jeudi 15 avril 2010

Lessons From The Tragedy Of Rodyanne’s And Her Unborn Twin Babies’ Deaths

21-year old Mrs Rodyanne Elizabeth–Fred, in her 38th week of pregnancy, died at the Seychelles Victoria Hospital’s Intensive Care Unit on New Year’s Day 2010, along with her unborn 2.6kg and 2.7kg twins.
An inquiry into the circumstances of this tragedy was called by the President and the One-Man Inquiry Commission report by former Attorney General A. Fernando, found that the deaths were the direct result of professional to high professional negligence by the personnel of the Ministry of Health.

In going through the report (http://www.statehouse.gov.sc/index.php
?option=com_filecabinet&task=download&cid[0]=60&item=74) I could not help but feel what must have been the utter despair, and painful realisation of Mrs Fred’s family that over 11 days from 20th December 2009, they were helpless spectators as their beloved daughter, sister and wife Rodyanne in obvious distress, and her babies, slipped away from them while under the care of our national health service.

The report obviously had no business to go into the blunted trust of the family, nor into the matter of those other sudden deaths, in or outside the health service, that have gone by unexplained and un-inquired.
As with all investigations, it did however provide pointers to how similar tragedies could be avoided, if we have the heart and will to take decisive action on its findings and recommendations. For Rodyanne’s and her baby twins’ deaths not to have been just a singled out case for a commission of inquiry, we will need to move far away from that presidential office shelf that is the fate of all such inquiries and reports.

Firstly, there is the matter of Responsibility for Negligence.

Professional Negligence having been confirmed, it would be most unprofessional and an invitation to future tragedies, to let this go by without taking firm steps to root it out.
Doctors, Obstetricians, Anaesthetists, Nurses, Midwives, Engineers were found to have singly and collectively erred in doing what we expected their training and experience demand of them, though I am certain none of them deliberately took the option to ignore Mrs Rodyanne’s many and repeated complaints and let her babies slip into death..
This failure was compounded by the lack of clearly-spelt-out patient-diagnostic and follow-through medical intervention procedures, a negligence which can only be laid at the doors of those responsible for running the system.
Both the professionals and the system seem guilty of complacency.
How strong is our will to go into the structural and operational details of our free national health service to cauterise this sore of complacency? How prepared are we to invest in giving ourselves the required resources (personnel, training, equipment, procedural codes, etc) that would clearly point to health service as our top priority over, for example, maintaining a national, armed military force?

Then there is the matter of Respect for Life as embodied in our 1993 Constitutional Bill of Rights. This raises two issues, to do with on the one hand, the rights of the unborn and on the other, on the need for investigation into any Life that ends suddenly.

As regards to the unborn twin babies who died with their mother, chapter 19 of the report could have perhaps restricted itself to establishing their status as persons with the right to life, as provided for under the laws of Seychelles.
It’s all very well to seek to place our laws in the context of international conventions, but how the heck are we to interpret, let alone apply, what goes on in Peru, Hungary, USA, UK, Africa, etc, unless there have been specific provisions incorporating these legal decisions, applications and ideals in our national statutes ?.
That the former Attorney General saw the need to argue lengthily on this simple matter of establishing the Seychellois unborn baby’s right to life would seem to indicate that, along with the founding fathers of the 3rd Republic, we all missed out on an essential definition of the scope and extent of our Constitutional Bill of Rights.
At this time of Constitutional Review, maybe this is yet another blurred area that we must bring into sharper focus to clearly spell out both what we define to be a person as well as when we demand respect for a person’s right to life. In this, we should perhaps allow ourselves to be guided by the intent of the current pregnancy interruption regulations, which indicate the point beyond which any action or omission to prevent the foetus from being born should be no more no less than homicide!

As regards to the Inquiry Commission itself, it seemed to be a glaring demonstration of the saying “missing the forest for the trees”.
The Inquiry Commission into that single tragedy clearly showed that we must not allow any single death to go by without a thorough investigation into the circumstances, including the eventual contributory actions or omissions of persons, leading to it.
The One-Man-Inquiry Commission, whatever its merits, seems to stumble over its own feet in so far as it seeks to impose the perception of an authority it does not really have because we have unfortunately grown to forgo the requirement of formal enquiry into sudden deaths. That’s where the trees hide the forest. The One-man Commission was being made to enquire into one tragedy, singled at the discretion of the President, among several others that went largely unnoticed.!!

At this time of Constitutional Review, we must retrieve the spirit of the Hon. MNA Anthony Derjacques’ recent motion to the National Assembly, for formal, public inquest into each and every sudden death in our land, with an authoritative body created for that specific purpose. This, rather than leaving this prerogative at the pleasure of the President, will be a better way to give substance to the respect for a person’ s life spelled out in our Constitution.
No one may die in our land without us all knowing why and how and without whoever be found responsible for causing the death, being called to account for his actions or omissions, in disregard to our Bill of Rights.

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