By Abdul Heraclitus Aminathiff –

Recent PCR Test Experience Summary

A recent Colombo Telegraph article has brought out the fact that that PCR tests for COVID for air travellers have been authorized only at a handful of private places in Colombo including a Colombo lab in existence only for 3 years (Forte Dynamics PVT LTD). Army Hospitals too are authorized while long established State Hospitals are not. Intending passenger Prof. Dushyanthi Hoole had her trip to the US ruined when Durdans Hospital on 30 Aug. 2021 gave her  a report that she is infected. Most passengers would have meekly accepted the result in trust but she feeling quite well, asked a for a second test, was refused and rejected a room at Rs.17,000 a day in quarantine urged on her at the hospital and ignored threats to call a PHI to confine her in quarantine. As a Professor of Chemistry and Associate Professor of Chemical Engineering, and a trained Analytical Chemist teaching laboratory techniques, she pointed out that those drawing samples at Durdans were not properly trained and the insufficiently trained technicians were carelessly handling the samples.

All this was by desk staff without meeting a doctor. When infection by a deadly life-threatening illness is communicated, should trained medical personnel not be involved? She went to Nawloka that very night for a second test and given a clean report the next day. By the time she had established through the Nawaloka test  that the Durdans report was wrong clearing her for travel, she had missed her flight as she was forced to cancel her booking 24 hours prior to her flight scheduled for 11.30 pm on 31 August. Getting a new flight, she had to do the test again. Nawaloka cleared her once again on 2 Aug..

Suing Doctors and Hospitals

Although some have prevailed in winning medical malpractice suits in Sri Lanka, it is an uphill task. It is clear that Durdans’ untrustworthy laboratory procedures make their lab work totally unreliable. The above referenced article pointed out that a lady who came with a burst appendix was treated for something else. I now learn that she was misdiagnosed with a broken hip and put through painful surgery for that. By then the infection from the burst appendix had got worse. She died. Huge bills had to be paid.

I also have since learnt that a Reverend Pastor was referred by Mannar General Hospital for clots in the brain but was put though heart  surgery by a surgeon who did an excess of heart surgeries for one surgeon that day. The Reverend was sent home and died. The family had to find nearly Rs. 1 million for the surgery.

There is really no restitution for these medical crimes. The lady probably had a broken hip besides appendicitis. The pastor probably had blocks in the chest even though that is not what he went for. These are reasonable defences in court. In any case doctors make mistakes that will be covered up by fellow doctors. Further, relatives who took them to Durdans believing that “what is more expensive is better” would be reluctant to admit that they took the “short and convenient route” to a private hospital instead of going to the General Hospital where many doctors of many specialties would have attended to the patient, making mistakes less likely. In any case, mistakes through ignoring bad lab techniques without correction are  a worse form of medical negligence and malpractice. It is failing to address what can be.

Durdans: Its Laboratory Collection Center and Home for Elders

In fact, Durdans uses one Dr. Subramaniam Sivanandarajah of Skanthavarodaya College (and son of former Principal Subrmanaim who is annually feted by the College). Sivanantharajah took nearly twice as many years as normal to earn an MBBS degree. He  runs a clinic from Sagara Road, Colombo 4. His son who took more years than the father to qualify has been seen 2 years ago sitting seemingly as locum tenens in the father’s absence without passing the relevant exams. Beer bottles were stacked in the clinic (Photos available). Whether he has passed now, I do not know.

Dr. Sivanantharajah’s  home-clinic is an authorized collection center for Durdans and Home for Elders (presumably for those who cannot afford Rs. 17,500 a day. Things like urine samples are collected from a filthy toilet (See photo). The second exterior toilet (squatting type) was seen with fish scales strewn all over and stinking. How can test results from samples collected there ever be trustworthy? How can elders be accommodated there in healthful conditions? Quality and cleanliness are sacrificed for profit.

Durdans has to make the effort not to ruin people’s vacations. These lead to shocking people untruthfully into thinking they might die of COVID and worse, they are used to place people unnecessarily in quarantine making Rs. 17,500 a day for Durdans at rates higher than at luxury hotels.

In our democracy, flawed though it is, an explanation is owed on why only Colombo-based labs are licensed to do PCR tests for airlines, on why people from outside Colombo need to come to Colombo 3 days before travel to do their tests instead of using their local government hospitals, on why highly qualified government medical specialists are not as trustworthy as any military doctors, on who is making these huge sums of money, etc. The way new buildings for Durdans are coming up everywhere, the profits are very high.

When private hospitals with shareholders play such a central role in PCR testing and do not have to be accountable, these mistakes are unavoidable and the costs uncontainable. Quality and safety are higher standards for Durdans to uphold over profit.

Lessons from Lee Iacocca’s Experience at Ford

Named after a classical ethicist, Heraclitus, it is fascinating to me to see how in history people stubbornly refuse to learn from mistakes. Durdans must take note.

The Fourth Arab-Israeli war was launched by Egypt’s Anwar El-Sadat to recover occupied territories and in effect to enforce UN Security Council Resolution 242.  He first expelled 20,000 Soviet Advisers from Egypt, and opened new diplomatic channels with the US, relations having been strained by unstinted US support for Israel. He launched a war on 6 Oct. 1973 to take back territory occupied by Israel in the 1967 war where the Arab armies had faced a humiliating defeat. The Egyptian and Syrian armies (joined by Iraq and assisted by Jordan), using their Soviet-supplied weaponry, made quick and impressive gains. But Israel mobilized, decisively helped by a US airlift of arms and $2.2 billion in emergency aid, and began driving back the early Arab gains. By 25 Oct. there was a ceasefire that held. Although the Arab Armies had again been defeated, the early Arab gains left the message that Israel cannot be guaranteed military superiority forever. Indeed, shifting world opinions against Israel and the dynamics of lopsided population growths favoring the Arabs, make the continuation of the status quo unlikely in the long run.

In this milieu OPEC imposed an embargo against the United States in retaliation for the U.S. decision to re-supply the Israeli military and to gain leverage in the post-war peace negotiations. Arab OPEC countries also curtailed production.

Gas Shortage: Big Cars to Small

There was chaos in the US as a result. Petrol bunks ran short. With long queues at serving stations, irate customers had fisticuffs. Petrol went up from 29 cts a gallon to 55. The reduced speed limit of 55 MPH was imposed on US highways for conservation.

The long, huge cars that were the fashion of the times were now resented. Customers, fearing the heights to which petrol prices may go, wanted fuel efficiency.

Imperative on Ford

The need for small cars was clear to the perceiving market strategists at the big motorcar companies.

Indeed, Volkswagen in its Beetle had long experience with small cars. It had been made to meet Hitler’s specifications for a small car. It saw its most widespread use as an officer’s car during the Second World War, with a bucket seat and no doors. It received an important position in history when the Desert Fox’s, German Field Marshall Erwin Rommel’s, desert forces were facing pressure from British Field Marshal Bernard Montgomery. The air-cooled engine, already being developed by Porsche, was the answer to water shortage in the desert.

The modern version of the Volkswagen Beetle had been available since 1949 to the public. The Toyota Corolla was introduced to North America in March 1968. The newly introduced Datsun 1200 appeared in 1970.

Ford had fallen behind its rivals. Waking up suddenly, then Ford President Lee Iacocca wanted a 1971 model that weighed less than 2,000 pounds and that would be priced at less than $2,000. His engineers produced the Ford Pinto, taking but 22 months from concept to production. A two-door sedan, entry level models were priced around $1850, well below GM’s Chevrolet Vega and directly targeting imported models such as the Mazda 1200 in 1971, the Subaru DL in 1972, and the Honda Civic in 1973. By January 1971, the Pinto had sold over 100,000 units and 352,402 for the entire 1971 production run. The year 1974 saw the most Pintos produced in a single model year with 544,209 units.

The Pinto was an immense success except for the catastrophic faults from the rush to production. After 1977, allegations arose that the Pinto’s structural design allowed its fuel tank filler neck to break off and the fuel tank to be punctured in a rear-end collision, resulting in deadly fires from spilled fuel. Critics alleged that the vehicle’s lack of reinforcing structure between the rear panel and the tank meant the tank would be pushed forward, and punctured by the protruding bolts of the differential.

Ford claimed in an internal memo that it was aware of the design flaw, refused to pay for a redesign, and decided it would be cheaper to pay off possible lawsuits. That Ford cost-benefit analysis rather callously compared the cost of $11 repairs per vehicle against the cost of settlements for deaths, injuries, and vehicle burnouts. Paying off the settlements, they estimated, was cheaper. It was a cold-blooded calculation. It came out at trial.

In the end, Ford recalled 1.5 million Pintos. The automaker was the subject of more than 100 lawsuits because of the Pinto and paid millions of dollars in restitution. Lee Iacocca was fired. But he went on to revive Chrysler.

The Emerging Volkswagen Scandal

With consumers convinced by VW’s advertisements and the several environmental awards won by VW, VW diesel car sales soared. But even Volkswagen, despite Germany’s reputation for precision engineering, succumbed to pressures to cheat. Volkswagen, the No. 2 car manufacturer after Toyota today, has been recently plagued by scandals. According to the New York Times (2 Feb. 2016),

“Volkswagen admitted in September [2015] that 11 million diesel vehicles, including almost 600,000 in the United States, were programmed to produce exemplary emissions readings when being tested, but to flout the rules at other times.”

The emission crisis has caused lasting damage to VW’s once-solid reputation. Volkswagen had installed emissions software on its diesel cars that allows the car to recognize when it is being tested for emissions  using steering, throttle, and other parameters used in the test. Armed with that, the cars run so as to comply with federal emission standards while being tested. At other times, the software changes the fuel pressure, injection timing and exhaust gas recirculation. As a result, the car delivers higher mileage and more power at the cost of more cancer-causing nitrogen oxide emissions well above federal limits.

VW was a victim of its own success. An estimated 60 persons died of cancer. Volkswagen Group CEO Martin Winterkorn resigned. Many others were suspended from VW. As a result of the scandal, the secondhand value of VW diesel cars collapsed leaving many loyal customers high and dry.

Lessons for Durdans

Hiding mistakes never works. Admit mistakes as soon as you become aware of them. Do not employ cheaper personnel to cut costs. Correct course.

Durdans forced the Daily Mirror to take down the online version of the article that appeared on 1 Sept. 2021 but nothing could be done about the print version. That is hiding mistakes. They had promised a rejoinder. But none has appeared. Perhaps they have learnt that unreasonable cost-cutting, and admitting and correcting mistakes made are cheaper and more salubrious than lawsuits where only lawyers make money.