Hospitals of Horror

By Raffique Shah
March 27, 2011

Raffique ShahIF DOCTORS in the public health care system feel that they are being unfairly targeted by Government and the public, they need to pause, collectively inhale, and look into the mirror. They should also weed out those in their ranks who have given this once noble profession a bad reputation. Indeed, many senior doctors who have long moved on into lucrative private practice must also shoulder some blame for the ills that bedevil the public health sector today.

I have long maintained that, for all its shortcomings, most of which are beyond the control of staff, our public health system is not as woeful as many people make it out to be. Mercifully for me, as a now senior citizen (if that “status” is marked only by age), I have not had to depend on doctors to maintain my health. When one realises that the basics for staying relatively healthy lie in one’s own hands, or more accurately one’s feet and lifestyle, doctors become a secondary port of call.

I should add that my personal doctor and a few others I’ve had cause to visit from time to time, have all been very professional, very courteous. I have not always heeded their advice or recommendations. In other words, I am somewhat of a maverick: I believe I should always be in charge of me.

On occasions when I’ve had to use the public health system, I have found the staff, both nurses and doctors, all of them quite young, equally professional. But most times they are under stress, what with hordes of patients waiting to see them, and equipment they need, or medication, unavailable. Sometimes the clinics at these institutions appear to be severely under-staffed. Frustration builds among both patients and staff, and in such scenario, hasty-but-fateful decisions or actions could result in things going fatally wrong.

Which is when professionalism, cool and calculated thinking, ought to kick in. Doctors, nurses and other medical personnel deal with life and death situations almost on a daily basis. Besides their grasp of medical procedures, young doctors also need to have leadership qualities that they employ when they face crises. Under immense pressure, they must make tough decisions. There may be no senior practitioner around. Their colleagues may panic. Sometimes the senior officer loses his nerve and it’s left to a junior to fill that decision-making breach.

I shall not dwell further on this aspect of health delivery since I am not au courant with the training doctors go though at medical schools. I should hope, though, that those who determine the curricula at these institutions see the need to include leadership training for doctors. Every graduate of medical school should be able to take charge of life-and-death situations with authority. The last thing you need in an operating theatre is panic, should something go awry.

While our public health system is far better than what passes for such in countries more developed than ours, it is hampered by archaic regulations, poor remuneration packages, and near-primitive working conditions in some instances. With the exception of the Mount Hope Hospital and several district health facilities that were constructed over the past 20 years, most other institutions stink.

Take the San Fernando Hospital, which was built by the colonial authorities back in the early 1950s. Except for a new wing that took ages to come on stream, and maybe some modern equipment added from time to time, it looks decrepit. Neither patients nor staff can be comfortable there. Why are we surprised that fatalities occur at the institution, or at the Port of Spain Hospital, as frequently as they do?

Ten years ago, I spent three nights in San Fernando after I fractured five ribs in a bad bike fall. There was no room in the ward, so I slept in the corridor. When I used the toilets, I had to wade through water to get to WCs that had no seats! The doctor administered morphine on the first night to ease the excruciating pain I endured, not by choice, but because there were no other strong pain relief drugs in the dispensary.

I refused to take a second dose of morphine, opting instead to have my family buy a less dangerous tablet the doctor recommended. My colleagues sought to move me to a private institution, but I dismissed that idea. I wanted to experience what ordinary citizens in this country who cannot afford private health care do. Sheer guts took me through those three nights.

But good doctors, like good soldiers, learn to function in the most adverse conditions.

And this is where I have problems with doctors and other professional staff who, because their work environment is close to atrocious, vent their frustration on patients. If they must protest for better remuneration and working conditions, by all means do that. Confront the regional health authority. Attack the minister, the government. Cuss Patrick Manning for wasting money on structures we didn’t need, even as hospitals remained low-priority or no-priority.

However, in pursuing these goals, doctors and other staff should never allow patients to suffer, or worse, to die. That is inexcusable. I hope the probe into the passing of Chrystal Ramsoomair triggers some dramatic changes not only at the San Fernando Hospital, but also at the other facilities that are crying out for attention.

It is the least we taxpayers expect. No one can resurrect Chrystal. But we can certainly restructure the health sector so that such tragedies can be avoided in the future.

7 thoughts on “Hospitals of Horror”

  1. As long as the Public health system is the least prestigeous part of a multi-tier health sector it will stumble along providing the most atrocious leve of health care in the vilest of conditions. It was this conclusion that informed the decision in the UK to aim for a SINGLE tier public health system in the form of the NHS. Over the years this ideal has been eroded, much to the detriment of the NHS.

  2. The situation you describe is correct. The most important part of the article is “I have not always heeded their advice or recommendations. In other words, I am somewhat of a maverick: I believe I should always be in charge of me.”
    The education system is falling apart to begin with. I have seen young people’s report with so many errors, both grammatical and spelling, that I wonder if the teacher and the supervisor of that teacher actually practiced due diligence in putting the report together.
    The patient must be able to explain the problem to the doctors and nurses and the doctors and nurses, as you say, must treat the patients with patience. Then they should together arrive at a solution to the patients problem.
    The hospital situation is deplorable, that is the building and equipment. People are living longer and more beds should be made available. We can start with additional hospitals and then upgrade the older institutions.

  3. The Point Fortin hospital, ah mean medical facility, was handed over to the trinidad Government by the Shell oil Compamy during the early Sixties. To this day nothing was done to improve or repair that medical center. The structure is in a horrible state. The people will remain all day and not receive medical attention, no doctors or no medicine. Yes! WE SHOULD CUSS MANNING.

  4. While I will join in throwing stones at the public health system, I see this condition as part of the malaise that is Trinidad. The malaise includes interminable lines at the banks,and the UTC offices. Long lines at supermarket checkouts,long lines at the bus terminals. Long lines for everything except to live long. We need a series of national focus groups, that are as non-political as they can be made, that would look atsettig high expectations of public service and how to obtain such high expectations.I HATE long lnes, because I grew up during WW11, when rice and cooking oil were rationed, and despite the ration card one had to push to get your allocation, for which you paid, before the available supplies r out. The state, in the form of a vigorous crusader for health for all, needs to step in. There should be no “priate practice” if you are state employed. Suppose all teachers were allowed to give “private lesons” to their pupils after school, starting at about 3.00PM and using the school’s facilities, what a mess we would have.
    I do not go to “sales” because of mmeories of those rationing lines. Even in London, in 1976, I went to a store that had a sale, and I was dilly dallying with a sweater that I might or might not have bought, when an Arab woman snatched it out of my hand and tried it on. I stood there stunned. The salesgirl saw the shock on my face. ” They are all like that I am afraid” she said as if that explained anything. I wanted to buy a large bottle of the then popular Vitabath, but the Arab women, on a grand shopping spree, had bought up the store’s supply by the caseload. Trinidad has too many people chasing after an inadequate health care system, when a few, like those Arab shoppers in 1976 could afford better, and snatch good health care only for themselves and their friends.

  5. I am happy that someone has started to raise a voice about the appalling hospitals in Trinidad. It is not due to lack of public funds by due to a lack of real care about the needs of those who cannot take a plane ride to Canada and the US for treatment. I lost my mother in the POS General Hospital in one of the most traumatic experiences of my life. The horror has never left me. I just pray that I never get ill when I come home. That is not really how I should be thinking. We have the money to build world class stadiums…but not hospitals! Aren’t the people of Trinidad worth more?

  6. the health care in trinidad is disgusting…The nurses and doctors are rude and dont care about the patient.
    There is never the right medicine at the hospital or they always running out….its a shame

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