Credit: Family Photo provided to RIP.ie

Her name was Ahana Singh, and she died because of our broken, beleaguered HSE

Her deep brown eyes glittering full of fun, she beams up at the camera as her newly finished piece of artwork is held up with pride to be snapped beside her. The playful yet careful strokes and swirls of hot pink, burnt orange, dark blue, and bright yellow dance on the piece of card, beside a beautiful young artist who is clearly proud as punch with the result.

Her name was Ahana Singh, and she was just four years old. Now she is dead, from a treatable infection, even after her distraught parents begged the hospital to give her an antibiotic that might have saved her. 

Dressed in a paint-splattered apron, Ahana is the picture of health and happiness in the gorgeous recent photo, released by her family and published in a heartbreaking piece in the Irish Independent at the weekend (Sunday 8 January). She was a beautiful child, full of love and vivacity and brightness, who, as told by the Irish Independent’s Rodney Edwards, dreamed of living in Dublin.

In the run up to the move from India to Ireland last Autumn, Ahana would watch videos of Dublin on her father, Varun’s phone. Mr Singh, his wife Nalini, and daughter Ahana, got the opportunity to move to Ireland as part of his work with an IT company. Although the family made the move mainly for Ahaha – that she would grow up and have lots of opportunities here – the small girl was the one who was most filled with excitement and anticipation for the move.

Thousands of miles later, the family arrived in Dublin just over three months ago, at the start of October. But just two months to that day, on December 3rd 2022, their precious Ahana was gone. The Singh family are now left entrenched in an unthinkable type of anguish; seeking answers after their daughter died from a Strep A infection which went undetected during a visit to Temple Street Children’s Hospital. 

Strep A is a common type of bacteria, and the majority of strep A infections are mild and easily treated with antibiotics. The HSE advises parents to: “Trust your instincts. Contact your GP, GP out-of-hours or emergency department if you are worried about your child”. But in Ahana’s case, her family were unable to access a GP, and, deplorably, the presentation of a sick and exhausted child at a Dublin A&E did not result in the right treatment being given. 

Ahana was only two weeks short of celebrating her fifth birthday. She had already picked out the birthday cake she wanted, with plans made on the week she died to decorate the Christmas tree for the Singh family’s first Christmas in Ireland. Her birthday presents, a pair of roller skates and a Barbie, were ready for her to open, and she had selected a special party theme: Princesses and Barbies. Her mother says Ahana had asked that all her friends attend.

When asked on one occasion by her parents if she had friends at her new school, St. Brigid’s Girls National School – which she had joined just three weeks previously – the little girl replied cheerfully: “I have 100 friends”. She is now bitterly missed by her classmates and family and friends both in Ireland and India. 

The Singh family’s new start in Dublin was supposed to promise opportunity, but instead, grief, shattered dreams, and bewilderment are all that is left. There are many unanswered questions, and as her father relayed, so much punishing, unshakeable guilt – but nothing in the way of answers, and little in the way of consolation.

Questions like: How could such a thing happen to a child in Ireland in this day and age? A wealthy country; a developed nation; a ‘progressive’ EU member state with a well funded national health service? 

How did a Strep A infection go unnoticed, at a time when health officials were warning parents up and down the country to look out for symptoms amid a rise in cases? How could a family, who should have felt so safe and protected in an Irish hospital, have been so catastrophically let down?

Speaking to The Independent, Ahana’s mother said she was surprised at the way Ahana was treated in the hospital when she presented there with dehydration. She was not put on a drip or taken for tests. 

At Temple Street, a nurse gave Mrs Singh two bottles of water to give to a dehydrated Ahana.  “In India, they put you on a drip if you are dehydrated,” Mrs Singh said. “Sometimes you need that IV drip to bring you to normal. I was hoping that maybe to remove the excess dehydration they would give her a drip or something. But they were asking me to force the fluids down her throat”, she told the Independent.

CHI declined to comment on this when contacted by the paper.

The family felt they were failed at so many stages. Having tried to get registered with a GP here that previous Monday when Ahana began coughing once every two hours, they were not given an avenue to visit a GP in person. Still awaiting their PPS numbers and other things, Ahana’s parents called multiple GP surgeries. All told them they were full, and were not taking new patients. 

Her parents didn’t feel there was anything serious to be concerned about at that point, and Ahana went to school. However, on the Thursday, she started to develop a fever and a temperature. When she began to complain about pain around her neck, the family knew something was wrong, as Ahana “never complained about anything”.

They only knew to bring Ahana to Temple Street when they eventually found a virtual GP who advised them they may want to check for meningitis, so they called a cab to bring her to the children’s hospital. 

Her mother relayed to the Independent how Ahana, for the first time since birth, was sick while inside the taxi. It was a full six hours before Ahana was seen by a doctor at Temple Street.

Inside the crowded hospital, all the chairs were occupied, as well as the benches, so Mr Singh stood for almost six hours while his wife brought Ahana into triage – invoked when acute care cannot be provided owing to a lack of resources. 

He relied on text messages from his wife as just one parent was allowed inside the emergency room with Ahana. Suspecting his daughter was very unwell, as it reached midnight, a desperate Mr Singh, separated from his wife and Ahana, texted Ms Singh from just yards away, “Please ask them to give her some antibiotics – or something”.

“It must be some sort of infection,” he ventured, “…this is not normal”. 

He told The Independent that the hospital failed to perform any tests, X-rays or blood tests on Ahana. Instead, the family say she was given medicine to stop the vomiting. They were told her condition would “get better”. 

They left the hospital feeling assured that what Ahana was suffering from was nothing which would require urgent treatment.

When they returned home, the little girl had just hours to live. She was now bleeding from her nose and her mouth, and soon fell unconscious. At around 5am, she had returned home from the hospital, but by 4.10pm that same day, she was gone – after the hospital missed all warning signs and failed to treat a bacterial infection which should have been treatable. 

As told in the heartbreaking interview with the Independent, Ahana’s final words were “Papa,” as she laid her head on Varun’s shoulder, weak and barely able to speak. He rubbed her back, and tried asking her what was wrong, but she was already fading away; her parents now helpless to do anything but to look on in utter despair. They placed their trust in our health service, and it failed them beyond measure.

 “Maybe we should have protested more, maybe if she had got an antibiotic things would have been different,” they say on reflection. A devastated Mr Singh says he has lost faith in everything. 

The family have been left with a horrific sense of guilt, but the guilt is not theirs. Her parents did everything they possibly could, but were let down at so many stages – from not being able to register, to tests not being done, to being sent home.

Just days later, on December 19th, another child died after waiting up to 16 hours in an Irish hospital. 16-year-old Aoife Johnston, from Clare, died from meningitis after waiting a period of 13 to 16 hours to be seen at a Limerick A&E. 

She also needed antibiotics but was not seen promptly enough. Her condition was not classed as non-life threatening, and by the time she was finally prescribed the antibiotics, the schoolgirl’s condition had deteriorated past the point of recovery. Both children’s condition were not taken seriously enough, and treatment in both cases was not given on time.

And in both cases, just days and miles apart, both parents pleaded for action to be taken. In what other developed nation do parents have to plead and beg for their children to be treated in a hospital?

Where is the media spotlight? – and where are subsequent vigils and protests and social media posts? Why are we not taking to the streets in anger and anguish over the deaths of these children? Perhaps the answer is found in the fact that such preventable losses, which simply would not be tolerated or accepted elsewhere, have become so shamefully predictable in modern Ireland.

If seems we have become conditioned in Ireland to accept a margin of error, in the form of tragic and avoidable deaths. Lessons should have been learned long before now. 

And it is surely an indictment of our media — and the failure to hold politicians to account — that both cases have attracted incredibly minimal media coverage. 

The death of Aoife Johnston did not make the RTE main headlines until Christmas Eve, after Taoiseach Leo Varadkar confirmed that a serious incident management team had been set up to review Aoife’s care. And many of us, myself included, had not heard about the devastating death of Ahana Singh until The Examiner spoke to her parents last weekend – more than a month on from her death after returning from an Irish hospital, having failed to get the help she needed.

The shattering deaths of Ahana Singh and Aoife Johnston show us we live in an Ireland of zero accountability. Ministers don’t bother to release statements, and our state-funded media fail time and time again to hold ministers to account – because they are above being answerable to any of us. 

In many other countries, the Health Minister would have resigned weeks ago. How can we have two children dying preventably in a month, and yet our Health Minister and Taoiseach are once again allowed to give stock answers? 

The Johnston and Singh’s families are only the latest to be bereaved by the ineptitude, incompetence, and unfathomable unaccountability of those in this country who are obliged, and well-paid, to run a functioning health service.

In Ireland, it is estimated that there are 1,000 deaths every year due to medical negligence, including deaths relating to surgery, medicine, maternity, and gynaecology.  A further 160,000 people are estimated to experience an injury owing to human error in our hospitals. 1,000 unnecessary deaths each year as a result of medical error is an inexplicably shocking reality. 

The usual statements when tragedies like this happen are rolled out time and time again. We are told, as we were last week by the interim head of the HSE, that adverse events are reported, and fully investigated; that lessons have to be learnt – but nothing ever changes. 

Each time we try to seek accountability, we receive the HSE’s quintessential response – which is that it cannot comment on individual cases. Indeed, as Children’s Health Ireland said in a statement relating to Ahana’s death:

“Children’s Health Ireland cannot comment on individual cases. When a patient or family makes personal information public, this does not relieve the hospital/CHI of its duty to preserve/uphold patient confidentiality at all times.”

“A review is under way and CHI is in direct contact with and supporting the family at this time,” they added. But people are not statistics; they are individuals, whose broken-hearted and bewildered families deserve answers at a bare minimum. 

Health service spending has increased from €13 billion to €23 billion under this Government, over the past decade. But what do we have to show for that money? Despite our health service having more money than ever, people are discouraged from using the service anyway – to ‘consider all options’ before showing up at a hospital. Others, again, especially older people, say they are afraid of turning up in the first place, for fear of dying on a trolley, because they cannot guarantee they’ll get a bed.

The words of Ahana’s devastated father ought to haunt our HSE: “If we hadn’t come here it would never have happened”.

A friend from India recently told me about how someone he knows got sick last year. Fearful he had cancer, the individual in question was told that he would have to stay on a waiting list in Ireland for roughly eight months before he would be seen for tests by the HSE. On telling his family the situation, his father called him and told him to go home to India as soon as he could to receive care there. 

On returning home to India, he was able to undergo tests straight away, which revealed that he had an early stage cancer. He immediately underwent treatment – remaining in India for the next eight months or so. Thank God, he is now expected to recover fully, and is now back in Ireland. 

What would have happened had he remained in Ireland and waited for that initial appointment? What does this say about our health service? Chances are, by the time he was expected to be able to get initial tests here under the HSE, the cancer could very well have progressed to stage three, stage four. God only knows what would have happened.

Perhaps, decades of putting up with a health service which is not functioning how it should be, and is now unfit for purpose, has conditioned us in Ireland to tolerate a totally unacceptable margin of error, one which comes in the form of human lives. But what’s clear is that such a situation would not be tolerated in many other countries. 

How many more human victims Is it going to take?

Speaking to The Independent, Ahana’s mother recalled a nurse at the hospital saying to her: “Welcome to Ireland”. But this is far from the welcome Ahana’s family should have received. 

What they have endured should shame, anger and upset us all. And unless we find a way to fix our broken, beleaguered health service, it is unfortunately the welcome Irish people presenting to hospitals, and others coming here in search of a better life, will inevitably receive.

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