June 24, 2021

St Kitts & Nevis: Health problems and solutions

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dwyer_astaphan7By G.A. Dwyer Astaphan From Caribbean News Now

One area in which very serious problems have been inherited by the young Team Unity administration in St Kitts and Nevis is the nation’s health sector.

Over the years prior to the general elections of February 16, 2015, a number of concerns had been raised, both behind closed doors and publicly, but substantively very little was done in terms of solutions.

The hard evidence shows that, as with many other things, the Douglas administration’s highest priority was itself, not the people.

Let’s be honest. An administration that amassed nearly $1.5 billion in the SIDF, yet still leaving the health sector in the mess that it’s in today, is a failed and bad administration. It’s a failure, not just in administrative leadership and vision, but perhaps even worse, it’s a failure in compassion, love and respect for human life.

After all, what can be more precious than life and health?

And the failure of the Douglas administration is crusted in callousness by the fact that there were two medical doctors in his Cabinet, and other doctors lurking by.

Time and space don’t allow me to chronicle the many problems in the health sector left by them. So here are just a few.

For years, there has been a concern — and not only in St Kitts and Nevis, but regionally — with regard to the state of preparedness, in general, of physicians who come here direct from their medical training in Cuba, as against going to Jamaica, the UK, the US, Canada or elsewhere to further their training and development in diagnostics, etc., etc.

And the question has been asked as to whether they should be put through a six-month program at the University of the West Indies or elsewhere before being allowed to practice here and in the region.

Now I know that this matter may raise some hackles, but please be assured that it isn’t my intention or desire to disrespect or discredit the government and people of Cuba, their medical training programs, their graduates, or anyone else. Indeed, I’m grateful to Cuba for helping and partnering our country, our region, and, indeed, so many other needy parts of the world.

But we’re dealing here with a very serious issue which came to the fore under the previous administration, and was not addressed.

It needs to be addressed. We’re talking about human health and life.

On-the-job training takes place in every facet of human endeavour, but when for example, a problem exists in a hospital’s accidents and emergency department or a ward, and quick diagnostic and/or other action is required, if the skills sets aren’t there, then greater pressure is placed on the more experienced doctors, and of course, the more experienced nurses (who, let’s not forget, are vital cogs in the machine, and not just as service providers but also as sources of information, knowledge and even skills for doctors — yes, doctors can, should, and do, learn a lot from nurses).

But if the experienced doctors and nurses are in scarce supply, if they’re tired and frustrated, and holding on by a mere thread, simply because they don’t want to leave the health sector in an even worse state and jeopardize the health and lives of our people, then those young doctors and nurses are deprived of a great and necessary source of learning, guidance, stability and confidence, and we all lose.

So are the experienced doctors and nurses in scarce supply?

It seems that the answer is yes. While there are some excellent professionals still on the job, burnout and low morale are real threats.

I attend the same church as Dr Bichara Sahely and there’s hardly a Sunday that he can stay for the entire service, as he flies off to duty at the J.N. France General Hospital.

He needs help. Does he have back up? Adequate back up? No.

And God knows how many calls he and other experienced doctors get, day and night, from their younger counterparts for advice on cases.

I want to recommend that health minister Eugene Hamilton and Dr Terrence Drew work out an arrangement whereby Dr Drew can be engaged. No politics on either side, just service to save and enhance lives. Peace, love and life!

Dr Drew is regarded as having excellent potential in his profession. He can choose or not choose his politics. Just get down to work.

And while he’s being engaged, that is, if he accepts, the ministry should prepare others and have even more back up resources. Back up is good. Back up is necessary.

Let me insert here the need to pay these doctors properly. Consideration ought to be given to engage the necessary amount of doctors full-time and pay them what is right.

I prefer for my good full-time doctors to be getting $25,000 or $30,000 monthly pay cheques plus reasonable allowances than see my tax money going towards globe-trotting and other waste. And likewise for my good nurses (among whom I’m told there are also some worrisome idiosyncrasies and disparities in pay, with the obvious knock-on negative effect on morale). And likewise for my good teachers, national security service providers and other front-liners (but that’s for another day).

Pay them well, demand and expect greater efficiency and better results and the investment will be well worth it.

Then there’s Dr Cameron Wilkinson, the surgeon. When he returned home some years ago he was a handsome looking young man. Today, he’s still handsome, but his hair has turned grey. Too much stress.

It’s unsettling to think of him in the operating theatre performing surgery and being the only surgeon present. Suppose something happens to him in the middle of a procedure. Where does that leave the patient? And what does that raise in terms of legal liability issues?

And I can take this argument right across the spectrum of health services.

Now, some time ago the former administration retired a number of highly experienced and committed nurses.

That created a void in the nursing sector, depriving younger, less experienced nurses and students, and even doctors, of the critically required expertise of these retired nurses.

This step further weakened the government’s health service. And what does a weakened health service to you, to your ill child, or to your parent or other relative or loved one? Bad things is what it does.

Clearly, too few of us were sufficiently watchful with regard to the administration of our health sector while Denzil Douglas, a medical doctor, reigned over this land. Too many of us were willing to allow illness and death to consume us under a leader who had $1.5 billion in cash and squandered much of it, never seeing health as the first priority that it should be.

But we now have to set the bar higher: our health and our lives depend on it. It has to be first priority, along with preserving our environment and properly educating and training our youth.

And I can go on and on with this, but I think you’ve gotten the point.

The former administration caused grievous bodily harm to the health sector.

And do you know what the Douglas administration was planning to do if they were re-elected? Privatize the public hospitals, which would’ve plunged poor people’s lives into even greater jeopardy. Somebody would’ve made big money out of it, but we would’ve taken the hit, because we’re not ready for that in St Kitts and Nevis.

A number of health sector workers voted for Unity because of that!

And it’s now time to make things right. Minister Eugene Hamilton, make the difference and make your good mark.

IMAGE: Dwyer Astaphan is a lawyer and former St Kitts-Nevis minister of national security and tourism

Or more on this story go to: http://www.caribbeannewsnow.com/headline-Commentary%3A-Health-problems-and-solutions-27953.html

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