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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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Majority of 300 luxury vehicles to be released

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… some shipped in without opening LCs, EU wants restrictions abolished

By Shamindra Ferdinando

The majority of the luxury vehicles imported by special permit holders in contravention of the import ban imposed by the government in view of precarious economic situation caused by corona first wave are likely to be released subject to penalties.

Well informed sources said that those vehicles shipped in without even opening LCs would be released. Among the violators were many government servants.

Sources said that vehicles brought in without opening LCs were likely to be confiscated.

“We have categorised over 300 vehicles, including BMWs, Mercedes-Benz and Audis into two groups. Customs are now in the process of evaluating individual cases,” a high ranking state official said.

The government announced a ban on vehicle imports to arrest the depletion of foreign reserves. Sources acknowledged that at the time the vehicles

arrived in Sri Lanka the second corona wave hadn’t erupted. The situation was far worse now and further deteriorating, they said, adding that the Customs were being inundated with requests for releasing vehicles on sympathetic grounds.

Controversy surrounds the failure on the part of the government to strictly implement the import ban in view of the sharp drop in state revenue due to the pandemic.

Recently, the EU demanded that Sri Lanka immediately lift import ban or face the consequences. The EU issued the warning in talks with government representatives. Foreign Minister Dinesh Gunawardena explained the circumstances that compelled the government to impose import restrictions. The EU sought an explanation as to when the ban would be lifted. The Foreign Ministry quoted Foreign Minister Gunawardena as having explained to the EU the challenges Sri Lanka economy was facing amidst the dwindling foreign currency reserve situation due to the significant reduction in remittances and tourism revenue induced by the COVID-19 global pandemic. The minister said that the import restrictions were being reviewed.

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Nearly 74,000 persons under home quarantine

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Close to 74,000 people belonging to 27,974 families had been placed under home quarantine, Police Spokesman DIG Ajith Rohana said on Wednesday (25).

He said that the number of cases from the Minuwangoda and Peliyagoda clusters had increased to 17,436 with 458 persons had tested positive for the virus on Tuesday.

Two wards of the Kethumathi Maternity Hospital, Panadura were temporarily closed on Wednesday after two pregnant women admitted there tested COVID-19 positive.

The two women are from Atalugama, which has been declared an isolated area. During the last few days close to half of the COVID-19 patients detected in Colombo District are from Atalugama.

The two women have been sent to Neville Fernando Hospital, Malabe. The patients and staff in Wards 3 and 4 at the Kethumathi Maternity Hospital are now under quarantine. Their family members too have been asked to undergone self-quarantine.

The Police had arrested 61 persons who had violated quarantine laws within the 24 hours that ended at 8 am yesterday, Police spokesman, DIG Ajith Rohana said, adding that they had been arrested for not wearing masks or for not maintaining physical distancing. With those altogether 688 persons had been arrested for violating quarantine laws from October 30, he said.

Commissioner General of Prisons Thushara Upuldeniya said that apart from Welikada, the spread of COVID-19 had been controlled at other prisons. COVID-19 cases had been reported from six prisons, he added.

“We are conducting PCR tests and hope that the situation in Welikada too would be brought under control. Twenty four new cases were detected from prisons on November 24 and from October 04, we have identified 708 cases within the prison system.”

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Severity of impact of second wave on economy could be far worse than anticipated – CBSL

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By Shyam Nuwan Ganewatte

The impact of the second wave of COVID-19 could be severer on the economic growth than previously anticipated, Director of Economic Research at the Central Bank Dr. Chandranath Amarasekara said yesterday (26).

Dr. Amarasekera said so responding to a query by The Island at a CBSL media briefing. The top official said that an assessment couldn’t be made yet as the second wave was continuing.

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