Phyllis Thomas, Enterprise Editor
Patients, medical and ancillary staff rub shoulders in the tight squeeze at the Spanish Town Hospital's ER.
One of several old benches in the ER leaning out of shape and threatening to collapse under the weight of patients.
A gaping hole in the ceiling of the Accident and Emergency Department.Spanish Town Hospital on Wednesday, October 3, 2007. - photos by Peta-Gaye Clachar/Staff Photographer
Space is a major problem. Doctors are attending to very ill patients in every crevice into which they and the patients can be squeezed. Those who cannot fit are attended to on chairs. Forget privacy.
Sometimes they are attended to on the floor. There aren't enough beds or space to hold beds. And it is not inconceivable that doctors hop over a dead body while trying to save the lives of people, scores of whom are there at the same time.
Welcome to the Accident and Emergency Department of the Spanish Town Hospital.
Located on Burke Road in the Old Capital, the Spanish Town Hospital serves the parish of St. Catherine, which in 2001, had a population of 482,308.
The country's largest parish has seen exponential growth over the last decade. It grew 26.3 per cent, which is nearly three times the rate of the entire country, the Population Census 2001 Country Report states.
rapid growth in population
The parish includes Portmore, the population of which has also experienced rapid growth and stood at 170,000 in 2001. The hospital serves parts of Clarendon and the Corporate Area as well.
The Accident and Emergency Department sees over 45,000 patients per year. Because of its proximity to major highways, it sees many motor vehicle accident victims. On September 24, there was a major traffic accident on Highway 2000 in which six persons were killed.
They were taken to the Spanish Town Hospital ER (emergency room). The following day, another four persons were removed from the wreckage of an accident on the Guanaboa Vale main road near Kitson Town, St. Catherine, and taken to the Spanish Town Hospital ER. This, while dozens of other patients with other emergencies had converged on the institution for attention. Such is the pressure on the limited resources and space in the ER.
tight squeeze
But amid that tight squeeze, a $52 million contract to refurbish another building to house the Accident and Emergency Department, which should have been delivered last year September, is yet to be completed, more than one year later.
The upgrading work was to be completed in time to cope with cases that could have arisen during the ICC Cricket World Cup in March this year, and it was intended, also, to improve the unit's operating efficiency.
However, the project has missed at least four deadlines for completion, to the extent that the authorities have refrained from setting another deadline for completion.
Sources tell The Sunday Gleaner that the delays were due to the fact that it was discovered midway into the renovation of the building that several important components necessary for the effective running of the ER had been left out of the initial plans that had been approved for the project.
In the initial plans, there were no washbasins for the emergency area. Changes had to be made to the ambulance bay because no provision had been made for ambulances coming in or leaving.
There was no provision for oxygen to be piped to the ER. Currently, patients are hooked up to huge cylinders. It was discovered that the building to house the new department, like the current department, is infested with termites from one section to the next. Windows need to be replaced and the roof repaired.
The changes to the plans are documented as variations which must get approval from the Ministry of Health. That has not happened.
A senior administrator at the Spanish Town Hospital conceded that the omissions in the original development plan accounted for the bulk of the variations and the delays. Another factor is that the initial contract sum of $52 million has escalated.
"The cost has increased beyond 15 per cent of the initial sum," he said. "Normally, when a contract experiences escalation within 15 per cent, approval is not difficult. Anything above that has to be a Cabinet approval and therein lies our problem."
In the meantime, he said: "No date is set for completion because we have not yet received approval for those variations. What we know is that the work done so far is about 70 per cent completed.
"The health authorities seem to be avoiding the issue, however. Neither the South East Regional Health Authority (SERHA) which has jurisdiction over the hospital, nor the Ministry of Health has responded to our queries about the delays.
"Regional director of SERHA, Catherine Gregory, ignored our calls, while the ministry requested that questions be sent via email, and has failed to provide answers even after telephone calls."
A representative of Tank-Weld Construction, the project manager, asked that The Sunday Gleaner speak with SERHA before getting to them.
phyllis.thomas@gleanerjm.com
ER CASE LOAD
The Accident and Emergency Department of the Spanish Town Hospital saw:
110 victims of motor vehicle accidents per month, last year.
130 victims of motor vehicle accidents per month up to the first quarter of this year.
An average of 10 victims of motor vehicle accidents, brought in dead per month, since March this year.
30-40 patients are brought in dead per month, half of whom are as a result of trauma, for example, gunshot and stab wounds.
