NATOYA Brown remembers the day she was blinded by a bullet.

The 40-year-old heard about four explosions, felt a sting to the face, and felt her head shaking. She fell to the ground and cautiously touched her face with both hands — there was liquid running down which she later realised was blood. She then saw that her right eye had fallen out. It was on the ground.

“I shouted out for help, but no one could come to assist me because gunshots were still firing. So I stayed on the ground and then I crawled to a corner. After that, someone came and took me to the Denham Town Police Station,” Brown told the Jamaica Observer.

It was July 7, 2001 and she was at the intersection of Regent and North streets in West Kingston. Police had entered Tivoli Gardens and clashed with thugs following weeks of gang violence in Hannah Town and Denham Town. By July 11 a total of 20 residents, one cop, and a soldier had died.

Brown, who was 19 at the time, eventually underwent an operation to save the sight in her left eye, but it wasn’t a success. Now, she wakes up every day not being able to see — a constant reminder that she is a victim of crime.

“All the liquid drained out of my left eye too. There was nothing doctors could do. While I was on the ground waiting for help everything drained out of both eyes. I took too long to reach the hospital. I cried for months because I couldn’t see,” she said, crying.

She later enrolled at Salvation Army School for the Blind where she learned to adjust to her new reality, which took some time.

The cost of crime is financially and mentally crippling for many. Some gunshot victims ultimately pay with their lives, some are unable to recover physically, while others have to resort to physiotherapy to restore movement and body function, which costs them thousands of dollars.

And the money expended does not guarantee them a full recovery as some are damaged beyond repair by bullets, officials say.

“You find that a lot of persons who do get gunshot wounds and a lot of gunshot-type wound victims they are more found in the public [health] sector, and the very few that can afford the private sector get treatment in the private sector. But it is also dependent on location,” Dr Noel Brown, physiotherapist at Pro Physio on Constant Spring Road in St Andrew, told the Sunday Observer last Wednesday.

He recalled one gunshot victim whose treatment lasted three years.

“The shortest I’ve ever seen someone was eight months,” he told the Sunday Observer.

“Being eight or 12 visits a month [for treatment], at a cost of $5,000, that’s about $60,000 a month. Not a lot of persons can afford that out of pocket. Those who can, they do it,” he shared.

As at October 1 there have been 897 shooting incidents across the island this year. A European Union-funded study conducted in collaboration with the national security ministry and other State agencies revealed that hospitals spend $400,000 per day to keep one gunshot wound victim in intensive care. The study, released in July 2022, also noted that the cost of crime could be as high as US$633 million ($85 billion) when put in the perspective of the country’s 2019 gross domestic product.

An analysis of the epidemiology and cost of violence-related injuries and road traffic crashes to the health-care system, released in 2017, pointed out that violence-related injury is the third-leading cause of premature death in Jamaica.

Data were collected from University Hospital of the West Indies, Kingston Public Hospital (KPH), Bustamante Hospital for Children, Spanish Town Hospital, May Pen Hospital, St Ann’s Bay Hospital, Cornwall Regional Hospital, and Sir John Golding Rehabilitation Centre.

Samantha Davis, senior physical therapist at National Chest Hospital, told the Sunday Observer that the majority of spinal cord injury patients are as a result of either motor vehicle crashes or multiple- or single-gunshot wounds.

“It all depends on where in the body the shot passes or affects. So, what we are seeing is that we have a lot of patients getting nerve injuries and multiple fractures. That’s one of the biggest issues I’ve seen with the increase in crime and violence — we are having more persons with these injuries,” she informed.

“For the most part they may recover, but it takes time and resources. If the person is not able to get therapy through the hospital system then they would have to resort to private care so, of course, it’s costly. It affects their ability to work so it affects their income. For the persons who have spinal cord injury, it’s life-changing,” Davis shared.

She corroborated Brown’s account that treatment is not only costly, but also very lengthy.

“If it is a case where the person had a complete injury or incomplete injury, it can take up to eight months to a year. Complete injuries are the ones that we know that they won’t regain any function after we have assessed them. Those persons, you may give them a lesser time, because we may just want to improve on what they have. So it could be up to six months — and that’s without complications,” she explained to the the Sunday Observer.

For the most part, she said, they may become paralysed.

“Depending on where they get the shot it [paralysis] could be from waist down, it could be from chest down, it could even be from neck down. These persons are then totally dependent on family members; and not all family members might be supportive, so that’s a problem,” she disclosed.

Davis added that depending on the severity of the a gunshot wound the victim may be viewed as “serious” and thus get the space of other sick individuals in need of treatment.

“That happens sometimes. For instance, you might have a multiple-gunshot wound patient who has to go in the ICU (Intensive Care Unit); that person trumps another sick person who would need surgery. That person who needed surgery would literally have to be rescheduled because that [gunshot victim] would be an emergency. It’s burdensome.”

Davis, who is also the owner of Therapeutic Haven Physiotherapy Services, said there’s a long list of gunshot victims with spinal cord injuries waiting to be admitted to Sir John Golding Rehabilitation Centre, formerly Mona Rehabilitation Centre.

“Some persons actually don’t make it there. And if they are at home with the inability to move they end up with complications. They end up getting bed sores [which may] get infected, and they can die. It puts a strain on the health-care system,” she said.

Additionally, Davis pointed out, the problem moves from the physical level to the mental.

“They become depressed and their families may become depressed. If they have children, that affects their children,” she explained.

Dr Mindi Fitz-Henley, president of the Jamaica Medical Doctors Association, echoed similar sentiments.

“We do end up seeing quite a few patients who are suffering because of their illness from the repercussions of the violence that they have endured. A lot of these patients are struggling with post-traumatic disorder, they are struggling with different depressive episodes, they are struggling with anxiety, and even struggling with suicidal thoughts. There’s a lot that these patients have to endure,” she told the Sunday Observer.

“They have to physically be doing physiotherapy and be going in and out of the hospital,” but their mental health is also pressured.

“We don’t have a lot of support here for those sorts of victims. Some of these persons are actually unable to even leave their house due to the level of anxiety and fear that they now have,” Fitz-Henley said. “This will now impact their ability to earn and [that of] their family members. They may need caregivers [but] even their caregivers can end up with burnout. It’s always important to remember that it’s not just always the medical side of things.”