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Iraqi Hospital Investigates Pregnant Women's Death

Posted on: Thursday, 28 July 2005, 09:01 CDT

Text of report by Adnan Samir Duhayrib from Al-Muthanna, headlined "Al-Muthanna general health director talks to Al-Mada about administrative corruption and the Japanese role in support of health departments; we investigated causes of death among pregnant women in Al-Samawah", carried by Iraqi newspaper Al-Mada on 11 July

Being a big village or a small city, what happens in Al-Samawah resounds among the people and the search for a reason continues. The greater the effect the event has on citizens' life the more people talk about it.

One of the serious issues which the people talked about repeatedly was the phenomenon of pregnant women mortality in the obstetric hospital in Al-Samawah. The issue preoccupied public opinion and spread fears among both women and men, especially since deaths occurred between short intervals and the real causes were not determined. Circulating rumours talked about contamination of operating rooms, women doctors having ulterior motives and doing harm to pregnant women, polluted oxygen, among other things. The health department in Al-Samawah had to take unprecedented measures to address the problem and tackle the issue of financial and administrative corruption which many doctors talk about in different places, and which Al-Mada reported earlier.

To acquaint ourselves with the measures which the health department adopted in Al-Samawah, the biggest ever department in the governorate, we met with Dr Falih Abd-al-Husayn, director general of the health department in the governorate of al-Muthanna. This is what he said:

[Abd-al-Husayn] What happened was that three deaths occurred within one week for unknown causes. Hence, it was decided to stop all operations in the obstetric hospital in Al-Samawah. A committee was set up of various medical, engineering, environmental, anaesthetic, and technical experts. All medicines were checked and found valid. They all came from official sources. Al-Isma'iliyah company inspected all anaesthetic devices and found them compliant with specifications. Oxygen was found 99 per cent pure. Smears and samples were collected from operating rooms and tested in the public health laboratory. All devices were found valid and free of contamination. We reached the conviction that the problem may have to do with the physician or the patient. Therefore, an investigation committee was set up to determine the scientific cause of death in each individual case.

It turned out that the cause of death was different in each case. A patient stayed for six hours in the operating room with her obstetrician and a urinary tract specialist. That specific case showed the complexity of multiple surgeries in a hysterectomy case. Unfortunately the patient died.

To determine the cause of the second death, an autopsy was conducted on the body and samples were taken for tests. Results were identical [with expectations?]. Investigation is still under way with a woman doctor who caused death in the third case.

[Al-Mada] What did you do about administrative and medical violations?

[Abd-al-Husayn] We decided not to keep any bad element in an administrative post. A committee was set up inside the hospital to assess and prepare operations, determine how badly the patients needed them, and to ensure compliance with scientific criteria. The hospital is monitored constantly. We have not overcome the problems, although their rates have dropped. We also transferred some employees for bad conduct and issued punitive measures against some people, including doctors.

[Al-Mada] But bribery continues, and so does extortion.

[Abd-al-Husayn] I heard about that. I made my utmost to know the people involved to punish them. I believe that they are very few.

[Al-Mada] Some employees and doctors accuse the department of spending millions of dinars without achieving any positive result. This is administrative corruption. What is your comment?

[Abd-al-Husayn] Between the time I took office as director general in the health department in early 2005 and until mid-May there was no financial allocation for the department apart from salaries. When the department buys material and conducts repairs, it does that with a personal guarantee, just as we do when we buy surgical threads and make emergency repairs on equipment.

[Al-Mada] What measures do you take to fight financial and administrative corruption?

[Abd-al-Husayn] Financial corruption has become a serious disease in the Iraqi body. As far as the department is concerned, we developed a new spending mechanism by setting up a central purchasing committee made up of persons known for their clean- handedness. We also set up a main repair committee for all hospitals and health centres. Purchasing committees were also set up in hospitals. They are entrusted with repairs and simple purchases. They get a monthly loan of 1 million dinars. Each centre is allocated 150,000 dinars for overhead expenses according to specific spending disciplines. These committees are subjected to auditioning almost weekly.

The funds were approved by the ministries of health and finance. Purchasing lists concentrate on patient service and not on luxury issues. They involve bed spreads, sterilization, and air freshening.

Speaking of developments and of the role the Japanese forces played in supporting the health establishment in Al-Muthanna, Dr Falih Abd-al-Husayn said: We focused on centres that offer primary health care. We requested the Japanese forces to provide the necessary medical equipment and signed an 8m dollar contract to equip 32 health centres with ultra sound devices, laboratory and dental equipment, obstetric devices, and emergency instruments.

We hope to receive the equipment in early November. To put these devices in suitable places, we asked the Japanese to rehabilitate the centres. We started a full rehabilitation and reconstruction plan. Work is still under way in centres like Al-Thuwwar, Al-Najmi, Al-Suwayr, Al-Haydariyah, Al-Majd, Al-Istiqlal, Al Abas, Al-Sadiq, Al-Hasanayn, and Al-Warka. Parts of these centres were completed and the rest is under construction. There are future plans to turn these centres into mini hospitals to ease the burden on main hospitals.

Abd-al-Husayn added: The emergency aid centre was inaugurated and we received 32 ambulances from the Japanese and distributed them on hospitals and health centres. We also received several sophisticated medical equipment, some of which are rare, such as the laser device for examining and treating the retina, a tri-purpose speculum for examining bowls, stomach, and lungs, a stress test device, and a device for examining the thyroid glands. There are many other important devices, such as mobile x-ray machines, ECG devices, and blood cell separators. We signed a contract with the Japanese side to equip specialized centres with medical equipment, such as the asthma, allergy, teeth, chest diseases and general hygiene centres.

He affirmed that the department purchased 100 beds, 50 cars for transporting patients, and wheelchairs. During a visit to Al- Samawah, the health minister recommended the allocation of 625m dinars to building a residence for doctors in Al-Samawah and setting up an emergency and consultation centre in Al-Rumaythah hospital.

Source: BBC Monitoring Middle East

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