By Kumudini Hettiarachchi
Dead at 22. Baby Bimsara, just 54 days old, in a country that boasts
of having a maternal mortality rate equal to Britain – 50
deaths per 100,000 deliveries -- is motherless.
young woman in the prime of her life with no major illnesses has
a baby through a caesarean section and just over six weeks later
is dead. The funeral of pretty and versatile Shiromi Kumari who
died last Sunday, August 7, was on Wednesday at Pahala Bomiriya
in Kaduwela, with grief-stricken relatives and friends still in
it a death in isolation? Unfortunately not……….
another young woman from Ganemulla is also dead while four more
mothers are engaged in a grim battle with death at the Institute
of Neurology, Colombo National Hospital. Five of the mothers had
undergone C-sections at the De Soysa Hospital for Women and the
other at the Castle Street Women’s Hospital. The cause is
widely believed to be meningitis, with the germs entering the patients’
bodies when they were given spinal anaesthesia for the caesarean
operation. (See box)
June 22, for Shiromi and her family was a special day. In addition
to getting their brand new baby, Shiromi was overjoyed – where
earlier the scans had indicated that it would be a girl, the baby
turned out to be a boy, what she had longed for in her heart of
was an operation. But she was conscious throughout the whole thing,”
says husband Upendra Indrajith (30), adding that Shiromi “took
bad” on June 20 and they rushed her to the De Soysa Hospital,
with the already-packed suitcase full of nappies, little pillowcases
and sheets that mother and grandmother so lovingly collected.
baby was born at 6 in the evening of June 22. And Bimsara Bhashitha
Nethmanika was Shiromi’s choice of name for the beautiful
baby boy whom she held close all the time. Though suffering from
a headache on and off, fever and also back pain, Shiromi, assuming
it was “normal” after a caesar went home on June 25.
She had been told to come back on June 28 to get the stitches cut
and they dutifully returned and even complained that she was suffering
from “oluwe kekkuma, konde kekkuma and una”. But nothing
was wrong with the cut or the stitches.
being with the baby, many were the times Shiromi told her mother
that the handahana indicated that the baby would grow up to be a
bright boy, little realising that he would have to do so without
the tender care and guidance of his mother. She believed she was
destined to teach him, for she too was a talented woman. Fluent
in all three languages, Sinhala, Tamil and English, she was not
only a daham pasal teacher but had also passed the public service
examination for clerks and was computer savvy, securing a job in
the internal audit section of the Samurdhi Authority.
satisfied with her qualifications she had also entered the Sri Jayewardenepura
University where she was a second-year undergrad in arts. An all-rounder
she was a good singer and could play the serpina. It was a year
ago, on July 22, that she tied the knot with Upendra, working as
a Samurdhi Development Officer.
July 2004 was ecstatic, this July brought only sorrow, heartache
and loneliness. For the threesome, Upendra, Shiromi and Bimsara,
July 2 dawned like any other day in a home where there is an infant.
The baby’s routine of sleeping and feeding taking priority
over all else. But that morning Shiromi couldn’t raise her
head. She was suffering from a severe headache and ran a fever of
102 F. “Her spine was hurting and she couldn’t move
her neck,” says Upendra who rushed her to a private hospital
where they suspected that “a germ had gone into her brain”.
They advised them either to enter that hospital or if they couldn’t
afford it to go back to De Soysa Hospital, where she had delivered
the baby. Both mother and baby son were then admitted back there.
From then started their agony of tests including spinal taps, more
tests, uncertainty and finally the transfer to the Institute of
Neurology, with Shiromi’s condition see-sawing, sometimes
giving hope to her loved ones and then dashing them to bits.
the while, parents, in-laws and husband were in and out of hospital
taking the food she liked to eat and coaxing her to take nutrition
to fight off the infection. One day she wanted cake. “She
loved chocolate cake,” says Upendra.
30, had seemed a turning point for Shiromi. When they went to see
her, she had been given a bath and her lovely long tresses were
loose. “Before that she was walking and talking,” says
mother D.H. Swarnalatha, looking at the tiny babe sleeping near
her on the bed and smiling in his dreams. Swarnalatha is numb with
shock and the tears come slowly at this unfathomable cruelty dealt
to their family.
the evening of July 31, however Shiromi was screaming in pain. “She
wanted me to hold the back of her head and press hard, saying that
it gave her relief,” weeps Chathurika, a childhood friend,
adding, “We were together from Grade 3.”
evening she was taken to the ICU and it broke her heart, for she
had to let go her baby. “She wouldn’t allow us to take
the baby. But after much persuasion she promised that she would
get well soon and come home. She hugged him and kissed his tiny
feet and begged me to look after him,” says Swarnalatha.
the baby close and let him feel your warmth,” she had urged
her husband many times. The family ticks off the days on the calendar
sadly. August 1 was the last they were able to feed her anything.
Her father fed her a couple of string-hoppers and she swallowed
with difficulty and her husband made her sip some milk tea. After
that tubes kept her alive.
to people in high places and bodhi poojas at various temples were
her frantic family’s answers to her deteriorating condition.
Nool bandinna thenak thibbe ne, chokes father J.D. Chandrasiri Piyadasa.
last time she was able to mumble a query was on August 4, when with
much difficulty she held Upendra’s hand tightly and inquired
after the baby. On August 7, Shiromi was dead.
is up to the health authorities to take urgent action on a priority
basis, on this life and death issue that has reached a critical
point, before another mother succumbs to a deadly germ, that the
hospitals are infecting healthy women with.
due to fungal meningitis
All medical supplies used for spinal anaesthesia such as needles,
syringes and the anaesthetic in recent times, have been removed
from the shelves of all government hospitals forthwith, assured
Director-General of Health Services Dr. Athula Kahandaliyanage explaining
that the common thread in all six cases seems to be that the mothers
have been given a spinal anaesthetic before the caesarean section.
emphasises that all possible investigations are being conducted
to identify the source of the infection that is believed to be fungal
meningitis. A decision has also been taken to minimise the administering
of spinal anaesthetics. “We can’t take a chance.”
six mothers were alright after the caesarean operations and most
went home but were readmitted with the infection, The Sunday Times
“The post-mortems on the two dead mothers have confirmed they
died of a fungal infection leading to meningitis. We don’t
know where the fungus came from and we are doing everything possible
to locate the infection,” says the DG.
and national agencies such as the Communicable Diseases Centre in
Atlanta and the Medical Research Institute (MRI) have been mobilised
to come up with answers, other health sources said. “Medical
stocks sent as tsunami relief are in circulation but there has been
no confirmation yet that they are the culprits. Samples from each
batch are being checked.”
Spinal anaesthesia is the common trend in caesarean sections and
considered safer than general anaesthesia. Under spinal anaesthesia,
the mother is conscious and the side-effects on both the mother
and the baby are minimal, it is understood.
the DG said that a meeting was held at the De Soysa Hospital on
Wednesday chaired by Health Minister Nimal Siripala de Silva and
attended by consultants from De Soysa, Castle Street and also the
National Hospitals along with officials of the CEB and CECB to take
some conclusive action against this threat.
of the operating theatre of De Soysa Hospital as of Wednesday as
there is an extensive leak from the toilets on the upper floor and
fungus has formed on the wall of the theatre.
operations at this hospital to be postponed while there will be
only minimal admissions.
of transfer of patients from other hospitals. Castle Street, Ragama
and Kalubowila will take the patients, the DG said.
old theatre of De Soysa Hospital to be repaired.
National Hospital to loan a theatre for De Soysa Hospital operations.
new seven-storey building being constructed at De Soysa Hospital
to accommodate the theatre and ICU on the upper five floors, with
the first two floors being earmarked for the premature baby unit.
State Pharmaceutical Corporation to replace all essential drugs
being taken off the shelf.
is no conclusive evidence of contamination to point a finger at
the donations of tsunami medical stocks,” says the DG stressing
that there has absolutely been no negligence on the part of the
staff at these hospitals. “They have performed their duties
well and continue to do so. This is purely accidental.”