Death of babies in hospital sends jolt of despair through Tunisia

TUNIS - The death of 15 newborns at a Tunisian state hospital, which returned the bodies to grieving parents in cardboard boxes, shocked Tunisians and exposed the country's social and economic malaise.

The babies died in a 3-day period in early March during an outbreak of a hospital-acquired nosocomial bacterial infection, government health authorities said.

Health Minister Abderraouf Cherif resigned and was replaced on an interim basis with Youth and Sports Minister Sonia Ben Cheikh, a medical doctor. The government fired 13 senior health officials and an investigation tried to determine the cause of the fatalities was ordered while Tunisian leaders scrambled for damage control ahead of elections this year.

Tunisian President Beji Caid Essebsi had the incident discussed by the National Security Council, which handles sensitive matters such as jihadist threats and other threats to the state stability.

Prime Minister Youssef Chahed vowed to punish those found responsible in the babies’ death.

"Everyone cites corruption, laxity and the total impunity before the state authority in the health sector," Chahed said during a gathering of health officials. "The economic difficulties and the decline in investment in the health sector do not explain the other problems in the sector."

He cited issues such as "untidiness" and “loss of authority” at hospitals.

"We do not know now whether the deaths were caused by outdated serum or human error. The investigation and analyses will determine the cause," said Dr Mohamed Douagi, chairman of the neonatal intensive care unit at Tunis Military Hospital.

"This kind of infection is lightning [quick]. When it hits, we lose the baby within 3 hours whatever the efforts and means deployed," said Douagi, who is among those investigating the infections.

For doctors and other health-care experts, the tragedy was not unexpected wall.

Experts pointed to the effects of political instability with 12 ministers rotating at the head of the Health Ministry in eight years amid declining investment in the health sector because of the economic crisis facing Tunisia.

"The number, the brutality and the concomitance of the deaths point to a highly aggressive agent as the cause of death. How is it that this agent, whether it is microbial or toxic, could enter such highly protected area in the hospital and cause such deaths?" asked former Health Minister Habiba Ben Romdhane.

"I admit that I'm afraid of the results of the investigation of these cases," she added.

Others cast doubt on the investigation itself, citing widespread corruption and the influence of vested interests in the health-care system.

"The deaths of the babies are a premeditated murder. They are a state crime," said leftist Popular Front parliament member Ammar Amroussia. "I'm certain that our country under this government of Mafia and criminal gangs will experience more disasters."

Doctors gave a grim picture of state hospitals with some hospitals in less advantaged regions struggling to pay water and power bills.

"The tragedy of the deaths of the newborn babies is terribly shocking but it is not isolated or unpredictable," said health publisher Synda Tajine. "In these state hospitals, patients are treated like cattle with sick people crammed, humiliated and mistreated without minimal conditions of hygiene and safety."

"How is it that anyone can still be surprised when such a bomb of baby deaths explodes," she said.

Official data indicate that 87% of the population relies on the public health sector and public hospitals for medical care. Wealthy and upper-middle class Tunisians generally turn to relatively better services in privately owned clinics.

Free education and health-care development had been the priorities for Tunisia's governments since its independence before the country plunged in a socio-economic crisis since 2011.

"This disaster, because there is no other word to describe it, has laid bare in all its ugliness the reality of our health-care system which is dilapidated, obsolete and ossified and is now completely unfit to provide needed care for 87 percent of Tunisians," said political writer Sofiene Ben Hamida.

"All the sector professionals saw the disaster coming and the death of the babies was an announced and expected tragedy."

Parliamentary Health Committee Chairman Souhail Alouini said: "The current governance of the sector does not permit the upgrading of the sector. The sector is now dilapidated."

"When we called loudly that there is no medicine, no equipment in public hospitals, no one heard us with some blaming young doctors for wanting more money or seeking to leave the country," said Dr Nesrine Ben Hadj Dahman, who was among many doctors who took to social media to give gruesome details of the deteriorating health-care sector.

"Why are you shocked by the death of the babies?" she asked.

"No one paid attention to us when we raised the alarm about the absence of crucial medicine and equipment, when we ran from one place to another to try to find insulin for extreme cases of diabetic patients, when we begged for antiseptic Betadine to attend a boy who was hit on the head by his moody father. Now and again, No one heard us," she added.

Lamine Ghanmi is a veteran Reuters journalist. He has covered North Africa for decades and is based in Tunis.

This article was originally published in The Arab Weekly.