Editorial | Jubilee Hospital neonates deserve more

It's appropriate that the health minister, Christopher Tufton, has instructed the regional health authorities to audit the management of morgues at hospitals within their jurisdictions in the wake of the findings of a collapse of systems at the Kingston Public Hospital (KPH).

For if what happened at KPH and Victoria Jubilee, the adjoining maternity hospital, which fall under the South East Regional Health Authority (SERHA), is as bad as reported, we dread the situation at other smaller institutions and in regions not as well endowed as SERHA. In fact, this matter raises the spectre of a potential health crisis.

The genesis of this issue was the discovery in May of the bodies of two neonates, or newborn babies, on the streets behind the hospitals, apparently being fed on by stray dogs. There is something gross and indecent that a human body, whatever the circumstance, could fall to such a situation. It is worse when these bodies were supposedly in the care of the English-speaking Caribbean's largest trauma and maternity institutions, which often promote themselves as being the most competent at what they do.

The report of SERHA's investigation into the incident, conducted with the help of the police, has not been published but, according to the chairman of the authority's technical assessment committee, Dr Patrece Charles, it revealed "an apparent systemic breakdown at both KPH and VJH, which would have resulted in the mishandling of dead neonates and stillborns".

It has emerged that babies' bodies are stored in deep freezes designed primarily for domestic or home use, rather than cadaver refrigerators, and that the record-keeping at the institutions, including at the morgue, was poor.

What is not clear from all this is how these two bodies found their way into the back alleys of west Kingston, the public-health implications of this, as well as their being eaten by dogs.

Further, it is clearly within the realm of possibility, given the poor record-keeping at the hospitals, that these were not the first bodies, or at least of neonates, that have made their way on to the streets without being discovered. That potential perhaps demands a deeper, robust, forensic analysis.

SIGNIFICANT ISSUE

There is another significant issue that flows from this development, that is, the absence of a centrally operated public morgue. The longer-term storage of bodies, the circumstances of whose deaths would demand that they be in the control of the State, is outsourced to private funeral homes, whose facilities are often stretched.

Jamaican governments have, for decades, talked of developing such a morgue. Against the background of what has happened, such a facility, as part of a modern coroner's system, seems a necessary and urgent public-policy undertaking.

Indeed, the insufficiencies of pathologists and modern facilities often cause delays in autopsies and slow police investigations, which may impact when a criminal case is completed, thus contributing to the backlog in the courts and weak confidence in the justice system. This dysfunction also frustrates families who merely want to bury their dead.

In that sense, we don't agree with Phillip Armstrong, SEHRA's chairman, that in completing the report, improving record-keeping and interdicting some morgue employees, the authority has done its job. It has a larger responsibility to public health in southeast Jamaica.