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Sigma donation will help fill great need at Spanish Town Hospital

BY KIMBERLEY HIBBERT
Observer staff reporter
hibbertk@jamaicaobserver.com

Tuesday, January 23, 2018

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The wish list at Spanish Town Hospital's Paediatric Unit is long. Ideally, the medical staff would love to have enough of the machinery necessary to treat the 1,300 ill newborns who are admitted to the special care nursery annually.

For many years, the doctors and nurses have been making do with the thin resources available, and have even gone as far as using apple juice bottles to create a type of oxygen support system.

“It's an improvised way of respiratory support and it mimics a CPAP machine, which is continuous positive airway pressure,” Dr Jacqueline Wright James, head of the unit, explained yesterday. “The difference between it and the ventilator is that babies have to be breathing, but sometimes premature babies stop breathing, so they need a ventilator.”

Dr Wright James and the hospital's CEO, Dwayne Francis, are anticipating that the donation from this year's staging of the Sagicor Sigma Corporate Run will help transition the special care unit to a neonatal intensive care unit.

It will be the second successive year that the hospital will be a beneficiary of the fund-raising 5K event, now in its 20th year. Last November, Sagicor presented the hospital with medical equipment valued at over $14 million, procured from proceeds of the 2017 staging of the event.

The equipment included five incubators, one ventilator, five vital signs monitors and related accessories, three warmers, three Resuscitaires, one arterial blood gas analyser, six volumetric infusion pumps two LED phototherapy lamps and two neo puff infant resuscitators.

That, however, is still not enough for the hospital to meet the needs of its infant patients.

“Being transitioned into a neonatal care unit would allow us to be able to deal with those neonates who are extremely sick with appropriate equipment. At the institution, when we find ourselves with those neonates that require a certain level of oxygen or specialised equipment, we have to transfer them out. Those babies either go to Victoria Jubilee Hospital, University Hospital of the West Indies, or Bustamante Hospital for Children for care. But there are times when they don't have space and we have to make do with the little we have,” Francis told reporters and editors yesterday at the Jamaica Observer Monday Exchange.

Dr Wright James explained that the hospital has two main paediatric areas — the general paediatric ward and the special care nursery. She said between both areas, the population is roughly 3,300 children admitted per year between the ages of 0 and 13.

“At the Spanish Town Hospital Special Care Nursery we admit ill babies who are at the hospital. But if there is any baby who is born outside of the hospital, or who becomes ill after being discharged from the hospital, they will be admitted to the general paediatric ward. So, we have ill newborns on the general paediatric ward,” she said.

The special care unit, she explained, houses 40 beds, and has an average of 28 babies. But, though it is not always full, the intensity of the care delivered is great, and there are times when the patient population soars to 60.

“We have had to house babies in the parents' room and also in the passage on some occasions. Although we have had some improvements in infrastructure recently, we have outgrown the physical space, so that is one of the issues we have there,” Dr Wright James pointed out. “We deliver over 5,000 babies per year, second to Victoria Jubilee Hospital. We have our challenges, but we try to give the best care we can to all our patients. We work with what we have and try to make the best use of it. But we are always trying to acquire more and certainly to offer the best care we can to our patients. Even with the best support we are still not able to offer the level of care we would want to.”

To illustrate the extent of the need the hospital faces, Dr Wright James said 25 per cent of babies admitted to the special care nursery are premature — an increase since 2015 which saw roughly 18 per cent of infants born being premature. These babies require specialised equipment which are very expensive.

“They need a ventilator to help support their breathing, as respiratory problems are our main challenge of survival in babies. If you look at the numbers I gave you would see procuring one ventilator may not very well be sufficient. One ventilator with the accessories that come with it can run upwards of $6 million,” she said.

“We do not only have premature babies in terms of respiratory problems. There are babies that are born also with lung infections, congenital pneumonia, and babies who will have respiratory problems because they pass stool before they are delivered and that may have aspirated into their lungs. So, if 50 per cent of our babies have respiratory problems we can see the need that we have,” she said.

“Presently we have eight vital sign monitors and eight infusion pumps. With the numbers I gave you, every sick baby in that unit should have one of these monitors to ensure we can make quick clinical judgements that result in the best outcome for these patients. One vital signs monitor will run anywhere from $300,000 to $500,000. One infusion pump runs about $150,000. To allow for this transformation to fully take place to a neonatal intensive care unit we certainly have identified some other things. We want to acquire at least one or two more ventilators and more of the vital signs monitors and infusion pumps so each of the babies can have one,” she explained.

Additionally, the paediatrician said the hospital needs transcutaneous monitors to determine the level of gases within the baby (to avoid taking blood), and oxygen blenders to control the percentage of oxygen each baby gets. Each of these cost $4.2 million and $250,000, respectively.

The Sagicor Sigma run will take place on February 18.

St Christopher's School for the Deaf in Brown's Town, St Ann, will be the other beneficiary of this year's staging.

People interested in donating to the cause are being asked to go to www.sagicorsigmarun.com and register, make donations or purchase items on sale. Early bird registration, which offers a discount, ends today.

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