Baby Kimorah was born at the KHMH on May 18, 2004. Since she was two months old, she had had about 13 trips to the hospital. So what went wrong this time? Public sentiment is that both the hospital and the doctor failed to do everything in their power to keep the disabled child alive, but the summary report has not outrightly identified negligence on anyone?s part.

?The report concludes that the services offered by the institution were within the generally accepted parameters of reasonable standard of care for most of her treatment,? said a 4-page summary report the ministry presented to the media. ?The issues raised by the inability of her doctors and the institution to assure that Kimora Leslie continued to receive treatment necessary to ensure survival are to be addressed expeditiously.?

The report, presented at a press conference at the KHMH this morning, went short of pinpointing any specific person or persons who may have caused the girl?s death; however, the investigating team, headed by Director of Health Services, Dr. Jorge Polanco, is calling on the Belize Medical Council to investigating Guatemalan neurosurgeon Dr. Giovanni Lara, the doctor who attended to the girl just prior to her death.

However, Dr. Polanco also told Amandala that there was no way of telling whether the girl would have survived if the neurosurgeon had attended to her earlier. Conversely, he told us that he could not say whether the absence of a neurosurgeon was a contributing factor in the girl?s death.

Still, Minister Coye, in his statement to the media acknowledged that when Baby Kimorah was first admitted, the KHMH did not have a neurosurgeon there to care for her. He said that the hospital had suspended neurological services since April 20, because Dr. Lara was on leave.

According to Dr. Polanco, the Council is being asked to look at whether the doctor?s conduct breached the professional code, since he did not report to work at the KHMH when asked to do so. According to an April 12, 2006 letter from the hospital?s CEO to Lara, he was to be on leave until Friday, April 28, 2006, but the hospital said it had called him back early to work because of some urgent cases. Lara did not return to work until April 28, when his leave was scheduled to end.

The Ministry?s summary report to the media said, ?The Belize Medical Council is encouraged, as the requisite regulatory authority, to investigate Dr. Lara?s conduct in this particular case, and no employment agreement should be entered into with him until the Belize Medical Council has completed such an investigation.?

Meanwhile, KHMH has no neurosurgeon and that department remains in limbo. At the time of Baby Kimorah?s death, Lara was the only neurosurgeon on staff, but he has since resigned. Ministry officials said this morning that the KHMH had been trying to bring in two other neurosurgeons from Cuba and Ghana.

Minister Coye informed that the board of the KHMH was meeting today to decide what would be done in the area of neurosurgery. The summary report states that the intention is for the hospital to continue providing neurological services.

Last week, the KHMH offered to rehire Belizean neurosurgeon Dr. Joel Cervantes, who they had hired eight months ago. However, Cervantes declined the offer, saying that he does not wish to return if the KHMH does not rehire Dr. Lara. Together, the doctors operate a business enterprise, Neurological & Spinal Services Associates. For a total fee of $12,000 per month, they had offered their services to the KHMH under this entity; however, the KHMH has not accepted the offer.

Minister Coye said that the real dispute between the doctors and the KHMH was over money, but that difference should have been put aside to save the girl?s life.

Conflicts between the doctors and the KHMH surfaced late last year, when doctors raised concerns over not just their salaries, but also the unavailability of some equipment and supplies at the KHMH. In the case of Kimorah, it was reported that a shunt (a special tube) needed for an operation was not available at the KHMH.

However, Dr. Polanco this morning said that the baby did not die because the KHMH did not have a shunt. It was complications of her disease, hydrocephalus, that killed her, he claimed.

?The prognosis of that child was not the best. No shunt would have saved the child,? he commented. He said that he has learnt that Baby Kimorah has had two shunt failures, and this increased her risk of death.

Embedded in the four-page summary is an admission that the KHMH?s neurosurgery is not just lacking in human resources, but in material resources as well.

?Every effort is being made to procure the services of a neurosurgeon, and the necessary equipment and supplies for the neurosurgery department,? it states, further acknowledging the need ?to continue strengthening the procurement system for the complementary equipment and supplies for the neurosurgery department.?

The investigating team was charged to determine if there were any breaches of contract, code of ethics, policies and protocols, or negligence were contributory factors to Kimorah Leslie?s death, and to make recommendations regarding the appropriate course of action to minimize the reoccurrence of similar situations, restore public confidence in the public health system, and to recommend that disciplinary action be brought against any person or persons determined to have been negligent in the carrying out of their professional responsibilities.

Apart from Dr. Polanco, other members of the investigating team were Dr. Peter Allen, director, policy analysis and planning unit in the ministry; Dr. Mauricio Navarette of the Belize Medical and Dental Association (replacing Dr. Martha Habet, who had also attended to the baby at the KHMH prior to her death); Ms. Marjorie Parks, deputy director of health services; and Andrea McSweaney, Crown Counsel in the Attorney General?s ministry.

The ministry?s summary said that the team interviewed KHMH staff, including the chief executive officer, the director of medical services, the head of accident and emergency, neurosurgeons Lara and Cervantes, and Kimorah?s relatives. The team examined the death certificate and reviewed the chronology of events in her treatment, leading up to her death.

According to the report, Baby Kimorah?s case is a 1% rarity. It claims that over the last four years since the KHMH began providing neurological services, it has successfully treated 100 patients.

At this morning?s press conference, we asked Minister Coye what would be done to ensure that there is no recurrence of what happened with Baby Kimorah. To this, he said that the Ministry would try its best to see how it can continue to improve health services, but they will also have to determine how far they can go in providing services to the public. He also pointed out that there has to be a focus on changing the attitudes and behavior of professionals, and said that egos and money should not come before people?s health.

The summary report concludes by saying that the ministry will press forward ?to legislate national patient care standards and will reevaluate policies governing patient advocacy with the view of increasing the amount of information readily available on what procedures and level of services are provided.?