Botswana: Drama in Court As War-of-Words Erupts Over Medical Report

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Original Post Date: 2009-05-19 Time: 03:00:14  Posted By: Jan

By Ephraim Keoreng

A defence lawyer tried unsuccessfully to throw out a medical report by a clinical psychologist at the High Court in Lobatse in the case involving a woman who was wrongly diagnosed with HIV/AIDS in 2003 in a government health facility.

From the onset, Charles Gulubane of the Attorney General’s chambers was in a fighting mood.

He took on the expert witness, Claire Hearne – a clinical psychologist – who gave a report indicating that Kgakgamatso Sekgebetlela suffered post-traumatic disorder as a result of being wrongfully diagnosed of HIV/AIDS with the ferocity of a jaguar. Armed with a Diagnostic and Statistical manual of mental disorders textbook, Gulubane moved in and told the witness that she had not followed the right procedures whilst examining her client, Sekgebetlela.

He also said that it was surprising that the report showed that Sekgebetlela was estranged from her husband as a result of the wrong diagnosis, something she failed to tell the court when giving evidence.

“I have a problem with some of the information in the report because your client did not in this court, disclose what’s in your report. She didn’t say it in court, that she ended up being estranged from her husband,” said Gulubane.

For her part, Hearne, who looked ready to take the punches from the attorney, explained that a clinical interview is an accommodating environment, and with three women (Hearne, a social worker and the client, Sekgebetlela) talking to one another in a relaxed mood enabled one to speak freely. She said that it was not like in court, a public place which is also formal. People might feel uncomfortable revealing some personal information, she said.

However, the lawyer was adamant, saying that such an environment under which Sekgebetlela gave the information could give an opportunity for information that was not put before the court, “inserted,” he said.

Gulubane asked the clinical psychologist how come she recommended family therapy yet she never interviewed Sekgebetlela’s family.

“The husband was already hostile to his wife and this showed that it was necessary for them (family) to be treated,” she said.

The cross examination nearly turned into a war-of-words, when the defence lawyer asked to see the test results from the interviews conducted on Sekgebetlela by Hearne.

She said that she left it in her office in South Africa and would not give it to anyone other than a certified clinical psychologist. Though Gulubane tried to impress it upon her that “in your report you gave an interpretation, we would like to see what you were drawing your conclusion from,” she stood her ground, insisting that she would not hand the results to him or the court “because it may be used for something else” .

When Gulubane said that it was unprofessional to use one sentence for an evaluation of a test result, instead of a whole page, Hearne, who was clearly enjoying herself, retorted: “If your IQ is 110 and I write 110, do I need to write a whole page?” she said, sparking a rebuke from the judge.

“Don’t argue, just answer the question,” said Justice Key Dingake.

Gulubane also had problems with the fact that Hearne, in her examining of her client, only took four hours in just one visit and made all the evaluation just from that single visit.

“Would you be pleased with a diagnosis made from one visit? One visit is not enough,” he said.

However, the clinical psychologist said that any experienced expert of clinical psychology profession would ” tell you it is common practice,” she said.

The report by Hearne said that a series of tests and procedures were conducted on Sekgebetlela. The report said that according to clinical results of a psychometric test procedure it “was noted that Sekgebetlela was presented as neatly dressed, cooperative, serious and fully orientated for time, person and place. She was somewhat anxious in wanting to put her opinions and version forward. She was able to express herself well with the assistance of an interpreter, a registered social worker. The tests also revealed borderline problems in cognitive functions,” it read in part.

According to the report, there was evidence of suppressed aggression and anger. She also was noted to be experiencing feelings of guilt and shame.

“She is highly sensitive to rejection from her environment. She has some social anxiety that does not easily diminish with familiarity and tends to be associated with subjective fears of negative judgments of the self.

She seeks approval and acceptance from her environment. She can at times show a tendency to isolate herself from meaningful interactions with her environment,” reads the report, which emphasised that Sekgebetlela was suffering from a post-traumatic disorder.

The defence lawyer who appeared not to be convinced by the expert’s report on Sekgebetlela’s condition, plunged in, saying that the latter could have faked the symptoms just to bolster her demand for damages. Sekgebetlela is claiming P570, 000 from the government.

“Initially she was claiming for P10 million. Would it not be enough incentive for malingering,” he asked Hearne.

The defence was granted 30 days to call its expert to come and examine Hearne’s report.

Judge Dingake set June 26 as the date for Gulubane to bring the expert to examine Hearne’s report which is before the court.

The plaintiff was represented by Duma Boko as lead counsel, assisted by Uyapo Ndadi of Botswana Network on Ethics Law and HIV/AIDS (BONELA).

Original Source: Mmegi/The Reporter (Gaborone)
Original date published: 15 May 2009