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A hospital case

February 4, 2001
By Raffique Shah

MANY readers of my column may be aware by now that earlier this month I suffered injuries as a result of a bicycle accident. Okay, before you laugh "til yuh belly buss", let me explain briefly. I was cycling as part of my fitness regime when I encountered a pack of mean "pothounds", one of which ran directly in my path as I sped up to escape them. The result was a nasty fall and five ribs fractured, along with other minor injuries.

Needless to say, the pain from such injuries was excruciating. I was rushed to the new Couva hospital and thereafter, for four days, I was to get a first-hand experience of the new, improved public health care service that Dr Hamza Rafeeq’s Ministry of Health and the various Regional Health Authorities have been boasting about for some time now. I was taken to the Couva unit shortly after 6 p.m. and it did not take long for the nurses and doctors to attend to me.

Before I go further, I need add that I’ve long maintained that the staff at the Couva hospital are among the most caring I’ve met in the health service. When they operated out of the derelict buildings that must be at least 100 years old, they performed creditably under the most adverse conditions. I had cause to go there twice at around midnight, and the prompt attention and care I saw being given to patients at that unearthly hour spoke volumes about their dedication to duty.

This time around I was in spanking new facilities that were, well, new, and still blessed with a caring staff. But then the cracks in the system started showing up. Firstly, the X-ray unit was closed: it operates only until 4 p.m., so after that hour one has to be transferred to San Fernando to be X-rayed. The staff had, in the meantime, done for me all they could, which included taking vital data and doing basic tests as well as administering a strong pain killer.

When the time came for me to be transferred to San Fernando, it took an agonising hour-plus wait for the ambulance. Note well, I said "the" ambulance. I could not believe that Couva was allocated only one ambulance, which had taken another patient to the south, so I had to await its return. Where was the highly touted Emergency Health Service? I waited for about an hour for the lone ambulance. Luckily, the driver, attendant and nurses were all helpful, and I reached San Fernando safely.

Bear in mind that although I was unaware of the exact nature of my injuries, I suspected they were serious judging from the level of pain I experienced. Fortunately for me, I have a high pain threshold, so I bore it as any trained soldier would. After a series of X-rays, I was returned to the stretcher to await the results. Five fractured ribs: hell, not one or two, but five! Fortunately, none had punctured my lungs, so at least I was not in mortal danger.

But the doctor said I had to be warded. The procedures weren’t lengthy, but when I was wheeled into Ward Three, I immediately sensed that I was back in time, back into the past, not the future, as the ministry and the RHAs tell us.

The stench that hit me when I reached the ward reminded me of prison: one way of knowing you are in jail (if you have any doubts) is the "jail stench"—a combination of stale urine, filth and other human waste accumulated over a long period of neglect. Not that the wards weren’t cleaned every day. Far from it, early on mornings, an attendant duly reported for duty and proceeded to mop the entire ward.

That did not, however, eliminate the grime and the stench. Once more I should add that the medical and allied staff at San Fernando are clearly dedicated, given the conditions under which they operate. The doctors visited on time, as did the nurses, and where it was available, medication was given to patients. In my case, though, strong pain relief medication was needed: the hospital had none!

On day two of my stay, in the absence of anything else, I was given a shot of morphine. Morphine, for heaven’s sake!

On day three the doctor said my family would have to buy medication, since the hospital had none. They did, so later that day I began feeling some relief. If the ward was hell, then the toilets were purgatory: they had no seats, water leaked everywhere, and they certainly did not seem to have been built with sick people in mind. And if my family had not taken sheets, a pillow and a blanket for me, I would have had to sleep on a bare mattress. By the time I started moving around on my own (afternoon of day three), the complaints I received from fellow-patients and staff members were numerous.

Patients who are poor—and these are the people who need the public health service most—suffer for lack of drugs, long waits for surgery and other specialist attention and general neglect.

Staff members, from doctors to nurses, are overworked: many of them work double shifts, and they also feel helpless because they cannot perform at their best under the conditions that exist in the institutions. By day four, even as someone who had spent 27 months in jail, and more than that, one who had stayed fairly fit and tough through the years, I had had enough of the RHA and Dr Rafeeq. So I was released from the ward since the same pain killers they administered there I could get at home (I had to pay for them anyway).

Clearly, many of the improvements to the health service are cosmetic. New buildings, new ambulances and expensive public relations exercises do not make for better health care. Medications for those who cannot afford to buy them are infinitely more important, as are the expediting of surgery and other life-saving procedures. And better working conditions for dedicated staff won’t hurt. Dr Rafeeq and the RHA spokespersons should note that health care, unlike beauty, is not skin deep.

And here I write with authority since I deliberately chose the public hospital over a private nursing home, refuge of politicians and power brokers who speak glibly, but unknowingly, about advances in the health service.

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