Dr. Momodou Bittaye, Chief Medical Director EFSTH
By Landing Ceesay
The Chief Medical Director of the Edward Francis Small Teaching Hospital (EFSTH), Dr. Momodou Bittaye, appeared in court on behalf of Health Minister Dr. Ahmadou Lamin Samateh to address the High Court’s concerns over the Ministry of Health’s delay in providing crucial documents related to the deaths of Gambian children from Acute Kidney Injury (AKI).
Dr. Bittaye’s court appearance followed Hon. Justice Ebrima Jaiteh’s rebuke of the Health Minister’s absence during a previous session despite being formally summoned. The judge described the absence as “unacceptable and disrespectful,” underscoring the seriousness of the matter.
The court had summoned the health minister to present medical certificates relating to the tragic deaths of Gambian children from Acute Kidney Injury (AKI), which is believed to be linked to contaminated syrup imported from India.
During the court session, Dr. Bittaye, representing the Health Minister, informed the court that some of the requested documents were available, while others were still being sought.
“Do you have the notice to produce documents on this trial?” Hon. Justice Jaiteh asked.
“Yes, I have the notice to produced documents. I have the death certificate of Fatoumatta Keita. On the notice to produce, I have the following: the death certificate of Musa Kamaso, the death certificate of Madeline Mendy, and the death certificate of Ismaila Danso, and we are still searching for the remaining documents,” Dr. Bittaye said.
Dr. Bittaye informed the court that a team had been sent to several healthcare facilities across the country to collect the requested documents. He explained that this was necessary because the country does not have a computerized record-keeping system.
Justice Jaiteh instructed Dr. Bittaye to submit the remaining documents on the next adjourned date.
“If you help us, that will be great. I am glad that your team is out and about looking for these documents. I know you have to go through your archives and look for these documents, but you have to help us. If you help us with these documents, it helps us to reach at the just conclusion of this case,” Hon. Justice Jaiteh said.
“Insha Allah, we will do our best to provide these documents,” Dr. Bittaye assured the court.
Justice Jaiteh subsequently discharged Dr. Bittaye from the courtroom after he provided some of the requested documents.
These documents were tendered, admitted, and marked as exhibits, as the State raised no objections to their admissibility.
Counsel V. Andrews, representing the Plaintiffs, informed the court that they had no further documents to submit, aside from those Dr. Bittaye and his team were searching for.
Before Counsel Binga, representing the State, could tender the documents they intended to rely on in the trial, Hon. Justice Jaiteh encouraged the State to consider an out-of-court settlement of the case.
“I crave the indulgence of the state to engage the victims to settle this matter out of the court. It is still not late to settle this case out of the court. That can be done anytime before the judgement. These are Gambian citizens, and they are living in the Gambia. All they want is Justice for their children. The court is the last resort for them and their last resort cannot be shattered like that,” Hon. Justice Jaiteh said.
However, Counsel Binga proceeded to tender the documents the State intended to rely on in the trial.
“My lord, we are applying to tender the photocopies listed on the Medicines Control Agency, The Gambia (3rd defendant), the Ministry of Health (4th defendant), and the Attorney General (5th defendant) list of documents subject to the production of the original copies,” Counsel Binga applied.
Counsel V. Andrews informed the court that they have no objections to the admissibility of the documents.
Hon. Justice Jaiteh then admitted these documents into evidence and marked them accordingly. The documents tendered by the State are: The Medical Control Agency Guidelines for repackaging and Labelling of Medicines, dated 10th July 2020:
The Medicines Control Agency, the Gambia Code of Ethics and Conduct dated December 2020: A letter from the Medicines Control Agency dated 4th October 2022 with registration MCA/AD/22/MJK (182) addressed to Healthcare Professionals with the subject: Urgent Medicine safety alert: The Medicines Control Agency guidelines for importation and export of medicines and related products dated the 10th July 2020.
The State also tendered Medicines Control Agency guidelines and registration of medicines dated 15th April 2020, a letter dated 1st November 2022 with the subject (update 6: from medicines Control Agency on suspected products in case of Acute Kidney Injury and death in children in the Gambia; A letter from Medicines Control Agency dated 7th October 2022 with reference MCA/AD/22/MJK(184) addressed to the Managing Director of Atlantic Pharmaceutical Company.
Counsel Binga also tendered a letter dated 4th of October 2022 from Medicines Control Agency addressed to the Managing Director of Atlantic Pharmaceutical Company with reference MCA/AD/22/MJK(181); a letter from the Medicines Control Agency dated 21st September 2022 addressed to all importers, wholesalers, distributors and retailers of Pharmaceuticals; A statement from the Medicines Control Agency dated 10th September 2022 and a statement from the Medicines Control Agency to all importers, wholesale, distributors and retailers of paracetamol syrup which is suspected in the case of Acute Kidney Injury and health in children in the Gambia.
Also among the documents the State wants to rely on in the trial are; A letter dated 7th September 2022 from the Ministry of Health with reference DHS/AD/2022/01/(42-MB) addressed to RHDs, OICs, CEOs of hospitals; The World Health Organisation (WHO) medical control alert No6/2022 with subject: substandard (contaminated) paediatric Medicine identified in WHO region of Africa; A letter dated the 3rd September from Medicines Control Agency with reference MCA/AD/22/MJK(203); report from Medicines Control Agency dated 28th October 2022 with reference MCA/AD/22/MJK(199) with a subject report on the product for analysis to Ghana, Switzerland and France.
Counsel Binga for the State further tendered a certificate of analysis; the World Health Organisation medical product alert No5/2023: substandard (contamination) syrup Medicines; and an update from Medicines Control Agency on the 16th September 2022 addressed to all importers, wholesalers, distributors and retailers of pharmaceutical products.
“My lord, this is all for the Medicines Control Agency, The Gambia (3rd defendant), the Ministry of Health (4th defendant), and the Attorney General (5th defendant) with the intention to provide further documents,” Counsel Binga informed the court.
Hon. Justice Ebrima Jaiteh directed both parties in the case to file their issues by the next adjourned date, 21st November 2024.
He further imposed a fixed cost of D2,500.00 to discourage delays and unnecessary adjournments. The trial is set to commence on the same date, during which families of AKI victims are expected to begin presenting their testimonies before the High Court of The Gambia.
Hon. Justice Jaiteh then adjourned the case to 21st November 2024.
Background History of the CaseOn July 26, 2022, cases of AKI emerged among children in The Gambia. Investigations in Ghana, France, and Switzerland detected Diethylene glycol (DEG) and Ethylene glycol (EG) in medication samples, leading to the removal of numerous paediatric medicines from the market. The affected products, all from Maiden Pharmaceutical Company, were promptly withdrawn.
The Ministry of Health of The Gambia confirmed that at least 70 children died due to the consumption of cough syrup produced by Maiden Pharmaceutical Company in India.
In response, 27 families of the AKI victims filed a lawsuit against several entities: Maiden Pharmaceutical Company Limited (1st defendant), Atlantic Pharmaceutical Company Limited (2nd defendant), Medicines Control Agency, The Gambia (3rd defendant), the Ministry of Health (4th defendant), and the Attorney General (5th defendant). These families are seeking damages of 15 million dalasis per child.