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An investigation has commenced into the death of a woman who sought an abortion at a clinic run by aChief Medical OfficerDr Shamdeo PersaudBerbice doctor. The woman, 22-year-old Kamili Arjune, had gone there to seek an abortion. The probe, now, is to ascertain whether the doctor was certified to perform medical terminations of pregnancies.This is according to Chief Medical Officer (CMO), Dr. Shamdeo Persaud, who yesterday intimated to this publication that the fact that the matter was not reported to him constitutes a violation. He said that he first learnt of the woman’s death from a report carried in yesterday’s edition of this newspaper.According to the report the woman, a national of Suriname, was visiting Berbice during which time, she sought the services of a doctor to perform a medical termination (abortion). The doctor is attached to the privately-operated Dr. Rahaman Clinic. The operation reportedly occurred on Good Friday and lasted more than one hour at the doctor’s clinic situated opposite the Port Mourant Hospital.Arjune, a mother of four, was accompanied by her aunt, Valley Permaul, who told this publication that she became concerned that the procedure was taking too long.  Her worse fears were confirmed when the doctor informed her that Arjune had died.Following the post mortem examination conducted by Pathologist Dr. Vivikenand  Brijmohan, specimens have since been taken and sent to the city for further investigations.Dr. Brijmohan said that he did not see any perforated uterus, so he concluded that the death was notDead: Kamili Arjuneabortion-related. He said that it could have been the result of the anaesthetic. He also noticed an enlarged spleen which could have signalled an underlying medical condition.However, the woman’s family members are calling on the relevant health authorities, including the CMO, to look into the death.Neither the woman’s death nor the findings of the PM were reported to the Ministry of Health, according to the CMO.  He said it is required by law that once a pregnancy-related death occurs, that it be reported to his office.“Any woman who dies during any stage of pregnancy or up to 42 days after delivery must be reported to the relevant authority (the CMO’s office),” said Dr. Persaud as he related that it is expected that such deaths within Regions Two, Three, Four, Five, Six and 10 be reported within 24 hours, while those that occur in the hinterland regions must be reported within 72 hours.“I have been trying to get on to my people in Berbice,” said Dr Persaud when contacted by this publication yesterday for a comment on the matter. He noted that while he has not received any formal complaint from the family, he had expected that, at least, the pathologist would have sent him a notice.“The only thing I have on file right now (as it relates to this case) is a clipping from your newspaper,” said Dr Persaud.Even as he highlighted that any doctor performing an abortion must first be so specifically certified, Dr Persaud noted that he could not say whether the doctor in question was certified. And according to him, the process of certification has been completed for this year.In order to be certified to conduct abortions, doctors are required to present their credentials to the office of the CMO for them to be reviewed.In the case of a private doctor, the CMO is then tasked with coordinating an inspection of the doctor’s facility to determine whether it has the capacity to deal with any eventualities and therefore must have in place sanitary/sterility requirements, in addition to the capacity to provide counselling to those accessing the service.“I am currently investigating all sides of the legality of this doctor’s operation…I will write to him to get a complete statement of the evidence that led to the demise of the young lady,” said Dr Persaud as he reiterated that the matter not being reported to him is a breach.Added to this, the CMO asserted that “if he is not certified it is a further infringement.”Without certification, the actions of the doctor, which resulted in the death of the woman, could be classified as misconduct or malpractice which will attract disciplinary measures from the Guyana Medical Council. Should the doctor be found guilty, the Council, according to Dr. Persaud, could impose sanctions such as a letter of reprimand, suspension of licence (determined by both the Council and the Minister of Health) or he could be stricken off the Council’s list of doctors eligible to practice in Guyana.As part of the probe into the death, Dr. Persaud said that the doctor in question will have to provide him with all relevant charts, documents, notes of the operation in addition to a report on the matter and the result of the PM.The investigation comes at a time when the Health Ministry has identified a number of selected health facilities countrywide that are able to offer the medical termination of pregnancy service at no cost to patients.Although a Medical Termination of Pregnancy Act was brought into being since 1995, under the tenure of then Minister of Health, Ms Gail Teixeira, the related issue has been one fraught with controversy with some persons advocating for the provision of the service while others have been opposing it.“We didn’t make an announcement deliberately, because we didn’t want to stigmatise any institution or health professionals, because in some countries there are designated abortion clinics and we don’t want to go there…” Dr. Persaud said during an earlier interview.Although recently implemented, the termination of pregnancy service has been running smoothly at several public health facilities, according to the CMO.  He pointed out that this has seen the Ministry being able to “institute the full law, which means that women seeking a termination of pregnancy, not related to medical conditions, incest or rape, can by choice come to one of the clinics to access the service.”Ahead of being afforded the service, Dr. Persaud explained that women are provided with pre-termination counselling. This, he noted, is in keeping with the Act which requires that a 48-hour period be given to patients to consider whether they still desire to proceed with the procedure or not. And according to Dr Persaud too,Cheap Basketball Jerseys, “if they wish or wish not to discuss with their partner that’s fine; the law does not mandate them to do that…it is fully the woman’s right; she has the time to consider based on the counselling session whether she would like to go ahead and there are also options that will be given to her.”“The law says that options should be described to the pregnant woman, one of which would be to go through with the pregnancy and maybe adoption options and so on, and then of course detailing the termination process itself which can have consequences,” outlined Dr. Persaud.He noted, however, that there may be instances when some women may not opt to voluntarily have an abortion, but are instead forced to do so for various reasons which could range from migration to marital issues.As such, the importance of counselling cannot be understated as part of the process, said Dr. Persaud, as he stressed that “counselling gives enough room for people to consider all the factors and make informed decisions in the end.”Once a woman has carefully considered the possible options, she can then return to an approved health centre that is certified by the CMO to have the procedure done. On completion of the procedure, patients are then subjected to post-termination counselling which, according to Dr. Persaud, “includes the provision of contraceptives so that they do not use termination as a form of contraceptive…this is to ensure that the next time around they would use an approved non-termination technique.”Dr Persaud disclosed too, that the Health Ministry has been working to ensure that all those certified to conduct the procedure are properly trained and are making use of the recommended safe measures for pregnancy termination.