Human error or criminal negligence?
By Nusrat Nasarullah
A PRIVATE television channel reported on Friday that the doctors have contended that it was a “human error” that caused Shahzadi Shahida Sultana, 35, to lose her life, in the complications that surfaced when she was operated for removing the forceps which were left in her abdomen in an earlier surgery. And the doctors were quoted as saying that they would be protesting further if the action taken against the concerned doctors was not withdrawn.
It is indeed shocking what has happened and brings into agonizing, painful focus the much heard lament, and frustration that the quality of medical care in our hospitals is declining, despite the technology that is being inducted into the healthcare system.
About the best of doctors there are complaints and grievances, at many of an individual nature, which reflect the overall attitude that most doctors have towards their patients. About the best of hospitals and the quality of the health care, they trumpet about and exorbitantly charge their patients there are disgusting stories of inefficiency, indifference, and even over billing. The sad death of this young woman in Hyderabad, which has angered the public and compelled one to once again contemplate the ugly reality that many times characterizes the medical system of this country.
This defensive argument that the Hyderabad doctors have taken about “human error” is baffling. It mirrors a certain insensitivity and lack of compassion on the part of a professional community whose job entails being kind and considerate, besides being competent.
This plea about “human error” is, by the way, something that most incompetent or erratic men and women put forward in other spheres of life too. And with this information technology expansion in our lives, another defence argument for harassing citizens is to say: “The system is down”. One feels like saying that for the common man, it appears that the system is always down. Or there is no system at all. It is, despite all the rhetoric and the policy making, the absence of a system or its abject failure that stands out. The solution to problems in public dealing departments and domains is still what comes within the purview of “personal contact”.
In this tragic case of Shahzadi Shahida Sultana, details carried in Dawn on March 8 (which was the International Women’s Day), it is said that the deceased woman carried a pair of forceps in her abdomen for almost a year and during this period she suffered severe pain and vomiting.
Apparently the forceps were left in the stomach in February last year, when she gave birth to a baby girl on 13th of the month. Her brother is quoted as saying that it was on 18th February this year that the forceps related pains surfaced. And subsequent events, investigations and two major surgeries were carried out for removal of the surgical instrument. But her condition did not improve and she died.
The family of the deceased woman has lodged a criminal case against five lady doctors and the in charge of the gynaecology unit 111 at the Liaquat University of Medical and Health Sciences, Civil Hospital Hyderabad.
Making one contemplate, the sadness of the case is that the woman’s husband is a rickshaw driver and could not afford private medical care for his wife in pain, spread over a year. Private hospitals or clinics can be no better at times. Patients pay fabulous fees for what many citizens regard as “sheer fleecing” by doctors, who of course have their own points of view.
A colleague of mine took his eight year son, Taimoor, to an eye specialist. For the child, it was a first ever experience of facing a doctor for an eye test. The doctor was intimidating, abrupt, dismissive and his little patient was terrified. With the result when the prescription came, the parents were dissatisfied and they went for a second opinion, naturally. They said: “An eye specialist should have been polite and kind with his eight-year-old patient.” This experience relates to a private clinic.
But look at these two examples that another colleague emailed to me about two experiences that took place recently at a posh large private hospital. The irony is that we all have to live with these doctors, these hospitals, these situations. In the first instance, a leading gastro-enterologist “banged on the table, and threw out a file of a patient as soon as she found out that she had got a CT scan done on the advice of a relative.” Then he told the patient that she should leave, as he had no treatment for her, now. He was evidently unhappy about a second opinion she had gone in for. Keep in mind that the patient was suffering because of an undiagnosed medical problem. The doctor concerned for all his experience and stature did not understand the vulnerability, sensitivity, and emotional state of the patient, and her family. There is much to think about such interactions that sound so familiar.
Or take this instance from another leading private hospital, a senior pulmonologist reportedly misdiagnosed a cancer patient and began treatment for tuberculosis. And he was adamant that TB it was, if it wasn’t cancer!! A biopsy report confirmed cancer, and the patient, who could afford to do so, took the first flight to get treatment abroad.
Let’s face it. If one looks at this doctor-patient relationship, complaints and grievances are long standing. Were one to generalize, it is obvious that anyone in authority in this society, ill treats the man in a lower position and assumes that he (the stronger man) is always right. That strength could be in matters material or moral.
Returning to the case of this woman who died following the surgery for removal of forceps, there is much more to mourn here. The doctors of the hospital concerned, all the paramedical staff and just about everybody has gone on strike, says a report and “hundreds of patients suffer” as a result. They are all protesting about the case that has been registered against the six lady doctors. Isn’t that strange? But then who is to protest about the death of Shahzadi Shahida Sultana, only her husband? Is it not expected of society to protest?
Let me end with an observation that came from a woman this week when she read this sad story. She said it was disappointing that though this case surfaced on International Women’s Day, there was virtually no mention of this story by any of the speakers, in the country. For that matter, in Karachi, I haven’t heard anyone take real notice of this incident.


Lot of the Pakistani worker
By Geof Malone
DURING the past year there have been widespread reports in newspapers here of the poor treatment of labourers working on the UAE’s mega construction projects, but it appears that most Pakistani workers seem to suffer in silence when things go wrong.
There are reckoned to be more than 500,000 Pakistani expatriates in the UAE. This figure includes those who are here illegally, either on visas that have expired or who managed to smuggle themselves into the country and never had a visa in the first place.
Most are from Punjab and the north and, according to the Pakistani consulate in Dubai, about 75 per cent are labourers or blue-collar workers.
Mohammed Waseem, who is in charge of welfare matters at the consulate, told the Evening Post newspaper that, despite the numerous reports about labourers being treated badly, the consulate only receives about three or four complaints a week.
He reckons that the workers stay silent and compromise with poor conditions because of job insecurity and their need to keep earning to send money home.
The complaints that are received are usually about non-payment of wages, often for many months, and in these cases the consulate asks the UAE ministry of labour to help sort things out. The Dubai authorities are currently being quite positive in such cases and send officials to the construction sites to pressure employers to pay their workers.
It is not, however, always a case of companies deliberately not paying, but being unable to do so because of cash flow problems caused by not receiving money for work completed. I know from talking to acquaintances in the construction industry that payments are frequently delayed by clients and some of the worst payers can be government departments. Well down the line of contractors, sub-contractors, sub-sub and so on, it is the poor labourers who are at the bottom of the pile.
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DRIVING to Abu Dhabi this week I reflected on what a fabulous road system we have here in the Emirates. The federal capital of the UAE is about 130 kilometres from Dubai and the two cities are linked by a highway that, even at its narrowest, has four lanes in each direction.
Once over the border into Abu Dhabi emirate, I motored along at the current permissible limit of 160kph and reached the outskirts of Abu Dhabi city in less than an hour.
With crash barriers in the centre and along the sides, and fencing to stop pedestrians or camels wandering onto the road, I felt safe and certainly not a danger to other road users.
On such a highway, accidents should not happen but the mangled and twisted barriers every few kilometres bear witness to the frequent crashes that take place. Most are caused purely by speed, and the driver who overtook me as though I was standing still — I reckon he was doing more than 240kph — was an accident waiting to happen.
The problem is that the roads, designed to the highest possible standards, are so good that people drive too fast, beyond their capabilities and lose control of their vehicles.
The death toll is rising. On average, somebody is currently dying on Dubai’s roads every day and last week the man in charge of the city’s traffic police likened the situation to a war zone.
Some experts say that one of the problems in Dubai is that the drivers come from all over the world and all have different driving mentalities but one of the most telling statistics indicates that, per capita, it is UAE nationals who are more likely to be involved in accidents and kill themselves (and others), with most crashes caused simply by reckless driving.
Within Dubai city accidents are mostly minor shunts, which is not surprising since the congestion means that vehicles spend lots of time crawling along.
Major road improvements are now taking place and there are plenty of promises about new roads and bridges over the Creek that divides Dubai into two parts but the population is expanding so rapidly that most people believe it will be almost impossible to cope with the increased traffic.
Now there are hints that the queues will be getting even longer before there is any chance of the situation improving.
Work has now started on building the city’s metro rail, which will be part overhead and part underground, and last week the roads authority said that drivers will have to show patience during the construction phase. You have a feeling that such a carefully worded pronouncement means that we are facing absolute chaos for the next three or four years. The city is already grinding to a halt and building stations in some of the most congested downtown areas is obviously not going to help in the short term.
Dubai does, however, have a knack of coming up with spectacular and futuristic schemes and there are currently rumours floating around of a dramatic announcement concerning transportation that will be made shortly.
I have no idea what it is likely to be, but I am currently passing the time in the endless road queues imagining what I would do to get the traffic moving again. I haven’t come up with a solution yet.


