Who is at fault with re­cent in­fant deaths?

Fiji Sun - - Suncity - Ne­mani De­laibatiki The fol­low­ing is an edited ver­sion of My Say aired on FBC TV yes­ter­day at 7.30pm. Edited by Paula Tu­vuki Feed­back: ne­mani.de­laibatiki@fi­jisun.com.fj

Re­cently we have had three in­fant deaths that have got the na­tion think­ing and talk­ing about the state of our health care ser­vice and the abil­ity of health pro­fes­sion­als to pro­vide ad­e­quate care.

The first one I want to talk about is the death of a one day old baby at the CWM hos­pi­tal in Suva. The mother’s ac­count of events place the baby in the doc­tor’s care – an in­tern, when the baby fell ill and later died. Af­ter birth she claims that the baby was healthy.

It is al­leged she was not told that there was any­thing wrong with her baby. Mid­wives came and took the baby for a bath on June 15. The mother claimed the baby was fine. On the same day in the evening, the mid­wives took su­gar, blood tests and tem­per­a­ture. They said it was fine. On June 16 at 2am, the in­tern came to see the mother when she was chang­ing the di­a­per. The mother did not un­der­stand why the doc­tor took the baby. Her cu­rios­ity and con­cern for her baby led her to in­quire af­ter her baby. Af­ter a cou­ple of hours (with­out her baby) the doc­tors came and told her that her baby was in ICU and that she was sick. The baby later died. The se­cond fol­lows a sim­i­lar pat­tern this time in Labasa, again an in­tern was al­legedly in­volved, ap­par­ently in­volv­ing an al­leged over­dose of medicine.

The first ques­tion I want to ask is – is there a pat­tern? I can­not say there is a pat­tern but in two cases med­i­cal in­terns were al­legedly in­volved. Two ba­bies have died at the hands of a sys­tem that seems in­ad­e­quate. Both moth­ers were not sat­is­fied with the out­come of the in­quiries into their ba­bies deaths. Its tragic and should never have hap­pened. These are hu­man lives.

My se­cond ques­tion con­cerns blame. Who is to blame? The in­terns? The se­nior doc­tors su­per­vis­ing them? The moth­ers for not be­ing more as­sertive with their in­quiries? Or the sys­tem?

This is a dif­fi­cult ques­tion to an­swer. If we are go­ing to en­sure that these fa­tal­i­ties don’t hap­pen again then our health sys­tem needs to be bet­ter, our health pro­fes­sion­als need to be bet­ter. There are sys­temic changes that need to take place.

Firstly, en­sur­ing that pro­to­cols are in place that are con­sis­tent across all health providers and that health pro­fes­sion­als are made ac­count­able for en­sur­ing that such pro­cesses and pro­to­cols are main­tained.

It is nor­mal prac­tice in hos­pi­tals that in­terns work un­der su­per­vi­sion. Whether this hap­pened in the two cases in ques­tion is not clear. One of the es­sen­tial re­quire­ments in med­i­cal ser­vices is proper doc­u­men­ta­tion. It records all the ex­am­i­na­tions, di­ag­no­sis and treat­ment of pa­tients. This guar­an­tees that the con­ti­nu­ity of care is main­tained by shift work­ers. Also if there is a med­i­cal mis­ad­ven­ture it can be quickly traced and ap­pro­pri­ate re­me­dial ac­tion is taken. Re­search has shown that the pa­tri­ar­chal sys­tem that char­ac­terises our health care sys­tem, rem­i­nis­cent of the colo­nial era in Fiji, re­mains, and is not catered to the needs of the pa­tient. We hear sto­ries of in­tim­i­da­tion, lack of com­mu­ni­ca­tion; the pa­tient not know­ing what’s go­ing on, switch­ing be­tween dif­fer­ent health care providers. There is lit­tle com­mu­ni­ca­tion, limited un­der­stand­ing. Pa­tient cen­tred care al­lows the pa­tient to be at the cen­tre of the con­sul­ta­tions and care. I was very happy to hear that doc­tor’s pay is go­ing to be in­creas­ing from 56 per cent to 81 per cent. This is great news and a step in the right di­rec­tion. What health pro­fes­sion­als need to ac­cept, how­ever, is that with such in­vest­ment comes re­spon­si­bil­ity. They need to lift their qual­ity of care. They are pro­vid­ing a ser­vice to the peo­ple of Fiji. They are be­ing paid for this ser­vice and so they need to en­sure that the re­ceivers of this ser­vice are sat­is­fied with their care.

We can have the best med­i­cal fa­cil­i­ties but un­less proper sys­tems and pro­to­cols are in place and fol­lowed by med­i­cal pro­fes­sion­als, we will con­tinue to have med­i­cal mishaps.

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