The cure is finding the cause

THE "old" Klang District Hospital near Istana Alam Shah was a place one would send his enemies to in case of an emergency. It was under-staffed, over-crowded and the facilities were wanting.

Over the years, it made headlines for all the wrong reasons including the delivery of a baby in a garage meant for ambulances. Things were so bad that the late Sultan Abdul Aziz Shah made periodic visits to the hospital, unannounced to check on the conditions there. On each visit, I would find myself there and hear the dressing down he gave the hospital director. It was the Sultan’s concerted effort that brought about the brand new hospital in Jalan Banting in the eighties. Its status was upgraded and it is now called the Hospital Tengku Ampuan Rahimah, named after the Sultan’s wife.

Even after becoming a "general hospital", it continued making news for wrong amputations and for plaster casts on the wrong leg. While all these were "visible" actions, Malaysians were given an insight into the ills and the shortcomings of what goes on behind the scenes.

Last week, at the inquest into the death of K. Sujatha, two doctors testified that they could not confirm what actually happened to the samples taken from the actress. First, Dr Vengkata Prathab said he ordered samples of blood, urine and gastric lavage to be taken from the actress on the first day she was warded at the hospital’s emergency ward on June 19, 2007.

"I had ordered these samples to be taken immediately after she arrived at the emergency ward. However, doctors who treated her at the normal ward did not receive the report on the tests," he was quoted as telling the inquest.

The results of the samples, he said, were crucial to conclude conclusively that the patient died due to poisoning. It was not an isolated case either. Dr Prathab told the coroner that personally, he had a bad experience when samples taken from his mother were also reported missing.

Medical officer Dr Lim Ai Wei testified that she had taken urine samples of Sujatha to check for traces of paraquat. "When I failed to receive the result, the following day, I personally went to the lab (laboratory) to check what had happened. But staff at the lab claimed that they did not receive the sample from the ward where Sujatha was treated," she explained.

The doctor testified that she was instructed by another doctor, Dr S.P. Sakthiveloo not to ask Sujatha about her last period or whether she was pregnant, in order to complete the required documentation.

But Dr Prathab put a caveat: Although such cases occurred occasionally, doctors should not be singled out for blame as it involved several departments of the hospital. So, while we cannot blame the doctors whose primary aim is to alleviate pain and save lives, who is to blame for the missing samples?

The case of missing samples would have been dismissed as yet another routine happening in the hospital but it underscores a major flaw in the administration. What happens when a doctor reports a major shortcoming in the system? Is action taken to trace the source of the fault or is it treated just as "another" event which no one should be bothered about?

Herein lies the Malaysian malaise of sweeping everything under the carpet as if the problem never occurred. Herein lie the symptoms of what goes on in most government departments. Herein lies the apathy and the tidak apa attitude of those charged with running the hospital.

Was there an inquiry into the missing samples? While doctors who had no hand in the missing samples face the firing squad when examined and cross-examined, those responsible for the loss twiddle their thumbs and mentally pray to the Almighty that they are not issued subpoenas to give testimony.

So, what is going to happen next? Is the hospital director going to wash his hands and say: "It does not matter anymore" or is he going to institute measures which will prevent a recurrence? Will he tell us of the procedures in place or will he remain silent and say it’s "under the Official Secrets Act"? Will those responsible for dereliction of their duties be pulled up or will they be told to be "more careful in future"?

Your guess is as good as mine.