Resigning not the solution: Health Minister Dr Shakeela

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

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

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

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

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

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

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

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

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

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

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

ISO standards

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

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

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

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

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

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

Budget constraints

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

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

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

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

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

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

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


IGMH lab technician responsible for HIV blood transfusion in custody

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


New copyright law will hurt small businesses, claim MPs

New copyrights legislation passed on Wednesday could potentially be harmful for small businesses in the country, MPs from both sides of the aisle cautioned at yesterday’s sitting of parliament.

Opposition Dhivehi Rayyithunge Party (DRP) MP Dr Abdulla Mausoom argued that the new laws would pose challenges for small business who rely on “fake products”.

“The government should conduct broad awareness programmes to circulate information on the new law, it would be a huge loss for the small businessman,” he said. “But the bill is more like a prevention bill than a bill dedicated for punishments.”

Once ratified, anyone found guilty of violating the Copy Right Act could be fined between Rf50,000-Rf300,000 (US$3800-US$23,400) or sentenced for six months imprisonment or banishment.

“My greatest concern is that people might suffer the penalties without knowing about the Copy Right Act. Not being informed is not an excuse before the law,” Dr Mausoom said.

It was essential for the government to establish a culture of respecting the rule of law within the government, he added.

Speaking at the 47th session of the World Intellectual Property Organisation (WIPO) in September 2009, former Economic Development Minister Mohamed Rasheed announced that the Maldives intended to be in full compliance with international intellectual property (IP) obligations by December 2010.

At yesterday’s sitting, Maldivian Democratic Party (MDP) MP Mohamed Shifaz agreed with opposition MPs that the law could create complications for small businesses.

“Small businesses rely on the market of trading copied properties, either it is T-shirts, videos or songs,” Shifaz said. “After this law is enforced the trade of fake logo products would be prohibited.”

Shifaz said that the government intended to provide assistance for small businesses to adjust to the new legal framework.

“I personally think the amount of the fine is way too high, however, that is passed now, and now we are trying to figure out a solution,” he said. “It is also questionable whether the new Act can actually be enforced.”

However, Dr Mausoom argued that the Act could be enforced if owners of intellectual property seek protection under the new laws.

“It is their product and they should start taking legal action for losses and then there is the role of the government as well,” he said.

A number of small businesses in the Maldives rely heavily on the trade of pirated products, notably in the music and movie industries.

Pirated copies of video games and computer software are highly popular among Maldivian customers – even the cash-strapped government has been observed to regularly use illegitimate software.

However the lack of copyright legislation has led to reluctance among foreign investors to invest in a market with no legal protections.