The future of health care – Part 2

by Dr Jerrol Thompson

(Last Tuesday, I began re-examining the 10 critical health problems inherited by the ULP from the NDP in 2001 and discussed how two of them were remedied by the ULP. These were a crippling shortage of nursing staff and expert medical specialists (doctors) and an inadequate promotion of public health, nutrition, wellness and poverty alleviation. This week, we continue by looking at how six more of these problems were dealt with.){{more}}

3. The long waits at the Casualty could only be addressed by (a) an innovative plan to construct three (3) rural polyclinics and many additional new medical centres which ensured that no citizen was ever more than eight minutes away from help. Polyclinic facilities at Stubbs (already completed), Buccament and Mespo (at the site of the old Levi Latham Hospital) started in February 2015 at costs of $4.42 and $4.6 million respectively, both part of a $34 million EU (10th EDF) health care grant. These strategically placed facilities would provide 24-hour doctor and nursing services, x-rays and simple labs and serve as a catchment facility to quickly and professionally treat accidents, urgent care and minor cases like cuts, flu, etc, and avoid the need to travel to the Casualty in Kingstown. As these other two facilities become completed in 2016, they will significantly reduce the congestion and exasperating long waiting time at the Casualty. (b) Additionally, the number of doctors in the Casualty was increased, so allowing more serious cases, major accidents and minor cases from Kingstown to be handled.

4. Health facilities: The polyclinics are complemented by over 10 new clinics, renovated hospitals and medical centres like Vermont, Clare Valley, Union Island, Port Elizabeth, Bequia, Biabou, Lowman’s, New Grounds and Sandy Bay, etc. The first Smart Hospital in the Caribbean region was created at Georgetown and soon other smart facilities like Chateaubelair Hospital. A million dollar state-of-the-art Pediatric Unit at the Kingstown Milton Cato Memorial Hospital is the best pediatric facility in the Caribbean. It uses ICT to have specialists in the USA-based World Pediatric Program review unique cases remotely and deliver lifesaving surgeries and care as part of a regional Children’s Surgical Hospital concept, where St Vincent and the Grenadines is the prestigious regional hub. It has already performed over 1,000 surgeries at the SVG hub and sent over 300 children to the USA. This has had a profound impact on the families touched and many young lives have been saved. There is also a partnership with the Sick Kids Hospital in Canada, offering pediatric cancer care. Many have benefited from specialized care in Cuba, Trinidad, Barbados and the USA. It is unfortunate that health care is too often seen by some as only a new medical hospital. However, the reconstruction of a $3.83 million new Mental Hospital at Glen is also a critical component of our health care revival, especially when we recall how deplorable this facility was.

5. Shortages: The periodic shortages of medications and supplies is probably one of the biggest challenges we face and since 2001 the cost of medications and supplies has jumped, where newer, better, yet far more expensive medications are being prescribed. While some medications are cheaper, a number of drug companies have raised prices by huge budget breaking amounts. Further, the OECS Drug Purchasing Unit has had to step up its surveillance, as over 60 per cent of all medications are now made in India and China and serious questions are being raised over the quality of some bogus cheaper medications on the market. The periodic shortages have been reduced by the new innovative Health Information System (HIS), where Internet and computers at every clinic allow faster reordering and reporting of low supplies and a display of a patient’s current medications and illnesses and once fully implemented will help eliminate all shortages.

6. Diagnosing the correct illness in the fastest possible time and then using the most appropriate medication or surgery is the most critical phase of health care. This saves lives and averts further deterioration of the illness. Diagnosis is not a guessing game, so modern medicine requires new innovative,affordable diagnostic services and technology such as CT-Scans, MRI, Echo-Cardiograms, lab tests, etc. The new CT-Scan services at MCMH has the lowest prices in the region. The modern Diagnostic Centre in Georgetown, now completed, will also add scores of new diagnostic tools. However, diagnostic services have also come with the help of friendly nations. No one can deny that the Vision-Now! Programme provided by Cuba dramatically revolutionized eye-care for thousands of Vincentians. This programme is being continued through the Venezuelan Government as the Miracle Mission.

A Cuban team completed an extensive survey of persons with various disabilities, who, in previous decades, were “the forgotten,” often hidden away by some family members as a symbol of shame. This survey formed the origins of the compassionate Lives-To-Live programme.

7. Chronic non-communicable diseases: hypertension, diabetes, obesity and cancer are the new scourge of people’s health, accounting for 60-70 per cent of deaths and 60 per cent of the cost. An EU-funded National Health and Nutrition (STEP) Survey started in 2013, has recommended extensive measures, re-education, schools, sports and nutritional support launched to combat this incursion of western style diets, etc. New thinking that sweet potato, breadfruit, soursop, etc, are great, while certain other foods are bad, needs to be reinforced. Other extensive studies in mental health and hospital management have guided ULP decisions taken, rather than the kind of arbitrary, ill-informed suggestions of the NDP. How can NDP claim to be able to cure HIV with retroviral drugs when it is anti-retroviral drugs and many others which are used?

8. The Milton Cato Memorial Hospital for decades only had three operating rooms. Early in the life of the ULP it battled with leaking roofs at the operating rooms. OBGYN – maternity patients are usually given priority for operating room time and is part of the success of St Vincent and the Grenadines in lowest maternal death rate in the region. However, patients waiting for routine elective surgery often had long delays or had to be postponed for these OBGYN or other emergency trauma cases, due to the limited operating room space. Through an EU grant, four operating rooms were reconstructed at MCMH and when the new state-of-the-art Specialized Acute Referral Hospital at the Arnos Vale Airport site is constructed additional operating room space will be available, thus eliminating any delay in time for any form of surgery and potentially attracting regional cases and valuable revenue.

( In the final part of this article in the next issue of Searchlight on November 24, I will look at the new state-of-the-art hospital the ULP intends to build.)