One death is too many

Last week we heard the tragic death of yet another school girl, Ashanti Wasana (13) of Minuwangete Maha Vidyalaya, Wariyapola following the Rubella vaccination. It was seven months ago on March 19 that the first death following Rubella vaccination was reported from Matara. The victim then was Peshala Hansini (12), a student of St. Thomas’ Girls College, Matara.

In both cases the immediate reaction of the authorities was the same. They blurted out drab statistics to show that everything was normal. It is said that the casualty rate following Rubella vaccination is one in a million or so. (So, why worry?) True. Yet is that the way to react?

Taking their own statistics, we find the casualty rate in Sri Lanka much higher. It is up to the authorities to generalise. From the point of view of a lay observer there must be something wrong somewhere. Either the vaccine was sub-standard or it was not stored properly leading to contamination. Or else, there was something wrong in its administration - either necessary precautions including a proper diagnose of the health condition of the child was not made or some other medical negligence had taken place. The exact reason could be known after a full investigation.

Among the excuses blurted out by the Spokesman is the fact that it was not mandatory to indicate the date of manufacture or date of expiry in the vaccines or in the packaging. He even cited examples from foreign countries. However, how credible his assertions were is a debatable question.

He admitted that the vaccines currently in use do not have the date of manufacture marked but ensured that only those that have the date of manufacture marked will be imported for next year. This raises the question why such vaccines were imported at all. Reputed manufacturers mark both the date of manufacture and the date of expiry on their products including vaccines. This is essential as every product has a maximum life span, for no product could be used eternally. In the case of Rubella vaccines it is about two years from the date of manufacture.

The callous attitude of the authorities is seen from another incident, also related to rubella vaccination. A Health Ministry spokesman told the media last week that the first Rubella death was due to negligence of the provincial authorities and a charge sheet was delivered to the responsible officer on October 12. That is almost seven months later. The authorities had to wait till another death to charge those responsible for the first accident.

It is the height of irresponsibility and criminal negligence of the higher authorities that they waited so long and for another death to occur. What is worse is the attempt to exonerate themselves from the blame by referring to bureaucratic delays and trade union pressure. This is conduct most shameful and despicable.

No one should find cover behind statistics or administrative difficulties in matters that concern life and death. They should, first of all be humane. The principle to be followed should be ‘One death is too many’.

Mistakes could happen, for no one is infallible. The first thing to do when a mistake occurs, however, is to admit it and then to ensure that it does not happen again.

The worst result of this callous approach and attitude of the authorities could be loss of confidence in the immunization programs among the community. Sri Lanka has one of the best immunization programs in the world and it had an unblemished record despite the recent deaths.

In fact, Sri Lanka has handled the immunization programs so well that it was chosen as a venue to train personnel that man such programs in other Asian countries.

Incidence of Rubella did go down following the introduction of the immunization drive in the country. Hence, any loss of confidence in the program among the community could lead to a reversal of this trend and the future population could be exposed to risk.

What is urgent is to check the reliability of all vaccines imported and ensure that only quality vaccines are imported.

Also it is essential to maintain storage capacities at optimal levels and train all relevant staff on safe administration of the vaccines.

Above all a mass awareness campaign on the necessity of the vaccines should be conducted to ensure sustainable popular confidence in the immunization programs.