Yoliswa Dube-Moyo, Senior Features Reporter
The cold feeling of betadine solution dripping down my pregnant belly in the theatre still has not left me.
The low-frequency noise of the ECG machine, the electrodes stuck onto my skin and the theatre nurse taking notes, all is still vivid in my mind. I was stark naked in a room filled with people but before I could be too embarrassed about that, an anesthetist delivered the anesthesia medication through an intravenous line in my arm and gave me a gas to breathe from a mask.
I checked the clock on the wall at that point and it read 7.10AM. At 38 weeks gestation, my obstetrician had reason to believe my baby and I were in danger due to various reasons and had to deliver the baby via Caesarean section.
When I woke up after the procedure, it felt like I had been asleep for days but it had just been a little under an hour.
I glanced at the clock in the recovery room and it read 8.10AM. I was to later learn that my daughter was born at 7.25AM. Once I was fully awake, I felt something tightly wrapped around my ankle – it was the BP machine monitoring my blood pressure. Next, I felt excruciating pain around my abdomen. I knew the baby was out.
The theatre nurse asked how I was feeling and I told him the pain was killing me. He said he would give me something for it but needed to make sure I was awake first.
While I was asleep, the anesthetist had inserted a tube into my mouth and down my windpipe which ensured I got enough oxygen and protected my lungs from blood and other fluids. This explained the sore throat.
I was eventually wheeled to the ward where I later met my daughter after a few hours. I was in pain but relieved that the worst was over. So I thought.
I would be heavily sedated for the most part but even then, the pain was excruciating. I struggled to get in and out of bed. I could barely sit up to feed my baby.
I couldn’t walk upright and worst of all, I wasn’t getting better but worse off than I was on day one post-surgery. I knew something was wrong but couldn’t quite figure out what it was.
Ten days after surgery, I noticed some blood tainted liquid oozing out of my incision site. I had seen my obstetrician the day before and he had noticed nothing amiss. But I had developed an abscess under my skin on the incision site; the wound needed to be reopened so that the pus could be drained and the area cleaned.
For the eight weeks that followed, I had to visit the doctor’s office every day to get the about 6cm by 7cm wound cleaned with betadine solution and packed with gauzes. The process was more painful each time as the old bandage was pulled out and a new one stuffed in. But, the question on everyone’s lips was, “How did this happen? What went wrong?”
The obstetrician said, “It happens sometimes.” The nurse who attended to my wound post-surgery said, “The hospital staff didn’t mobilise you soon after surgery, that’s why.
” My mother, a retired medical practitioner, thinks I was the “Friday car”. This essentially means after a long week of work and being the third C-section in a row that morning, the surgeon was probably tired or in a rush and was bound to make some mistakes.
Surgical site infections are caused by bacteria from the skin, the operating room, a surgeon’s hands, and other surfaces at the hospital.
I was fortunate to survive to tell the story but others are not so lucky. Scores of Zimbabweans across the country are victims of surgical malpractice and few successfully go through litigation or are compensated. Many others lose their lives or those of their babies while some develop worse conditions as a result of botched surgeries.
In 2019, Miss Mongiwethu Mathe (27) had her rectum mistakenly cut by a surgeon during a Caesarean section to deliver her baby at Mpilo Central Hospital. As a result, she had excrement coming out of her privates as the mistake left a hole that now connected her rectum to her vagina.
Despite being told to go back to Mpilo to have the condition corrected, Miss Mathe found no joy. Two years on, she is still trying to get the condition rectified.
“I went to Harare for rectum repair but they told me the damage was too much but they tried their best. I’m still waiting to see how successful the procedure was; if the rectum is finally closed, then they can reverse the colostomy,” said Miss Mathe.
She had to have a colostomy bag inserted to collect fecal matter from her digestive tract.
“The doctor who made the mistake has been mum about it. In fact, I’m still in credit for the unsuccessful operation. I’ve been getting help to correct the condition through Amnesty International,” said Ms Mathe.
Her story mirrors that of many others whose surgical procedures have gone wrong with no clear explanation of what really happened, who is to blame or if anything can be done to help the situation.
When surgery goes wrong, you may not know who should be held accountable. It is common for surgeries not to go as planned since the medical field in itself is an imprecise art. And when an honest mistake happens or medical negligence takes place, it may be unclear who to hold responsible.
In September, a couple lost an unborn baby at Mpilo Central Hospital due to negligence after the woman spent more than 48 hours without being attended to.
The baby reportedly died while the mother was still in labour.
A total of 378 women died while giving birth in Zimbabwe last year and of those women, 66 died at home while 312 lost their lives at health institutions.
It is thought by some medical experts that a medical error is the third biggest killer. Both ethical and legal responsibility is necessary for patients to trust the professionals that carry out these surgeries.
Patients need to know that they can be compensated when medical errors occur.
With liability is the hope that surgeons will not take extra risks or do things they would not ordinarily do in their practice.
If a doctor does not follow the standard of care when carrying out their duties, they have to explain their decision.
Lawyer Mr Lison Ncube said if the patient can prove that the doctor made a mistake or there was malpractice, they can sue the doctor.
“When such cases of surgical malpractice occur, we’re saying there’s a procedure to follow that wasn’t followed or that wasn’t done correctly. We’ve had cases where the anesthesia given is not of the right quantity or quality leading to surgical problems,” said Mr Ncube.
He said litigation of surgical malpractice has not been successful in Zimbabwe because it is a specialised field which needs experts to guide the patient.
“Most of us are lay people and when we say a surgery wasn’t done right, we wouldn’t know exactly what was right or wrong. In most instances, you’ll need expert testimony. Either other doctors or other specialists in the same fraternity will have to come in and say in terms of our procedures, this is not how this thing should’ve been done. But
I’ve noticed over the past few years that we have very few cases of surgical malpractice that have succeeded in our courts,” said Mr Ncube.
He said a lot of people may not have taken up their cases legally because of many reasons.
“They may not know the laws of medicine or the rules of procedures that doctors undertake. Secondly, there are cost implications. You also realise that the majority of the people who experience this are people who may not be able to afford a lawyer to help them take up the case.
Thirdly, some of these cases fail because of lack of evidence,” said Mr Ncube.
In most cases, he said, one would be required to be furnished with a paper trail that led to a particular surgery.
“Many times when a case of surgical malpractice occurs, the doctors themselves are not willing to produce documentation that speaks to the actual procedure.
Either pre-procedure or during the procedure. You’ll find that in most Government hospitals, the facilities for all these recordings to be done are not even available.
They’ll turn around and say I did what I could with the resources available. In that case, it becomes very difficult for you to be able to pin a person down,” said Mr Ncube.
He added that most professionals are not willing to give evidence against their colleagues especially in cases of malpractice. – @Yolisswa