Don’t be Caught Dead in a Jamaican Public Hospital : A Rant

I read a few days ago of Mr. Jason Forbes who died on the floor of the waiting area at the Spanish Town Hospital in Jamaica. The next day I read the response of the president of the Jamaica Medical Doctors Association. I was saddened to read of the man’s death but the caustic response of the highly esteemed Dr. Alfred Dawes angered me to the core. According to The Jamaica Observer Dawes said,

“… If you’re going to blame anybody, don’t just single out doctors and blame doctors, blame the infrastructure, blame the lack of adequate staffing, and blame the patients who are crowding up the emergency room unnecessarily.”

What an asshole. I probably would have sympathized with his statement had he not laid the blame on me – a poor, non-politician, non-elite  Jamaican who relies on the public hospital system – for Forbes’ death. What. An. Asshole.

Throughout the article Dr. Dawes explained why his colleagues are not culpable in the situation but never once expressed an ounce of remorse for the death of Jason Forbes. I am not sure what events have calibrated his moral compass but he seems quite callous to sickness and death in the Jamaican poor, which is not something desirable in a public health servant. He is defending the healthcare workers who claim to be unable to do their job because of, among other things, ‘the patients’, but if you are unable to do your job do not collect the paycheck. You have no compassion or remorse for the condition the poor Jamaicans who have no choice but to pay taxes and those of you who have private practice might be applying intense TLC to the wealthy who can afford you but are known to evade the taxman. Although we are lacking, Jamaica is better off than many developing countries as far as healthcare infrastructure goes, we are most deficient in the elements of love for each other and respect for the humanity of the poor.

When I tell people of my ordeals in the emergency room and public health clinics, which Dr. Dawes presents as an alternative to a hospital, they express the belief that I am not from the segment of society that should rely on the hospital for care but I am, we all are unless we can afford to be airlifted elsewhere. If I fall seriously ill at my home in rural Jamaica, the nearest hospital is only a 10 minute drive from me but I most likely will not be able to drive during an emergency health scare and it turns out I cannot call an ambulance either because there is no such service in my area. My primary care doctor would have been asleep in his Kingston home and being not a doctor myself, I would need some answers on whether I am gonna die or not. So I would have someone drive me to the ER. And I would wait, had I been Jason Forbes I would die. Better case scenario – I would be refused care for wearing too-short sleeves and die at home or on the way there.

I went to the public hospital in my rural Jamaican town on two occasions, on the first time I was seen by a second doctor after five hours and was injected with a very strong painkiller and told to return to the adjacent clinic at 5am. The second time I suffered with severe lower abdominal pain which the doctors seemed to suspect was some form of kidney problem so they decided to sign me up for an ultrasound, which they encouraged me to do at a very specific imaging centre since it was an emergency and not wait three months to do it at the hospital where it would be free of charge. They injected me with a painkiller that was contraindicated for kidney problems and sent me on my way to do a $12,000 ultrasound. I returned with the results of the ultrasound which the doctor read and decided was inconclusive so he wrote me up another form to do a test elsewhere that would help him better determine what was wrong with me. I didn’t do it. My intuition said that this guy doesn’t give a fuck about my kidneys if he would really let me wait three months for a conclusive exam if I couldn’t afford to go to his friend’s private facility in Portmore so I stocked up on painkillers and proceeded with my upcoming trip to the USA where I saw a doctor who prescribed the same ultrasound and actually came to a conclusion. I was medicated and the problem was soon under control. By the way, that first time I went to the hospital and was told to return to the clinic the following day, I did indeed arrive at 5am but I didn’t leave until 4pm.

During the ongoing Chikungunya outbreak, my mother waited late one night with my brother, who had fainted (and possibly hit his head), at the hospital for several hours; when the waiting became unbearable for him she asked a nurse if there was a cafe where she could get him some tea and the nurse responded, “You see anything like that yahso?1”. It would take far less effort to say “No, sorry” but our healthcare workers are, apparently, well-trained assholes. They do not understand that sick people tend to seek care and they would not subject themselves to this torture by “crowding up the emergency room unnecessarily”, which I am sure must be so much worse with the Chikungunya outbreak, unless they have no viable alternatives. Dr. Dawes, if patients are preventing you and your colleagues from doing your job, I think it would be appropriate for all of you to not collect pay from the public purse for work that you cannot do. It might not be easy but it is very simple.

  1. English: Do you see any signs to suggest we have such a facility here? []
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  1. Nicky
    Posted October 5, 2014 at 12:37 PM | Permalink

    Palpable pain and anger.
    I wish this could be the headlined story for tomorrow’s newspaper.

  2. David Jo
    Posted October 5, 2014 at 3:22 PM | Permalink

    I find the simple solution to be the only solution in so many other Jamaican cases.
    But it is hard to do the morally right thing.
    It is more dramatic in Healthcare but the solution should be the same when confronted with institutional ineffeciency, incompetent management and dysfunctional Boards.
    If we go along with the slackness for whatever reason we are all ultimately responsible for the system we end up with. Politics, health , education, families, nation building.
    I don’t think prayer will do it. Not ruling it out but I think what is needed is a national debate and decision to do.
    Just decline to participate for a week maybe . But as a block. Representing civil society.

  3. Posted October 6, 2014 at 9:59 AM | Permalink

    There used to be an ethos of public service in Jamaica. Even at Jamaican public hospitals. What has happened to it?

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