Bellevue challenge

Minister wants reform; appeals for help from corporate Jamaica

BY NADINE WILSON Observer staff reporter wilsonn@jamaicaobserver.com

Wednesday, February 01, 2012

A shortage of critical staff, infrastructural mishaps, challenges in controlling patients and the inability of reformed mentally ill patients to secure jobs, were just a few of the complaints that greeted Health Minister Dr Fenton Ferguson during a tour of Bellevue Hospital yesterday.

The minister, along with other health officials, toured the Windward Road facility for nearly four hours to do an assessment of the institution which currently treats 800 of the country's mentally ill patients. But midway into his tour, which saw him visiting the wards, the emergency section and the kitchen, the minister was already calling for urgent attention to be placed on the institution.

"For me, the challenge right now as minister (is that), there has to be some reform," he declared.

Health officials and members of the media were exposed to a host of irregularities during the tour, which gave credence to a Sunday Gleaner report that the hospital was in need of attention. In the kitchen area, for example, a chef was observed stirring and sharing rice with a shovel from a pot that was just metres away from a drain. Other sections of the hospital were in need of painting and repairs and the bathrooms were, for the most part, deplorable.

The first place visited on the tour was the Open Arms Dropping Centre, where 107 mentally ill patients were being rehabilitated in preparation for their release back into society. Although most of the men were certified in different skills, they complained that they were unable to get jobs.

"We are people who are willing to work," said one patient who told the group he was a certified electrician.

Most of those at the facility are out-patient clients who visit for meals and skills training, although 28 rehabilitated persons were fortunate to receive boarding at Maureen's Place, which was built last year to assist residents in making their transition.

At the next stop — the ward for acute male patients — the team was greeted with the scent of disinfectant and floor polish. A visit to the bathrooms revealed wet floors, walls badly in need of a coat of paint, bathroom stalls without doors and makeshift shower heads from PET bottles.

As the team made its way to the seclusion area for patients needing restraint, a cockroach scrambled for cover and a bed was seen on the floor behind burglar bars seemingly for those patients who proved uncontrollable for the staff.

"We have to use physical force at times," admitted nurse-in-charge, Sonya Edmondson, before adding, "We do get very aggressive patients".

Most of the patients from the ward had already formed a line in the cafeteria to collect meals to take their medications. One by one they were handed a plate with slices of white bread and pieces of sausage along with a cup of porridge.

Although the number of men at the hospital far outnumbered the women, the ward for acute female patients also saw some of the challenges being faced by administrators on other wards — the primary one being the shortage of staff. One nurse told the Observer that the hospital now had only two nurses attending to the needs of the 19 female patients on any given day. The bathrooms here, too, offer little privacy for patients as most stalls are without doors.

At the medical ward where severely ill patients are treated, the major issue was the leaky roofs which caused discomfort for patients and staff. "When the rain falls, I have to literally have umbrella on the ward," said the charge nurse for the ward.

The bathroom was not much better here either, as the tiles and paints were stripping from the wall and nightgown were strewn over doorposts. About 20 toothbrushes fought for space in an empty butter container which was precariously perched on a piece of board covering a drum half filled with water.

Outside the facility, patients milled about, talking mostly to themselves and seemly oblivious to the impromptu press briefing the minister held after making his exit from the ward. Dr Ferguson assured that an audit would be conducted, which will help the ministry to determine its next move.

"This audit will form the basis for the reform or restructuring process that will come," he said. He didn't, however, give a timeline for the completion of the audit.

A part of that reforming process, he said, will include the changing out of the current board of mangement at Bellevue and the recruitment of more doctors and nurses. There are only 15 doctors and about 150 nurses currently working there.

"From the tour thus far, it is obvious that there are some serious structural challenges. Much of these buildings were constructed a long time ago," he said. "From my own conversation with the nurses and doctors, it is clear that there is a problem as it relates to doctor-patient ratio [and] nurses-patient ratio."

At the emergency unit, which treats about 5,500 patients annually, there was an immediate need for ambulances and psychiatric nurses. But, perhaps, the areas most in need of attention at the facility were the T-ward for disabled patients and the geriatric ward for the elderly. It took about five minutes of driving over a rugged terrain to get to the wards, which were secluded from the administrative section and the hub of activities.

Although the T-ward was supposed to be for disabled patients, the structure did not reflect this as there were no handrails in the shower area and makeshift board ramps had to suffice for more permanent fixtures.

The geriatric ward raised more concern as there was hardly any room for privacy. In fact, the team was stalled for a few minutes in order that a patient could complete using the bathroom before they could take a look inside; since there were no doors in sight. Here, too, saw more peeling paint and cracked tiles.

Given the challenges currently facing the hospital, the minister is hoping that more private sector firms will come on board to assist with the reformation process.

"My own view is that it is going to be a work in progress. I am making a special appeal to corporate Jamaica. I believe that the Bellevue experiment is one which demands adoption of wards. I think it is a good opportunity for private-public partnership and we have good corporate citizens out there that I believe could come to the plate at this time," he said.

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