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Respected surgeon gives docs rap on the knuckles



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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SJB: Excise, FM officials all out to pocket Rs 1 bn



By Saman Indrajith

Matara District SJB MP Buddhika Pathirana yesterday told Parliament that the Finance Ministry and Excise Department officials had misled Prime Minister Mahinda Rajapaksa and State Minister Ajith Nivard Cabraal in order to obtain billion rupees, fraudulently.

The officials had got a contract for printing stickers or barcodes to be displayed on bottles of liquor awarded to an Indian company.

“The project would result in one-billion-rupee loss to the government coffers annually,” the MP said, adding that the money being taken from the public purse would end up in the pockets of corrupt officials.

Pathirana said that the Excise Department had commenced a project to paste stickers on bottles of liquor to differentiate them from the fake and counterfeit bottles in the market.

“As per this project’s requirements, 32 million stickers would be needed per month. The stickers are to be purchased from Madras Security Printers company of India. This method was proposed in 2016 but it failed and the officials thereafter decided to introduce a barcode system.

“The cost of a sticker at 25 cents and the new barcode system will cost of two rupees a piece. This is a dubious deal. It seems that the Finance Ministry officials and the Excise Department heads have ganged up to give the contract to the Indian company and get commissions. There are many unanswered questions. First, the contract of printing the barcode too has been given to the MSP company, which could not secure the first contract. I want to know whether the proper procurement process has been followed. The second question is whether the barcodes would be up to the standards listed in the tender. Third question is who had selected the MSP company which is black-listed in India after being found guilty of frauds with Indian liquor companies in providing stickers to them. MSP has been blacklisted in many other countries. The company has been banned in Sudan and Liberia for supplying the stickers to private companies. The last question is whether this fraud is being committed with the knowledge of ministers of this government.”

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Reserves fall to lowest since 2009, rupee strengthening to be short-lived: report



by Sanath Nanayakkare

Sri Lanka’s Foreign reserves had dropped to USD 4.1bn in March 2021, the lowest since August 2009, on the back of over US$ 4bn outstanding debt payment during April-December 2021 period, a report issued by First Capital Research yesterday said.

According to the report, rupee appreciation is likely to be short-lived considering Sri Lanka’s depleting foreign reserve position, high foreign currency debt repayment requirement and limited funding sources available in the market are expected to further increase depreciation pressure on the currency during 2Q and 3Q.

“We maintain our exchange rate target for 1H2021 at Rs. 196-202 with 2021 year-end target at Rs. 205-215 as mentioned in our ‘Investment Strategy 2021 – January 2021,” the report recalls.

“Sri Lankan rupee appreciated 5% against the US dollar over the last 2 market days reversing the continuous accelerated depreciation witnessed in January-April 2021. On 12th April, Sri Lankan rupee recorded a historical low of Rs. 201:1 US$. Ministry of Finance (MoF) reported on the same day that the government of Sri Lanka entered into a loan agreement with the China Development Bank (CDB) for US$ 500mn and MoF expected the funds to be disbursed during the same week. Following the announcement, the market registered a steep appreciation with mid-rate recording at Rs. 190.9 on April 19,” it says.

The total foreign debt repayment (capital and interest) for 2021 is US$ 6 bn, according to the report.

Meanwhile FC Research believes that the temporary appreciation in USD-LKR, may adversely impact earnings of export companies such as Hayleys, Haycarb, Dipped Products, MGT Knitting Mills, Teejay Lanka, Expolanka Holdings etc. in the short term.

“However, considering the potential future currency pressure, we expect an overall depreciation of approximately 12% for the rupee providing a significant gain for companies with foreign currency revenue”, FC research predicts.

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Govt. asks Opposition not to propagate lies



By Saman Indrajith

Chief Government Whip and Highways Minister Johnston Fernando yesterday accused the Opposition MPs of abusing parliamentary privileges to mislead the public by propagating lies about the Easter Sunday terror attacks. 

Addressing Parliament, Minister Fernando said: “The Opposition MPs level wild allegations in the House knowing that they have the cover of parliamentary privilege. If they have anything substantial or any knowledge of the perpetrators of the Easter attacks still not in custody they can go to the CID and lodge complaints so that such complaints could be investigated.”  

Fernando said so after SJB Galle District MP Manusha Nanayakkara had told the House that he possessed evidence of those who carried out the Easter Sunday terror attacks.

Nanayakkara also said that the facts that he had were not in the report of the Presidential Commission of Inquiry into the Easter Sunday carnage.

“You are making various statements regarding the Easter Sunday terror attacks in the Chamber without any proof because you know that you have Parliamentary privilege. You even quoted some statements which are not included in the PCoI report. How did you obtain such information? Why didn’t you complain about this to the CID in the first place? Your action is aimed at misleading the public,” the Minister said. 

Minister Fernando said that the Opposition should stop insulting Archbishop of Colombo Malcolm Cardinal Ranjith by misinterpreting the latter’s statements. 

“When you are in the Government you never said that this is a Buddhist country. Now you are insulting the Cardinal too. You should not do that,” the Minister said. 

“The former Government should be responsible for the terror attack. Now we are trying to punish those who are responsible for it. We will take action against everyone who is responsible. You should support us, not try to obstruct the on-going investigations,” Minister Fernando said.

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