A few weeks ago I had occasion to pay a pastoral visit to a patient in the University Hospital of the West Indies. After making the visit on Ward 20 and descending the stairs of that multilevel block of the hospital, I asked a member of the staff if there is a restroom anywhere in that section of the hospital. She indicated that there is none. I do not live in proximity to the hospital and would be wending my way home and would have appreciated the opportunity to respond to that which nature directs.

During the past week I also visited another seriously ill patient on one of the wards on the main spine when one enters the hospital. After visiting the patient and spending some time with the family member who was present, I inquired if he were aware of any restroom in that section of the hospital, whereupon he responded in a similar vein as the staff member of previous weeks, but went on to narrate the experience of a child who needed to use a restroom in the same location and was told there was none. The parent, having approached a rather sensitive and sympathetic security guard for assistance for the child, he engaged in a search and eventually the single unit he found was in such a state that the child decided not to use it.

It seems incredulous that in what is perhaps the leading medical facility in Jamaica, and which serves the wider Caribbean, that there should not be at least one properly identifiable, equipped, and maintained multiple unit restroom for the hundreds of visitors to the hospital each day, apart from those serving patients receiving in-patient and out-patient care. This should also be clearly visible and available to the relatives attending, and individuals waiting long hours in the Accident and Emergency Department.

I am totally befuddled regarding the lack of consideration and respect being given to visitors who have to travel from rural communities to visit their relatives in hospital, and who are not just travelling a few miles away from the hospital, as in my case.

Perhaps I am being overly sensitive as I am in that age cohort of men whose physiological changes and medical conditions require frequent restroom stops, but something tells me deep down that a restroom is a facility that is to be provided for all genders and age cohorts out of respect for their health, well-being, and their dignity as human beings. If this is not provided in a health facility of this nature, why should we be concerned and repulsed by public expressions, primarily by men, of their restroom moments by every tree, wall, utility pole, or sidewalk.

Here I must acknowledge that there are more restroom facilities popping up among private sector businesses, though at times they seem overwhelmed by a need that should be met by public facilities that should be part of the infrastructure certainly in urban communities.

I must also acknowledge what I understand to be rest stops that have developed along heavily travelled roadways in rural Jamaica, and which I am told receive some support from a public institution like Tourism Product Development Company Limited.

As a Jamaican, I am fully aware of the fact that the University Hospital of the West Indies, like other sections of the health sector, is facing serious challenges in terms of its funding and in meeting its operational expenses. I am also aware that in the present situation, in which there are insufficient bed spaces and physical spaces to accommodate the patients, every physical space is utilised and the pressure is there to find the funding to better equip the institution. In this scenario, the provision of facilities for visitors remains a good idea at the bottom of the wish list.

You may be wondering why I should focus on such banality when there are so many other pressing issues to be addressed. I have raised the issue because, in the context of the recently publicised auditor general’s report on the widespread fraud and apparent financial irregularities that have taken place at the hospital, we tend to think of the big ticket (multimillion dollar) projects that are deprived of funding, when in truth it illustrates how far-reaching the consequences of corruption are for even the seemingly small ones that affect people at a basic level.

From the auditor’s report it seems apparent that, in the case of significant financial transactions undertaken by the hospital, it did not receive value for money and may have simply being hit by culprits who found a loophole through which to funnel transactions of significant value. At the same time, the Government of Jamaica was clearly cheated of millions of dollars of tax revenues that could have made a difference to some element within the health sector, or be applied to the budget of the institution to provide even the basic service of restroom facilities.

I believe that most of us know the expression “robbing Peter to pay Paul”. Used loosely, it is seen as a reference to simply transferring the legitimate resources present in one source (Peter) to settle a legitimate or competing debt or expense due to another (Paul). Indeed, it speaks of a situation that is already fraught with financial problems or shortfalls and which is being addressed in a manner that leaves Peter with a shortfall and situation of vulnerability and is not sustainable.

What the audit of the University Hospital reveals is a situation in which individuals have been “robbing Peter” not to “pay Paul”, but to “enrich Paul” with unearned wealth. As one within the Christian tradition I cannot help identifying some symbolism in the names chosen to reflect this principle as those of the two leading figures of New Testament Christianity, Peter and Paul, to highlight what is not only ill-advised financial management, but also that which lends itself to moral and illegal manipulation.

Our Jamaican population has been saturated with references to macro and micro economic principles in relation to the economy and the operation of economic and social systems within the nation. What seems clear, however, is that when it comes to things that are perceived to impact the life of individuals in a direct way and personal way, they opt for thinking in terms of the micro dynamics. Nowhere has this been better illustrated than in recent months in the way in which individuals and communities have responded to the Government-led relief work and the restoration of public utilities. It does not matter how much the Government or the management of the utilities company speak of the damage to the national economy or grid and the time frame and cost that will be necessary to return to a measure of normality, the demand is for the local community and the individual household to have their need satisfied now.

I have used the euphemism “robbing Peter to pay Paul” to describe the auditor general’s findings as the nation has settled for this kind of approach to such revelations, rather than call it what it is, namely, corruption, and which comes in many guises — bribery, extortion, fraud, trafficking, embezzlement, nepotism, cronyism, and the abuse of legitimate authority. Over the years our political leaders of both political parties have not demonstrated the will and the courage to leave no doubt in law as to what is meant by corruption. It is for this reason that every report by the auditor general is followed by some platitudes that new steps and procedures are to be put in place to prevent any recurrence, but no one is brought to account and face the legal consequences.

So, for all those who are repulsed by the auditor general’s report, do not hold your breath, as euphemisms and vague commitments to prevent an recurrence will be offered, even as visitors to the University Hospital of the West Indies must learn to restrain their natural bodily functions and ignore the exercise of hygienic practices promoted by our public health authorities.

Howard Gregory is retired Anglican archbishop of the Province of the West Indies and lord bishop of Jamaica.