Letter To Dr Balkanski, Varna Regional Healthcare Center Director
To: Dr Balkanski, Varna Regional Healthcare Center Director
Copy: Mr. Sl. Bogoev, Minister of Health
12-Dec-2003
From: Reneta Stoyanova,
[address]
Dear Mr. Balkanski,
Re: Your interview published in Pozvanete Novini (Call Us News), issue 271, 13-Nov-2003
I will not go into details about the incompetent assertions which appeared on your behalf on the pages of the above mentioned newspaper because I assume the journalists might have misinterpreted some of your words, not intentionally, of course.
I shall only bring your attention to a few moments which have impressed me strongly especially on the background of the Libya trial.
First, you say that medicine is risk, that it always exists. I agree that there is risk in medicine indeed, but it will be minimal when the standards of good medical practices are observed. And vice versa, it will be indefensibly high when they are not observed. An example for indefensibly high risk is the infecting with the virus of AIDS of two nurses from the hospital in Bengazi compared to 50 health workers infected with AIDS in the whole world. St. Marina hospital presents even a better example: not less than three nurses infected with the virus of hepatitis B, the three of them from the same hospital ward. I believe it was this that you should have told the journalists and thence the citizens, and not "every one manipulation in medicine goes with its risk."
Second, there is Regulation 13 of 30-Jul-2003 containing several pages most detailed medical, technical and other standards for the dialysis centers to comply with, incl. clear virologic standards: testing of all patients and staff for hepatitis B, C and AIDS every six months. This regulation was published in State Gazette, issue 80 of 9-Sep-2003. I believe it was this that you should have told, and not "I do not know all the standards by rote. I have my subordinates who perform their duties... most probably, there are regulations as to how often or over how many months testing of the staff working in a risky environment should be made."
Third, the regular testing of the patients and staff in HD units is like testing of blood for transfusion: both are obligatory and both seek reducing the risk to a minimum. You say, "We cannot be sure about any single patient even if he has been tested... If certain patient gets infected with something, there is incubation period during which we cannot catch the virus." For the same reasons, we cannot be sure about the blood for transfusion, either. Why not cancel blood testing before transfusion then, too, since we cannot be sure?
And last, during the foreigners' stay, for two weeks almost all of our not-infected patients were dialyzed on infected machines so that there were clean machines for the foreigners. This topic you should have discussed. However, I cannot see any obstacles why you should not do it now, after half a year.
I shall be very grateful if you shared your opinion on the questions raised here, especially on the last of them.
Sincerely, Reneta Stoyanova, ex HD nurse in the HD unit at St. Marina hospital, Varna