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The indignity of being poor and sick in Jamaica — Part 1
The public health sector urgently needs resources to not only equip our health facilities but to adequately pay our doctors, nurses, and other critical medical personnel for their work.
Columns
May 6, 2023

The indignity of being poor and sick in Jamaica — Part 1

Poverty is a hellish state to be in. It is no virtue. It is a crime. To be poor is to be hungry without possible hope of food; to be sick without hope of medicine; to be tired and sleepy without a place to lay one’s head; to be naked without the hope of clothing; to be despised and comfortless. To be poor is to be a fit subject for crime and hell. — Marcus Garvey

Last week my phone rang late one night from a lady I have known for the past 20 years. Lorna, as she is affectionately known, is a pillar of her community church in the quiet district of Eight Mile, up in the hills of St Ann, and a strong working-class community leader whose powerful voice speaks on behalf of those in need. Her tall, imposing build pales in deference to her smooth coffee complexion and perfectly aligned white teeth. Lorna is what we call the quintessential “big woman” in the country.

Usually, when Lorna telephones, it is always for someone else. For example, “MP, the community tank is dry, and the people need water,” or “MP, the farmers need fertiliser.”

This time Lorna was on the other end of the line calling for herself. She was in tears. Her daughter had been through several surgeries at St Ann’s Bay Hospital.

“Lorna, tell me what happened,” I responded.

Her daughter, whom I have known since childhood, was born with Hirschsprung disease, a congenital disability in which some nerve cells are missing in the large intestine, so her intestine can’t move stool and becomes blocked. Over the years she has had problems, and Lorna would have to administer stool softeners consistently to aid her daughter.

Early last month Lorna told me her daughter was in agony over several days. She took her to the clinic in Alexandria, where they told Lorna her daughter was pregnant. Lorna explained to them that she had just had her period and was not; however, it was the stool problem that was making her stomach bloated and painful.

Lorna then journeyed to St Ann’s Bay Hospital. Once again, they told Lorna her daughter was pregnant and would need emergency surgery as it seemed ectopic. On April 6, she went into surgery. There was no pregnancy. But, apparently, they found her bowels enlarged. So they performed a colostomy.

A colostomy is a surgical operation in which a piece of the colon is diverted to an artificial abdominal opening to bypass a damaged part of the colon.

Lorna said that she saw the colostomy bag when she came out of surgery and was told that she would not only have to wear the bags for the rest of her life, but had to buy them and bring them to the hospital. A colostomy bag is changed one to three times daily. The bags cost over $1,000.

This is not the worse part of this experience. On April 15, the stitches in her incision opened, and they took her back into surgery to close the wound. But, yet again, her incisions later opened.

As I listened to Lorna try to explain through her tears, I learned that when she visited her daughter after the third surgery she could smell her before getting close to her; as she lifted her bed sheet, to her disbelief, her daughter’s stomach was ‘opened’.

I was speechless.

“MP, I need your help. Nobody won’t help me to understand what happen to [her] and is different, different doctors, up and down, and nobody cyaan tell me why she stay suh… All I keep doing is signing consent form,” Lorna said.

She not only needed help to get answers about what had happened to her daughter, and why, but she also needed assistance to buy the daily colostomy bags and transportation costing $3,000 and $1,200, respectively.

I immediately contacted the Ministry of Health and Wellness, lobbied on her behalf, and got a successful intervention. It was good that she escalated it to me so I could have aided her. However, many people do not have access to someone who can assist them.

Lorna told me the following day she had not seen so many doctors come to visit her daughter and speak with her. Now the doctors are talking and meeting with Lorna, and she is grateful for their patience and respect, because all she wants is to get proper care for her daughter and for her to get better.

But how many patients and families have access to the minister of health during a personal public health crisis experience?

The hospital has since told Lorna she needs to buy a mattress since her daughter has to be there longer, and they don’t want her to get bedsores. Lorna must also source a special cream to dress the wound immediately and bring it to the hospital. Cost: $25,000

St Ann’s Bay Hospital clearly doesn’t have the resources, and neither does Lorna.

A few years ago, my husband developed an autoimmune disease called ulcerative colitis — a chronic inflammatory bowel disease (IBD) in which abnormal immune system reactions cause inflammation and ulcers on the inner lining of your large intestine.

While not terminal, it is a debilitating disease that significantly affects and interrupts people’s lives and must be managed. If not managed properly, over time ulcerative colitis can lead to other complications, such as severe dehydration, a perforated colon, bone loss, and inflammation of your skin, joints, and eyes, among other things.

Like Lorna’s daughter, my husband suffers from an intestinal problem, which takes expensive management, from diet to medication.

The primary difference between them is he can afford the best private care locally and overseas, which is not cheap. Every six weeks, I have to give him an injection at home. Cost: $650,000. His insurance pays for most of that.

Lorna and her daughter have no medical insurance.

So what happens when you’re poor and sick in Jamaica?

Lisa Hanna is Member of Parliament for St Ann South Eastern, People’s National Party spokesperson on foreign affairs and foreign trade, and a former Cabinet member.

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