No surprises in health audit report – doctor
NO SURPRISES. That is what one doctor told The Gleaner yesterday, following the eventual release of the much-anticipated audit report of the four regional health authorities (RHAs).
"I got a chance to look through them briefly when they were posted on the website today (yesterday), and frankly, I saw nothing that surprised me. In fact, we have been saying a lot of this from long ago," she said, speaking on condition of anonymity.
"When [Dr Alfred] Dawes and his team held that press conference earlier this year, he was saying all these things, so we all know this. Every health-care worker who has to work in the public hospitals knows what we are up against."
She continued, "Frankly, I don't know why they wouldn't release this because if persons don't know what is happening, how can we fix the problems, how can we get help to fix the problems? I just don't know how we could expect to continue like it's business as usual."
She said she wished to "stay off the radar, for fear of being victimised like Dawes".
In May, then Health Minister Dr Fenton Ferguson had directed the four regional health authorities to conduct a comprehensive audit of their operations, following outcry from both health-care workers and the general public about the poor state of the public-health facilities. The Jamaica Medical Doctors Association, of which Dawes was president at the time, also held a press conference to reveal several of the challenges health-care workers were up against.
After receiving the report in August, a summary was released in September, with a decision made not to release the full report because the health ministry did not want the public to have negative views of the implicated public-health facilities. A decision was made to release the audit report after intense pressure from various quarters.
The audit mainly examined the maternity/obstetrics, operating theatre, neonatal unit, intensive care unit/high dependency unit, accident and emergency (MONIA), in the North East Regional Health Authority (NERHA), South East Regional Health Authority (SERHA), Southern Regional Health Authority (SRHA), and the Western Regional Health Authority (WRHA).
Overall, the four individual reports revealed that a lot of the problems and challenges were overlapping across the RHAs, and several recommendations were made to correct the issues that were uncovered.
In the SERHA, whose chairman is Dr Andrei Cooke, it was revealed that the operating theatres were outdated, having been built several years ago, and were badly in need of upgrades. The structural issues also led to other problems, which made them unsterile.
"The theatre doors at the majority of facilities need urgent replacement. It is quite easy to see through the space between the doors when they are 'closed', compromising sterility in the rooms. Some doors have holes, hinges are rusted, and others are infested with termites. Subjectively, the operating theatre lights are dull and some fixtures have absent and non-functional bulbs. In general, the operating theatre suites need to be assessed by the engineers to check on structural integrity," the report said.
It also noted that standard operating procedures were not adhered to for cleaning and portering "in any of the institutions visited". The reuse of disposable tubes and airways was also a common feature throughout the region.
The report also said: "Enema is no longer provided by the pharmacies, hence women are delivered without; the result being foul odour in the delivery room, staff health being affected, and possible infection of the neonates."
In the NERHA, whose chairman is Leon Gordon, among the major findings the audit revealed were that the supply of a number of critical pharmaceutical were at times less than 50 per cent of demand. The critical shortage, the report said, was due to insufficient supplies from the National Health Fund. It was also revealed that staff did not always adhere to proper procedure and protocol.
In the Michael Stewart-chaired SRHA, key findings were shortage of linen, gowns, and drapes, as well as insufficient supplies in the operating theatres, such as caps, shoes, goggles and face shields. The operating theatres also did not have correct handwashing faucets, as the theatres used manual faucets which requires direct contact with the individuals.
There was also a shortage of drugs, and a need for additional incubators, cots, cardiac monitors, suction machines and infusion pumps in the nurseries.
While in the WRHA, with Calvin G. Brown as chairman, there was a lack of overall general supplies and staff did not always adhere to proper procedures and protocols. It was also revealed that routine microbiological swabbing was not conducted as prescribed.
"The real question now is, what are we going to do to fix these problems?" the general practitioner asked, having worked in both Jamaica's private- and public-health sectors for more than 25 years.