Patient grievance rages on at Cornwall Regional Hospital in St James, the main health service provider in Jamaica’s western region.

For the last five years the 10-storey, 400-bed capacity hospital has been undergoing over $3.5 billion worth of rehabilitation and has been reduced to carrying out operations outside its main building and, instead, in the nurses’ and doctors’ quarters.

In December 2019, faith was high when promises were made by chairman of the Cornwall Regional Hospital’s Independent Oversight Committee, Professor Archibald McDonald, that the renovation was slated for completion by the end of 2020.

Prof McDonald had said the project was being executed in three phases with work on the roof of the 10th floor, under the first phase completed. He said phase two, which included the demolition of interior walls and strengthening of the hospital roof, was “progressing well.”

But two years later, while the main building still remains inoperative, tents assume some responsibility to its left.

“Waiting under this tent is infuriating. It is baking under the sun and you’re just sweating like a pig. To be poor is really a crime. Three fans are under the tent… two at the front and one at the back. But when you are under a plastic tent that is trapping the hot air for hours, those fans have no use. There is also a little AC up at the front, but the tent is wide open and if you’re at the back, you feel noting. It is just hot air,” one man lamented to the Jamaica Observer on Thursday.

Inside the tent, people sat waiting to be attended to. One man, with a bandaged left foot stretched across two chairs at the front with a walking stick, waiting to be called. Around the back, another man laid barefooted across three chairs.

A board structure with sheets of zinc above it creates a walkway where patients make their way to a security barrier when called.

“Please come to the yellow security barrier,” a woman announced each time she called a patient.

Dr Delroy Fray, clinical coordinator at Cornwall Regional, told the Sunday Observer that due to the renovations being done, the hospital has employed the use of the tents.

“There’s one tent where we do triage. We put you at that tent until you’re sorted. When you come, whatever symptoms you have, you stay and a doctor will determine if you need to be seen or if you can go home or go to your health centre. And we have a tent where if you come with respiratory symptoms, you don’t mix with the others. This tent houses them until they are seen,” he explained.

“Another tent is being put up. That one is going to be an AC tent and it’s almost finished. We’re going to use it to house COVID patients before they go to the ward,” Dr Fray continued.

The Cornwall Regional Hospital was built in 1974 and is located two miles from the centre of Montego Bay, on a hill in Mount Salem.

According to the Ministry of Health and Wellness, “There have also been reports of indoor air quality (IAQ) concerns from the first to fourth floor since 2009 affecting the first floor — Radiotherapy; second floor — Western Regional Health Authority (WRHA), Laboratory and Accounting Department; third floor — Radiology; and the fourth floor — offices of the senior medical officer.”

Prof McDonald said the main challenge standing in the way of completion was ensuring the building was dry in order to address air quality issues caused by mold. He further stated that the budget was increased to approximately $4 billion, up from the $3.5 billion disclosed by Minister of Health and Wellness Dr Christopher Tufton, during his contribution to the 2020/21 Sectoral Debate in the House of Representatives.

An elderly man told the Sunday Observer that he had to wait over 24 hours to get medication.

“I came to the hospital from eight o’ clock Wednesday morning and I get through Thursday afternoon after 12. Me up here for one whole day waiting on medication. I had to sit down in the chair the whole night. When I get up in the morning, all a me body pain up. These things need to be discussed because we a nuh animal. We shouldn’t have to go through this. The Government need fi have a proper place fi people stay. The doctors nuh plenty and dem tired the same, but if the patients have a comfortable spot, it woulda bad and not so bad.”

But Dr Fray said these cases happen occasionally, given the circumstances.

“That happens sometimes. When we do a triage, we decide if you can sit or if you need to lie down. That’s how we have to do it. We have no apology for that. We have to just work with what we have, to give the patients the best. I’m happy he got through this morning (Thursday). That’s good. That’s not so bad.”

In addition, a 60-year-old man from Albion, who gave his name as Kerr, described his experience at the hospital as frustrating.

“It’s been tedious and long, but the length of time you spend depends on the time you come. You join a line, get a number and sit down and wait on the number to be called. I came here a little after seven and it took me almost six hours to get through,” he told the Sunday Observer at 12:50 pm last Thursday.

“The waiting area could be less tense, in the sense that you could sit down or probably listen to something playing or something and wait until you’re called instead of you just being there and jostling with people. It is a very packed space. It’s just chairs under the tent. It’s a very small tent and that is where I had to wait.”

One woman added: “I just come and go. But people complain all the time about the service over here when they come to see doctors. To get simple medication, you have to be staying for a very long while. It takes more than patience. It’s not good.”

Dr Fray admitted that most complaints from patients stem from the lack of bed availability.

“The major complaint that we have is like when they have to sit on a chair awaiting a bed. So what we do, we put things in place. We have good patients care reps who go around, and the doctors look and will prioritise. So the sicker ones get the beds, those who can wait have to wait and then we move them accordingly. It’s a pretty complex job to run it pretty smooth. If you’re sick, you’re going to think you’re the sickest person and you’ll think everybody should look after you. But we have to look at the overall picture,” he maintained.

Dr Derek Harvey, senior medical officer at the facility, told the Sunday Observer that there are also criticisms from doctors.

“You will have persons who are disgruntled. Regardless of where you are, you would like to contribute to medicine in an ideal situation. We are told that we’re going to be using temporary facilities for a period of time. Unfortunately, with COVID-19 plus other factors, the temporary is longer than we anticipated. This is not ideal. Even when I worked on the main building prior to anything going down, there were circumstances which were never ideal,” he said.

“Some persons strive for the ideal. What is the ideal for that person? It might be the American ideal but we’re not in America. So what one has to do is to look at the circumstances you have and try to make the best out of a bad space. It’s not the best. I agree with some of my colleagues and yes, I agree it’s frustrating especially if you’d like to advance health care in the 21st century. But it’s a temporary situation we would like to remedy by getting the hospital back.”

In June, one doctor, who was speaking on condition of anonymity, complained bitterly about the conditions of the State-run facility.

“It does not look good, and it is not standard of care. It is almost an inhumane, not almost, it is an inhumane experience, and we have to remember these are not well [people], these are [people] who are sick,” the doctor said.

Currently, the main building is only accessible to “authorised personnel.”

At the Information and Customer Care sections on the first floor, dusty tables and chairs are packed on top of each other. Mattresses and a sign with the words ‘Silent Zone’ inscribed are on the floor, leaned against a wall. Three-wheeled stretchers, also known as beds or carts, are parked along a walkway.

Meanwhile, Dr Fray said the COVID-19-designated ward comprises of two areas.

“There is Block C with 29 beds, which are dedicated for both male and female COVID patients, and we have a mini-ICU that can house three patients; four if we push it. Two weeks ago, when we were pressured with over 120 patients, we opened up another ward and turned it into a COVID ward. But what we’re doing now is we’re scaling back down that area,” he said.

“Our numbers have been cut by almost 50 per cent. And we hope it stays that way, so people should not let up on the protocols. We want to go into single digit admissions now. What’s going to facilitate that is maintenance of protocols and if people run go and take the vaccine. Don’t listen to nonsense people — run go and take the vaccine. It makes a difference.”

Early September, 48 of the 377 nurses assigned to the facility were quarantined after being exposed to COVID-19 patients and suspected of contracting the virus during their duties.

As visitors waited in line 1:30 pm on Thursday for clearance to see their relatives and friends, a disposed intravenous (IV) bag (drip bag) could be seen on the ground mere metres away.

Dr Harvey told the Sunday Observer that there are protocols when dealing with the disposal of IV bags.

“An IV bag is just a plastic bag so if it’s used in an area where it’s contaminated, you put them in a red bag and people should follow protocols. If you use it in a non-contaminated area, it’s not domestic waste so it goes in the non-red bag. There is a coding system for dealing with waste. Infectious waste goes in red bags and non-infectious waste go in black bags.”

When asked whether these bags should be visible on the compound under any circumstance, Dr Harvey responded: “There are circumstances because you’re dealing with people who may be subject to human error. You’re also dealing with a situation of whether or not you have the adequate resources in place. Now remember there is a company which is employed to deal with your disposal of waste. That is not a clinical question. That’s goes to the administration because the clinical person like myself, uses the IV bags My responsibility is to put it in the appropriate disposal unit.”