Editorial | Transparency in Sangster airport death

Like Christopher Tufton, the health minister, this newspaper is concerned about the sensibilities of the family of Leroy Smith with respect to a public, tit-for-tat litigation of his death earlier this month at Sangster International Airport, as he prepared to check in for a flight to the United States.

But as Minister Tufton is aware, in Jamaica, such matters often play out in public because regular folk generally don’t trust people in authority to do the right thing and to tell the truth. They expect them to prevaricate and cover up, hoping that matters under scrutiny will atrophy and die.

That, we hope, won’t be the case with Mr Smith’s death. His family should be allowed closure and justice. In that regard, this matter must be rigorously investigated and its report made public, except if his family wished otherwise.

At the same time, this issue is not only about what happened to Mr Smith. For it calls into question Jamaica’s health emergency response system, including at busy public facilities, such as airports, that are traversed by tens of thousands of people daily.

SANGSTER LOOMS LARGER

A place like Sangster tends to loom larger, given Jamaica’s dependence on tourism, and the airport’s pivotal role as a gateway for visitors in and out of the island.

Mr Smith’s case came to wide public attention through an emotionally charged, heart-rending viral video testimony of a woman who witnessed his death.

Apparently, Mr Smith collapsed at the airport check-in area. Apart from whatever might have been the cause of that episode, he seemed to have injured his head.

The woman in the video reported that she was among a handful of people, including, apparently, an airline staff member, who attempted to offer assistance to Mr Smith.

Two bits in this woman’s telling are especially harrowing.

While the airport worker provided rudimentary first aid and she and someone else searched Mr Smith’s phone to find a family member or some other contact to report on his condition, they also shouted for emergency assistance.

By the woman’s account, it took between 20 minutes and half an hour for a nurse to arrive at the scene.

Second, she claimed that having reported that no ambulance from Montego Bay’s Cornwall Regional Hospital (CRH) was available to transport Mr Smith for treatment, an airport official badgered to find out who would pay the US$400 for a private one. The payment arrangement had to be settled before one was called.

That, the Good Samaritans were reportedly told, was the “protocol” – no matter that this was a life-or-death situation.

The operators of Sangster airport have offered a different version of events, except for the fact that they didn’t address the issue of the “protocol” for private ambulances.

Within six minutes of their operations centre being advised of the incident, they said, a nurse from a private service provider arrived at the scene. It is not known how quickly after Mr Smith collapsed that the operations centre was advised. Nor is it known what the protocols for reporting these issues are, who is responsible for making these reports, and how.

The airport operators also indicated that for 13 minutes after the report was made, there were unsuccessful efforts to get ambulances from the government-owned CRH and Emergency Medical Services (EMS), which is an arm of the Jamaica Fire Brigade. However, 28 minutes after the incident report, an ambulance from the airport’s emergency medical support provider arrived at the scene.

It wasn’t made clear at what point an ambulance was requested from the private service provider, or where it was before or after the calls to Cornwall Regional Hospital and the EMS.

Clearly, there are major discrepancies between the version of events offered by the woman on the viral video and that offered by the airport. These must be resolved.

SERIOUS PROBLEMS

But it doesn’t need that for sensible people to conclude that there are serious problems with Jamaica’s emergency medical response system. These problems must be addressed as a matter of urgency by Dr Tufton and his counterpart at the local government ministry, Desmond McKenzie, who is responsible for the Fire Brigade.

Established 28 years ago, the EMS, as the Fire Brigade reports on its website, is “to retrieve, care for and the delivery of victims to an appropriate medical facility in the shortest possible time and under the best possible conditions”.

The service operates from six fire stations, mainly on the tourist strip on the north shore – Falmouth, Trelawny; Ironshore, St James; Lucea, Hanover; Negril, Hanover/Westmoreland; Savanna-la-Mar, Westmoreland; and Linstead, in the mostly southern parish of St Catherine.

The intention was for the expansion of EMS across Jamaica into a genuine national first-responder service, with a cadre of highly trained and adequately resourced medical technicians.

The technicians might indeed be well-trained, but after nearly three decades, that service has not been built out. And the anecdotal evidence suggests that they are not adequately equipped. Jamaicans have not nearly reaped the full benefit the then health minister, Peter Phillips, promised of the EMS.

In recent years, the United States has placed several travel advisories on Jamaica, telling their citizens to be wary about coming to the island. The Americans mostly cite crime as the reason for these advisories. But they also claim the inadequacy of health care as a problem. The perceived shortcomings of the EMS might well be lumped in this.