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Archive for July 23rd, 2012

A Kenyan mother in sorrow: Martha Wangui Kiiru’s baby died February 20th, 2011 in a Norwegian hospital due to negligence

Posted by African Press International on July 23, 2012

This is now confirmed in a report that African Press International has received from the Norwegian Board of Health.

The Board accuses the hospital of negligence and has demanded that the hospital must reorganise the way things are done in order to avoid such deaths in the future.

In the report information coming out is scaring. The hospital has been having doctors and nurses who are not experienced in child care. On that fateful day when baby Evans died, doctors did not give him the necessary attention. The nurses have tried to say that the mother had problems in communicating with them and that they did not understand that she wanted the attention of the doctor, when the baby became more sick that fateful day. The late baby Evans Kiiru, in Oslo-Norway

The late baby Evans Kiiru (photo) Was born in Norway in 2010.

The cheerful child who only became one year old, before he succumbed to death in the hands of hospital personnel, is said to have suffered a lot of pain for days in the hospital’s children ward in AHUS University hospital.

It is now believed, that it was while there in the hospital ward that his fate was sealed when the hospital personnel enabled his death to occur due to negligence. The hospital has tried to excuse their negligence by saying there was communication problems between the child’s mother Martha Wangui Kiiru due to language. This is, however, questionable because the child’s mother understands and speaks English. There is no doubt that some nurses and Doctors at the hospital have no problem handling English as a language. In the Norwegian Board of health report, it also comes out clear that the hospital has a nurse who speaks the same mother tongue as the child’s mother. If the problem was seen as a major obstacle, there was no reason why the hospital did not utilise the services of the nurse who speaks the same mother tongue as the late Evan’s mother.
It was not long after he was born, that he started getting stomach problems culminating in severe pains. Little did the mother know that her lovely baby would not survive, even after getting an operation in the National Hospital (Rikshospitalet) – the main hospital in Oslo, Norway when doctors discovered that his stomach pains was caused by his entangled intestines.
It was after the operation and a number of days in the hospital that the child was released and sent home with the mother. Soon after, the child’s health worsened, and forcing him to become a regular patient AHUS University hospital near his home, just a few kilometers outside the capital city Oslo.

Baby Evans, then a year old,  lost his life in the hands of AHUS University hospital staff on February the 20th 2011. 

His death caused an outcry and the Akershus District Patient’s Ombudsman Knut Fredrik Thorne – a man whose job is to assist wronged patients to launch their complaints with the State, has told African Press (API) that the hospital staff are to blame 
In our video interview below, Mr Thorne also points a finger at the Ministry of Health for doing little in streamlining services in Norwegian hospitals so the patients may feel safe whenever they are undergoing treatment.
 After Mr Thorne’s castigation of the top leadership in the ministry of health in the media recently, his criticism has not gone unnoticed by the political leadership there. Recently, the Ministry of health represented by the Permanent Secretary has shown interest in the case, demanding that the AHUS hospital submit a report as soon as possible on baby Evans death.
Patient’s Ombudsman Knut Fredrik Thorne speaks out: 
The Norwegian Health Board has investigated the case and found that the hospital is to blame, and has now demanded that the hospital director furnishes the board with a report explaining what really took place on that fateful day when Baby Evans died after having staying in the hospital undergoing treatment for two weeks.
AHUS University Hospital has of late accepted that their methods of dealing with sick children is not without blame. They are, however, trying to run away from responsibility when it comes to the death of Evans whose mother Martha Wangui Kiiru is originally from Kenya. It has been reported that she travelled to Norway in 2007, where she now lives.
In their response to the request from the Ministry of Health about the report they are required to submit, the assistant hospital director is hesitant to do so soon, but wishes do so by the 15th of November this year.
When the baby died, the police did not take time to investigate properly. They opened the investigations for a short period, before concluding that the hospital had no case to answer.
This did not go down well with the mother of the child. She chose to pursue the case by engaging the hospital through a complaint handled by the patient’s ombudsman. When the Norwegian Board of Health (Helsetilsynet) concluded recently that the hospital was to blame, the Police came forward saying they have decided to re-open the investigations. The late Baby Evans mother Martha Wangui Kiiru during the interview with African Press International on the 23rd July 2012 in Norway The late Baby Evans mother Martha Wangui Kiiru during the interview with African Press International on the 23rd July 2012 in Norway

In the report the Health Board criticises the hospital is criticised for not having given the necessary guidance to the child’s mother Martha Wangui Kiiru (photo) after the death of the child. The hospital should have coordinated proper follow-up with the municipal council where she lives in an effort to ease the psychological tension that comes with the loss a loved one, the Report says.

 The Progress Political Party, a right-wing party in Norwegian, a party that is extremely negative in their policies when it comes to foreigners and their rights in the country has even come forward in agreement with those calling for a thorough investigation of AHUS hospital, not only on this case, but also to look into what has happened to other cases whereby patients may have died or did not get the required follow-up after treatment. The Progress Party represented by their Health policy spokesman Per Olsen has criticised the hospital administration and pointed out that the government should order an investigation that will look into the operations of the hospital as a whole. He demands an immediate investigation.
However, one adviser to the Ministry of Health Mr Dale has come out strongly objecting to such investigation saying, the Norwegian Board of Health’s conclusions in the case is enough.
African Press International sends condolences to the late Evans family and may his soul rest in peace.

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Security Council paralysed over Syria

Posted by African Press International on July 23, 2012

“It is regrettable that the UN Security Council has not reached agreement on a resolution on Syria,” said Minister of Foreign Affairs Jonas Gahr Støre.

On Thursday, Russia and China vetoed a Security Council resolution that would have condemned the use of violence in Syria, called for compliance with Kofi Annan’s six-point peace plan, and allowed for sanctions against the regime. Eleven members of the Security Council voted in favour of the resolution, while two countries, Pakistan and South Africa, abstained.

The civil war in Syria continues to rage and is gaining momentum; there is now heavy fighting in Damascus itself. This is the third time in nine months that Russia and China have vetoed resolutions on Syria in the Security Council.

“The civil war in Syria is continuing to escalate, despite the diplomatic efforts. The two countries that vetoed the Security Council resolution have a particular responsibility for the current deadlock,” Mr Støre said.

Mr Støre also emphasised the importance of being able to provide humanitarian assistance to refugees and others in need.



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Half a million undiagnosed diabetics

Posted by African Press International on July 23, 2012

 An A MA DIA volunteer does a blood sugar test at a health fair in Tamatave

TAMATAVE,  – An estimated one million people in Madagascar are diabetic, but only about half of them know it. Finding the other half presents a major challenge for this large, island nation in which 80 percent of the population live in rural areas where few people have ever heard of this chronic and potentially deadly disease.

With the country’s underfunded public health sector barely functioning, this task has mainly fallen to the Madagascan Diabetes Association (A.MA.DIA.) which dispatches its doctors and nurses to the provinces to conduct blood sugar tests and raise awareness at fairs, schools and health centres.

“We have done this work for over five years now, and people are slowly starting to know more about the illness,” said Jean Marie Andriamanonga, coordinator of A.MA.DIA.

“Malagasy people think that diabetes is not a problem in this country, because they don’t drink Coke and don’t eat cakes, like Westerners. But there are many components in the traditional diet that can cause the illness,” Andriamanonga told IRIN. “In the countryside, for instance, people drink local rum made of sugar cane. They also like to eat fatty meat and plates full of rice. In the cities, people are starting to eat Western foods and they don’t move as much as they used to.”

Based on the tests that A.MA.DIA. has conducted, Andriamanonga estimates that 5-6 percent of Madagascar’s population of 20 million has diabetes, while only about 3 percent have received a diagnosis.

“In the bush, people really die of this illness,” he said. “We have seen cases where people’s limbs were amputated. People often complain about vision problems, high blood pressure or wounds that don’t heal well. We used to only find cases among the elderly, but now it is spreading among the young also.”

If finding diabetes patients presents a challenge, treating them is even more difficult. Moussa Bako, a 69-year-old farmer who lives 160km north of Tamatave, a port town on the east coast of the island – which is also known as Toamasina, was diagnosed with diabetes three years ago after complaining of chronic fatigue. At the time, the doctor at the public health centre in his region gave him some advice on diet and treatment and administered one dose of insulin. “I felt better after this, but never had the opportunity to go back,” said Bako, who thought one treatment would cure him; he lived too far from the clinic to return for regular check-ups.

''Malagasy people think that diabetes is not a problem in this country, because they don’t drink Coke and eat cakes''

Today, however, Bako has decided to come to a mobile clinic A.MA.DIA. has set up in the centre of Tamatave and become a member of the Association. Membership is not free, but it gives patients access to regular check-ups from specially trained doctors at A.MA.DIA. clinics at half the normal price of a consultation in the private sector. During his introduction, Bako receives detailed information from educator Marcel Robiamanantena about how to manage his diabetes.

“I tell him how to eat a balanced diet, and to avoid anything toxic, like alcohol or tobacco. He also needs to come for a check-up every month. This is an illness for life and he will shorten his life span if he doesn’t come to our centres regularly,” Robiamanantena told IRIN.

Lack of equipment, insulin

A.MA.DIA. has established clinics like the one in Tamatave in a number of regions and, with funding from the World Diabetes Foundation, plans to open several more. A.MA.DIA.’s main clinic in the capital, Antananarivo, treats 1,500 people with diabetes every month and has 20 beds for in-patient treatment and a dispensary for out-patients.

Often the only treatment available through the public health sector is that provided by nurses or health workers who lack the training to manage diabetes patients. Rural health clinics usually lack the equipment to even conduct blood sugar tests, while patients that are diagnosed with diabetes are referred to private pharmacies to buy insulin at a high cost.

Despite being on the World Health Organization’s list of essential medicines, insulin is scarcely available either through Madagascar’s public or private health sectors. Even A.MA.DIA., which receives support from several donors including the World Diabetes Foundation, struggles to ensure a steady, subsidized supply of the drug to all its members. Andriamanonga said Madagascar’s protracted political crisis had increased the difficulty of procuring insulin while the lack of drug storage facilities in the provinces posed another significant barrier.

“Many of the new cases we find are children with type-1 diabetes. They will have to take insulin for life at exorbitant cost. Someone who has an average salary of 100,000 ariary [US$45] a month will have to spend 25,000 ariary [$11] a month on insulin,” said Andriamanonga.



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The biggest threat to a woman’s life

Posted by African Press International on July 23, 2012

JUBA,  – South Sudan has the worst reported maternal mortality rate in the world.

“More women die in child birth, per capita, in South Sudan, than in any country in the world,” says Caroline Delany, a health specialist with the Canadian International Development Agency (CIDA) in South Sudan which is funding a raft of maternal health programmes.

A 2012 report entitled Women’s Security in South Sudan: Threats in the Home by Geneva-based think-tank Small Arms Survey (SAS) says a national survey carried out in 2006 indicating 2,054 deaths per 100,000 live births may have been an underestimation.

“Many deaths are not reported, in part because 90 percent of women give birth away from formal medical facilities and without the help of professionally trained assistants,” it said.

Childbirth and pregnancy, rather than conflict, are the nation’s biggest killers of girls and women.

“One in seven South Sudanese women will die in pregnancy or childbirth, often because of infections (from puerperal fever and retained placenta), haemorrhaging, or obstructed births, with a lack of access to healthcare facilities playing a large role in their deaths,” SAS found.

“When we talk about security in South Sudan there is a tendency to focus on issues such as guns and militia groups. But real human security means protection from anything that threatens health and wellbeing. In South Sudan there is nothing that poses greater threat to a woman’s life than getting pregnant,” says SAS researcher Lydia Stone.

Lack of midwives

“Midwives can prevent up to 90 percent of maternal deaths where they are authorized to practice their competencies and play a full role during pregnancy, childbirth and after birth,” the UN Population Fund (UNFPA) in South Sudan said in a May report on maternal mortality.

At the maternity ward in Juba Teaching Hospital, staff members say there are not enough (or the right) drugs, and never enough trained staff.

Midwife Julia Amatoko is one of three registered midwives at the country’s ramshackle and constantly overcrowded hospital in the capital.

“We are just a few and a lot of mothers are coming. And beds are not enough for the mothers. We have just eight beds for the first stage of labour and for the post-natal mother,” she said.

According to UNFPA, South Sudan has just eight registered midwives and 150 community midwives.

IRIN’s latest film, South Sudan – Birth of Nation, focuses on Juba Teaching Hospital’s new college of nursing and midwifery. Students here, drawn from all of the country’s 17 states, speak of their determination to take their new skills back to their villages to reduce the scourge of maternal mortality.
View Film 

Amatoko said the lack of professional midwives working alongside traditional birth attendants (TBA) and community midwives caused needless death. “Those who are TBA’s are not able to cope with the serious cases, like when the mothers have post-partum haemorrhage.”

Giving birth even at the country’s leading hospital is a lottery, especially at night. “I’ve been here for three months, and two mothers died, in the night,” she said, due to a lack of human resources.

“Midwives are the backbone for reduction of maternal mortality… but here, with all the midwives and birth attendants put together, there are only around 20,” said consultant obstetrician and gynaecologist Mergani Abdalla.

“If you have professional midwives that can provide basic obstetric care – once South Sudan can deploy those, they can expect progress, but it will happen slowly,” said midwifery specialist for UNFPA Gillian Garnett.

UNFPA is looking forward to the graduation of around 200 midwives next year.

Treatment delays

Many women come to the hospital late, when they are already in the throes of a difficult labour, said Abdalla.

“There are delays at the community level, with a lot of cultural and other kind of issues; there are delays in getting to the hospital because of the transport infrastructure, the lack of ambulances, the roads; and then there are delays in the hospital as well,” said Garnett.

Mariam Kone, a medical coordinator for a Médecins Sans Frontières (MSF) hospital in Aweil, Northern Bahr-el-Ghazal, echoed the problem. “We are receiving ladies at a really late stage… They’re usually in a septic condition or they’re anaemic, and many have malaria,” she said.

Photo: Elizabeth Deacon/IRIN
View the related slideshow

MSF admits around 6,000 people a year to the maternity ward and had 18 deaths last year, mainly due to postpartum haemorrhage, septicemia and eclampsia.

Blood, scissors and gauze

At Juba hospital, UNFPA is supplying kits for mothers, surgical instruments and life-saving drugs such as oxytocin to stop bleeding, but Amatoko bemoans the lack of basics: “We need scissors for delivery, and browns for packing. We don’t have even cottons in the ward; gauze-we don’t have.”

The nation’s first blood bank has been built but not filled at the hospital, which only has a family-size fridge full of blood (mostly allocated by relatives for patients due for surgery).

“The biggest need is blood transfusion, because most of the [maternal mortality] cases are due to post-partum haemorrhage”, said Abdalla.

Garnett says that if these were normally healthy women, blood loss would not be so tragic, but a combination of poor health and the delays at community and hospital level to seek health care puts most women at risk even before they go into labour.

In a country where girls are often married off in their early teens, the number of children they have is often not up to them.

“A married woman of childbearing age is expected to become pregnant at least once every three years, and to continue until menopause,” the SAS report found.




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