Carolyn Cooper | ICU-B at the UHWI needs more intensive care

When I first visited the Intensive Care Unit (ICU) at the University Hospital of the West Indies (UHWI) where my brother, Kingsley, was a patient, I was surprised by the state of the entrance mat. Once upon a time, it must have been an elegant sign of welcome. The name of the Unit was stamped on it in bold letters. The mat was obviously designed to brandish confidence in the ICU.

If that mat could speak, it would tell an alarming tale of lowered expectations. It appeared to be a disturbing symbol of decline. The mat must have been trampled on for many years. The edges were ragged. Some letters were erased by wear and tear. The mat looked like it belonged in the infamous Papine Market dump across the road.

I wondered if nobody who works in the ICU, stepping on that grimy mat day after day, cared about its deterioration. I suppose there are far more pressing issues than mere aesthetics. But the optics were not reassuring. A few weeks after I commented on the condition of the doormat, it was replaced. That may have been pure coincidence.

RED TAPE

I must express my profound gratitude to the doctors and the entire medical team who rescued my brother from immediate death when he belatedly went to the hospital. They did their best to save him. But the lack of resources made recovery from the impact of the infection caused by his ruptured appendix very challenging. Kingsley’s lungs were badly damaged. A family friend, head of Respiratory Therapy at a major teaching hospital in the US, advised that respiratory therapy should be administered every two to three hours, based on his understanding of Kingsley’s condition.

There are no respiratory therapists in Jamaica. The ICU has only physiotherapists. They do not provide the same service as a specialist respiratory therapist. When we raised the possibility of our privately engaging a respiratory therapist from abroad, we were told that it would not be a simple process. The therapist would have to be vetted by the hospital administration. We realised that by the time the red tape was disentangled, Kingsley would no longer need the service. He would be dead.

In addition, there was only a three-day supply of an essential drug for Kingsley’s care in Jamaica. Another family friend sourced it in the Bahamas. The logistics to get it here were overwhelming. Our sister Donnette had to bring the drug from the US. We need a CARICOM database of drugs that are available across the region. These essential medicines should be easily transferable, without complex customs regulations that delay access.

Further, there needs to be a national database of prescription drugs. I met a man at the ICU who had been hunting in vain for a drug needed by a relative. He had called practically every pharmacy in Jamaica. Finally, a pharmacist told him that the drug had not been here for five years! I tried to console the distressed man by suggesting he follow our example. Surely, doctors should not be blindly prescribing drugs without knowing if they’re available!

“A POLITICAL PLOY”

One of Kingsley’s doctors expressed his unease that essential drugs had to be sourced by relatives. Given the complexity of Kingsley’s case, we decided to transfer him to a hospital in Miami where services and medicines would be more readily available. On the evening that Kingsley was to be taken from the hospital to an air ambulance, neither of the ICU-B’s two portable ventilators seemed to be available. A manually-operated oxygen mask was used. I wondered if that was ideal.

I don’t know if portable ventilators were among those that have, apparently, mysteriously disappeared. Minister of Health and Wellness, Dr Christopher Tufton, claims that not one of the donated ventilators is missing. He insists that the alarm raised by Dr Alfred Dawes, Opposition spokesperson on health, about the number of functional ventilators in the healthcare system, is nothing but “a political ploy.” Tell that to Chavanie Farquharson-Blackstock, whose new-born child died at the May Pen hospital because there was no ventilator!

Kingsley’s transfer from the ICU was most traumatic. The ambulance left the hospital at approximately 8 p.m., right after I went on board to put my phone to Kingsley’s ear so that Donnette could wish him safe passage. Kingsley’s partner, Romae; his son, Cole; Romae’s sister, Dionne; and I followed the ambulance. We got to the airport at approximately 8:35.

ANXIOUS AND AGITATED

Believe it or not, the security guard at the entrance to the tarmac refused to let the ambulance through to the plane. I was told that he said there wasn’t enough time for Kingsley to be processed before the airport was to be closed at 10 p.m. I do not know on whose authority this incomprehensible decision was taken.

Kingsley was kept in the ambulance for more than an hour waiting for the matter to be resolved. The doctor who accompanied him reported that he was anxious and agitated. The flight finally took off after 10. The following Monday, Donnette sent this email to the Airports Authority of Jamaica: “Please indicate where I may access the policies and procedures governing medical airlift from NMIA. I have tried requesting this info from you[r] website without success.” She received no response.

I did not want Kingsley to leave Jamaica to get medical care. But it seemed to be the only viable option. What about the hundreds and thousands of Jamaicans who can’t afford to go abroad for treatment that’s unavailable here? Our healthcare system needs life support. Missing ventilators are not even the half of it.

Carolyn Cooper, PhD, is a teacher of English language and literature and a specialist on culture and development. Email feedback to columns@gleanerjm.com and karokupa@gmail.com