Columns

• Amazing callous responses by Minister Keheliya and NMRA Chief 

HEALTH MINISTER: ‘There can be defects in 100k orders, this is normal’

After delivering a bold ultimatum last week in Parliament to his superiors that if the Treasury denies him the money to do his duties efficiently as Health Minister, he told the Daily Mirror on Tuesday: “We had a meeting with the officials of the Treasury on the day itself. As adequate funds have been allocated, there is no need for me to resign.”

But isn’t there? Or is he just a good-for-nothing bloke who, without a vast array of herbs and spices, lacks the ingenuity to turn out, with bare salt and pepper, nouvelle cuisine that makes the mouth water?

Like all bad workmen blame their tools for the shoddy jobs done, is he admitting he’s useless in a crisis and cannot make the best of what he’s got, unless a river of money is channeled his ministerial way for him to bathe and keep afloat? He hasn’t the fine art of a master chef to improvise and serve the best, only the menial drudgery of the humble cook, lost without his usual recipe flavourings.

If the rest of his cabinet colleagues had whistled the same tune, sung the same mournful dirge and despaired, bemoaned and threatened to give up their ministerial ghosts unless they, in an economy that has collapsed, are amply provided with funds to discharge their duties at the highest levels, it would leave the President marooned on the deck, to steer the ship of state alone, bereft of first deck mates.

No one expects miracles from Keheliya Rambukwella, with or without money, to get the Health Service out of the soup, but is it too much to ask of him to ensure that even the few drugs available at governmental hospitals are of sound quality, free from defects and can safely be administered to patients and will not result in their deaths?

Apparently not. There’s a special karmic force in the fall of a sparrow. The blame lies not in his actions or negligence but in the patient’s stars.

Consider this.

Questions were raised last week about the mystery deaths of two women at the Peradeniya Teaching Hospital within the last three months. A pregnant mother of two had died while undergoing a caesarian operation on April 2. It was alleged that she had died after being given the Indian-made hydrochloride dextrose anesthetic drug.

Her mother, cradling the newborn infant on her lap, told Sirasa reporters that the doctor at the hospital had told her that her daughter’s death was not due to the doctors’ fault. They had been supplied with an inferior defective drug purchased by the Health Ministry since it was Rs. 85 cheaper.

On June 15, a female principal, admitted for a hernia operation, had suffered the same sorry fate after being given the same anesthetic drug.

On April 8, the Health Ministry said it had sent a team of experts to securely fasten the stable door, and announced the immediate suspension of the defective anesthetic.

It also emerged last Thursday that the defective drug had been imported from a blacklisted Indian firm under the Indian credit line. It was further claimed that it had been imported using section 109 of the National Medicinal Regulatory Act.

Section 109 empowers the National Medicines Regulatory Authority (NMRA) to grant permission in an emergency and other special circumstances to import and supply a particular medicine on a request made by the Ministry of Health; or on a request made by an individual or an organisation recommended by the Ministry of Health.

Government Medical Laboratory Technologists Association president Ravi Kumudesh stressed that an investigation must be carried out into the report granted by the National Drug Quality Assurance Laboratory before the issuance of the drug in question. It is alleged that the report found the Indian-made anesthetic below US Food and Drug Administration standards.

In December last year, Health Minister Keheliya had flown to India to personally procure medicinal drugs from a blacklisted Indian company named Kausikh. In an unparalleled patriotic gesture in recent times, he had paid for the flight and his luxury hotel lodgings with his own funds. With Visa card limit, he had been unable to meet the hotel bill which amounted to US$ 1200 but luckily an Indian friend had lent him the money which he had now reimbursed.

This patriotic love for Lanka without noise, received an airing only when a political activist alleged ‘that the procurement was to take place in violation of procedures in place, and that Kaushik Pharmaceuticals was blacklisted by the State Pharmaceuticals Corporation; and the visit was sponsored by Kaushik Pharmaceuticals.’

SUSPICIOUS DEATH: 28-year-old pregnant mother of two

On his return, Keheliya held a press conference to defend his privately funded Indian sojourn.

The Sunday Times on January 1 reported the Minister’s explanation how he had been helped by his Indian friend to settle his hotel dues. The Minister admitted Kausikh was blacklisted but said, “thousand companies were blacklisted but when they lodge an appeal, they were usually reinstated. It wasn’t new.”

As to why he hadn’t gone at State expense but had flown and stayed at top luxury hotels out of his personal savings, Keheliya’s reply was: “Do I not have the right to use my own funds to inspect one or two of these factories?”

Yes, he certainly does. Shame to those who impute foul sinister motives to his silent act of secretly paying gratitude to the Lankan people for footing his Australian medical bills after his fall from a Melbourne hotel balcony in the midnight hours.

But private deeds to relieve one’s conscience apart, his callous reaction to the tragic deaths of the two women when the scandal broke out this month, threatened to swamp his unspoken sermon on gratitude.

Last week, he was asked by TV reporters whether he had procured the defective drugs from India. He flatly denied the allegations.

He then played the odds on the probability of deaths due to defective drugs and remorselessly told the astonished reporters that, “even when you bring down 100,000 America’s FDA-approved drugs, a few can turn out to be defective.”

On June 24, he strongly denied in Parliament that the anesthetic drug imported from India was linked to the deaths. He said initial investigations had revealed that the controversial medicine had been used on five patients, including the patient who was said to have died due to complications on the same day.

Playing Russian roulette to dice with death offers better odds: a 6/1 chance of beating the bullet. Government hospital 5/1.

The callous infection seems to be rife in the medical bureaucracy. The Chairman of the National Medicines Regularity Authority, Professor S. D. Jayaratne, held his own press conference last week.

Jayaratne, the 72-year-old Professor of Medicines, statutorily responsible to ensure that only the highest quality of medicinal drugs are imported to the island, shrugged off the charge that the Indian company was an unregistered body. “Whether registered or unregistered,” he declared, “has nothing to do with the final result.” And chuckling with complacent glee, he reminded us that death was the common fate of all mankind by referring us all to the Kisa Gotami story, which all Buddhists know by heart. (Please see Sunday Punch Ode)

It is from this profound enlightening tale that NMRA Chief Jayaratne draws inspiration to justify the squalid failures of the Health Ministry.  With an equanimous Dalai Lama smile, he says, getting his wires crossed and mistaking Kisa Gotami for some Amal Biso in the process, ‘this is the Amal Biso problem that is there, yes, the Amal Biso problem,’  And yet again, getting his duties mixed up with expediencies, says, “you can’t find a single house where there has been no death.”

With the Health Minister resorting to gauge his performance against the odds on human deaths and shrugging off defective drug deaths as ‘hard luck’ quirks of fate, it is sufficient reason for him to resign. A bankrupt nation cannot wait for manna to fall from heaven, and for its ministers to be deluged with gold before they can stir into action.

Arrogant tongue and insensitive heart cannot stand in for competence. While astute and diligent men will carve out their paths to reach their determined ends, the idlers will await the gravy train to hop a ride to wherever it takes.  Men who trivialise the sanctity of human life, and scornfully dismiss accidental or negligent hospital death as well within the statistical laws of probability, are unworthy to be in charge of the nation’s health.

And the NMRA Chairman, clinging on with dogmatic faith to his all-encompassing ‘Amal Biso’ fatalistic theory — that all deaths are preordained, and thus no matter the choice or actions pursued, it makes no difference –  should also follow suit for the good of the people’s health and calm of mind.

The Buddha didn’t expound a fatalistic theory of life. On the highest plane of human thought that man has ever ascended, he explained the why and the way out of sorrow, to gain liberation from man’s caged ignorance. And not once did he ask his disciples to stoically accept the inevitable decay and death of all conditioned things, but urged, with his last breath of life, to strive with diligence to transcend Maya’s world of deceptive illusions.

Sunday Punch OdeKisa Gotami’s mustard seed By Don Manu With a dead infant in her arms, and clothes in grief disarrayed, the wailing Kisa Gotama begs the Buddha to grant her child the gift of life. Knowing his refusal will drive her to the brinks of suicidal despair, and knowing too no sermon preached will soothe her wailing grief nor balm a heart distraught, the Buddha asks the grief-wracked Kisa Gotami to bring a single mustard seed from any home that never had known death, from any house that never had played host to the grim reaper’s scythe. KISA GOTAMI: ‘No mustard seed, no deathless home’ Street by street and house by house, She wonders through the city, She knocks on each and every door, But all she gets is pity, Till the truth finally dawned, Death is heir to all beings born *** When she returns, without her seed To revive her infant once more to bleed No mustard seed, no deathless home, She awakes to truth in Samsara’s tome *** Like night that grimly greets each morn, She knows all life await grave’s yawn. The truth beneath life’s smooth veneer: Gaunt sorrow’s shadow falls to life besmear

Govt doubles price of hopeNo one buys a sweep to enrich the nation’s coffers. Or to enable politicians to live out their rich lifestyles by skimming off the milk these cash cows generate by the bowser load. A sweep is a man’s witch’s broom to fly to wonderlands of dreams, his entry visa to a world unimaginable. His gateway pass from a valley of troubles to an affluent heaven in dreams. With only twenty bucks he buys his dreams to live immune to the horror of his strife.   With twenty bucks, the hope that springs eternal in the human breast gets reloaded to burst anew. With twenty rupees, he’s transported from sordid poverty’s miseries to an opulent world of a thousand delights. Hope that’s elusive in the miracle domes of mammon, concealed behind the mystic veils of illusions, is freely found on dusty pavements, hanging down from paper clips at lottery sellers’ kiosks, and blowing in the wind: the instant answer to their prayers for immediate relief from lasting pain and frustration. The fixed price for the pep-up sweep has been a constant twenty bucks. No more. From July 6, the price of hope — the cost of fleeting dreams — will be doubled. The Government’s two lottery boards announced last week that prices of sweep tickets will be doubled to Rs.40 each. And what will the punters get in return?  The jackpot doubled, the odds lessened? No way. The Government revealed by this unilateral act and giving nothing in return, its ruthless bent to squeeze the cornucopian udders of these cash cows, and milk them to death, if need be. But here it should tread warily. Hope’s the safety valve, hope’s the redeeming grace, hope that stops revolutions from exploding on the streets, for where there’s hope, there’s still the dream, and men denied hope have naught to live for, naught to pray for a better dawn to rise. But only a cause to die for, and a cause to war for, than live in hell without hope. The Government should tread with care, for it treads on the poor’s inspiring dreams. Doubling the cost of sweeps without doubling the jackpot dreams may, God forbid, turn out to be the last straw to make all hell break loose.