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Respected surgeon gives docs rap on the knuckles

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Much respected retired Professor of Surgery A. H. Sheriffdeen has questioned the failure on the part of the Lady Ridgeway to promptly treat a 10-year-old, boy with a ruptured appendix due to the non-availability of a senior surgeon at the premier paediatric hospital in the country.

The incident took place on Aug 22. Dr Sheriffdeen has brought the incident to the notice of the President, College of Surgeons of Sri Lanka, requesting the outfit to inquire into the incident.

The following is the text of the letter addressed to the CSSL President: “I write this letter following a bout of acute depression and a sense of hopelessness following an incident that occurred on Saturday 22nd August 2020.

I saw a 10-year-old boy at Ratnam’s Private Hospital around 11 am with an obvious clinical diagnosis of acute obstructive Appendicitis. The mother said that she could not afford treatment at a private hospital, so I gave her a letter to the Lady Ridgeway Hospital, assuring her that the boy would get the best possible care. The grandmother was screaming that she would pawn all her jewellery and take prefer treatment at a private hospital, but I again reassured her that I had faith in our trainees and doctors.

On the same day, at about 8.30 pm, I got a call from the boy’s father to say that the junior doctors had told the family that the appendix had ruptured, that the boy needed major surgery by a Consultant and there was no Consultant available. No solution was offered. They were desperate and agitated.

I told them that I did not do emergency surgery at night and suggested a few names and Private Hospitals they could go to.

That was when the depression hit me. Why, I asked myself repeatedly, why am I wasting my time? Why am I wasting my time talking about professionalism and ethics? Why did I waste my time chairing the Committee that produced the Book “Professionalism and Ethics in Surgical Practice” where in Chapter 2 on “Total Patient Care” this scenario is dealt with? Do not these doctors or their near relatives have 10-year-old sons whom they care about? How would they feel if this incident occurs to them?

Why are we wasting time talking about modern techniques, recent advances, updates, laparoscopic and robotic surgery, mentoring programmes, Scientific Sessions, workshops and so on when a 10 year old is left to die from a ruptured appendix due to non-availability of a senior surgeon at the premier Paediatric Hospital in the Country – in the whole of Sri Lanka?.

Professor Milroy Paul was my Professor of Surgery. This was in the early 1960s. He had a surgical Ward in the Lady Ridgeway Hospital. I have seen him driving his old Riley car in black trousers and white dinner jacket with a black bow tie arriving at the hospital at 10 pm to do a tracheostomy in a child with Diphtheria and stridor. He obviously had been at a dinner dance. Mind you, there were no pagers, mobile phones. He always left a contact land line number in the ward and if this method failed to contact him, the registrar was expected to go to the hotel by car or taxi to summon him. He always came promptly. The patient mattered more to him than that dinner, than that dance.

The government gives duty free cars to our doctors just for this purpose. Mobile phones are freely available. Contactability is not an issue. But something is lacking, is it not? All the fancy cars, all the fancy mobile phones did not help this child in an hour of need.

That is because we lack commitment- a commitment to care, treat and cure regardless of day or time-a commitment not to betray the trust – betray the trust that mothers, fathers, grandparents, brothers, sisters, children place in you.

There will be the usual explanations but they will only serve to compound the issue as trying to get explanations or hold an enquiry is usually an attempt at cover up. It needs a change of culture, a paradigm shift.

The child may have survived, but that is totally irrelevant to the issue at hand.

More ruptured appendices, acute abdomens, general, orthopedic, neurosurgical, urological, cardiothoracic, vascular etc. emergencies – more excuses; will they not end?

I am writing this as therapy for my depression. The foul taste will not go away. As a Medical administrator once said, “Patients will die, it cannot be helped!”

 

 



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Israel resumes attacks as Iran vows to avenge supreme leader’s death

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An explosion caused by an Iranian missile in Tel Aviv

* Iran begins 40-day mourning after Khamenei killed in US-Israeli attack

* President Pezeshkian condemns killing as ‘a great crime’

Iran has begun 40 days of mourning after Supreme Leader Ayatollah Ali Khamenei was killed in ongoing attacks by the United States and Israel, according to Iranian state media.

Top security officials were also killed in Saturday’s strikes, along with Khamenei’s daughter, son-in-law and grandson. The killings mark one of the most significant blows to Iran’s leadership since the 1979 Islamic revolution Al Jazeera has reported.

Iranian President Masoud Pezeshkian condemned the killing as “a great crime”, according to a statement from his office. He also declared seven days of public holidays in addition to the 40-day mourning period.

Reporting from Tehran, Al Jazeera’s Tohid Asadi said people were pouring into the streets of the capital following the news of Khamenei’s killing.

“There will be expected ceremonies,” he said, noting they would likely take place amid continuing bombardment across the country.

Protests denouncing Khamenei’s killing were also reported elsewhere, including Shiraz, Yasuj and Lorestan.

“There will be expected ceremonies,” he said, noting they would likely take place amid continuing bombardment across the country.

Footage aired by Iranian state media showed supporters mourning at the shrine of Imam Reza in Mashhad, with several people seen crying and collapsing in grief, according to Al Jazeera.

The killing also led to protests in neighbouring Iraq, which declared three days of public mourning. In Baghdad, protesters confronted security forces in the heavily fortified Green Zone, which houses Iraqi government buildings and foreign embassies.

Videos verified by Al Jazeera showed demonstrators waving flags and shouting slogans, with witnesses saying some were attempting to mobilise towards the US Embassy. Footage also showed protesters blocking vehicles at a roundabout near one of the entrances to the area.

There was also a protest in the Pakistani city of Karachi, where footage, verified by Al Jazeera, showed people setting fire to and smashing the windows of the US consulate.

However, there have also been reports of celebrations in Iran, with the Reuters news agency quoting witnesses as saying some people had taken to the streets in Tehran, the nearby city of Karaj and the central city of Isfahan.

Meanwhile, the official IRNA news agency reported that a three-person council, consisting of the country’s president, the chief of the judiciary, and one of the jurists of the Guardian Council, will temporarily assume all leadership duties in the country. The body will temporarily oversee the country until a new supreme leader is elected.

Ali Larijani, the head of Iran’s Supreme National Security Council, accused the US and Israel of trying to plunder Iran, in an interview aired on state TV.

He also called on Iranians to unite. “Groups seeking to divide Iran should know that we will not tolerate it,” he added.

Smoke rises over central Tehran following ongoing U.S.–Israeli strikes on Iran yesterday.[EPA]

Khamenei assumed leadership of Iran in 1989 following the death of Ayatollah Ruhollah Khomeini, who had led the Islamic revolution a decade earlier.

While Khomeini was regarded as the ideological force behind the revolution that ended the Pahlavi monarchy, Khamenei went on to shape Iran’s military and paramilitary apparatus, strengthening both its domestic control and its regional influence.

Meanwhile, the Islamic Revolutionary Guard Corps (IRGC) pledged revenge and said it had launched strikes on 27 bases hosting US troops in the region, as well as Israeli military facilities in Tel Aviv.

Explosions have continued to be reported in Qatar and the United Arab Emirates, while security alerts are in place in several countries across the region.

US President Donald Trump, in a social media post on Sunday, warned Iran that it would be hit “with a force that has ?never been seen before” if it retaliated.

Iran’s retaliatory attacks since Saturday have targeted Israel and US assets across multiple Middle East countries, including Qatar, the UAE, Kuwait, Bahrain, Jordan, Saudi Arabia and Iraq.

Harlan Ullman, chairman of the strategic advisory firm Killowen Group and an adviser to the Atlantic Council in Washington, DC, said the US may have made a “big mistake” by killing Khamenei.

“Decapitation only works when you get all the leaders, and I don’t think that we got all the leaders,” Ullman said, adding that the US should not expect Iran’s leadership to enter negotiations in the immediate aftermath.

Iranian state media reported on Saturday at least 201 people have been killed in the joint US-Israeli attacks across 24 provinces, citing the Red Crescent. In southern Iran, at least 148 people were killed and 95 wounded in a strike on an elementary girls’ school in Minab on Saturday, with the toll continuing to rise, according to state media.

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CPC has enough fuel stocks

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There would be no delay in fuel shipments scheduled for April and May, the Ceylon Petroleum Corporation (CPC) assured yesterday.

Addressing a media briefing in Colombo, CPC Chairman D.J. Rajakaruna said Sri Lanka’s fuel supplies did not originate from the present conflict zone in West Asia and, therefore, supplies to the Corporation would not be disrupted.

He noted that the relevant consignments were due to arrive from India and Singapore as planned.

“We are making this statement responsibly. There is no need for the public to queue up for fuel. Distribution was not originally scheduled for Sunday (01), but due to increased demand, we have deployed all distribution staff to continue fuel issuance. Although Monday (02) is a Poya Day, fuel supplies will continue without interruption,” he said.

The Chairman added that all filling stations had been instructed not to dispense fuel into cans or barrels, warning that legal action would be taken against those attempting to purchase fuel in bulk containers for resale.

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Lanka, Pakistan strengthen ties at 13th JEC

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Wasantha Samarasinghe, Minister of Trade, Commerce, Food Security and Cooperative Development and Haroon Akhtar Khan, Special Assistant to the Prime Minister of Pakistan for Industries and Production at the 13th Session of the Sri Lanka–Pakistan Joint Economic Commission in Colombo.

The 13th Session of the Sri Lanka–Pakistan Joint Economic Commission (JEC) was successfully held recently in Colombo, reinforcing the strong and longstanding economic and diplomatic ties between the two countries.

The Sri Lankan delegation was led by Wasantha Samarasinghe, Minister of Trade, Commerce, Food Security and Cooperative Development, while the Pakistani delegation was headed by Haroon Akhtar Khan, Special Assistant to the Prime Minister of Pakistan for Industries and Production. The session concluded with the signing of the Agreed Minutes by both Co-Chairs, formalising cooperation across multiple sectors.

The Pakistan High Commission in Colombo said that in the IT and digital economy, both sides agreed in principle to establish a Joint Working Group on IT and telecommunications, promote collaboration in emerging technologies, and support each other in international digital forums.

Industrial cooperation was a key focus, with discussions on expanding trade in chemicals, polymers, engineering goods, glassware, surgical instruments, and pharmaceuticals. Sri Lanka invited Pakistani pharmaceutical companies to explore investment opportunities in designated pharmaceutical zones. Both countries also agreed to strengthen collaboration in Export Processing Zones and enhance support for small and medium enterprises through their respective development agencies.

Significant progress was made in agriculture and livestock, including cooperation on meat exports, livestock farming, seed certification, sanitary and phytosanitary harmonisation, pest risk analysis, and capacity building. Procedures for the export of Sri Lankan pineapples and avocados to Pakistan were advanced. Both sides explored electronic phytosanitary certification (ePhyto), blockchain-based seed traceability systems, and increased trade in agro-commodities such as rice, sesame, and onions.

In education, the JEC emphasised academic and research cooperation, faculty and student exchanges, accreditation and quality assurance, and promoting Pakistan as a higher education destination for Sri Lankan students. A Joint Working Group on Education and Science was proposed, alongside renewal of several institutional Memoranda of Understanding.

Cooperation in science, technology, and innovation will continue under existing bilateral frameworks, with plans for joint research in advanced materials, biotechnology, climate change mitigation, and emerging technologies. Collaborative research projects, student exchanges, and co-authored publications were highlighted as key initiatives.

Health sector collaboration will focus on joint research, academic exchanges, regulatory cooperation on therapeutic goods, capacity building, fast-track registration of essential medicines, public-private partnerships, epidemiological surveillance, and coordinated responses to disease outbreaks.

Maritime cooperation was also discussed, with Pakistan offering technical expertise, training, and industrial collaboration through its shipbuilding institutions. Both sides explored enhanced maritime connectivity, including transshipment, port cooperation at Karachi and Gwadar, direct shipping routes, logistics integration, and maritime training programs.

Commerce secretary-level talks reviewed the progress of the Pakistan–Sri Lanka Free Trade Agreement (PSFTA), assessing current implementation and identifying measures to further enhance bilateral trade and economic cooperation.

On the sidelines, Special Assistant Haroon Akhtar Khan held discussions with Sri Lankan Cabinet members on collaboration in industry, labor and foreign employment, and health sectors.

Both delegations expressed satisfaction with the outcomes of the 13th JEC and reaffirmed their commitment to regular engagement and effective implementation of agreed initiatives. It was mutually agreed that the 14th session will be held in Islamabad, with dates to be confirmed through diplomatic channels.

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