitably there’s been a degree of suspicion at someone new coming in, at someone from the UK coming in and imposing their views. For me what has been important is how we work with people and lead. I firmly believe that how you lead is important – working with staff, rather than telling them what to do. You do need boundaries and parameters, but people need a sense of direction, and permission to do things themselves.
The other issue is that my contract is for a year with the possibility of extending to two years. Whatever I do, I will feel I’ve failed if I haven’t managed to find someone in IGMH to transfer leadership skills to, and leave a positive legacy. The worst thing would be for me to do would be to go back to the UK and for things to tumble down. That would be an absolute failure on my part.
JJR: How did these obstacles come across? Were there initial difficulties?
CW: People have been very accommodating and very welcoming. I’ve convinced people that they don’t need to stand up when I walk into the room, which was very traditional, and I don’t expect people to call me “ma’am”. People generally been very welcoming. There’s been a few challenges with language barriers, although this has proved less of a problem than I thought it would be. I have very good support in meetings- I might do an overhead presentation, and it is translated into Dhivehi. Unfortunately I’m failing miserably at learn Dhivehi words. Generally people have been helpful and make sure I’m involved in what’s going on.
JJR: What are some of the unique characteristics of the Maldivian hospital-going public?
CW: They are very demanding, and very quick to blame the doctors if things go wrong. Inevitably in a hospital things go wrong, by the very nature of the work we do. And because IGMH is the country’s main hospital, we inevitably get the more complicated and high-risk cases. People are quick to be cutting.
Equally the general public should demand good care, and rightly get that care.
We need to work to enhance communication. One of the things I’ve noticed that is quite different from UK is that different departments still work in silos. We’re trying to break down these silos and get people to work across the organisation.
JJR: There has previously been conflict and misunderstandings between Maldivian doctors and foreign doctors working at the hospital, amid the cultural challenges of having a high turnover of foreign medical staff. Is this something you have observed?
CW: It fascinating that the hospitial talks about ‘Maldivian doctors’ and ‘foreign doctors’ as though they are completely different. Part of the problem I think for the Maldivian doctors who are very dedicated and are here for the duration is that they don’t get some of the benefits expatriate doctors get, such as support with their accommodation. Inevitably that brings some degree of conflict.
Expat doctors are also here for a short time, and I’m making a huge generalisation, but the commitment of some of them may not be as high as that of the Maldivian doctors. Some of that is the sort of contract we have for expatriate doctors, and that needs to be reviewed. Some of the expatriate doctors see IGMH as a staging post to get broader experience and go off to somewhere else, which must be quite annoying for the Maldivian doctors.
We’re trying to move to a position where as much of the workforce as possible is Maldivian, but inevitably that takes time.
JJR: What about the training of local staff, such as nurses?
CW: We have a good relationship with the Faculty of Health, and more Maldivian nurses are coming back into the system. Liz [Ambler] is very keen on in-service training to make sure we are training effectively, and Dr Rob [Primhak]’s background is in education so I’m sure he’ll be keen to ensure high standards of education and training when he starts in July. It’s an area we’re developing.
JJR: How have you found living in Male’?
CW: We’ve settled in well. My husband is semi-retired; he used to be a director of Mental Health Services. He’s made a decision not to work at the moment – he’s a diver and he’s doing his diver master training and really enjoying it.
One of my worries at the hospital is that we haven’t got the facilities to care for patients at the acute stages of mental health problems, and we haven’t necessarily got the right staff.
JJR: What do you think of the relationship the hospital has with the community, and what did the outcry over the widely reported ‘baby decapitation’ incident tell you about that relationship (the head of a deceased newborn had to be surgically removed during labour after its shoulders became stuck during delivery, endangering the mother).
CW: I had only been here a few weeks when that happened. Without going into the details, what surprised me was how quickly quite confidential details about the patient and the case were spreading like wildfire across Male’.
Understandably there was a lot of anger and concern, and fear generated. One of the key learning points for IGMH was how we need to handle that more effectively with the media – we didn’t handle that very well at all. It’s in the hands of lawyers now – it was a tragic and very unfortunate case, and a very emotive situation. From the hospital’s perspective we did all the necessary investigations that we needed to do.
JJR: Does it come back to this recurring mistrust of doctors?
CW: That’s one of the things I’ve picked up on – there is this mistrust. We still have to rebuild that, because we have some fantastic doctors and clinical staff in IGMH, and inevitably when we have high profile cases like that it creates more damage for the medical profession, which bore the brunt of that incident. We need to be more proactive about how we talk about some of the great things that happen in the hospital.
I’m not sure Male’ is ready for it, but I’d like to start a patient involvement group – a number of people from the community who work with us to improve what we do in the hospital. We do that a lot in the UK, but I’m not sure people here would be interested in doing that yet. It does help people understand the challenges we face as an organisation on a daily basis.
The President has appointed an envoy to work with the hospital. He has already brought through some significant changes in terms of the environment. It’s looking much better when people come in, and the outpatient area is now air-conditioned.
We need to focus on what we need to do to implement quality of care and improving access – there are hundreds of things need to do, but have to manage expectations.
One of the things we want to introduce is catering – at the moment patients’ relatives have to bring food in for them. That’s so different to the UK – nutrition is so important to a patient’s recovery. We want to try and introduce a catering service before the end of the year, so patients get a better service.
JJR: What are the hospital’s key strengths and weaknesses at the moment, aside from the shortage of mental health support you mentioned earlier?
CW: One area we do need to improve on is diagnostic capacity, and tools for helping diagnose. We are going to get a mammogram machine, which will have the facility to do biopsies, and we are going to get an MRI scanner which will improve diagnostics.
One of the key problems we have is access to equipment and medical consumables. We’ve put new processes and deals in place which will hopefully improve that, but I didn’t realise until I lived here that absolutely everything has to be imported. We are reliant on things coming in a timely way, and I don’t think that just affects us.
We also have a hospital kindly donated by the Indian government, but inevitably the building itself is in need of renovation. It was fit for purpose then but with the influx of people living in Male’ the need for services is huge. We have 500-600 patients a day, sometimes more, and the building is almost too small now. We have to look at how we take care of it and develop a more modern facility.
One of our big concerns in relation to the operating theatre is lack of anaesthetists. We have to pay a premium for them to come, as there’s international shortage. That’s a real problem for delivering key services.
Those are some of the key areas. We have a good team paediatricians, and a very busy but effective neonatal intensive care unit with 20 cots.
JJR: Is it difficult to attract people to come and live and work in the Maldives?
CW: I think it’s becoming more difficult now because of the dollar situation, and the cost of accommodation in Male’. The MHSC provides accommodation to doctors as part of their package, but nevertheless food prices and living expenses are going up.
A big problem is paying people in rufiya – the expats who come and work in the Maldives want to send part of their salary home but banks are struggling to enable them to send dollars. That seems to be a very major problem at the moment.
The big thing is making sure there is the right commitment from expatriates to stay and make a positive difference. There’s got to be some way of making the working conditions right for the Maldivian doctors as well. They are the life of the organisation, and we are dependent on making sure they don’t move elsewhere.
We are in the process of expanding inpatient facilities, and renovating the old staff quarters into more private facilities. We will have 56 beds finished in late summer, and we have also signed an agreement with the 11 storey building next to IGMH to provide 72 beds. This time next year we will have a significant increase in the number of beds, but that brings its own problems, such as where we are going to get staff. We’re trying to make sure there is joined-up thinking going on.
Managing Director of Male’ Health Corporation Mohamed Zubair has confirmed that it is conducting an internal investigation after medical staff were forced to decapitate a baby during labour to save the mother.
IGMH said in an earlier statement said that the baby’s head had to be removed after its shoulders became stuck and it died during delivery, risking the life of the mother. Doctors were left with no other choice, the hospital said.
”It is the procedure at Indira Gandhi Memorial Hospital (IGMH) that when such incidents occur we always conduct an internal investigation,” said Zubair.
He declined to provide further information as the investigation was ongoing.
”The Health Ministry is the regulator at the hospital, so it is investigating the case as well,” he added.
Media Coordinator at IGMH Zeenath Ali told Minivan News that IGMH expects to conclude its investigation within two days.
”We will share the report with the media,” she said. ”We cannot reveal any information yet.”
She also said that the condition of the baby’s mother was improving.
The hospital came under pressure to investigate after a report in newspaper Haveeru raised public concern as to why the hospital had not performed an earlier cesarean section, given that it was previously understood the baby was large and the mother had been admitted to hospital for some time.
According to Haveeru, the mother was rushed to the operating theatre after the baby’s head became stuck in the birth canal.
The mother had reportedly been admitted to IGMH after doctors in Thaa Atoll and Laamu Atoll hospitals advised the mother to do so given the size of the baby and the mother’s high blood pressure.
Meanwhile, police and the Human Rights Commission of the Maldives (HRCM) have told local medias that they are also investigating the matter.
HealthCare Global Enterprises (HCG), an Indian-based supplier of specialist cancer treatments, is in the Maldives this week to consult with authorities and private medical companies over possible partnerships to treat the disease, an area of medicine that health officials is limited locally.
Speaking today to Minivan News, Bhavani Shankar, head of international marketing for HCG, said the company was in the early stages of consulting private and public healthcare providers in the country, along with the operators of Male’s ADK hospital and Indira Gandhi Memorial Hospital (IMGH) over a number of potential opportunities for cancer treatment.
“Basically there is no cancer treatment here. Only a few facilities are there; medical oncology, chemotherapy and some small investigation procedures are available in the Maldives,” he claimed. “Most people are flying to India [for cancer treatment], about 600 to 750 people are doing this each year.”
Claiming to operate more than 18 specialist centres across India and South Asia either directly or through partnerships , Shankar said that the company was experienced in providing specialised surgeries and state of the art cancer treatments throughout the region.
“We have a variety of facilities and technologies such as the ‘CyberKnife’ robotic radio surgery, radiotherapy as well as offering other surgical procedures,” he said. “We can offer screening in the country before considering flying people out to India for treatment, which is the easiest option.”
In contemplating potential healthcare roles or business opportunities within the country, the HCG spokesperson said the company was keen to work with both private and public partners in terms of supplying technical knowhow or training for doctors and nurses alongside NGOs. Given the limitations of Maldivians in the country travelling abroad for health reasons due to income, Shankar said he believed that there were a number of treatment options it could make available for the population.
“We are focusing on both kinds of things [private and public cooperation], we are trying to help even the people who cannot afford treatments as well. We have different options actually, but this depends on what the hospitals and health bodies can manage,” he added. “We are open; whether the government is able to fund a small cancer care centre or through work with a private partner, we are looking for both [opportunities].”
At present, the Maldives’ State Minister for Health, Abdul Bari Abdulla, said that there was no budget in the country specifically for cancer prevention, with any possible funding being supplied under a wider national health act.
“The cancer programme we have is currently led by IGMH, but we don’t have the capacity for treatments or screening,” he said.
The State Health Minister claimed that the main challenge for the nation regarding cancer prevention related to a lack of technical expertise.
“Cancer treatment within the country requires state of the art techniques,” he said.
In considering strategies for trying to combat cancer within the Maldives, Bari said that health was one area that the government was looking into the possibilities of private and public partnerships and the potential benefits that may be available.
So-called ‘medical tourism’ to countries such as India and Singapore is very common in the Maldives among those able to afford it, and is major expense for many families unable to afford it but who do so anyway because of low confidence in local services for surgery and serious ailments.
The Malé Health Services Corporation (MHSC) is expanding its senior management team with three health professionals from the UK, who have been recruited to support the health transformation agenda of the MHSC, accelerate quality improvements, and rigorously hone cost efficiency.
The volunteers were recruited with the assistance of UK-based NGO Friends of Maldives and the Maldivian High Commission in London who together,have selectively been placing health volunteers around the Maldives through the International Volunteer Programme (IVP).
The three volunteers will initially come for one year, extendable to two years, and say they hope to leave a lasting, positive legacy within the MHSC, by developing local leaders in the medical sector.
Cathy Waters will start as the new General Manager of IGMH at the beginning of February 2011. Waters has 17 years of senior health management experience, including eight years as a Chief Executive in the UK’s National Health Service (NHS), where she demonstrated exemplary management of staff, personnel issues and substantial budgets in the face of major financial challenges.
Waters has also worked effectively as a senior management consultant, achieving organisational change and strategic development targets. Amongst her many qualifications, she has two Masters Degrees (one in Business Administration), an Advanced Diploma in Coaching, a teaching certificate in further education and is a qualified nurse, midwife and health visitor.
Waters says she believes wholeheartedly in involving the public and service users in providing better health care, and in coaching and developing individual health professionals into new and sustainable roles.
Liz Ambler will begin in the role of Nursing Director for MHSC in mid-March. She currently works for the UK’s Department of Health, whilst her specialist clinical background is in blood disorders and cancer care. With significant senior management experience in UK, the Middle East and Africa, she has a proven track record of improving health care quality whilst reducing expenditure.
Ambler has a Nursing Degree, a Masters in Public Health and a postgraduate certificate in Global Development Management, and says she “can’t wait to get stuck in” training, auditing, and developing clinical guidelines with MHSC’s nurses.
Liz is passionate about nursing, improving patient safety and motivating others to achieve good governance.
Rob Primhak has been appointed as Medical Director of MHSC and will make an initial visit mid-February 2011, before starting in earnest in July when he retires early from his Consultant Paediatrician post to take up this new and challenging role.
Primhak has 35 years of clinical and research expertise, primarily in the fields of respiratory medicine and treatment of children and newborn babies, both in UK and Papua New Guinea. He has successfully introduced innovative services and demonstrated a life-long commitment to the education and training of doctors, through the establishment of new curricula and training programmes. He aspires to leave a lasting impression on clinical governance at MHSC through development of health professionals and clinical quality standards.
“We look forward to working with the UK experts in revamping health care quality at MHSC, and are very optimistic about their successful team efforts in turning around IGMH”, said Mr Zubair Muhammad, Managing Director of MHSC.
Backup generators at Indira Gandhi Memorial Hospital (IGMH) failed early on Tuesday morning, after a power outage in Male’ left the hospital without electricity.
A person who was at he hospital at the time told Haveeru that IGMH was in pitch darkness when the blackout occurred at 1:30am, with even staff in the intensive care unit forced to use torches.
“They did not turn on the backup system after the power outage. The whole ICU was full. People were very upset,” the witness told the paper.
Male Health Services Corporation (MHSC) Media Coordinator Zeenath Ali told Haveeru that the power was restored after 15 minutes and that no patients had been hurt.
A STELCO engineer said the power outage was due to an overheating generator.
The deal between the Maldives government and Apollo Hospitals to manage Indira Gandhi Memorial Hospital (IGMH) has fallen through, local media reported Health Minister Dr Aminath Jameel as saying on Tuesday.
“We had to terminate the agreement because they [Apollo] were unable to meet the terms and conditions stated in the agreement. Every agreement specifies deadlines to settle certain matters,” Dr Jameel reportedly said.
“We have also informed them [Apollo] that the agreement has been terminated.”
Senior staff at the Health Ministry and Chair of the Privatisation committee Mahmoud Razee told Minivan News they had not been informed of the deal’s collapse and had only heard media reports. Minivan News contacted Dr Jameel but she was unable to confirm the reports as she was “travelling in the islands.”
The government reportedly terminated the agreement with Apollo after the Indian hospital giant was unable to invest the agreed amount to develop the hospital.
Apollo had estimated that it would cost US$25 million to bring the hospital up to global standards. The group also revealed intentions to make 80 percent of its employees Maldivian over a 15 year period, although it was unclear as to how this would be achieved given the lack of medical higher education facilities in the country.
Apollo planned to offer orthopedics, cardiology, gastro, neurology, acute care and trauma specialities in the first phase of the privatisation deal, as well as set up and operate a cardiology unit within the year, the Health Ministry stated when the deal was first announced in January.
CEO of IGMH Zubair Mohamed was not responding to calls at time of press, but expressed concern when the deal stalled in July, stating that uncertainly over the arrangement was making “little investments” more difficult.
“Apollo is an expert group and would bring a lot of benefits to the people,” he told Minivan News at the time. “They have the capacity to raise existing standards. But even if they do not come we will continue trying to improve services.”
However the agreement stalled after the private healthcare giant failed to submit a required operational management agreement by the July 2010 deadline. Both parties were required to cement the deal and sign the 12 year management agreement by the end of July.
The agreement between India’s Apollo Group and the Maldives government to manage Indira Gandhi Memorial Hospital (IGMH) has stalled, after the private healthcare giant failed to submit a required operational management agreement by the July deadline.
“We were supposed to receive a plan by the end of July,” said State Health Minister Dr Abdul Bari. “They required additional information which we have provided.”
The operations management agreement was to be submitted following a situational analysis of the hospital.
That agreement said that both parties were required to cement the deal and sign the 12 year management agreement by the end of July.
Dr Bari said the government had requested an update from Apollo, but insisted the hospital’s future was not in limbo.
Managing Director of IGMH Mohamed Zubair said the hospital was not preparing for a management change, but noted that the deal “has neither failed nor succeeded. It is yet to be decided.”
“Apollo is an expert group and would bring a lot of benefits to the people,” he said. “They have the capacity to raise the existing standards. But even if they do not come we will continue trying to improve services.”
However the delay was making “little investments” more difficult, he said.
Apollo has previously estimated that it will need to spend US$25 million to bring the hospital up to global standards.
Chairman of the privatisation committee Mahmood Razee said following announcement of the agreement in January that one of the first changes to be made by Apollo would be to management.
“The major issue was that the management structure [at IGMH] was not working properly, this led to high costs and some services and medicines not being available. The overall quality of service went down,” he said.
Apollo also signalled its intentions to make 80 percent of hospital employees Maldivian over a 15 year period, although it was unclear as to how this would be achieved given the lack of medical higher education facilities in the country.
In April, a series of alleged blunders at the hospital – including wrong injections being given, a woman who claimed to have had a vein sewn into her skin and parents of a suicidal adolescent who complained their son suffered a motorbike accident and was discharged after being given an IV – highlighted a system under pressure.
Earlier this month the victim of a stabbing told Minivan News that doctors at IGMH had stitched his wound and sent him home, “but I did not feel well. I was having difficulty breathing, but since they said I was fine, I thought I was fine,’’ he said.
“Later, I realised air was spreading inside my body and my back, chest, neck and arms were puffing up. Doctors at ADK said that I had been stabbed in the lungs and that one of my lungs had stopped functioning. They said if I had been any later the air would have reached my brain and they would not have been able to help me.”
IGMH was originally gifted to the Maldives by the government of India.
(0)Dislikes
(0)