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• Experts full report into ‘allergy’ deaths suppressed by Health Ministry

It’s almost as if nothing seems to seep through in Parliament today, pumped up and buttressed by his own inviolate belief that he alone knows best what is right for the Ministry of Health and what the best drugs are to order for the people’s health

Had he been a mere backbencher none will deny his sovereign right to bathe in Narcissist streams and indulge in worship to his household god of arrogance. But as the Minister of Health, the right to pray at this shrine to himself to such ridiculous excess is a right that must be restrained in the infinitely transcending interest of the nation’s health.

These last two months have seen the tragic toll of the Health Ministry’s disastrous state under his charge. Death after death has been reported allegedly to defective drugs imported by his Ministry. His cold insensitive initial remark that when the ministry orders thousands of vials, some are inevitably bound to be defective, shocked the nation and stabbed the bleeding hearts of families still grieving their dead.

The victims had entered the hospitals for simple ops. For one, it had been for a dental root canal filling. For another, it had been to remove her hernia. For one, it had been for a lens replacement after a previous eye op had gone wrong. For a pregnant mother of two, it had been to deliver her third through caesarian. The list goes on and on.

But later, made aware that his defective drug excuse served only to turn the surgical knife towards himself, he began to turn the knife against the innocent victims and, claimed in Parliament, allergies personal to them were solely to blame for their deaths instead.

Take the case of 23-year-old Sandeepani. She was admitted to Peradeniya Teaching Hospital on July 11th morn suffering from a stomach infection. She died the same day after she received an antibiotic injection. Health Ministry Additional Secretary Dr. Saman Ratnayake told Daily Mirror that the postmortem had determined that the death of the girl had been caused due to anaphylactic shock, which is a rare but severe allergic reaction. But the magistrate has issued an open verdict. Her death is being probed.

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The Minister’s explanation is that such deaths are not due to defective drugs but due to an allergy suffered by the patients. But can the Minister rule out with any certainty that it is the defect in the drug that made the patients turn allergic to the drug, not to the drug itself?

With his proud image of infallibility chiseled chip by chip as news unfolded of the tragic deaths, Rambukwella, although it left untouched his steadfast faith and left his god of arrogance unscathed, acted swiftly, amid the mounting call for him to quit, to limit and control the damage spread; lest the expected fallout from these serial untimely deaths reduces to smithereens his egoistic idol self, and leave his self-exalted image to be trampled in the dust.

Three weeks ago, Rambukwella appointed his own handpicked bunch of experts with a string of impressive letters tailing their surnames to be his chosen jurymen to stand in judgment at his own much-hyped mock trial.

They will be asked to judge on the sole evidence that will be presented ex parte by his Ministry of Health; and to decide if the man who had hired their services – all personally lobbied on the phone and hired instantly, some even late night – was to be strictly blamed for defective drug deaths or if the patients’ own allergies were to blame.

Of course, for this vain exercise, the hefty dollar bill for their expensive fees will be met by the public purse, in the same way, ten years ago, the Lankan people footed his Australian medical bills after his fall from a Melbourne hotel balcony in the midnight hours.

This week his handpicked jurymen released their much-awaited Rambukwella ministerial lifeline. As all expected it echoed Rambukwella’s explanation that the hospital deaths were due to allergies. It made all blink how Rambukwella could have prognosed the cause of death along the same line as experts; and the wonder grew – and still the wonder grows – how the Minister’s small head could hold such a wealth of medical skills beneath his master chef ‘toque blanche’.

On August 9, the Ministry of Health’s communique stated; ‘The Expert Committee appointed to investigate into the recent incidences of drug allergies and their aftereffects has determined that five out of the recent six deaths were due to anaphylaxis, which is a life-threatening allergic reaction.’

It also listed twelve recommendations for the Ministry to follow. Amongst the basic simple safeguards they proposed for the medical staff to follow in emergencies, they urged the Ministry to strictly maintain the highest standards in the quality of drugs during registration. It said: ‘Stringent evaluation of the quality of medicines during registration and post-marketing quality testing of random samples is recommended to improve the quality of pharmaceuticals in the country’.

In the buffet spread of consultative opinions, you can pick and choose what best suits your customised diet. Amongst experts, differences of views are rife. It is the cut and thrust of puffed debate that spurs the advancement of medical frontiers.

But in this seemingly unanimous finding by his own jurymen, the full report of their investigations into the cause of ‘allergic’ deaths, has been withheld. The Ministry’s statement on the report says: ‘Due to Doctor-patient confidentiality, the full report has not been fully disclosed.’

Doctor-patient confidentiality? What doctor-patient confidentiality is there in an official postmortem report to determine the cause of mystery deaths? In fact, the families of the dead are demanding a full-scale investigation to determine why their loved ones died.

Or did these top experts evaluate Rambukwella’s own mental state for any narcissist traces of an unreasonably high degree of self-importance? If so, understandably, the report deserves a doctor-patient confidential tag. If not, it’s funny why a few excerpts on him receiving absolution are disclosed but reasons for the jury dispensation remain undisclosed.

But the ‘defective drugs’ allegation is not the only charge he faced. Away from his committee’s brief to probe his ministry’s state of affairs, a sea of charges rage against the health service he runs as his sole personal domain.

For instance, section 109 of the NMRA Act 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.

But last week, former Minister of Health Dr. Rajitha Senaratne charged that this section has unduly been exploited by Health Minister Rambukwella who, since last year, has arrogated to himself the power to divine alone the suitability of drugs to be imported and used in state hospitals.

Dr. Senaratne said: ‘This exception in the Act existed during my time too, but we did not follow an ad-hoc policy and rubber stamp any request made. We formed a set of guidelines for the Committee to follow when approving emergency drugs. These guidelines were followed even during Gotabaya’s time. In 2020, out of 413 requests made for approval, 185 were approved, 183 were rejected. In 2021, there had been 338 requests but only 93 had been approved and 208 had been rejected.

‘But in June last year’ Dr. Rajitha Senaratne continued, ‘these guidelines were dumped and a new system was introduced. It was called ‘Special Pathway’, which paved the way for the Health Minister to be the judge and bypass the need for the committee’s basic checklist to be ticked off. The minister could order and approve whatever drug he wished. In 2022, that’s last year, 362 requests had been approved. This year, upto now, out of 55 requests for drug approval, 54 have been approved. This information is from the reports submitted by the NMRA to Parliament.’

It blows your mind, doesn’t it? What nerve! It boggles the mind to think of the sheer audacity that the SLPP’s Health Minister, the Honourable Rambukwella, must abundantly possess to dare presume he’s aptly qualified in the medical field, and thus fit to prescribe the drugs to cure the nation’s sick.

When one learns that his strengths lie in another field, in culinary arts he had learnt in youth in kitchens at the Hotel School and that he hasn’t the foggiest of pharmacology nor a clue of biology or nothing at all of the study of anatomy, one’s mind turns to a quivering mass of cold jelly on discovering, the man appointed since last June is a round peg in a square hole, a dangerous misfit for medicine’s hot seat.

But does that bother Minister Rambukwella? Not in the least. His arrogance provides him with his sword of attack and steels his shield for his defence.

It is this boldness that perhaps inspired and incentivised him to leave the beaten track and furrow his own ‘special pathway’ to Chennai in December last year in a quest to bring home the drugs from India’s drug companies to cure the nation’s sick.

What’s more – ah, see the brimming patriotism in the Health Minister – he didn’t claim his expenses for the trip from Governmental funds though it was an official visit but instead spent from his own pocket the cost of his airfare and stay at a plush 5-star hotel. He ran into a problem with his final hotel bill but an unnamed Indian friend helped him to settle the bill. But didn’t breathe a word of it nor claim reimbursement from state coffers but kept it secret sans a noise. He later said he had repaid the loan.

Nor did he take a single official to give or ask advice but went alone on his solitary quest for the drugs that would cure the people back at home. He didn’t need an entourage to help him choose and decide. He picked and chose, he bought the drugs, he sealed the deal for he was sole authority, a one-man show, the Lankan Czar of the medical field, and what he chose and what he bought, and what was finally decided on, none had the right to question why for he was lord and master of them all.

At a press conference held to quell the rumour that an Indian drug company had paid for his hush trip and stay, he was forced to reveal how he had come a cropper with his Visa card and had to ask an Indian he knew to pay his luxury hotel bill. It was alleged by a political activist, present at the conference, that the procurement was to take place in violation of procedures in place, and that Kaushik Pharmaceuticals was blacklisted by the State Pharmaceuticals Corporation.

Rambukwella admitted the company was blacklisted but shrugged it off saying that would be no bar. He said that many companies were blacklisted but when they appeal, they remove the blacklisting.

This statement does reveal how stringent measures taken in the past are swiftly taken off at ministerial whim and fancy. As a result, within one year of Rambukwella rule, the Ministry of Health is in a pathetic state of total disarray. To cap it all, how just ironic to find Rambukwella, who said in a TV talk show last month that he gets his own medicines prescribed for him by the staff at his ministry, should be prescribing the drugs all of Lanka have to take.

The arrogance with which he runs his ministry ascended another plane last month. In an effort to ban his staff from talking to the media, he gagged them with the book of rules, threatened the sack if they do, padlocked their lips and put the key in his hip pocket. He had the executive staff fingerprinted for a new marking of the roll system. He runs a tight ship no doubt where all can only listen to their master’s voice.

How long before he gets his comeuppance?

Earlier this week he trooped in with a battalion from his health ministry for his news conference. He said: ‘My wife and my daughter are asking me to resign but I won’t.’

It seems his arrogance insists he stays. How long before his tragic flaw devours him and ends the farce?

Will Nemesis arrive in Parliament when the delayed no-confidence resolution is taken up in September first week in cooler climes when the heat has worn off? Unlikely. And quite unnecessary. His nemesis is already on his doorstep.

With wife and daughter joining the nation’s chorus, he is in the line of family fire. The ultimate no-confidence motion has been signed sealed and successfully passed right in his home and heart. The writing on his residential wall beseeching him to go, must now appear writ large.

His loving family asks him to go for his own good and health. Likewise, the nation calls for his resignation for its own good and health.