Chik-V crush

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Outbreak of chikungunya adding to hospitals struggle to prevent long wait by patients

Erica Virtue

Senior Gleaner Writer

The current pressure on local hospitals by individuals seeking treatment for Chikungunya (chik-V) and the seasonal illness such as influenza are putting a strain on public health facilities which is expected to continue until next February.

The health ministry last week announced extended opening hours for health centres in Kingston, St Andrew, St Thomas and St Catherine, and has been urging persons with chik-V symptoms to visit these facilities first rather then running to the main hospitals. There is also a plan to use a portion of the $500 million budgeted to deal with the present crisis to contract more medical personnel for these health centres.

This would welcome by members of the Medical Association of Jamaica (MAJ) who last week told an Editors' Forum at the Gleaner's North Street offices that the hospitals are sagging under the weight of the sheer numbers seeking attention at their accident and emergency departments.

Vice-president of the MAJ, Professor Marvin Reid said the long wait by members of the public is a numbers game, and many more, especially children, will be presenting with respiratory illnesses between now and February 2015.

"Typically, if you approach a hospital, the hospital is seeing simple cases and more complex cases. Hospitals are designed for complex cases. Most hospitals have a triaging system, but even to go through the triaging procedure takes time. So if you say that the process will take three or five minutes, if you have a 100 people, it means that it will take 100 times whatever the period is," noted Reid.

"If you present at KPH (Kingston Public Hospital) with a simple headache. It takes you two or three hours to go through the triaging system. You then now will have to wait for the doctor. The doctor may have two or three additional cases before you and may take an hour to go through that, depending what the situation is. All you need is a bus crash, and everybody has a back-up for hours," explained Reid.

The MAJ vice-president was responding to question on the long waiting times being experienced at the island's public health facilities. In recent cases individuals have died in hospitals while waiting to be seen, while others have died shortly after being seen. Further pressure has been placed on the system in recent weeks, as hundreds present with symptoms of chik-V.

At the Bustamante Hospital for Children parents, used to waiting for up to 18-hours for medical care for their sons and daughters, now say the wait is even longer.

According to Reid the long wait reflects the ratio of doctors to patients.

"The reality is a simple ratio of physicians to patients. The number of doctors assigned to any particular location is dependent on what is called their staff establishment," Reid explained.

In the meantime, head of the MAJ Dr Shane Alexis, told the Editors' Forum that on average, more than 100 persons are being seen by a single doctor on an eight-hour shift at KPH. The numbers seen, were not necessarily those seeking help as some may have left in frustration.

"The patients are at various educational levels. Sometimes the doctor can tell you what's wrong with you in two minutes. But then you hear you are rushed, you didn't say good morning, or good afternoon. When persons come in, who are barely literate and with a limited vocabulary who cannot fully explain their symptoms, that patient will take longer to diagnose," explained Alexis.

According to Alexis, while it is easier to deal with persons with gunshot wounds as that diagnosis is clear, those cases need more than one doctor and one nurse, taking medical personnel away from those already waiting for medical care.