Cannot say when this all started there was the remotest idea that this would be what was being written.
However we are home, not sure for how long, but maybe a couple of weeks.

Whatever surprises we may have encountered in life, the sight of a baby shitting from its stomach is a first for me. She seems fairly unconcerned with the physical stuff.
However the extraordinary look of knowingness and terrible suspicion she gives everyone is not pretty to behold. Nonetheless she still grins at her mirror.

I keep changing my mind about whether to set out the whole grizzly and unedifying tale. One wonders what me dad would have made of it when he was still mens sana.

Why am I sending this into the world? I do not know. I suppose, in addition to the kindness so many people have given us, I just want it 'known'. We are both consumed with guilt- thinking that there must have been something we should have picked up on to suspect the hospital/doctors were incompetent. But the obstetrician was great…….and she seemed well…….
I think, too, the writing of it is therapeutic in a way. Maybe I am just trying to dream or write her better!

In spite of what follows…….. 'ahem' me learned friend speaks:

"I have been advised that neither the doctors, nor the hospitals, nor the little girl nor us should be named"………

I am not inclined to make it easy for the doctor to have the opportunity to do the same or worse to someone else's child. One of the heartrending aspects of the specialist hospital were the scores of kids who were there using up doctors time because they had been injured by private Thai hospitals.

We have to decide what to do. No-one wants to take legal action. But I am not young and we have to consider her future should she need long term medical care.

We have to be clear what we want and we have to be able to show that what occurred was negligent not misadventurous.

So.....yesterday you would have had the whole story...but I think it is better not. So here is just some of it!!

This little girl was born in May 2002 in a private Hospital in Bangkok Thailand.
She holds dual nationality from Thailand and a European country

The private hospital is recognised by insurance companies such as BUPA. It states that it holds ISO 9002 and ISO 14001 accreditation through the UK company SGS.

She was born by caesarian section there being some uncertainty as to whether she would alter her position which was over the pelvic bone. At birth she was given an APGAR score of 10 within 5 minutes and no malformations or defects were reported. She passed meconium and was urinating normally; she rejected infant formula and was breastfeeding. She was discharged from the hospital after three days.
Between birth and now she visited the Hospital on three occasions, was checked by the paediatrician and received appropriate immunisations. No problems were diagnosed nor presenting.

On August 31st 2002 she stopped shitting. Hitherto her movements had been apparently normal. As she is was breast fed there was apparently no undue cause for alarm; though some solid foods-banana, rice, papaya and prunes were introduced into her diet around August 31 she ate very little of them.

On September 2nd she was taken to the hospital for a routine immunisation and check up. No problem was diagnosed or presenting.

When by September 10 she had not passed a stool she was taken to the Hospital. The diagnosis, by two doctors, was that there was no cause for worry but that an enema could be administered. This was not done. There was no physical examination. On September 15 a hard mass could for the first time be felt in her stomach so she was taken back to the hospital.

She was admitted to the hospital. X Rays were taken and a mass of faeces was identified on the right hand side of her stomach; ..'suggestive of dilated sigmoid colon'. A small amount of faeces was also identified on the left hand side. The radiologist's report continues: 'dilated bowel loop in upper abdomen. Just below diaphragm; could be transverse colon. Some air density in small bowel. …Hirschsprung's disease should be considered.'

For whatever reason this report appears to have either not been read by the doctor at the hospital or ignored or rejected. No tests for Hirschsprung's disease were carried out, nor for any other possible malfunction; no barium meal was given for example, nor was any proposal for rectal biopsy made. The doctor's notes for the morning of September 16 raise, for the first time the idea that she has a congenital fistula as the enema administered on September 16 resulted in a discharge of fluid from the vagina. Such a diagnosis had never been previously stated.

We took the decision to remove her from the hospital and seek specialist advice. The doctor at the Hospital wrote a letter outlining the procedures that had been carried out and the diagnosis.

On September 17 she was taken to a specialist Hospital An internal camera identified that there was a fistula between the vagina and the rectum. He said that :'the fistula is very high up above the hymen.'

He said further that: ' I am astonished at what we have found. I have never seen such a thing before. It is certainly not a congenital fistula but a most serious trauma that someone had recently caused'

So amongst other things she now has a colostomy to begin the process of removing the faeces and cleaning the rectum, anus and vagina.

We now wait two or three months . If it does not close he will have to operate to try and close it surgically, with the attendant uncertainties of success. And we still do not know the precise cause of the build up of faeces.


On September 21 I went to the Hospital and obtained a copy of her medical history from birth. I spoke briefly with the paediatrician who inquired after her. I told her that she was with her mother and I did not know; and that the reason for wanting the notes was so that any hospital we took her to in England or the US would have her medical history. The paediatrician expressed the opinion that taking her abroad was un-necessary and 'that she had suggested to ** that she take her to C********** Hospital in Bangkok but that ** had refused'. This is an untruth. No such suggestion was ever made. Nor is any proposal for referral made in the notes.

The order of statements in the letter from the Hospital, the medical notes from that hospital, the sudden appearance of faeces in the vagina and the diagnosis from the specialist Hospital suggest to a reasonable degree of certainty that the trauma was caused by a doctor or an assistant at the hospital passing a dilator from through her rectum into her vagina at some considerable depth; and that the diagnosis from that hospital is a rather clumsy attempt to conceal their error.
..............................
Personally I cannot conceive of what was going on in the mind of the doctor......a child comes with what turn out to be some classic symptoms, a radiologist, too, suggests what to look for. I can find the possible diagnoses in the online pages of hospitals in Boston, Cincinatti and Iowa in a couple of minutes and the tests and treatments. No one suggests sticking dilators inside a small child as a start!

And, whatever the late Lord Denning or any other of me learned friends may think, I cannot interpret what happened as 'misadventure' or the inevitable concomitant risks of any medical procedure!