First court case treatment of medical negligence in the history of Maldives January 24, 2007

Phillip Wellman from minivan news reports on the first ever case of medical negligence being treated in a Maldivian court. This is a good start and hopefully more doctors, nurses and other health care professionals will think twice of the treatment and care given to the patients.

By Phillip Wellman
January 24, 2007

---

Indira Gandhi Memorial Hospital stood accused of “failing to exercise due care” in diagnosis and of “failing to give appropriate treatment” to nine-month old Ali Zakwan, who died of kidney failure last July, in a hearing at the Civil Court in Male’ on Sunday.

“After the child was admitted to the hospital the doctors failed to exercise due care in diagnosing Zakwan’s condition and to give the patient appropriate treatment,” said Husnu Suoodh, lawyer for the prosecution. The child’s mother, Wazna Ibrahim Majdhee, filed a medical negligence case against IGMH, claiming that her son’s kidney failure resulted from the negligence of doctors and staff at the hospital.

“On 13 July 2006 when Ali Zakwan was taken to hospital, Dr. Shafqa failed to diagnose Zakwan’s condition and therefore the child went into severe dehydration just two hours thereafter,” Suoodh said in a statement given to Minivan News.

“When Ali Zakwan was taken to the hospital at 5 pm on the same day,” Suoodh continued, “the doctors and staff at the hospital casualty room failed to attend the patient and to give any treatment until after 6:05 pm,” Suoodh added.

Indira Gandhi Memorial Hospital (IGMH) argued it was not responsible for the death of nine-month old, Ali Zakwan, who died last July while in the hospital’s care.

The prosecution has blamed Dr. Fathimath Shafuga, Dr. John George and Dr. Amir, who the boy’s mother said, “failed to exercise proper care”, while treating her child. The prosecution lawyer, Suoodh said one of the most important points he wanted to raise was the fact that on the morning of 13 July 2006, Dr Fathimath Shafuga did not pay proper attention to Zakwan.

Suoodh said this was clearly negligent as Dr Mahaputra from Imperial Medical Centre gave specific instructions to IGMH doctors on how to attend to the child. The lawyer for the prosecution added because the doctors at IGMH didn’t follow these instructions, delays in the patient receiving treatment occurred.

During Sunday’s hearing, Suoodh provided a list of witnesses he would be calling to the court. He also requested that IGMH produce the records of inquiry conducted by a committee appointed by the hospital management.

The trial continues.

Link: minivan news.

This blog is a supporter of Wikileaks January 20, 2007

It is a new concept, an idea and an excellent one by the look of it.

Wikileaks is developing an uncensorable Wikipedia for untraceable mass document leaking and analysis. Our primary interests are oppressive regimes in Asia, the former Soviet bloc, Sub-Saharan Africa and the Middle East….link

People in UK trying to prevent another Ashley X treatment January 19, 2007

The BBC reports that a campaign is on the way to prevent another Ashley case. They say that the treatment is an abuse of human rights.

“We mustn’t change the child to fit society - we need to change society to meet the needs of the child,” said Scope’s community development director, Bob Benson. Scope wants the government to increase funding so that the families of disabled children have access to the right support.

Read more from BBC.

Organ Doner industry January 19, 2007

In India it is a major problem. Now it seems that for the Iraqis it is the best way to get a decent income.

Drug Abuse in Maldives Islands January 14, 2007

Here is a picture slide essay presentation from UNICEF on the extent of drug abuse in the Maldives.

Should the Government pay for "treatment" of people with disabilities? January 14, 2007

USA: One of the most expensive models of health care in developed world where millions left out
UK: A failing National Health System due to underfunding
Australia: Following the footpath of US
Canada:Fully socialised system

In the MV blogosphere, me and Yasiph (someone who i havent met face to face or had a conversation yet) have been posting strips of articles on what a definition of disabilty could be. Does it mean that some one is abnormal? What is normality any way? Is it someone who is well educated, a politician (I am thinking of Ibra here), or…just the normal simple guy? I will leave it for you to answer.

I have on different occasions stressed on the stigmatization that is perpetrated against people with disability. One of the main contributors to this stigmatization in this age and time in the Maldivian media or who writes on Maldives happenings comes from the Dhivehi Observer who call themselves as the liberators of opression and champions of free media in Maldives, so they claim. The recently much talked about dementia case is evident to this highly gross stigmatization of the people who are suffering from dementia around the world and i feel that it is an injustice being done to them.

This brought me to the subject of “bad” disabled and “good” disabled. Why not read this essay on Changing Representation of Disability on the Media.

What one now gets (and this is especially true of television) is the clear distinction between the rights and representation of two quite distinct classes of disabled (impaired) people: the normalised and the un-normalisable disabled people: the ‘good’ and the ‘bad’ cripple (disabled people).

Normality – the belief that there is an essentially correct way to have been born, look like and be – the belief in normality, has defined the nature of the representation of disability and impairment (and non-disability) by formulating it as the basis upon which otherness (abject humanity bordering on inhumanity) has been defined in all figurative representation of humanity.

From this perspective it is easy to see and understand why (and how) some disabled people can reject one image as negative (because it fails to offer them the chance of normality) whilst another is deemed to be positive (it offers the prospect of some kind of normality). Additionally, one can see how (and why) the good and bad cripple nexus is becoming increasingly dominant: both reinforce the idea(l)s of normality – leaving no space for ambiguity on the value of one in relation to another (e.g., the ‘good’ normal and the ‘bad’ abnormal). In a culture (our Western one in particular) where identity and nationhood is seen –or, to be more precise, constructed - as being increasingly under threat from unseen enemies (e.g., terrorists, asylum seekers, illegal immigrants) the battle over the hegemonies of normality are increasingly less subtle and more overtly apparent (as is the case with disability representation).

Let us get back to the issue i intended to bring forward in this post. It seems that the social model of disability is being followed by the Government of Maldives which is indiscriminatory, full of equality and universalism. The Maldivian concept or how they have defined it puts a lot of blame on the society for all the discrimination that is happening to the person with a disability. I am not saying that the concept in its original form or the noble spirit behind the original concept is useless and should never have been followed by Maldivians. Infact Maldives uses a model that has the same name to it.

There has been instances in the developed world like Canada, where this model has proved to collide with health care with interesting outcomes. A quote below taken from here, talks about the ambiguity that can arise from such a system.

The relationship between the social model of disability and health care is ambiguous. The litigation discussed in this brief comment reveals one instance in which this ambiguity manifests itself. A major contribution of the social model of disability is to stress the human rights dimension of the allocation of public goods and opportunities. Recognizing quality health care as a public good of great value in Canada, social model theory would insist that it be distributed fairly and without discrimination based on disability. With a claim of discrimination going to the availability of treatment for disability, however, things get more complicated. The purported value of the therapy takes centre stage. Medicine’s proper concern with alleviating the impairments of disability (also the concern, of course, of families of children with disabilities) seems to overtake what the social model views as the proper concern of human rights law- respect for the equal worth of the person with a disability. A challenge lies ahead in identifying the grounds on which these approaches may be reconciled.

Maldives may not have a good legal system. Maldives may not even have the best hospitals and the best doctors, health equipment, experts on bioethical issues, compensationary measures for victims of the health care system etc…

One thing maldives does have are children, male and female, people who are categorised as being people with disabilities.

So, should the Maldivian government pay for the “treatment” or medical costs of people with disabilities? My answer would be YES.

Critical Periods in Human Development January 13, 2007

Click on images to enlarge.

Info taken from here.

Intellectual Disability, Mad, Print disability, Special Needs and Mental Retardation January 12, 2007

Ever wondered how a person with a disability would have defined themselves? Did i use the right word there? Disability? Impairment? Handicap? Mentally retarded? Lets delve ourselves a little deeper in to this. Shall we?

Do we use the term mental retardation today? The answer is NO. It is much nicer to refer to people for who they are instead of what they are.

Some definitions from WHO.

Impairment: The Functional damage - physiological, psychological, anatomical (stressed on the organic or medical problem)

Disability: The restriction of Normal Activities- results from an impairment (The emphasis is on the practical problems faced in the performance of activities)

Handicap: The resulting social Disadvantage- Handicaps are the social, behavioural and psychological consequences of disabilities (emphasis is on the disadvantage)

SHOULD DOs:

Avoiding stereotypical or stigmatising depictions of people with disabilities

Avoiding phrases or meaning that demean people with disabilities

Promoting what is known as the “people first” concept: not “disabled person” but “person with a disability”.

Portraying people with disabilities in the same multidimensional fashion as others.

Words to Watch	Acceptable Alternative
Abnormal, subnormal (negative terms that imply failure to reach perfection)	Specify the disability
Afflicted with (most people with disabilities don’t see themselves as afflicted)	Say “the person has…(the disability)”
Birth defect, also congenital defect, deformity	Say “the person with a disability since birth”, “person with congenital disability”
Blind (the), visually impaired (the)	Say “person who is blind”, “person with vision impairment”
Confined to a wheelchair, wheelchair-bound (a wheelchair provides mobility not restriction)	Say “uses a wheelchair” or is a “wheelchair user”
Cripple, crippled (these terms convey a negative image of a twisted, ugly body. Avoid)	Say “has a physical or mobility disability”
Deaf (the)	Only appropriate when referring to the Deaf community; say “person who is deaf”
Deaf and dumb (the inability to hear and speak does not imply intellectual disability. Avoid)	Say “hearing impaired” ; lack of speech usually results an from impaired hearing
Defective, deformed (degrading terms. Avoid)	Specify the disability
Disabled (the)	Say “people with a disability”; “the disability community”
Epileptic	Say “person with epilepsy”
Fit, attack, spell	Say “seizure”
Handicapped (the)	Say “person with a disability” unless referring to an environmental or attitudinal barrier, in such cases “person who is handicapped by a disability” is appropriate.
Insane (also lunatic, maniac, mental patient, mentally diseased, neurotic psycho, psychotic, schizophrenic, unsound mind and others are derogatory terms. Avoid)	Say “person with a psychiatric disability” or a specific condition .
Invalid (the literal sense of the word is “not valid”. Avoid)	Say “person with a disability”
Mentally retarded (also defective, feeble minded, imbecile, moron and retarded are offensive and inaccurate terms. Avoid)	Say “person with an intellectual disability”
Mongol (outdated and derogatory)	Say “has Down Syndrome
Patient (only use in context of doctor/patient relationship or in hospital)	Say “person with a disability”.
Physically/intellectually/vertically challenged, differently abled, ( ridiculous euphemisms for disability. Avoid)	Say “person with a disability”
Spastic (usually refers to a person with cerebral palsy or who has uncontrollable spasms. Derogatory, often term of abuse, should never be used as a noun)	Say “person with a disability”.
Suffers from, sufferer, stricken with (Not all people with disabilities actually suffer. These terms should not be used indiscriminately.)	Say “person with a disability”.

Now. So how would a person with a disability define themselves?

Disabled people have been the subject of much research and debate within the health professions for many years now. The World Health Organisation has spent the last thirty years devising ways of defining us as a health problem. The International Classification of Impairment Disability and Handicap (ICIDH), first used in the early 1980s, was developed by non-disabled ‘experts’ and was a medically-based way of measuring who and what disabled people were. It was a way of compartmentalising disabled people on the basis of our impairments and what level of social and medical ‘burden’ we were on a country’s economy.

Read more from the International Disability and Human Rights Network.

Ref:
“A Way With Words” (1995), Community Disability Alliance, Department of Families, Youth and Community Care and Department of the Premier and Cabinet, Brisbane
International Disability and Human Rights Net work

Mothers Age and Down syndrome January 12, 2007

Research has proven that there is an increased risk of having a child with Down Syndrome if the mother is above 35 years of age. These days we hear of mothers having babies in their 60s. Hmmm…There it is something for all the girls to think about.

What are "Special Needs"? January 9, 2007

One Term, Many Definitions: “Special Needs” is an umbrella underneath which a staggering array of diagnoses can be wedged. Children with special needs may have mild learning disabilities or profound mental retardation; food allergies or terminal illness; developmental delays that catch up quickly or remain entrenched; occasional panic attacks or serious psychiatric problems. The designation is useful for getting needed services, setting appropriate goals, and gaining understanding for a child and stressed family.

Minuses and Pluses: “Special needs” are commonly defined by what a child can’t do — by milestones unmet, foods banned, activities avoided, experiences denied. These minuses hit families hard, and may make “special needs” seem like a tragic designation. Some parents will always mourn their child’s lost potential, and many conditions become more troubling with time. Other families may find that their child’s challenges make triumphs sweeter, and that weaknesses are often accompanied by amazing strengths.

Different Concerns: Pick any two families of children with special needs, and they may seem to have little in common. A family dealing with developmental delays will have different concerns than one dealing with chronic illness, which will have different concerns than one dealing with mental illness or learning problems or behavioral challenges…

read more on specialchildren.about.com