Patients' horror from medical error
Health services are not as safe as they could and should be. Patient safety has become a major healthcare concern these days. As interventions are becoming complex with time, patients are more at risks of medical errors.
The case of Musrat Jahan, barely four months old, is a glaring example of this. Her tiny body has undergone two surgeries already and will require a couple more.
She was born on May 19 at Rajshahi's Islami Bank Medical College Hospital with imperforate anus, meaning her anus had no opening through which stools leave the body. According to Mozammel Haq, the physician who operated on her, the baby also had "excessive water" in one of her kidneys and her colon did not properly develop.
The following day, however, doctors conducted a colostomy surgery on her. It's a surgery that brings one end of the large intestine out through an opening made in the abdominal wall. Stools moving through the intestine then drain through the stoma into a bag attached to the abdomen.
She went home. Within two months, however, her intestines started to come out through the opening of her abdomen. Then on July 11, Dr Mozammel operated on her again so her intestines would not come out.
After this operation, she did not regain consciousness. In efforts to recover her from anesthesia-induced unconsciousness, doctors tried to heat her up with "warm cloths," inflicting deep burns in her hands and buttocks in the process.
Musrat's mother told The Daily Star last week that the hospital authorities discharged her baby several days later, saying there would be no problem this time. But the baby's condition worsened within days -- the burns turned frightening.
Nervous, the parents rushed from hospital to hospital where doctors gave conflicting advice. At Rajshahi Medical College Hospital, doctors said the baby's physical condition did not permit another surgery. But still, they said, they might be able to conduct one after a few months but could not promise success.
This frightened the parents. They took her to another private hospital where doctors first said the girl needed to be operated in a week. And when the parents took her as advised, the doctors declined to operate on her because she was “not fit”.
“We were left with no other choice but to take her home and wait we did not know for what,” said Joynab Abedin Munni, the mother.
Following media coverage in early August, the Islami Bank hospital authorities took responsibility of the girl's treatment and the girl has been put under the care of a team of specialists.
Musrat's is just one of the thousands of cases that happen every day in Bangladesh and elsewhere.
Data from upper income countries show that one in every 10 patients experience adverse events in hospitals and about 20 to 40 percent of total health spending is wasted due to poor quality care, according to the World Health Organisation.
In some countries, additional hospitalisation, litigation cost, infections or disabilities from complications, and lost productivity costs go up to $19 billion a year, it says.
Countries in Southeast Asia Region, including Bangladesh, currently do not have adequate data to make region- and country-specific estimates, but the picture from the developed countries suggests things would be pretty grim here.
Dr Iqbal Arslan, general secretary of Bangladesh Medical Association, said about half of the patients in Bangladesh are wrongly treated. There are many reasons for this including wrong judgement by doctors and a lack of equipment and technology for diagnosis.
At any given moment, 1.4 million people worldwide suffer from healthcare-related infections, at least half of them preventable, says the WHO.
The issue of patient safety is so vital that, among other things, it will top the agenda when the global health body sits for its 68th Southeast Asia Regional Committee Meeting from tomorrow till Friday in Dili, the capital of Timor-Leste.
Global health experts, health ministers or their deputies, government officials and journalists of the 11 member states of the region are now in Dili to attend the meeting.
Safety of healthcare, now termed “patient safety,” is a fundamental of healthcare and has long been on the global agenda. In 2004, the WHO created World Alliance for Patient Safety to advance the goal of "first do no harm" and then reduce the adverse health and social consequences of unsafe healthcare -- something that has evidently been ignored in Musrat's case.
Asked if Musrat's safety was ignored or overlooked, Dr Mozammel said they tried to do everything within their capacity to ensure her safety before, during and after the operation.
“But I cannot and will not say we've done everything 100 percent right,” he said.
So what went wrong? He said they should have used an incubator to make the girl recover from unconsciousness.
When this correspondent narrated Musrat's case to Zahid Maleque, the state minister for health who is leading the Bangladesh delegation at the meeting, spoke of the need to formulate a law to address the patient safety issue. A draft of the law has already been made.
Before that happens, Musrat's condition was worsening and she had stopped eating. But then again, hers is a single case on a single day in a single hospital.
[Anwar Ali from Rajshahi contributed to this story]