16th January 2000

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The blood feud

By Faraza Farook

A blood feud has erupted over the controversy where the Blood Bank director is under fire for seeking an explanation from a medical officer who broke regulations in providing blood for President Kumaraunga after the bomb attack on her.

Trade unions and political organisations joined the controversy yesterday by issuing statements condemning Blood Bank Director Dr. Ranjani Bindusara's action while plans were underway by pro-government groups to organise blood donation programmes.

Minister Alavi Moulana who heads the trade union wing of the ruling SLFP said the blood bank chief's action amounted to bureaucratic sabotage during a national emergency.

The SLFP affiliated Sri Lanka Independent Medical Organisation also condemned Dr. Bindusara's action saying it was a threat to any officer who went beyond regulations and responded to the call of duty.

The main allegation against the director has been that she acted insensitively when she called for an explanation from Dr. Athula Wijesundara who took 10 units of blood for the President without informing his superiors or filling the required forms.

Dr. Bindusara has strongly denied any ulterior motive and said she was only following routine administrative procedures. She said she had in no way tried to block the blood being sent to President Kumaratunga at the Nawaloka hospital.

Allegations have been made that Dr. Bindusara's husband was a UNP Pradeshiya Sabha member, but she says he is an owner of a Tea factory in Matale while his brother A. Bindusara was an organiser of the SLFP in Rattota.

The main medical union the GMOA has also got involved in the controversy by issuing a strongly worded statement condemning the blood bank directors action against Dr. Athula Wijesundara, who is the GMOA Blood Bank branch Secretary.

The GMOA has warned it would take trade union action if disciplinary action was taken against Dr. Wijesundara.

Responding to this Dr. Bindusara said she believed the GMOA action could be linked to her refusal to take part in a big strike called by the GMOA last month.

Meanwhile the Ministry of Health is also holding an inquiry on the dispute and a report is expected tomorrow, Secretary C. Abeygunew-ardene said.

Bad blood from GMOA and state media

Blood Bank director Dr. Ranjini Bindusara, outlining the sequence of events that led to the feud said:

"When I heard of the Town Hall bombing on December 18, I rushed to the Blood Bank at the Accident Service of the National Hospital to check on supplies and work out the emergency arrangements.

"I made inquiries as to where the President was and the staff told me she had been taken to Nawaloka.

"On arrival at the CBB I found that Dr. Athula Wijesundara had already taken 18 units of blood to Nawaloka hospital

"I was told by the nursing staff that this blood taken by Dr. Wijesundara was notcrossmatched group B positive.

"The usual procedure is for a sample of the patient's blood to be brought to the Blood Bank so that a quick matching process could be undertaken to ensure that the exact blood group is released. If, on the other hand, a sample of the patient's blood is not available, O positive packed blood is released because that is the blood group to give any patient if the patient's sample of blood is not produced to the Blood Bank.

"There had been several cases in our experience where human error by doctors had taken place in obtaining the wrong blood group from the blood bank. I then contacted Dr. Wijesundara at Nawaloka over the phone and his exact reply was as follows :

" I am with the President personally attending to her. She is out of danger and talking to me. She does not need a blood transfusion. Please don't disturb me".

"The purpose of my contacting Dr. Wijesundara was to inquire whether further blood was necessary, and if so, to organise immediately a mobile blood donation.

"On Monday December 20 I was informed by my staff that no formal requisition documents were processed for the release of blood. I requested Dr. Wijesundara to regularise this by asking him to obtain a request form from Nawaloka hospital.

"I never asked him for his explanation as the state media tried to portray. I have not taken any disciplinary action as to transfer him or remove his name from the roster as stated by Dr. Wijesundara. As a public servant I adhere to regulations.

"I have not found fault with Dr. Wijesundara except that by not adhering to normal procedures in the release of blood units which all the blood bank systems follow (American Association of Blood Banks) to prevent serious consequences. I have experience in the wrong blood groups being released, which has resulted in deaths. Therefore I had reason to be concerned about the release of blood without being crossmatched. Blood request forms for any patient who requires blood transfusion is essential, not only to find the correct blood, but also to trace any diseases transmitted through blood at a latter stage.

"I was one of the administrators who did not join the GMOA strike because my conscience did not allow me to do so at a time of war. I find that I am now being vilified by both the state media and the GMOA for doing my job according to my conscience."

Too much blood is dangerous says ex director

Medical specialist and former Health Director Dr.. Kinglsey Heendeniya who was the medical officer on duty when S.W.R.D. Bandaranaike was shot in 1959, has explained the risk of doctors being over enthusiastic when treating VIPs.

In the case of Mr. Bandaranaike, he said, too much blood was transfused which probably could have caused his death.

"When VIPs are sick, they run the risk of fatal over treatment by doctors," Dr. Heendeniya said in a statement which was faxed to the president.

Dr. Heendeniya has served as a Lecturer at the Peradeniya and Colombo Universities and a Consultant at the Commonwealth Secretariat in London among other posts.

Commenting on certain matters in the current controversy he said: "Dr. Chandima de Mel had no authority to order blood as he did. Blood is never issued without direct testing of donor blood on a sample of recipient blood, except when Group O blood is given in an emergency, awaiting blood typing.

Dr. de Mel issued a receipt for 18 units of blood on December 20 on Nawaloka hospital paper (after the President had left the hospital). Dr. Heendeniya also said 18 units of blood was an unusually large quantity. He questioned if the blood was ordered by the team of doctors attending on the President and if Dr. Wijesundara was part of the team.

"I was the medical officer on duty on the day Chandrika's father was shot. He was blood group B. We were very short of this group that day. Urgent radio announcements brought a flood of donors. Those days, we paid 10 rupees to a donor.

"That day, no one wanted money. We seized the opportunity and bled everyone whether group B or otherwise! Too much blood was transfused to the premier (which probably caused his death) When very important persons are sick, they run the risk of fatal over treatment by doctors," he said.

I did it in the national interest

Dr. Athula Wijesundara in the centre of controversy for obtaining blood from the Central Blood Bank for any transfusion required for surgery on the President after the December 18 bomb blast, says he acted in the national interest at a time of emergency and he did not check the blood sample because he knew the President's blood group.

Responding to charges levelled at him by Blood Bank Director Dr. Ranjani Bindusara, Dr. Wijesundara said:

"I was at the OPD of the Nawaloka Hospital when the President was brought in for emergency surgery. Dr. Chandima de Mel asked me to obtain blood from the Blood Bank. I rushed to the Blood Bank with Army escort and removed 10 units of 'B' Positive blood.

"Nurses on duty at that time noted it down on the issue book and I placed my signature, mentioning the patient's name as H.E Chandrika Kumaratunga.

"I did not have time to fill out forms or get the permission of the director to obtain blood because this was a special case and an emergency. Since I already knew the blood group of the President was 'B' Positive, there was no need to check this again at the Blood Bank.

"Subsequently Dr. Bindusara, Director of the CBB, wrote to me calling my explanation for the obtaining blood without filling a proper requisition form and without informing the director. I explained to her that it was an emergency situation and the President was the patient.

"I was asked to get a blood requisition form from the Nawaloka Private Hospital to rectify the administrative procedures involved in withdrawing blood during an emergency. I did that.

"In spite of this, Dr. Bindusara ordered my transfer to Ratnapura and took my name out of the roster as a consequence of my acting in the manner I did during this emergency."

The great divide

India and Sri Lanka may be close neighbours but they disagree on key issues

Opinion PollIn a survey of "literate metropolitan populations of the South Asian region'' ORG MARG SMART, the private market research agency based in Colombo found that economic problems, inflation and high prices plague the mind of the average Sri Lankan citizen, more than any other problem. In contrast in India, unemployment, underemployment and job losses were the major concerns, with around 31 percent of the population saying those were the major issues facing the India today. Only 13.2 percent of the population in India rated economic problems such as inflation and high prices as major concerns.

The government can be buoyed by the fact that 30.1 percent of the Sri Lankans rated "terrorism'' as the problem "best tackled by the government so far.'' Similarly, 33.9 percent of the Bangladeshi population rated terrorism as the problem best tackled by the government. However, Indians rated "national security'' as the problem best tackled by government while Nepalese rated environmental population "as the problem best tackled by government." In Sri Lanka, about a quarter of the population believed that the problem of corruption was well tackled by the government in contrast to India and Nepal, where very low ratings were given to the respective governments with regard to this problem.

imageConcerning foreign relations, most literate Sri Lankans find Japan to be the friendliest country followed by China, the United States, the United Kingdom, Saudi Arabia and Russia. In this ranking, "friendliest countries'' mean nations which are perceived as most friendly towards Sri Lanka. In contrast to Sri Lanka, Indians found the friendliest country to be Russia, with half those polled thinking so.

When it comes to selecting the most important leader, Sri Lankans rated Mahatma Gandhi as the most important leader in the last 100 years with S.W.R.D. Bandaranaike getting the runners-up position by getting 22.9 percent of the vote. He is followed by Nelson Mandela and D.S. Senanayake. The incumbent President is fifth ahead of R. Premadasa, Dudley Senanayake, J.R. Jayewardene and Sirimavo Bandaranaike.

By a very narrow margin, Indians voted for Indira Gandhi over Mahatma Gandhi as the most important leader of the last century.

ORG MARG SMART, a private market research organization is the largest employer of a full time market research staff in Sri Lanka. The survey is referred to as a mood monitor, and took into account four SAARC countries which included Sri Lanka, India, Bangladesh and Nepal. The sample size in Sri Lanka was 256.

The survey is also carried today in three other Asian newspapers The Times of India, The Daily Star of Bangladesh and the Kathmandu Post of Nepal.

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