By Rajitha Jagoda Arachchi and Aanya Wipulasena
He is known to most as a supportive colleague. They remember him to be generous, and always available when anyone needs his help. He was polite and greeted everyone as he went about his work at the hospital. As he associated everyone closely, he had no enemies while the patients recall him as friendly and warmhearted.
How did this gynaecologist and obstetrician’s life turn upside down following a newspaper article?
The tornado of allegations levelled against Dr. Seigu Siyabdeen Mohammed Safi, ignited after the newspaper article accused him of sterilizing 4,000 mothers without their consent.
The doctor – attached to the Kurunegala Teaching Hospital (KTH) – was arrested shortly afterwards, on May 24, over charges of amassing a large amount of wealth and assets. Soon, the authorities called the public to come forward with complaints if any, against him on sterilisation accusations.
There were instances where Muslims were attacked following the April 21 Easter Sunday terrorist onslaught, that left 258 dead and nearly 500 others injured. Mosques, houses and businesses belonging to Muslims were attacked leaving at least one dead.
On Monday (27), 51 complaints against the Muslim doctor were recorded at the KTH, on Tuesday the number reached 119 and by Wednesday evening, there were around 70 new complaints.
Thirty two-year-old Chamila Pushpakumari from Dampitiya in Kurunegala was one of the mothers who arrived at the KTH on Wednesday (29). A mother of a nine-month-old baby, she was also charged with the hysteria that loomed around the ongoing case against the doctor.
As the doctor who performed a caesarean surgery was being accused of non-consensual sterilisation, her family compelled her to lodge a complaint with the hospital authorities.
“He was friendly and warm. He called me putha when he spoke to me,” she said.
She remembers him asking her ‘Putha, is this your first baby?’ to which she has replied in the affirmative. Now, she is worried she wouldn’t be able to conceive a second child.
She complained of having back pains after the Caesarean surgery, a grievance repeated by many other mothers who complained against the doctor. Back pains are, however, common side-effects voiced by mothers who were administrated spinal anesthesia before they undergo a caesarean operation, medical professionals said. A large number of mothers who lodged complaints against the doctor had similar grievances. They also complained of abdominal pain and irregular periods.
The officer who recorded the mothers’ statements at the KTH said they were most ambiguous. The mothers, mostly young, were scared of possible future health complications. Complaints were also recorded at Dambulla and Galewala hospitals. By Saturday, the numbers surpassed a total of 300 complaints.
The week saw several protests staged by the public and KTH hospital staff demanding a probe into the allegations against the doctor. On Wednesday, the hospital staff staged a protest holding placards stating “Rata, Jathiya, Aagama Bera Ganimu” (let’s protect the country, nation and religion), and “Anthawadaya- Aagamwadaya Waha Paradawamu” (let’s immediately defeat extremism and racism), while some called on the President to appoint an independent committee to probe into the issue. A protest at the Dambulla Base Hospital on Friday (31) urged authorities to take legal action against the accused doctor.
The doctor’s family based in Kurunegala has since left the area fearing a backlash.
H. Anura Prasanna who worked as a health assistant at the KTH said that the doctor got along well with everyone. “I worked with him for three years. He had no enemies here. Prasanna also said the doctor didn’t spend over 15 minutes to perform a caesarean surgery.
“This is a hospital matter. The probe should first be internal. This incident has become a political drama now,” Prasanna said.
The protests organised at the KTH were led by the Government Medical Officers’ Association (GMOA) backed by other trade unions. Dr. Indika Rathnayaka, Secretary to the GMOA at the KTH said they are pushing for an ‘unbiased scientific investigation’ into the recorded cases.
“I knew this doctor for the past four years. But after that newspaper article, several mothers came to the hospital and lodged complaints against him,” Dr. Rathnayaka said adding that now, the GMOA and other hospital trade unions want to resolve the matter in an ‘unbiased’ manner. He said they do not trust that the Ministry of Health could conduct an impartial investigation. Addressing a press conference, Heath Minister Rajitha Senaratne said a four member committee, with members from the Ceylon College of Gynaecology and Sri Lanka Medical Council, will probe the allegations.
In an unprecedented move, On Tuesday, the members of the expert panel appointed by the Ministry was turned away by the officials at the KTH. The Director of the hospital Dr. Sarath Weerabandara said they have sufficient equipment and expertise to conduct an in-house investigation. Meanwhile, a media release on Thursday (30) by the Secretary to the Ministry of Health, Wasantha Perera stated that interruptions have delayed the investigations.
“This incident has left a black mark on this hospital. We want President Maithripala Sirisena to appoint an impartial expert panel to do a scientific investigation into the complaints by the mothers. That is the only way to resolve this matter,” Dr. Rathnayaka said. Twenty seven-year-old Chandima Kumari, a mother who couldn’t conceive a baby after the birth of her first baby in 2014 said she wondered if an illegal sterilisation was conducted on her.
“We tried to have another baby after our first child. I hope he has not done anything bad. I want another child,” Kumari said.
Meanwhile, a few doctors who had shown different angles other than the popular opinion were hunted down in the last couple of days. Especially, a lady doctor who had put a Facebook post had encountered a serious mud slinging on her. Minister Rajitha Senaratne was not available for comment. Secretary to the Ministry of Health Wasantha Perera told the Sunday Observer that more time will be needed to complete investigation into the incident. Commenting on obstructions made by KTH officers by not allowing the investigation committee appointed by the Ministry into Hospital premises, she said it is due to misunderstanding.
Doctor arrested under Assets and Liabilities Law
The police have powers to call for complaints with regard to a criminal investigation, President Counsel, Prasantha Lal De Alwis says.
Dr. Siyabdeen Mohammed Safi was arrested over charges of amassing huge amounts of wealth and assets.
“He could be arrested under the suspicion of possessing assets of National Thowheed Jamath (NTJ),” the President Counsel said adding that the doctor who is a public servant has to be arrested by the Commission to Investigate Bribery or Corruption, or Inland Revenue Department.
He said the sterilisation charge against the doctor falls under the penal code.
“Once such a charge comes up, the police don’t have any other way than record public complaints,” he said.
Statistical methods vital to find out truth
If Sri Lanka does not possess the technology to conduct tests to assess if sterilization of women can be achieved by damaging the Fallopian tubes, we need to look at existing statistics, Senior Research Professor at National Institute of Fundamental Studies, Prof. Gamini Seneviratne said.
He said there is a possibility for women to be sterilised after a caesarean surgery.
“We can take the patients list of this doctor and take a random sample of 200 or any larger number. Then, we could contact them and ask whether they are sterilised or not. That way, we can get an idea about, what percentage of his patients are sterilised after the caesarean,” Prof Seneviratne said.
He said if there is a difference between percentages – the percentage of normal sterilisation possibility and alleged doctor’s patient sterilization percentage – then one can say that something suspicious has happened.
“If this doctor is found guilty, he should be punished. But we must follow a scientific and statistical method to analyse the allegations levelled against him,” he said.
Reflecting on the issue, a gynaecologist who wished to remain anonymous said that it is almost impossible for a doctor to damage the Fallopian tubes without others noticing it during a delivery.
Case against Dr. Safi manipulated says senior consultant
Addressing the sterilisation allegation levelled against Dr. Siyabdeen Mohammed Safi at the Kurunegala Teaching Hospital, a senior consultant who spoke to the Sunday Observer on the basis of anonymity said there is a 10 percent chance for a mother to have difficulty in conceiving for a second time after the first pregnancy.
“This is called the ‘secondary sub-fertility,” he said adding that if this alleged doctor has done 8,000 ceasarean surgeries, at least 800 might have become sub-fertilized.
This happens due to various reasons.
“It could be because of a problem of the husband or an ovulation problem and also due to no reason, such as unexpected infertility. In this context, 800 women can face secondary sub-fertility due to any of those causes or with no reason,” he said.
“Now, it is like election results, the hospital officials say 100, 150 and 200 complaints have been received. However, my observation is that most of these complaints are not on sub-fertility. As I get information, only 10-20 number of patients are with sub-fertility issues. That number can go up to 800. It is normal as I said earlier. A majority of these complaints are about back pain or similar concerns. One woman had complained on blindness too. This is just rubbish,” he said.
Another fact the doctor pointed out is that in order to guess a woman’s sub fertility, one should wait at least one year after stopping breast feeding. The officials recording the statements need to take these factors into account when recording complaints.
He said after the sub-fertilisation is established, one has to investigate why they are sub-fertilized.
“If it is a tubal problem, an infection could be the cause of it.
At least 1,000 to 1,500 mothers with sub-fertility issues due to tubal issues should be found to charge the doctor. No one can prove that a doctor is responsible for such a crime without a deep analysis,” he said.
He said he was not trying to defend the accused doctor, but said the hospitals’ methodology in recording complaints is wrong. He added that the College of Obstetricians should tell that the hospital cannot entertain this kind of ad-hoc complaints.
“I have worked 30 years in maternity and obstetrics. I know in and out of what is going on. When you crush the Fallopian tube, there is a risk of bleeding. And they might have to open up again. You can’t crush 4,000 tubes and get escaped without a single reopening,” he said.
“This is wrong and manipulated by the Hospital Director and some other authority. The GMOA also wants to accuse Minister Rajitha Senaratne.”
A member of the Kurunegala Urban Council told the Sunday Observer that eight businessmen in Kurunegala town had bid for a building in the lake road, Kurunegala which Dr. Safi had also been keen on buying. The building had later been purchased by Dr. Safi for Rs. 130 million reportedly. This business dispute has gone further, and these businessmen had spoken to a high-level police officer in the North Western Province to ‘teach a lesson’ to the doctor.
Meanwhile, Dr. Channa Jayasumana a university lecturer and forefront campaigner for the Sri Lanka Podujana Peramuna threw allegations at doctor Safi via social media. He enacted a hullabaloo on the incident in numerous platforms. Without submitting solid evidence, other than the number of complaints, he stressed that sterilisation had taken place.
Joining the political drama, Ven. Omalpe Sobhitha Thera told the media that he urged the Government to halt the service of all Muslim doctors considering it as an emergency. Then Ven. Athuraliye Rathana Thera started a protest fasting at the Temple of the Sacred Tooth Relic in Kandy last week. Athuraliye Rathana Thera demanded the immediate ouster of Minister Rishad Bathiudeen, Western Province and Northern Province Governors Azath Salley and M. L. A. M. Hizbullah.
Hospital Director sought complaints
Kurunegala Teaching Hospital Director Dr Sarath Weera Bandara convening a media briefing on Saturday (25) at the hospital premises asked women to lodge complaints if they have suspicion on sterilisation.
Since then, hundreds of women came to the Kurunegala Hospital on mere suspicion. Most of them had back pains or stomach aches, but they had not done a fertility test.
As this incident created public mayhem, the Health Ministry issued a circular to Kurunegala hospital officials banning statements to the media without the Health Ministry approval.