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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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Domestic debt restructuring will cripple EPF, ETF – JVP

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By Sirimatha Rathnasekera

The Employees’ Provident Fund (EPF) and Employees’ Trust Fund (ETF) will lose about 600 billion rupees during the proposed domestic debt structuring, Co-Convener of the JVP affiliated National Trade Union Centre (NTUC) Wasantha Samarasinghe claimed.

Samarasinghe is of the opinion that the government is planning not to pay 20 to 25 percent of the loans it has taken from domestic sources. Successive governments have borrowed significantly from the EPF and ETF, he said.

Samarasinghe said that due to the depreciation of the rupee, the real value of EPF and ETF funds had decreased by half. “In such a context, can these institutions take a 20 percent haircut? This might be a big problem to the workers,” he said.

The NTUC Co-Convener said that a number of domestic banks, too, had lent to the government and domestic debt restructuring might lead to a collapse in the banking system.

However, Central Bank Governor Dr. Nandalal Weerasinghe says that they are confident of reaching debt sustainability without re-structuring domestic debt, which would lead to problems in the banking sector.

“There have been concerns among domestic bond investors about rupee debt/internal debt to be restructured following comments made by President Ranil Wickremesinghe to the effect that financial advisors were looking at domestic debt. However, there has been no request to restructure domestic debt. We are confident that we can make debt sustainable without restructuring domestic debt,” Dr. Weerasinghe told the media at the CBSL’s 6th Review of the Monetary Policy stance for this year, at the CBSL head office auditorium, in Colombo, on Thursday.

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Powerful CEBEU says yes to restructuring but on its terms

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Sri Lanka will experience periodic power cuts until 2027 if the government did not take steps to increase electricity production, the Ceylon Electricity Board Engineers Union (CEBEU) said yesterday.Due to electricity shortages, the Norochcholai Power Plant had been operational non-stop, sometimes even without scheduled maintenance, CEBEU President, Saumya Kumarawadu said.

“A generator is down. We will get it back online within 14 days. We had started maintenance on another plant in June and it was to be back online in September. But it has been delayed till November,” he said.

Kumarawadu said there would be 10-hour power cuts without Norochcholai. However, the power cuts could be reduced in two weeks when the generator was restored, he said.

He added that while they support restructuring of the CEB, they oppose de-bundling and selling the CEB to various private actors.

“Power cuts might have to go on till 2026 or 2027 unless new plants come up. A proposal to build an LNG power plant is still languishing in the Cabinet,” he said.

The CEBEU President also said that the electricity tariff was last increased in 2012. In 2014, the tariff was reduced. Without increasing electricity tariffs, the CEB will have to get increasing amounts of money from the treasury.

“The government should have increased the tariff at regular intervals. We haven’t increased in a decade and suddenly we have increased by a large amount.That’s why it has come as a shock to people,” he said.

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SJB opposes blanket privatisations

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… questions logic of selling cash cows like Telecom and Insurance

The SJB was opposed to the privatisation of profit-making government entities, Chief Opposition Whip, MP Lakshman Kiriella, said yesterday, in Colombo.Kiriella said that President Ranil Wickremesinghe had told The Economist magazine that they are thinking of privatising Sri Lanka Telecom and Sri Lanka Insurance.

“These are two institutions that make a profit. What is the point in privatising these?” he asked.

MP Kiriella said that they are not opposed to privatizing SriLankan Airlines, which has been making losses for years.

“We can talk about these things in Parliament. Even when we privatize loss making entities we have to take a number of things into consideration. What will happen to the workers? How will we compensate them? How will we re-skill them? We have to talk about these things openly before doing anything,” he said.

The Chief Opposition Whip said that one of the main reasons why people oppose privatization is because everything is done in secrecy.

“People wonder why things are hidden from them. We need to be open and transparent when we restructure,” he said.

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