Medical System a Mess

By Raffique Shah
January 11, 2015

Raffique ShahThe public medical institutions in this country are in crisis. Note well that I did not say the “healthcare system” because while there have been some initiatives in promoting healthy lifestyles and preventative health care, these have not reached the mass of the population.

So we are saddled with a network of district health centres and a handful of hospitals that are charged with diagnosing and treating the sick, but which have failed to fulfil their mandate.

In the midst of an economic crisis that may yet spin out of control, a violent crime wave that defies police statistics, and political shenanigans that could make you weep with frustration, I have chosen to address the medical mess because of the many horror stories that have been drawn to my attention in the past few months.

Victims of the failed system have appealed to me to highlight the plight of the poor and powerless, those who cannot afford the services of money-or-your-life private facilities.
I should start with the good news: many people who utilise the services of district health centres, especially those that operate around the clock, have mostly good things to say about the staff and the facilities. Of course these are basic clinics that offer primary care, continued treatment for persons with chronic lifestyle diseases, and medication.

Except for peak hours or on particularly bad days, service is prompt and professional. However, there is the recurring problem of the pharmacies not having medications, hence the need for patients to purchase drugs, some of which are quite expensive. I am told that there is currently a critical shortage of vital medications, even at commercial pharmacies.
The real problems begin at the nation’s main hospitals, especially the big three—San Fernando, Port of Spain and Mount Hope. I’ve heard some good things about Sangre Grande and only bad things about Point Fortin.

Since infirmities tend to increase with age, older people, often with no assistance from younger relatives, have to travel long distances to reach the hospitals. Pity the poor souls from the deep-south-west, south-east and north-east Trinidad where public transport is erratic, who must spend stressful hours travelling to the facilities.

When they finally get there, sick, tired and hungry, the torture begins. Mostly, they wait for hours to see a doctor, more hours to have preliminary procedures done (blood analyses, X-rays), beyond that to be handed prescriptions for medication that the in-house pharmacy does not have, or worst of all, the agony they must endure if they are to be warded.

The minimum time a patient spends in what is commonly called “casualty” is six hours. The average time is nine hours. And a nightmare could last more than 24 hours. No meals (unless you buy something from a vendor or the cafeteria), no rest (you sit on an uncomfortable chair), no pity from staff members, some of whom can be downright “hoggish”.

Is that what citizens must be subjected to by a system that absorbs upward of five billion dollars a year? And that is only recurrent expenditure. Health Minister Dr Fuad Khan and the hierarchies of the regional health authorities must answer to the people.

Mark you, this damn nonsense did not start under Khan’s stewardship, or the current RHAs. But it must stop at some point, so why not now?

What little I have mentioned above is just the scab of a festering sore that has afflicted the health system seemingly forever.

Let me add instances of additional horrors that I know as fact. Last week, a young man was stricken with what appeared to be a stroke (thankfully it was not). After going through the routine 24-hour torture at San Fernando casualty before being warded, the doctor ordered a CT scan. The family was told they would have to take him to a private facility since the hospital’s equipment had “broken down”.

Does that main hospital have one CT scanner, one MRI machine, one set of operators? How much do these vital pieces of equipment cost—more than the millions we pay people to wine at Carnival or to religions to mark festivities? But it gets worse. A 69-year-old friend was recently referred by his clinic to Mount Hope for an echocardiogram: he was told to return sometime in 2016! Back in 2012, he was diagnosed as needing surgery for cataract. If he is lucky, he will have that done in May this year.

What I gather from these cases and many more like them is that after spending tens, maybe hundreds of billions of dollars on the country’s medical services over the past 40 years, we have hospitals that are not equipped with what should be basic equipment. Are we for real? And we claim to have world-class medical facilities? Orville London wants to promote health tourism?

Worse, the Government is building more hospitals, one at Couva, another at Point Fortin and, I believe, one in Penal.

What’s the point in having shiny new air-conditioned buildings, maybe some beds on the inside, but inadequately staffed and equipped? We mad, yes.

5 Responses to “Medical System a Mess”


  • The growth of the population and the poor eating habits of the population is creating this health crisis. The good news is that the government is working hard to address these defects in the system that will soon be rectified. The PNM after 42 years of bad governance saw two oil booms with no new hospitals built but a handful of poor equip health centers. Now they begging the PP to build the Point hospital.

    The PP is currently building several hospitals but it is the mentality of the PNM employees who are trying desperately to make the government look bad. They don’t treat the people like humans, they are arrogant like Rowdy. Despite the government vision to make the hospital staff people centered, if you take a pig bath him and put a ring on his stout he is still a pig.

    It will take the PP another term in office to bring health care up to an acceptable standard. Until then get your lazy azz off the chair and excercise( I mean that in a nice way).

  • Average wait time in a Canadian hospital : 4 to 6 hours
    Average wait time for a CT scan in Canada: 6 month
    Average wait time for an MRI in Canada : 1 year

    Ageing populations and poor health habits are creating medical problems worldwide.Those who could afford to pay private clinics receive immediate care.Most developed countries are struggling with health care costs and staff shortages.In an international context, T&T’s public health care system is quite good.

  • It’s about time that there be ‘guards’ watching over these doctors who are quick to refer patients to private medical clinics..these clinics are owned & operated by these same doctors & are milking the system by stealing the drugs & equipment & further putting patients lives at risk by refusing them care at State Hospitals..they should all be fired

  • While it is tempting to comment politically, it is too serious a matter to treat with partisan treatment. For those whose instinct it is to treat this situation as political folly, they need only remember that the world is dangerous and full of health problems that can spread like wild fire. Ebola and chikungunya whilst associated with Africa and African wild life, is nothing that we in the Caribbean should feel comfort with because they are not as challenging to us, like say dengue and other tropical diseases that threaten normal living. As much as we who were around during British rule like to bash them for the treatment meted out to us, there is one thing we cannot accuse them of and that is how they treated public health and health care. What we are experiencing today is neither public nor health care. What we have is health care designed for public consumption with a distinct commercial flavor. The health care industry is no different from the gas, oil, agriculture or financial industries.
    This has been made so by the practitioners of the trade with an unregulated appetite for financial success. Health care, what health care? There are stories awash that as soon as the medical practitioners experience a few cases of success, the next thing they do is open a ‘private practice’. Trinidad has no shortage of medical practitioners, what it has a shortage of is proper medical facilities whereby patients can be served with best practices in mind. The practice of Medicine in Trinidad and Tobago today is all about PROFIT not health care. The population has gone on an ‘eating out’ binge where cooking at home is no longer a lifestyle event. That event is taken over by the mighty ‘KFC’, subway, white castle and other ‘fried chicken’ enterprises who delivers with joy the fritters that are not even fit for feeding dogs but is consumed by the majority households in the land each day. Feed our dogs the same diet every day and we would how long they last! Not to mention the hosts of ‘by the roadside’ vendors selling their questionable dishes that are not supervised or monitored by the sanitation department properly. These and other habits such as the high consumption of alcohol can only add to an already poor eating habit. God gave us a healthy functioning body for us to treat well with fruits, vegetables and animal products but we misuse our bodies with eating all kinds of rubbish that are not suited for our bodies. And so with with all this why should we be surprised that we suffer such poor health in the end? In the case of medications, there are even more surreptitious behavior on the part of the merchants who bring them into the country. There are many medications out there used specifically for placebo effect. The sources of such medications are questionable but there is a population hungering for medication that will get them well (or so they think) as long as it is available. With all of these competing practices surrounding health care how can we effect proper public and private practices to bring up a healthy nation? While government and governance play a major role on how we become advocates for good health care activities and behavior there must be responsible governing bodies that have the nation’s health at heart. There must be responsible advisory boards advocating best practices and behavior with encouragement to produce more fruits and vegetables for local consumption and also exercise for healthy bodies and organs.

  • “Food is medicine”-Aristotle. We are abusing our bodies living in /with material opulence. Instead of eating a variety of food and exercising, we are eating KFC loaded with fatty substance because taste is good. Drinking soft drink loaded with up to 10 spoons of sugar. Sugar according to British researchers are leading cause of cancer especially if it is laced in fast food. I prefer to think of the sugar/diabetes connection.

    Western food is filled with preservatives and all kinds of chemical concoction. For instance Tricolsan is a known cancer causing agent in Colgate. The flour that consume in various products is bleached, all nutrition taken out and other agents are added to make it look attractive. Most of our food supply is loaded with some kind of chemical. To remove chemical simply soak in lime or lemon water for 10 minutes.

    Exercise is still the key to good health, walking for 1/2 hour each day is all it would take to keep your energy level high. That and some B12 is all you need.

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