Death blow to immunisation programme

“To lose one... may be regarded as a misfortune; to lose both looks like carelessness.”
-Mark Twain, in ‘The Importance of Being Earnest’
In March this year, Peshala Hansini, a 12-year-old schoolgirl from Matara died following immunisation with the Rubella vaccine at a government clinic.

On that occasion, we wrote editorially that, “What all this suggests is that the Ministry of Healthcare & Nutrition is not in the best of health, and is, in fact, in need of urgent resuscitation...; yet, if this latest incident can contribute in any way towards reforming the mess that constitutes the Ministry of Healthcare & Nutrition, then little Peshala Hansini’s death would not be entirely in vain.”

Sadly, this week, we must record that Peshala Hansini’s death was, in fact, in vain. That is why 13-year-old Asanthi Vasana from Wariyapola had to pay with her life, after getting herself immunised against Rubella-again!
The Ministry of Health and its irrepressible and seemingly indispensable Minister, Nimal Siripala de Silva has promised a complete and independent inquiry, and doesn’t appear unduly perturbed, saying that, he cannot jump into conclusions about the incident just yet. And, for good measure, the Rubella immunisation programme has been suspended until further notice.

Sounds familiar? It should. This is the exact sequence of events that unfolded following Peshala Hansini’s death in March. And, for the record, what followed was that, after much publicity and the promised inquiry, the unsuspecting general public was assured that all was well with the Rubella vaccination programme which was resumed.

And, just to confound the issue even more, the Health Ministry, this week, initiated disciplinary action against the medical officer who administered the vaccine to Peshala Hansini seven months ago. Why nothing was done for seven months about this - if indeed the doctor was at fault - is a puzzle. Even more ‘curiouser and curiouser’ is that, disciplinary action followed soon after Asanthi Vasana’s death seven months later!
This latest death will no doubt deal a death blow to the national immunisation programme, as parents will no longer be reassured by the assurances provided by the Ministry. The danger of this is that, given the public’s now apprehensive mindset about immunisation, vaccination against other major illnesses will also be affected. This, if it is sustained over a period of time, could lead to many epidemics and disastrous consequences for the nation, especially its children.

But then, for the Ministry of Healthcare, Nutrition and Uva Wellassa Development, that would hardly matter, for this is only one more issue at its doorstep.
In 2005, three patients died following an outbreak of meningitis in mothers who had spinal anaesthesia for caesarean surgery. In that incident, syringes used at government hospitals were found to be contaminated, because they were stored in Ministry warehouses in less than satisfactory conditions. Last year, the Blood Bank was at the centre of a scandal, when it was alleged that expired kits were used on donors, thereby putting them at risk.

In the last few months itself, we had a raging dengue epidemic that claimed over 250 lives this year alone, and the good Minister’s comment was a lewd remark about mosquitoes being attracted to the exposed areas of skimpily clad women.

The Minister, when accused of mismanaging the dengue epidemic, boasted that it was not so, and that, he was successful in preventing an outbreak of swine flu in the country. Since then, the number of cases of swine flu in the country has risen to over a hundred, and a school closed this week as a result.
Also this week, President Mahinda Rajapaksa had to intervene personally, to resolve a dispute between doctors to get a kidney transplant centre up and running. The unit, built at a cost of millions of rupees, was lying idle, as the Minister and his officials were unable to break the deadlock for months.
All this poses the question as to whether it is ethically and morally correct to entrust the state of health of the nation to a group of people who are at best incompetent and at worst, corrupt and callous about the sufferings of their fellow countrymen.

Healthcare utilises a significant proportion of our Budget, and for long, Sri Lanka has taken pride in its free Healthcare system and in being among the healthier countries in the region, if not the world. Both politicians and public officials have a duty by the nation to protect that status, and if they are found wanting in that task, they should be held responsible and accountable for their lapses.

Thus far, despite the many shortcomings that have been glaringly exposed, this has not happened. In fact, most Health sector professionals yearn for the day when the sick giant that is the Ministry of Health will get the treatment it deserves, now hoping against that this would happen perhaps after a general election, when even seemingly indispensable politicians can be dispensed with.
Or else, we would have to tragically record some months later that even Asanthi Vasana died in vain.