Jamaicans have endured unacknowledged and severe, unequivocal decline in healthcare services for years.
The protracted, exorbitantly expensive, renovation of the Cornwall Regional Hospital has missed multiple deadlines as the costs exponentially escalated.
Reasonable or not, some have concluded this renovation became necessary because the hospital had become unusable due to years of malfeasance and absence of essential basic preventative maintenance.
Others are more concerned that the unreasonable, unexplained, ballooning costs for the current renovation will soon be followed by a return to the status quo and deterioration of this newly refurbished physical plant.
Political leaders in some third world countries appear to be incentivised to be non-strategic about proper healthcare delivery as human life is ascribed minimal value and these leaders behave as though people can be easily replaced.
Many of these countries appear to be devoid of adequate expertise in basic healthcare management. Instead, ascent to healthcare leadership is decided based on political connections and other reasons some have considered to be unsavoury.
Many Jamaicans remain confused and concerned about leadership assignments in recent times at the University Hospital of the West Indies, and oversight for the renovation of the Cornwall Regional Hospital.
The impact on political decision making in Jamaica of the recent US travel advisory.
The recently issued United States Travel Advisory to Jamaica (January 25, 2024) has brought new focus and attention to these concerns.
The advisory stated in part:
“The emergency services and hospital care vary throughout the island, and response times and quality of care may vary from US standards. Public hospitals are under-resourced and cannot always provide high-level specialized care. Private hospitals require payment upfront before admitting patients and may not have the ability to provide specialized care. Ambulance services are not always readily available, especially in rural areas, and are not always staffed by trained personnel.“
All these statements seem to be irrefutable. The response from those responsible for healthcare and in positions of political leadership in Jamaica appear to have been significantly more than those provided when Jamaicans locally and, in the diaspora, had raised those same concerns about poor healthcare and healthcare delivery.
It is evident the weight of the US government will have greater positive impact on the lives of poor and disenfranchised Jamaicans seeking healthcare than Jamaicans themselves appealing to their own government.
The reality of everyday Jamaicans seeking healthcare.
The Jamaica terrain is very demanding so transporting severely ill patients from one local hospital to another may be associated with unacceptable medical risks based on established standards.
Despite this basic principle many hospitals in Jamaica have been downgraded to clinics which are unable to provide the most basic services required to manage emergencies like ectopic pregnancies (ruptured tubal pregnancies), heart attacks (acute myocardial infarctions) and strokes (cerebrovascular accidents).
In some of the hospitals that have remained operational the scope of services has also been reduced. The absence (due to inadequate staffing) of nurses, senior doctors, well-trained junior doctors, and residents and medical students results in delayed or inadequate provision of adequate healthcare services when urgently required.
Outcomes for patients receiving care in these situations may not achieve the expected basic standards and may be unsatisfactory when measured by international standards.
Meanwhile unsuspecting Jamaicans who have no choice may be lulled in to believing that these bad outcomes are normal and acceptable. Public and private hospitals all seem to have some degree of deficiency, or limited staffing and expertise.
Strategic planning for healthcare in Jamaica?
A consortium of experts in healthcare, sociology, business, tourism, logistics, and town planning should be assembled to evaluate the healthcare realities in Jamaica.
Patients, employers, international healthcare accreditation agencies, environmental experts, and other relevant stakeholders must be consulted.
Questions for consideration should include the current health care needs of Jamaica and the requirements over the next several decades. Exploring the required number of hospitals, their location, and the services each provides is paramount.
How to afford the cost of healthcare and reasonable access to the same must be determined. Manpower needs for the healthcare sector and reliably meeting those needs should be clearly delineated.
Since travel to Jamaica and travel tourism are exploding any final plan must address these emerging realities. Hospitals close to airports and cruise ship terminals should be geared towards dealing with a high influx of patients with travel related disorders (gastroenteritis, water sports accidents, seasonal diseases) and trauma due to all type of travel related accidents.
Regional hospitals can be designated as specialty care institutions (comprehensive vascular diseases in Kingston and Falmouth, state of the art orthopedics in Montego Bay and Mandeville, etc.) after being adequately equipped at the highest level to manage those categories of the diseases.
All other non-specialty hospitals should be equipped to manage the more common emergencies and should be able to stabilise for transfer to the specialty hospitals those with less common but more serious disorders.
By this prioritisation and rationalisation of resources the country would be able to provide care to the highest level in every specialty in at least one facility thus maximising care delivery to Jamaicans.
At the same time, using public private partnerships the country could eventually build out world class hospitals providing care to the burgeoning health travel tourism market. Implementing these approaches should maximise return on investment of every dollar used in the healthcare sector.
Most Jamaicans are aware no dramatic new unacceptable healthcare problems or incidents, or severe deterioration have occurred in the delivery of healthcare in recent months.
Meanwhile, Jamaicans are increasingly relieved the government has been adroitly and aggressively addressing the perennial severe crime problem, especially murders and gang warfare, with increasing success.
The noticeable decrease in homicides is clear to even the uninterested and uninvested. Other currents, some posit, possibly political, may have influenced the awkward wording and timing of this US travel advisory.
Irrespective, those in the public sphere with common sense and conscience would be wise to admit the poor healthcare delivery and service landscape in Jamaica currently is intolerable and incapable of sustaining the country’s other areas of advancements.
Fortunately, Jamaica already has exceptionally well-trained doctors and other healthcare experts at every conceivable level in every specialty either locally or in the diaspora who are eager to contribute to the professional development of healthcare in Jamaica and delivery of world class patient care.
Many of these professionals have been already volunteering their expertise and donating supplies to the Jamaican healthcare landscape.
These consummate professionals are desperate for sincere, honest, qualified, visionary leadership, political commitment and stick-to-itiveness to advance the Jamaica healthcare sector to its rightful place in the world.
By Guest author: Leon Wright
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