On 06.04.2017 dawn Romali was at the Asiri Central Hospital where the doctors never accepted or might have never known a process called "A dengue protocol", her platelet count was decreased to 10 000, but by noon it was 13 000. Even in such a situation what the doctors told Romali's parents was that they can take Romali home tomorrow or the day after. She suffered from a severe abdomen pain, and on 07th the count decreased to 12000, by dawn at 1.15am Romali was screaming in pain. Her whole body, specially her neck and left arm was burning with pain. But the nurses only gave her paracetamol, the consultant in charge of her treatment Dr. Panduka Karunarathna said that this is just because of gastritis. But in realitythis was a heart attack. She was cold as death; "I can't breathe" she yelled and fell on to the bed.
At once she closed her eyes.
Then she opened again."Ammi I'm going to die." she murmured weakly.
And then only did Dr. Panduka Karunanayake direct to take Romali to the ICU a decission that should have been made a couple of days before.
Romali's parents, wanted Romali to be treated by SriLanka's best dengue consultant, Dr. Ananda Wijewickrama, and here at Romali's final stages,, Dr.Panduka Karunarathne was saying that they are going to treat Romali at the ICU and that Dr. Ananda Wijewickrama will be visiting the patient at about 2pm.
But was she able to hold on to her life till 2pm?
At the ICU
Romali's mother fainted twice while Romali was at the ICU. Rohindra was left beside Romali.
"Thaththi, carry me to the toilet" said Romali weakly.
But Rohindra feared even to move her daughter from her current position. A diaper was worn. Oxygen mask was put on to her, but she removed and threw it away, even that was panful to her. “Thaththi hold the mask near my face, it's really hard" So did Rohindra.
Thaththi let me go!
Romali sat on her bed, and got closer to her father as if to hug him, and at one said, "Thaththi I'm going to die".
Rohindra was sobbing while he was recalling final words from her daughter.
"No putha, you can't go, you have me, and I won’t let anything happen to you" Rohindra was sobbing too: Then she said "Let me go Thaththi, I'm going to die...let me go"
Maybe at that point, she just knew that she was going to go.
"She told me 3 times that she is going to leave, she asked for water, and I gave some water to her."Rohindra says.
"Remember something from your religion "said a kind nurse who was seated beside Romali’s bed. But she said that she couldn't remember anything.
The nurse asked whether to recite some pirith for her, and Romali let her do so. At this point, the heart rate in the machine kept turning to zero and the nurse seemed to be panicking and kept resetting it.
Rohindra was really upset and helpless and he was praying that someone would come and save his daughter's life.
At about 5.30 am, a relation of Rohindra who is a VGO visited Romali, Rohindra was sent out of the ICU. Then the doctors asked if it is alight to insert a catheter on Romali. Rohindra agreed. After about 45 minutes the doctor came out. He was crying.
Rohindra questioned why he is crying.
But he said nothing, He didn't say about the worsening situation. "She will be okay" he said.
It was just 5% probability that Romali could be saved in that sort of condition. He didn’t have the heart to explain the reality to Rohindra.
"To make breathing easier"
At 9 am Romali's parents were summoned, they said that another cardiac arrest has taken place.
And then when they were summoned at 10.30am Romali was breathing with the help of a machine.
And again at 11.30 am another cardiac arrest occurred.
"She will be okay" that's what they were saying.
Meanwhile Romali's mother brought a priest from the Fatima Church, Maradana. The final prayer with the final communion he gave, was a relief for Romali and her beautiful soul.
At 12.30 pm where there's more than an hour left for Dr.Ananda Wijewikkrama to come, Romali was gone.
"Sorry we lost her" they said.
"We doubt whether Romali was gone before and the doctors didn't inform us about it" Rohindra flashbacks. "A blood test was done at 1.45am and a scan was done at 12.15pm."
The scan was done just before her death: where it should have been done daily, since she was brought to the hospital, or even since the report stated "Early fluid leak ".
"Her condition is stable!!"
Asiri hospital where Romali was treated for gastritis while it was evident that its dengue, never gave the disease notification sheet to her parents. Their point was that if the patient is dead, the hospital only issue the death certificate.
Her parents were requesting to get a photocopy of the bed head ticket, but the authorities haven't allowed it. On the day when Romali was in the ICU, when a friend of had asked about Romali's condition via a text message with her name and the room number, the doctors have replied "she is recovering". And one text message has mentioned that her platelet count was increasing from 8000- 11000.
This pt's (diagnosed with Dengue fever) platelet count is 13000, PCV is 37.9,Hb 12.8, day7, Rocephin omitted today, on PCM and P'prazole under Dr. Panduka Karunanayake. Stable, no other complaints.
… patient's platelets are picking up now it had gone down to 8k now its 11k so she is out of critical phase…
Romali's parents have heard that an internal investigation was going on about Romali’s case. But for 3 months nothing has happened. After 3 months Rohindra requested for a report of the investigation, and it said that continuing fluid charts for a dengue patient is essential, but during the period Romali was admitted to the hospital they never had such a protocol. And what they all had was an exercise paper which said the volume she consumed and the volume she passed.
The Medical Council is still silent!
Rohindra has appealed about the negligence of the doctors and the way they lost their loving daughter with all the details and documents that they have to the Medical Council. Their only wish is to take up an impartial investigation about the hospital and those responcible as this should not happen to anybody else. It's been 10 months after Romali's death but still the Medical Council has never fixed a date for the investigation.
Rohindra asked about the progress of his daughters investigation from the Registrar Officer at the Medical Council, where he was told, that they get these kind of complains in loads they will be processing it orderly.
Roshendra joined to speak with us having the reports of his sister;
"The report says that 45 hrs after the critical period the patient has under gone an intra-abdominal bleeding. But the ultra sound scan was done on 3rd April. The day she was admitted. It clearly says "Early fluid leak", but why didn't they do the scan? When we went to the IDH they said the patients should be scanned daily; but why didn't they do it? We are here to pay the bills, and they should have been doing the scan tests, I can't understand why the doctor said it is not needed. I personally and honestly think that this doctor should not treat any patient. Like this happened to my sister, it could be happened to anybody else"
In Sri Lanka 1 doctor has 1500 patients, the guardians of the patients who admit the patient to a private hospital hope and wish that the authorities there would do the best for the patient. But here the situation is really tragic.
Romali's bill for the Asiri Central Hospital was about 700000 LKR.
"The reason why we lost our daughter is, they haven't done enough scan tests, if she was scanned daily the doctor would read the reports, the most important part from the scan report from her 3rd day, was not read by the doctors; Mistakes can happen: but this is not a mistake it’s negligence. This was not a doctor who graduated at a foreign country or at a private university, but they are from state universities."
Rohindra's point is clear. We are here in an era where state doctors yell and protest saying that Sri Lanka doesn't need private universities. But Romali's life was stolen by one of them who graduated from a state university. If this is the situation for a family who can afford the so called best medical care, what can wesay about a family with financial issues?
"Even Dr. Wijewickrama asked about Romali's platelet count. He didn't check the patient's situation, what he said was to admit the patient and he will check after the count decreases to 100 000." said Romali's mother.
Romali was gone on 07.04.2017. Even today Romali's parents can't get a sound peaceful sleep. They cry of stress, the pressure of losing their child. How can they forget her?
Not only her family but also her friends do things in her memory. Trying to keep her name alive, continuing the good that she did.
It was after about 3 months since Romalis passing that Asiri Central sends its first batch of staff consisting a team of 30 nurses to IDH, to practice and learn about the proper dengue protocol, how to manage it.
"My daughter didn’t die, she was killed:"
Rohindra speaks with so much of pain. His tears are for the unconditional love for his only daughter, dear reader do give a name for his sorrow:
Contributors: Radika Gunaratne | Hansani Sampath
Photos: Pathum Senarathne