Heartless

The Government’s decision to push back indefinitely the construction of a cardiac ward at the island’s sole children’s hospital has placed scores of kids in need of heart surgery in further jeopardy. 
That’s the belief of Dr Sherard Little, consultant cardiothoracic surgeon and clinical director, and his team at the Bustamante Hospital for Children in St Andrew. 
In July 2021, Prime Minister Andrew Holness officially broke ground for a two-storey building at the hospital. The first floor was to house a 20-bed overnight parental suite, while a much-needed cardiac ward was to be put on the second. 
The project is funded by the National Health Fund (NHF) and the National Housing Trust (NHT). The South East Regional Health Authority (SERHA), which oversees the hospital, outlined a sum of $120 million for the construction of the suite, and $500 million to construct the ward dedicated for paediatric heart patients. 
Today, only 50 per cent of the construction is completed. And not only has the deadline been pushed back to next summer, but the promised cardiac ward has been put on hold indefinitely, Health Minister Dr Christopher Tufton confirmed to The Sunday Gleaner last week.  
Shocked by the revelation last week, Dr Little said the decision was ill-informed, as giving greater priority to an overnight suite for parents cannot take precedence over something that impacts the health of the children. 
According to the paediatric cardiothoracic specialist, there are more than 150 children on the cardiac surgery waiting list islandwide. Most of these children are at home, while others have been admitted to peripheral hospitals as their parents worry sick about their health. 
Fifty-one cardiac surgeries were performed at the hospital last year. 
“Before the surgery, there is a need for admission; and then after the surgery and patients’ stay in ICU, there is a need for admission for recovery,” Dr Little explained to The Sunday Gleaner. “If there is no ward, the ICU becomes blocked with patients; and if they can’t leave, it means, then, that new patients can’t get their services. It’s almost like a roadblock.” 
“Without a ward to feed patience into the system and to receive patients afterwards, we cannot achieve the full benefit of the Cardiac Unit, and there are patients out there waiting to have surgery,” he stressed, arguing that shelving the ward would further demotivate an already short staff, and significantly dampen trust and morale, especially after numerous meetings about the proposed ward. 
“I would want to think that parents would prefer for their children to get treatment versus being comfortable in an overnight suite. I think it is totally ridiculous.” 
The Intensive Care Unit (ICU) is mainly for observation directly after surgery and has only 10 beds. Cardiac patients are currently being housed with other children in at least three other wards at the hospital, which the staff say presents logistical challenges because of the sensitive nature of those cases. 
‘Not true’ 
However, Tufton scoffed at the argument that sick children are being hampered by the lack of a designated cardiac ward and said he is prepared to make accommodation for any overflow at the University Hospital of the West Indies, as he has done before, free of cost to the public.
Additional ward space for paediatric care in the western health region will also help with accommodation, he noted.
“That is not true because a lot of the time the facilities are there unused. One of the bigger problems is not so much ward space but personnel. This idea that because you have a ward space you are going to be operating every single day, as much as I can appreciate and want it, I am not sure that is the case,” the minister told The Sunday Gleaner yesterday.
“The reality is that we are prioritising. The parental suite was always high on the agenda because the parents need somewhere to stay. They (Cardiac Unit) have an operating theatre, they have an ICU Unit, and provisions are made for the patients to go on the wards. If they schedule ten cases a week, which they are not doing, we can find the ten beds to put them. But what they want is their own dedicated space. It will come but it will take time. We don’t have the money.”
Tufton continued, “So I am not convinced that patients are being deprived of surgeries because of ward space. We have to consider that the hospital caters to multiple areas, and multiple people, and we have to adjust for the collective. They shouldn’t be unfair about it and say that somehow people are losing their lives because of ward space. That is not true.”
“Everybody wants their department to be a priority so I can understand the complaints. Wherever people feel that there are less than perfect conditions they have to wait until we can accommodate those. It’s not a perfect world,” retorted the health minister, listing already executed and planned upgrades for the children’s hospital – among them an expansion of the A&E department that is under way.
Bustamante Hospital’s Chief Executive Officer Anthony Wood confirmed the decision to delay the construction of the cardiac ward with The Sunday Gleaner, but redirected questions to the funders. 
Everton Anderson, chief executive officer of the NHF, a co-backer of the project, told The Sunday Gleaner that he would have to meet with all stakeholders on the matter before providing an official update to the media later this week.  
Holding on to faith 
Celebrating its 60th anniversary last week, the Bustamante Hospital for Children, which was initially a hospital for injured British troops, is the only specialist paediatric institution in the Caribbean. 
It now suffers from space and accommodation challenges, and an ageing infrastructure, which the Government hopes to address with the redevelopment under way. 
Last week, some staff members told The Sunday Gleaner that they were holding on to faith as they do their duties.  
So, too, were parents Ian and Dian Smith, as they waited more than a year, even pursuing overseas options, before their then nine-year-old daughter, Demoya, was summoned for heart surgery at the children’s hospital in November last year.  
Demoya was not only born with two holes in her heart but also suffers from sickle cell disease, which drastically increased the risks associated with the open-heart surgery she needed. 
On November 17 last year, she was finally able to do the surgery, which was the first of its kind at the hospital’s state-of-the-art Cardiac Unit. Costing US$40,000, it was paid for through the ‘Mend a Heart Programme’, offered by the Chain of Hope. Demoya is now recovering well.  
Limited space 
The Sunday Gleaner was informed that there is limited space in an area designated for overnight stay for parents and guardians at the children’s hospital. Those beds are mostly reserved for those travelling from out of town or for those whose children have developmental challenges and may not readily accept medication or food from the staff. It costs about $500 per night for accommodation. 
There are some parents who dare not venture into their communities after dark due to violence and must weather the storm on or around the compound. Those who can afford accommodation nearby or who drive motor vehicles are more fortunate. 
Sheryl Clayton*, a resident of John’s Lane in central Kingston, travelled via taxi when her granddaughter was admitted at the hospital for a chest infection last month. Wanting to stay with the child as long as possible, Clayton said she spent two evenings on the compound evading security guards until late. 
Luckily, the child’s bed was near a window in Ward 4, she said, and so she spent hours cheering up the seven-year-old from outside. On both occasions, she was eventually asked to leave by security guards. 
Clayton said she understands the urgent need for the overnight suite, but said making it a priority is a difficult call. 
“Another time when she (granddaughter) was admitted, I was up there and I heard a young baby crying non-stop for about a hour. It was only after they (staff) felt like looking at her they went,” fumed Clayton.  
“In the case of that baby; staff can deal with the medicine but you need the mother to take care of her when she is crying. But if I was to choose between a place for parents and the heart ward now; it gets kinda sticky. I guess I would choose the ward because it is pickney and a them life we a talk bout. Parents would just have to hold on.”
[*Name changed to protect identity]
corey.robinson@gleanerjm.com