TRAGIC TOLL

Kerry-Ann Brown is a broken mother who, for the rest of her life, will bewail the actions of a distracted taxi operator, which forever altered the lives of both herself and her 15-year-old daughter, Shantavia Harrison.

In 2022, Shantavia was mowed down by the taxi operator in St Ann, who reportedly reversed, hitting her, before driving several metres with the teenager trapped underneath the vehicle.

She said it was only after onlookers alerted the driver to what was happening that he reportedly realised what had transpired. By then, it was too late. The impact broke two of the teen’s limbs in multiple places and badly disfigured her.

After several skin graft surgeries, the youngster, who spent almost a year hospitalised, was released in May last year. But that’s when things took a turn for the worse.

Sipping a soda outside the St Ann’s Bay Regional Hospital’s (SABRH’s) main entrance two weeks ago, Kerry-Ann explained that depression had gotten the best of the once-budding student, who was worried about her appearance and her inability to complete her studies.

Those concerns had landed her once again in the hospital after she stopped eating, her frustrated mother said, telling The Sunday Gleaner that she was desperately in need of assistance for her daughter, whether financial assistance or, better yet, a chance to fly Shantavia overseas for additional skin graft surgery.

But that was not to be.

Shantavia passed away at the hospital early last Thursday morning, leaving Kerry-Ann, who prides herself as being a strong individual, in shambles.

“Yes, she gone home, man. She gone home this morning,” was all the broken mother could offer via cellular phone last week.

“They said she died of stress and organ failure,” she added, her voice dropping as she relayed the preliminary doctors’ report.

The mother said she spent at least $3 million in transportation and healthcare for her daughter since the accident, and that the child’s death was the culmination of a two-year financial struggle after she left her job to take care of the older of her two children. Now, with funeral arrangements added to the mix, Kerry-Ann said she has no idea how she will handle her son’s back-to-school expenses.

Then, there is the psychological impact of the ordeal – the sleepless nights, the worry, and even guilt as she convinces herself that she tried her best to motivate her daughter, even though that was difficult in her final days.

“I’m a Capricorn. I am a fighter. I don’t like asking for help, but sometimes you have to ask. I did all I could to take care of her, but the mental part frustrates me,” the Walkerswood, St Ann, resident told The Sunday Gleaner.

Mounting bills and pain

Shantavia was among 1,586 persons admitted to the SABRH as a result of motor vehicle accidents in 2022, and her death amplifies what staff at the facility, as well as those at the Cornwall Regional and the Kingston Public hospitals regard as a very costly mental and physical toll to victims and staff alike.

This pain and suffering, they said, often endures long after the victims make it through expensive surgeries undertaken immediately after the accidents.

Cumulatively, a study of 485 patients at the SABRH between 2015-2020 revealed that it cost the facility upwards of $2 billion in resources for rehabilitation treatment. This is only a small segment of the impact, which is bereft of the mental and psychological costs that plague victims, their relatives, and even hospital staff dealing with heavy influxes – mass casualty crash cases, in particular.

Staff at the SABRH say that at least 60 per cent of those cases involved treatment of lower limb fractures, followed by tissue injuries, and very painful nerve damage. There are also strains, sprains, and more problematic and long-term brain injuries that come with the more severe crashes.

“We are talking about victims, most of whom are in their prime years. So it not only impacts the hospital in terms of care, but it also impacts these individuals’ ability to earn a living for themselves and their families over the long term,” offered Tanya Hamilton-Johnson, senior medical officer at the SABRH.

“These accidents are often so severe that they lead to critically ill patients. We are talking about head injuries and multiple upper and lower limb fractures, [and] trauma to the abdomen and chest. What this means is that some will end up having to be transferred to another institution, primarily because of the head injuries,” she explained, citing the Kingston Public Hospital (KPH) and Cornwall Regional Hospital (CRH) as medical facilities to which victims may be transferred.

Last week, KPH officials noted that the downtown Kingston-based facility treated 13,462 crash victims from 2017 to 2023; and that there were 99 fatalities in the emergency department. Some 198 crash victims were pronounced dead on arrival.

At CRH, there were 4,187 road accident patients from 2021 to 2023 – a steady rise from 1,227 cases in 2021 to 1,443 in 2022 and then 1,517 in 2023.

Errol Greene, regional director of the South East Regional Health Authority (SERHA), which oversees the busy KPH and Spanish Town Hospital, explained that, while hospitals have the capacity to deal with crash traumas, the high rates at which they occur have been a long-standing problem.

“The nature of injuries coming into the hospitals’ A&Es (Accident & Emergency Departments) is also concerning. Some patients require rehabilitation due to loss of limbs, fractures, broken body parts – extensive/extended stays,” Green said. “Unfortunately, the A&E teams must also deal with the deaths of many of the patients who they attempt to save. This does have a psychological and emotional toll on the staff, as they are also tasked with notifying and comforting bereaved relatives.”

Like the other hospitals, Greene noted the increase in crashes at SERHA facilities during holiday periods, and cautioned motorists about their use of the roads.

At present, there is no alcohol testing of crash victims by the police, so the authorities could not say to what extent alcohol use plays a factor in accidents in recent years.

Blood, bandages,

and surgeons

From January to June this year, there were 760 admissions to the CRH and, in that period, there were five motorcycle and four motor car-related deaths upon admittance.

Dr Delroy Fray, the clinical coordinator at the Western Regional Health Authority (WRHA), which has responsibility for the CRH, told The Sunday Gleaner that accident patients continue to deplete a significant portion of that hospital’s budget and, similar to the SABRH, this is draining the ability of victims to work and provide for themselves and families.

“For one of these accidents that involve head, chest, and limb injuries, you are going to spend somewhere between three to six weeks in hospital,” Fray said, sounding a warning, particularly to motorcycle riders, who are aplenty in the western parishes. “If you have a femoral shaft fracture, that is your thigh bone, the current standard for fixing it is that you put down a nail, and that nail costs about $150,000.

“The operating time is about an hour and the surgeon time is about an hour. We don’t really cost it for public patients but, in a private setting, that is going to easily run you $1.5 million to $2 million to get your femur fixed,” he said. “Patients then end up in the intensive care unit (ICU); that is going to push the daily cost up a lot.

“Based on what we do every day related to surgeries, trauma cases probably eat up 60 per cent of our health budget here at CRH,” said Fray, a trained trauma surgeon who formerly served as the CRH’s senior medical officer.

The hospital representatives said trauma injuries from crashes also deplete blood and medication reserves at the facilities, especially in crashes involving multiple vehicles. The SABRH has seen several such crashes in recent years because of highways running across the parish; while, at CRH and KPH, crash and gunshot wound victims are among the major challenges.

“If we were to remove or minimise trauma cases, personal injuries, gunshot wounds, and motor vehicle accidents, we would have enough operating space to look after our patients with normal surgical problems like hernias, thyroids, and hysterectomies, common surgical problems that need to be addressed to allow the patient to be functional,” Fray said. “Not to mention the blood consumption to treat those patients. Depending on the severity of the injury, you may need six to eight units of blood, not to mention antibiotics and other medication.

“If the patient has insurance, then we source that money from them. But, if they don’t, then that money has to be found to buy that implant; because we don’t have that implant in a supply where we can replenish it,” Fray continued. “That just gives you an idea of the burden that it has placed on us.”

corey.robinson@gleanerjm.com christopher.thomas@gleanerjm.com