Since yesterday, I have watched friends post and re -post anarticle on facebook: the story of a little girl named

Afsheen who passed away due to the negligence of the doctors in United Hospital. A poignant story penned by the childs parent . I realize it is time for me to share my experience, my familys experience, my 3 year old daughters experience at United Hospital. On 3 August 2010, my 3 year 8 months old daughter was playing on our roof. She was wearing her sandals wrong [right sandal on the left fo ot and left sandal on the right foot, a rather endearing trait I used to think]. She saw some crows and decid ed it would be fun to chase them away. Arnavaz ran towards the crows wearing the wrongly worn shoes, lost her balance and fell on the hard concrete with her whole body weight on her left arm. By the time she was brought to me, to our flat one floor below, her left arm was hanging limply she had suffered a fracture. This is an image I will never forget; an image which struck terror in my heart, an a ccident that I as a mother can honestly and solemnly say, I will not wish on my greatest foe. Both our daughters were born in United Hospital and it is the nearest hospital to us. We straightaway thought of United. I covered my daughters hand with a towel and rushed to United while my mother and brother informed my husband. This was 6 pm on 3 August 2010. We reached in 10 minutes but what seemed like an eternity to me. Arnavaz was as quiet as a mouse, holding on to me tight. I entered the Emergency Wing of United with Arnavaz in my arms. A doctor prescribed an x -ray and went to call a n Orthopaedics doctor. Time for the first red tape: Is she a registered patient in United? Yes, she was born here, I said. I gave her name, spelled it out several times but t he record could not be retrieved. Minutes went by searching for Arnavazs registrati on; each moment like an hour. Can we not just do the x -ray. If you cant find her registration, I will register again. Lets just do the x-ray, I said. No Madam, this is our regulation, we cannot allow you to enter the x -ray room till we register your daughter, they said. The bureaucracy makes my skin burn even now as I recollect the conversation . We stood there helplessly while the person at the desk finally figured out t hat the name had been misspelled in the records. An x-ray was done, without any radiation protection gear for Arnavaz or me and we were told that an emergency operation would be required. When would this emergency surgery take place, we asked. Tomorrow morning at 9am the doctor said. It was maybe 7pm or 7.30pm at the time. My husband, Arif, and I were in shock. Our understanding of orthopaedic surgery or orthopaedic anything, to say the least, was scant and we were completely dependant on the experti se of the doctors. We were told that a cast would need to be placed on Arnavazs arm for the night. Arnavaz had been moved to a temporary cabin in the Emergency Department while a room was being prepared.Enter Dr. Mahbubul Alam, Specialist, Orthopaedic Sur gery, in the cabin with his instruments for the cast. Dr. Alam proceeded to eject our families from the room, sat next to Arnavaz and without further ado pulled, pushed and manipulated Arnavazs fractured bone and placed the cast without administering any painkiller to my child. We looked on in horror and our childs eyes grew large with terror and she started to howl in pain. We did not question this procedure till my sister-in-law (whose son had suffered a dislocated wrist in Uganda a few months back), hearing Arnavazs cries from outside, asked whether the doctor had given a painkiller beforehand. Arnavaz was taken to her cabin and asked to lie as still as possible till the next morning. Two doses of suppository were prescribed in case of pain over the ni ght. But the damage had been

done. Arnavaz alternated between crying Operation korbo na and silence till she fell into fitful sleep. I doubt she understood the concept of an operation, but knew that an event of some gravityinvolving her was to occur the next day. Numerous times she woke up duri ng the night complaining of pain . Each time we asked her whether she wanted medicine to make it better, and immediately she would get scared that the doctor would come again and said No Ammuna/Abbuta, aktu batha, a kta balish diyey rakho, thik hoyey jabey [No Mum/Dad, its a little pain, please put the pillow on my arm and it will be ok]. This is how she spent the night, waking up not less than 5 times in those few hours. I kid you not, that I am a strong person, ask anyone who knows me, but I have tears streaming down my eyes as I think back to those moments, almost a year from the date of accident, thinking of what my child had to endure and the strength she demonstrated during this ordeal. I have but one word f or that doctor, the so-called specialist, who caused her so much pain while putting on that cast and that is a word which has a synonym in the word donkey and an alternative in a word which has a synonym in a persons rear side. And I do not say this wit h any humour whatsoever. The morning came and a junior duty doctor came to visit Arnavaz, checked her x -ray and started talking about Arnavaz needing screw and plate. As I said, we have little understanding of orthopaedics but we knew screw and plate is serious. I was agitated.We waited for the Senior Doctor, the Consultant to arrive. In the meanwhile I asked Mr. Mahbubul Alam whether the surgery would be complicated. I was told, All operations are complicated. He looked at me like I was a fool. I tried again: How serious is this operation?. All operations are serious, he said. So much for a doctors duty to provide information! The Senior Doctor, Dr. Aminul Hassan, Consultant made his appearance after 9am. I repeated my questions to the doctors and expressly asked whether this was going to be a complicated surgery, because if that was the case, I informed them, then I would like to take my child abroad for treatment. My statement offended the Senior D octor and I was asked whether I was questioning his 30+ years of experience in the field . We were also told that no matter where we took Arnavaz (in Bangladesh or abroad) doctors would perform the same surgery as would be performed by Dr.Hassan. Amidst much discussion, consent was given for an open-reduction surgery and we were allowed to sit in the waiting room next to the Operation Theatre (OT) while the surgery took place. After 3 hours the doctors emerged and we were told that the surgery was a complicated one but has been successful. Note that we are informed about the complicated nature of the surgery after the surgery. Our gratitude to the doctors knew no bounds. Ashamed of my earlier behaviour, I even apologized to the doctors. We were informed that two pins /wires had been placed to k eep the bone in position, nine stitches had been made and the cast would have to remain for 4 weeks. In a few days Arnavaz was released. During the first follow -up we were told progress was satisfactory. Two weeks after the surgery a nei ghbour came to visit who had suffered a fractured hip the year before and arranged for us to seek a second opinion from his doctor in Appollo Hospital. This was Friday. We decided, why not? We met with Dr . Prashant Agarwal in Appollo the next day , 21 August 2010. Another x-ray was done and we were told Arnavazs bone was mal -aligned. What does that mean, we questioned . We were informed verbally that that means Arnavaz would loose 10 degree mobility from her elbow for the rest of her life! We had thought Arnavaz was doing so well. Could what this doctor was saying be true or was he try ing to malign a competitor? Confusion prevailed and a sense of foreboding reared its ugly head. Arnavazs records were sent to Mount Elizabeth Hospital in Singapore for a t hird opinion the same evening. On Monday, 23 August 2010, we received an e-mail to meet with the doctor urgently. We reached Singapore on Wednesday morning, 26 August 2010 and met with Dr. Francis Wong at 3pm the same afternoon. Dr. Wong is a paediatric ort hopaedic surgeon, which we understand now is a specialization in itself.

It was explained to us that where 3 pins/wires should have been used during the first surgery, only 2 pins/wires had been used. The 2 pins had been placed from the outer side of the ar m but no pin was inserted from the inner side. It is hardly reasonable that a child will keep a fractured arm still during recuperation, but apparently that is what the doctors at United expected from our 3 + year old. As a result of having inserted only 2 pins, over time and with movement, Arnavazs fractured arm had rotated, we were told, almost 90 degrees and callus (new bone) has formed to fix the bone at that angle. We were also told that todays technology allows such an accident to be surgically rectified by a closed-reduction, where a small incision is made and a microscopic camera feeding images into a screen allows the doctors to make the correc tions remotely, as opposed to an open -reduction, as was done to Arnavaz, which required a large cut and nine stitches after the operation. Closed-reduction is a much less invasive procedure and the aftermath a lot less severe. I am told that the closed -reduction technology has been around for 10 years and is being used in Bangladesh for the last 2 -3 years. We can only assume that United Hospital does not have this technology. But my question is, why not tell us about the alternative? United took away our option and right to choose. We were told that the same surgery [open-reduction] would be performed anywhere else in the world. This was a dire lie. I can only think of two option s why they would keep us in the dark: (i) Either the United Hospital doctors do not know of the alternative surgery themselves, or (ii) the lure of the fees to be earned surpasse s all moral and doctor-ly obligations owed by these doctors to their patients. If it is the former, then shame on the doctors. I f it is the latter, I say shame on the hospital and anyone involved with such a cut -throat money making machine. We understood i n Singapore what is meant by an emergency surgery. We met with Dr. Wong at 3pm, we were asked when Arnavaz had eaten last for anaesthesia purposes and a corr ective surgery was slotted for 6 pm the same evening. This surgery lasted 3.5 hours as a lot of callus had formed which had to be removed and the bone returned to the best possible position. The nurses were generous with their time, patience and kindness creating balloon games to keep Arnavaz occupied pre-surgery. I was allowed to take my daughter to t he OT this time [Arif had taken her in the last time]. In the OT, everyone tried to coax Arnavaz into trying out the laughing gas mask i.e. the anaesthesia mask, but this time she knew what was going to happen and started crying. I tried to soothe her and told her to try the mask on; it would make her laugh. In between tears she said she would, only if I tried it on first Finally, the nurses and I had to force her on the OT table and keep the mask pressed to her face till she passed out. They say that eyes speak and that a persons eyes are thewindow to their souls. My daughter eyes spoke to me at that moment with the anaesthesia maskforced on her mouth; it said How ca n you do this to me again Maa? Arnavaz was released the next day. We had to return to Singapore 3 more times in the next 30 days for follow-up. Her arm is now much better Alhamdulillah but we are advised that a few physiotherapy sessions are recommended. As Arnavaz improved, our initial zeal of filing a suit, complaining or writing to the m edia subsidedwith time. When we read Afsheens story yesterday, Arif and I decided that it is also our duty to inform people of our experience, or rather Arnavazs experience at United Hospital.There is much debate in our country about brain drain and how intelligent and resourceful people prefer to immigrate to foreign lands rather than staying in Bangladesh. Before Arnavazs accident, I used to wonder why. After this incident, I must say I understand. Everything else put aside, what is the point of staying in a country where we cannot have the slight est trust in our doctors and hospitals to advise us, guide us, inform us? Where is the duty of care? Where is the assurance that our doctors and hospitals will keep our loved ones safe? I am sorry to say that doctors like these make us question the credibility of all doctors of our country. Rationally, I know that sounds unfair. But ask a person who has experienced a malpractice [and there are many], ask them whether or not they think twice before going to any d octor in Bangladesh and I doubt that they would disagree with me.