By Surihe Gaomas WINDHOEK The Permanent Secretary in the Ministry of Health, Dr Kalumbi Shangula, revealed to New Era yesterday that the delay in signing the consent form for an urgent operation for “severe bowel infection,” had initially caused the rapid deterioration in the health of patient, Iuze Minyoi. The 23-year-old patient, who is currently in the Katutura State Hospital, is lying with an open stomach wound after a qualified Cuban surgeon conducted an operation on her on January 29 this year. However, it turns out that the patient had previously suffered immensely from complications of severe inflammatory infection in the abdomen, when doctors at Katima Mulilo first detected it early this year. It transpired that Minyoi was medically near death because of delays in the signing of the consent form for the operation. Giving a complete medical update on Minyoi’s condition to New Era yesterday, Shangula said the patient’s critical health condition was worsened by the fact that her relatives, including the patient herself, had previously refused to sign the consent form for an urgent operation. “The patient’s condition was very, very bad. She was suffering from severe infection. Her blood pressure was zero with no pulse, severe septic shock, while blood cells increased three-fold which is a sign of severe infection and they had to use a lot of medication to resuscitate the patient,” explained Shangula. Initially, when she was admitted to the Katima Mulilo State Hospital on January 21 this year after complaining of severe abdominal pains, doctors had first suspected pelvic inflammatory disease. Results from a sonar and x-ray scan showed that there were some “fluids in the abdominal cavity” and the diagnosis was in fact bowel infection. Shangula said that, surgically, if a patient is suspected to have bowel infection causing no passing of stool and collecting fluids in the abdomen, then an urgent operation is inevitable. “A person with bowel obstruction without an operation is a sure death. It was criminal for the patient and relatives not to agree to the operation as that would have cost the patient her life,” said Shangula. Within the space of six days Minyoi’s condition deteriorated rapidly, to the extent that she was in need of an urgent operation and of being placed on the drip. However, Shangula said that despite ongoing efforts by doctors and nurses to persuade the relatives and patient to sign the consent forms, this fell on deaf ears as they refused to comply. “By January 27, the patient’s condition deteriorated, with high temperature, abdominal pains and no passing of stool. But still they refused to sign the consent form saying they wanted other family members to also agree to the operation,” the PS explained. It was only after finding out that without an operation Minyoi only stood a 10 percent chance of survival and would die, that the relatives eventually agreed and signed the form on January 29. What transpired after that confirmed the doctor’s initial diagnosis. “What they found inside was that 60 centimetres of the intestines were dead and there were two litres of pus with stool in the abdominal cavity, which explains the septic shock. She was in a very, very bad state,” said Shangula. He added that previous claims that the wound was not closed up after the operation, were untrue. “They closed the abdomen” but after more septic fluids were still coming out, the qualified Cuban surgeon decided to re-open the wound for drainage on February 3. “They decided on the second operation because pus was still forming despite the abdominal cavity having been cleaned and the patient having been given antibiotics,” he said. Due to her critical condition, doubts were raised about transporting such a sick patient from Katima Mulilo to Windhoek, a distance of 1ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 200 kilometres. However, when her condition improved slightly, Minyoi was transferred to the Katutura State Hospital on February 21, where treatment could be more effective as all the necessary medical supplies were readily available.