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That was one great show

From the Management

Last month ADK celebrated its 25th Anniversary in healthcare. It was with immense pride and satisfaction that we passed a milestone in serving the people of Maldives. It is ADK Hospital’s vision to be the leading healthcare provider in the country and we now embark on addressing these challenges.

A number of events were carried out to celebrate the day. One initiative was to start a patient education program. Each patient who received services got a present along with it a set of messages on their rights and responsibilities when seeking care. The next step will be to develop a more comprehensive mechanism for patients to thoroughly understand and adhere to these rights and responsibilities as well as other desirable actions while in the care of medical professionals.

In addition, patient participation was a highlight of the day’s celebrations. Patients who utilize services were given the opportunity to inaugurate the new services and hence the relationship with the institute and its patients has been strengthened. It is the view or the Hospital that more often patients should be involved in such events.

The highlight of the celebrations was the Silver Jubilee Staff Night. The participation and enthusiasm of the staff was immense. The documentaries, dances, acts, commercial break and the fashion show all showed the amount of talent we have within ourselves. It was absolutely brilliant. The raffles were a major attraction too. Many expensive gifts were distributed and congratulations to all the lucky people who went away with the broadest of smiles and happiness.

Of course such an event could not have been possible without the effort of many and the sacrifices of many too. First, those who sacrificed while all other enjoyed are the heroes. They sat at the Hospital to ensure that services were not interrupted. The management’s heartfelt acknowledgement and thanks goes to that team. For all those who participated directly and indirectly in the event, it could not have been possible without your efforts and we appreciate and acknowledge your enthusiasm. We wish to thank, the caterers, Juwey’s Café’ and Buruzu Catering for the excellent food and services, AKASAKA band for their performance, Think Associate for their decorations and event management, So Cute for the photography and videography and all the sponsors who provided the prizes for the raffle winners.

The best thing was that everyone took part in one way or the other. The staff got a night to remember and proved to be a motivational factor for their continued contribution to the institute. We wish to continue the success we have had and reach new heights in future. We also wish to have many more celebrations with the staff and continue to improve in what we do. We will remain a major healthcare stakeholder in the Maldives and keep caring for the people.

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Categories: Issue 25: Apr 12

Code of Professional Conduct

By: Afaal, MD

Patients are entitled to good doctors. Good doctors make the care of patients their first concern; they are competent, keep their knowledge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy and act with integrity.

According to the American Medical Association (AMA) the medical profession has subscribed to a body of ethical standards primarily for the benefit of the patients. As a member of the profession, any clinician should recognize responsibility first and foremost to the patients, and then to the society, other health professionals and to self. Along this ethical guidance, in many countries, codes of professional conduct are developed to ensure that beneficial practices are carried out across all practitioners.

The Code describes what is expected of all doctors. It sets out the principles that characterize good medical practice and the standards of ethical and professional conduct are made more explicit. In countries where there is high compliance to these standards, well-established legal and regulatory mechanisms in healthcare are also in place.

Irrespective of the existence of such a code or legal framework, clinicians already, historically, take an oath, the Hippocratic oath to do no harm. This of course could be the basis of the modern developments.

I will prescribe regimes for the good of my patients according to my ability and my judgement and never do harm to anyone. (part of the Hippocratic oath, 12th century)

So the patient is at the forefront even then. And today, the new versions of the oath and standards and guidelines all revolve around the patient.

Coming to a state where there is minimal medical regulations and literally no laws to govern the profession and its practice, in the Maldives, the need for these developments are immense. Indeed, professionals, institutions and individuals can take initiatives to change the existing culture. It is very easy to declare that nothing is there, but to put an effort to develop proper Codes is what is needed. Of course, the legal process of a healthcare act is on the bench, but when these legal frameworks are made, the sensitivities and specificities of the community in which it will be practiced will also have to be looked into. Such regulations and legislation should aim to mutually protect both the patient and the provider.

In the Maldives, the change process can happen concurrently. While the Laws are being developed, guidelines and codes can also be developed. The Maldives Medical Council and the healthcare providers together can play an important role to ensure that these practices are made the norm in the country.

Here at ADK Hospital, we believe that we cannot wait hoping that these documents and practices will be developed, but rather, we believe that we can we can set these standards in the country. It is with this aim, the Hospital has developed a Code of Professional Conduct that has been issued and put to practice at the Hospital. The standards in the Code sets out principles in relation to a practitioner’s

  • Clinical competence and performance
  • Professional and ethical obligations
  • Relationships with colleagues and
  • Probity in professional practice

It is now expected that all doctors practicing in the Hospital to follow this code. This will also be used as part of the performance assessment of clinicians in the future.

It is noteworthy that this code was developed based on a set of guidelines adapted from the Australian and New Zealand Codes with the permission from the Australian Medical Council, the New South Wales Medical Board and the Medical Council of New Zealand.

Categories: Issue 25: Apr 12

Assault on healthcare professionals must be stopped at all cost!

By: Dr. Jamsheed

Way back in 2004 or 2005, we started witnessing the first obvious increase in the assaults on health professionals. I remember talking about this on a Television Maldives live forum where I urged the government to take it seriously and stop it before it gets out of control, and we find ourselves with insufficient professionals to continue with health services. What we were seeing back then was more of verbal abuses with very few physical assaults. Failure to take measures to prevent it have indeed led to the pathetic situation of today, where there is more of physical and sexual assaults than verbal! Not to say that verbal assault is justifiable, but the gravity of the matter has taken us to a point where there is very real and imminent threat on the continuity of healthcare service in the Maldives.

Maldives is a country, which depends heavily on expatriate health professionals (doctors, nurses and paramedical staff) who will not work here unless they find working in the Maldives attractive and pleasant. We all have to understand that we will not be able to continue the health services without them and that is a reality whether we like it or not. This reality is going to remain with us for a long time, perhaps for generations.

Health professional’s market is becoming very competitive with abundant job opportunities. Where there is enough and attractive jobs at home, people would usually not work elsewhere, unless the benefits are really high. If you can remember, we had a lot of Sri Lankan doctors in the Maldives, but I don’t think you will find a single one now. The reason simply is that they got relatively more attractive jobs back home (a similar scenario is slowly emerging in India as well), so nobody would prefer to come and work here. Of course, there are Sri Lankan doctors working in the developed world, where it is much more attractive than their home country. Can we offer such benefits, even in monetary terms, let alone all the other benefits and social harmony? The answer is NO.

Health professionals in the country are in constant fear: at work, on the streets and at home. Nobody is there to protect them. Law and order have failed pathetically and in many places it is worse than the law of the jungle! People who are working for us, trying to do what they can in resource-limited settings are being gang raped, beaten up, robbed and abused. The law enforcement authorities have failed to ensure the safety of law-abiding citizens and expatriates making the Maldives a safe haven for criminals.

Several expatriate health professionals have left the country for fear of their own safety and many more will leave if this continues. Not even the community has been able to provide security to these helpless people in a foreign soil. Ironically, when they leave under such fears, the same community stands up against the government or service provider for the disruption of services!

We are not rich enough to offer higher or competitive salaries; we don’t have equipped facilities for health professionals to work; we don’t have an environment for them to learn and grow professionally; there is no workplace safety; there is no security at work or in the society or at home; we don’t have the decency to treat people working for us as humans; we are silent to injustice, and vocal and even aggressive with our demands; we don’t even respect the basic human rights of ‘others’ and still we want them to treat us like respect and serve us as if we are kings! WAKE UP MALDIVES!

Categories: Issue 25: Apr 12

A bit of re-use: injection vials in tourist shops

Everyday hospitals give a large number of injections to patients. The empty vials are all thrown away or incinerated. In this age of environmental awareness, it is always a though in everyone’s mind to go green in everything they do. With a bit of innovative thinking, the empty injection vial is no exception.

Thousands of emptied injection vials now play an important role in the tourism industry. Many of this waste are re-used to produce attractive souvenirs that are in abundance at the local tourist shops in Male’. The attractive little bit of white sand and a couple of shells with a nice glass drawing on the outside don’t make these bottles look anything like the waste we produce. It is just such a beautiful piece of art work that tourist proudly buy and take home to their sitting rooms elsewhere in the world or as presents for their family and friends.

With a bit of innovation, it would be possible to find many other waste materials that could be recycled or reused from hospital waste. An effort should be put to identify and make use of such instance productively.

What is certain is that in the case of injection vials, it is a win-win situation both for the Hospital and also for the tourism industry. Indeed this is another way to contribute to the tourism industry from a hospital other than treating patients.

Categories: Issue 25: Apr 12

Alignments with a new OPD protocol

By: Afaal, MD

Continuous efforts to orient our services and care to a patient centred one, the Hospital has issues a new protocol on its out patient processes. The purpose of the protocol is to ensure that patients who seek out patient consultations at ADK Hospital get an adequate and quality care during their visit to the Hospital.

It is envisaged that by implementing this protocol, the hospital can establish a consistent and cohesive process the will help the OPD’s to perform smoothly. In the meantime, the protocol will also help doctors to spend a reasonable time with the patient to ensure better and quality care to the patient.

The main areas that the protocol address are

  • Consultations: The aim of this area is to ensure proper and adequate assessment of the patient and understanding the patients’ problem fully before so that a proper and sound treatment regime can be prescribed to the patient.
  • Medications and investigations: This area aims to ensure rational use of medications and investigations as well as other diagnostics.
  • Patient privacy: aims to ensure that patients are confortable and confident that their privacy and confidentiality will be maintained when they consult a doctor.
  • Recording: aims to ensure that proper medical information is collected and kept in order to provide adequate information for the continuity of patient care in future.

Apart from the above core areas, other areas such as patient load benchmarks, break timings and attending to emergencies as well as issuing of certificates and documentations are covered in the protocol.

It is important that these protocols are adhered to at all times. These protocols will only help to improve the way we do things and move towards a better position in what we do.

Any change will have adjustments that are required to make it perfect. There will be close monitoring of the implementation and the staff should get fully aware and aligned to these provisions so that it serves the purpose it was implemented for.

Categories: Issue 25: Apr 12