One death is too many
Last week we heard the tragic death of yet another
school girl, Ashanti Wasana (13) of Minuwangete Maha Vidyalaya,
Wariyapola following the Rubella vaccination. It was seven
months ago on March 19 that the first death following Rubella
vaccination was reported from Matara. The victim then was
Peshala Hansini (12), a student of St. Thomas’ Girls College,
In both cases the immediate reaction of the authorities was
the same. They blurted out drab statistics to show that
everything was normal. It is said that the casualty rate
following Rubella vaccination is one in a million or so. (So,
why worry?) True. Yet is that the way to react?
Taking their own statistics, we find the casualty rate in Sri
Lanka much higher. It is up to the authorities to generalise.
From the point of view of a lay observer there must be something
wrong somewhere. Either the vaccine was sub-standard or it was
not stored properly leading to contamination. Or else, there was
something wrong in its administration - either necessary
precautions including a proper diagnose of the health condition
of the child was not made or some other medical negligence had
taken place. The exact reason could be known after a full
Among the excuses blurted out by the Spokesman is the fact
that it was not mandatory to indicate the date of manufacture or
date of expiry in the vaccines or in the packaging. He even
cited examples from foreign countries. However, how credible his
assertions were is a debatable question.
He admitted that the vaccines currently in use do not have
the date of manufacture marked but ensured that only those that
have the date of manufacture marked will be imported for next
year. This raises the question why such vaccines were imported
at all. Reputed manufacturers mark both the date of manufacture
and the date of expiry on their products including vaccines.
This is essential as every product has a maximum life span, for
no product could be used eternally. In the case of Rubella
vaccines it is about two years from the date of manufacture.
The callous attitude of the authorities is seen from another
incident, also related to rubella vaccination. A Health Ministry
spokesman told the media last week that the first Rubella death
was due to negligence of the provincial authorities and a charge
sheet was delivered to the responsible officer on October 12.
That is almost seven months later. The authorities had to wait
till another death to charge those responsible for the first
It is the height of irresponsibility and criminal negligence
of the higher authorities that they waited so long and for
another death to occur. What is worse is the attempt to
exonerate themselves from the blame by referring to bureaucratic
delays and trade union pressure. This is conduct most shameful
No one should find cover behind statistics or administrative
difficulties in matters that concern life and death. They
should, first of all be humane. The principle to be followed
should be ‘One death is too many’.
Mistakes could happen, for no one is infallible. The first
thing to do when a mistake occurs, however, is to admit it and
then to ensure that it does not happen again.
The worst result of this callous approach and attitude of the
authorities could be loss of confidence in the immunization
programs among the community. Sri Lanka has one of the best
immunization programs in the world and it had an unblemished
record despite the recent deaths.
In fact, Sri Lanka has handled the immunization programs so
well that it was chosen as a venue to train personnel that man
such programs in other Asian countries.
Incidence of Rubella did go down following the introduction
of the immunization drive in the country. Hence, any loss of
confidence in the program among the community could lead to a
reversal of this trend and the future population could be
exposed to risk.
What is urgent is to check the reliability of all vaccines
imported and ensure that only quality vaccines are imported.
Also it is essential to maintain storage capacities at
optimal levels and train all relevant staff on safe
administration of the vaccines.
Above all a mass awareness campaign on the necessity of the
vaccines should be conducted to ensure sustainable popular
confidence in the immunization programs.