It has now come to light that the 14 year-old boy who was tortured by Guyana Police officers at the Leonora Police Station was while in Police custody examined by Dr. Mahendra Chand, at the Vreed-en-Hoop Police Station on October 29, 2009, shortly after the abuse occurred. Dr. Chand is a Government Medical Officer (GMO) and Police Surgeon, and was surreptitiously summoned to examine the child’s injuries – an indication that the Police Commissioner knew of the abuse but did not launch an investigation until the matter became public.

Detectives from the Criminal Investigations Department (CID) who were investigating the murder of ruling PPP government official, Ramnauth Bisram, arrested the lad and attempted to coerce him to sign a confession and to give up presumed information on the murder. When he refused, they beat him with a wood about the head and ears; stapled his genitals and doused it with a flammable liquid and lit him afire. He sustained second and third degree burns in the genital area.

The wounds were so severe that the command felt compelled to summon Dr. Chand to examine the child. Having seen the “areas of brutality” as he puts it, Dr. Chand failed to refer the case to child welfare or higher law enforcement authorities for investigation. The matter only became public when it was leaked to the press and a photographer gained access to the lad while in Police custody and published a photograph of his badly burnt genital area.

Demands have been made for the Guyana Medical Council and the Director of Public Prosecutions (DPP) to investigate whether Dr. Chand violated any criminal law and/or ethical rules by his failure to report obvious acts of torture of a minor, and whether he knowingly minimized the lad’s injuries to conceal the torture of this minor; thereby obstructing justice.

In response to public criticism of his conduct, Dr. Chand attempted to defend his actions in a letter published in the Stabroek newspaper on November 14, 2009. In his very letter of November 14, Dr. Chand admitted to ethical and/or criminal misconduct which warrants an official inquiry to determine criminal culpability as well as his competence to practice  medicine.

Foremost, it must be noted that Dr. Chand said in his letter that “I was called out by the police administration to see a patient about ten kilometers away from my home at 6 pm, a time very much outside my normal working hours.” This declaration reeks of unabashed indecorousness and arrogance which insults humanity and the medical profession. The supreme duty of a Medical Doctor (MD) is to help save lives whenever called upon. The MD should view such responsibility as an honor and commitment to civilization, not as a personal favor. Therefore, if Dr. Chand truly believes that seeing a patient at 6:00 P.M., in the afternoon is acting beyond the call of duty, then he needs to find a new profession.

This notwithstanding, Dr. Chand’s letter is a damning indictment of himself and what we believe to be an admission therein of unprofessional, unethical and likely criminally negligent conduct.  In the referenced letter, Dr. Chand made the following claims:

(I) Dr. Chand said that “I was presented with the said patient who was naked except for his head which was covered with a bag… the bag “was not tightened at the neck with a string and the patient was breathing comfortably.” No MD worth his salt should ever treat a patient with a bag over the head. His medical training would have emphasized that in performing a medical examination, it is necessary to obtain a complete history from the patient and to perform a comprehensive physical examination. Obvious Dr. Chand did neither. Who did he think he was seeing – an animal? As a human concern, why didn’t he demand that the bag be removed?  The fact that the Police had the audacity to present him with a patient in this condition should have insulted his sense of human decency and profession, and signaled possible abuse unless this in his experience was a normal practice. A bag over the head of an injured person in Police custody in itself constitutes cruel and inhumane treatment, which under the law, Dr. Chand is obligated to report to higher authorities. At no time did Dr. Chand say that he questioned the patient. Therefore his conclusion that the patient was “breathing comfortable” is speculative and medically tenuous.

(II) Dr. Chand asserted that “The injured area was exposed and that was solely my concern and focus.” How inhumane and unethical could Dr. Chand be? As an MD, it is Dr. Chand’s duty to be “concerned” with the holistic welfare of his patient. To abdicate this responsibility is to indulge in callous indifference to human life. For him to publicly admit that a patient in the custody of the Guyana Police, which has a sordid history of abuse and torture, who presented with a bag over his head and severe burns on his genitals, warranted no further concern is abominable and criminal. Wasn’t he concerned that the patient may have had no eyes, for instance or had other burns on his head which was covered?

(III) Dr. Chand further said “On examining the area I concluded that the patient was suffering from 1st degree (superficial) burns of the genital area, upper thighs and lower buttocks (5-9%). I did not see any other “areas of brutality” as alleged by the Guyana Human Rights Association (GHRA), nor did I see any signs of dehydration as alleged by the GHRA. This is an absurd, baseless misdiagnosis that violates every standard of the medical profession. First, Dr. Chand who herein admits to “brutality” knowingly failed to report the abuse. Second, it is now public record that the child suffered at least second degree and possibly third degree burns. Third, Dr. Chand’s obviously misdiagnosed the condition of the patient. Fourth, he admittedly never thoroughly examined, or in any way questioned, the patient to determine how he got the injury and how he was feeling. Neither did he state that he checked his temperature or counseled him on how to avoid such injuries in the future. All of this encompasses the responsibility of an MD and is essential to an informed diagnosis and prognosis. An investigation will therefore determine if his misdiagnosis was due to ignorance, lack of training or intentional to decrease the severity of the injury, pain and suffering of the patient.

(IV) Dr. Chand further stated that “Nor did I see any signs of dehydration.” How could he have made this determination? Did he ask the patient if he had access to food or water? NO. Did he ask the patient if he was experiencing abdominal pain which may be consistent with dehydration? NO. Did he remove the bag and examine the patient’s face, eyes, lips, mouth etc., to conclusively determine the absence of dehydration? NO! Having failed to perform these basic medical functions, Dr. Chand’s conclusion that there were no signs of dehydration was misguided.

(V) Dr. Chand also claimed that “I did mention verbally that the patient should have been carried to the hospital.” This is a very pedantic and imprecise account which further accentuates sloppy work. What does he mean by “I did mention verbally?” Did he or did he not direct the Police to take the child to a hospital? Given the severity of the injuries, and the fact that the patient was in a jail cell and susceptible to further infection, Dr. Chand had a professional duty to insist that the patient be taken to a hospital. As a medical professional, he was duty bound to ensure that his medical judgment prevailed over Police procedure and inhumane treatment. He had an obligation to contact the Police command to inform them of his medical judgment and recommendation. He also had an obligation to announce the patient to the intended hospital and to follow up with that institution to assure the patient’s best possible treatment and care. His contention that “I left the Vreed-en-Hoop Police Station with the assumption that the patient would have been carried to the hospital as soon as it was possible to do so,” is therefore unacceptable and repugnant to professional protocol.

(VI) Moreover, Dr. Chand stated that “I had a stamped prescription which I had walked with in anticipation of any medication that needed to be prescribed and I did prescribe antibiotics/analgesics and an antiseptic cream.” However at no time did Dr. Chand state that he interviewed the patient. How therefore could an MD have prescribed medication for a patient without knowing that patient’s name, address, date of birth and whether that patient was allergic to the medication being prescribed? This is unethical.

(VII) Clearly, if Dr. Chand had been competent enough to obtain a complete history from the patient – in the process ascertaining his age, he would have and immediately realized that he was examining a minor; determined that his injuries suggest that he was the subject of abuse, and that it was inhumane for the police to hold a child with such injuries in a jail cell, much less present him to a MD with a bag over his head. Human decency would have then dictate that he report such abuse and cruel treatment to the Police Commissioner and Child Welfare Division of the Ministry of Human Services. It is uncivil not to have done so.

(VIII) Dr. Chand posits in his letter that “I have always treated patients presented to me with care, sensitivity and concern, whether they be ranks from the Guyana Police Force, detainees from the lock-ups or prisoners. I have never ever knowingly or unknowingly encouraged torture, neither have I ever participated in any cover-up.” Dr. Chand’s should be ashamed to make such a brazen self-endorsement of his own professional integrity and ethics, as the facts in this case, eviscerate and disprove his contentions.

Clearly, Dr. Chand’s letter establishes prima facie wrongdoing on his part. The GHRA’s condemnation of him was apposite. He has admitted to obvious unethical and criminally negligent conduct which leaves the reasonable mind to wonder if he is a common “quack”.

Dr. Chand’s letter is incontrovertible evidence that he was complicit in the torture of the minor; the concealment of a crime against humanity and that he possibly committed obstruction of justice. His conduct therefore justifies a criminal  investigation as well as professional peer review; and is deserving of severe discipline, as I hereby request.  All awaits the Guyana government’s action.