Yasmin Williams - HEALTH-WISERECENTLY, I read two articles which dealt with medical emergencies in Jamaica. One of these articles was published in last week's Sunday Gleaner and dealt with the successes and challenges of the 'ER' at the Kingston Public Hospital (KPH) and the other titled 'Calling 911' written by Gail Defoe in a magazine called Lifespring, published about two years ago, but still very relevant.
The author of the latter article indicated that she had been spurred on to do the review because of 'emergency complaints' and she was interested in knowing what was the local equivalent of the North American 911 for health emergency and what could be expected.
She highlighted dialing 110 for fire and ambulance response in Jamaica and dialing 119 for police/air sea rescue with subsequent transfer to 110 if necessary.
VERY DIFFICULT
She indicated that one would need to dial directly to the local hospital or private ambulance services to access an ambulance to take a patient to the emergency room of a hospital. However, the pleasant lady at the end of the 110 telephone line indicated to me, when I called recently, that she could connect me to the nearest private or public hospital or private ambulance service depending on what I wanted.
I suspect that access to hospital ambulances may be very difficult at times and one is probably much better off calling a private ambulance service if the need arises with an emergency at home or on the road. As Ms. Defoe states, it seems that the government hospital ambulances are usually occupied with transferring ill patients between hospitals.
The Ministry of Health, under the leadership of the Senior Medical Officer, Emergency and Special Services, has been deve-loping in the western end of the island, a model in which ambulances are based at fire stations and manned by Emergency Medical Technicians trained in conjunction with the Department of Community Health and Psychiatry at the University of the West Indies.
It is reported that the fire department (call 110) will respond in a road emergency when a person is trapped but not for a home health emergency like a heart attack. Defoe reports police response (call 119) to home health emergency as nil but reports a head of the Island Constabulary First Aid Division as saying that the police are trained to varying degrees and can help in the home or on the road but will 'prioritise their role depending on the particular situation'.
NOT FULLY UTILISED
Non-governmental organisations, like the Heart Foundation of Jamaica, that provides training in lifesaving CPR, the Jamaica Red Cross and St. John's Ambulance Brigade, are reported as not providing home or road health emergency assistance. One insurance company has been highlighted as providing road assistance, which includes ambulance service if needed.
Defoe reports that the private ambulance services, which respond primarily to home emergencies and the needs of the private hospitals, are not fully utilised and need a central coordinating centre and mechanisms to ensure that payments are collected. She feels that while there is a pool of trained personnel, this has not resulted in an effective system for delivering effective emergency care for patients at home or on the road. She also feels that the Government cannot 'do it alone' and needs effective partnerships with private sector, non-governmental organisations and individual communities.
She makes the point that in the event of a full-blown heart attack, emergency treatment should be rendered within five minutes and for each five minute period that follows, chances of survival falls by five per cent. Others say that during the first 10 minutes after a cardiac arrest or 'stopping of the heart', each minute saved increases survival chances by about 10 per cent.
Dr. Yasmin Williams is a Family Doctor and Public Health Specialist: email: yourhealth@gleanerjm.com.
