INTRODUCTION
LADIES AND GENTLEMEN GOOD MORNING AND THANK YOU FOR COMING.
MANY OF YOU ARE AWARE OF THE RECENT REPORTS OF INFECTION OF SOME PREMATURE BABIES AT THE UNIVERSITY HOSPITAL OF THE WEST INDIES. THE MINISTRY OF HEALTH ALSO BECAME AWARE LAST WEEK OF A SIMILAR ISSUE AT THE CORNWALL REGIONAL HOSPITAL.
I WANT TO START BY EXPRESSING MY SUPPORT TO THE FAMILIES INVOLVED. AS A FATHER MYSELF I KNOW WHAT IT IS LIKE TO HAVE A SICK CHILD BUT I CANNOT BEGIN TO IMAGINE WHAT A PARENT GOES THROUGH WHEN THEY LOSE A CHILD NO MATTER THE REASON. I ASSURE YOU THAT YOU HAVE THE FULL SUPPORT OF THE HEALTH TEAM AND COUNSELLING FOR FAMILIY MEMBERS REMAINS AN OPTION.
ACTIONS TAKEN BY THE MINISTRY OF HEALTH
WHEN WE BECAME AWARE OF THE ISSUE AT BOTH HOSPITALS, WE IMMEDIATELY ASSIGNED A TEAM TO WORK WITH THEM TO CONDUCT INVESTIGATIONS AND PROVIDE GUIDELINES FOR CASE MANAGEMENT. THE TEAM FROM THE MINISTRY VISITED CORNWALL REGIONAL LAST WEEK.
WHEN I WAS INFORMED ON FRIDAY WHILE IN ST ANN OF THE SITUATION AT UHWI, ON FRIDAY NIGHT I MET WITH THE CHAIRMAN AND SEVEN OTHER MEMBERS OF THE BOARD IN KINGSTON. COMING OUT OF THAT MEETING I INSTRUCTED THAT ALL THE CRITIACAL STAKEHOLDERS SHOULD MEET ON SATURDAY MORNING AT THE UHWI.
AFTER THAT MEETING AT UHWI THERE WAS A PRESS RELEASE WHICH INFORMED OF THE PRESS CONFERENCE THIS MORNING. AGAIN ON MONDAY, 19TH, THE TECHNICAL TEAM MET, CHAIRED BY THE CHIEF MEDICAL OFFICER – DR MARION BULLOCK DUCASSE.
IT IS AGAINST THIS BACKGROUND THAT THE TECHNICAL TEAM WILL GIVE MORE SPECIFIC INFORMATION ON EACH FACILITY LATER ON.
AS A PRECAUTIONARY MEASURE, I SPOKE WITH THE EXECUTIVE DIRECTOR OF THE CARIBBEAN PUBLIC HEALTH AGENCY – DR JAMES HOSPEDALES – AND THEY ARE ON STANDBY TO GIVE ANY ASSISTANCE THAT WE MAY REQUIRE.
I ALSO SPOKE WITH THE DIRECTOR OF THE PAN AMERICAN HEALTH ORGANISATION DR CARISSA ETIENNE, WHO IS SENDING AN ADVISOR ON INFECTION PREVENTION AND CONTROL. SHE IS SCHEDULED TO ARRIVE IN THE ISLAND FROM WASHINGTON TODAY.
IN ADDITION, I HAVE BEEN INFORMED THAT THERE ARE 2 ADDITIONAL PERSONS COMING FROM PAHO.
THE MINISTRY HAS BEEN PUTTING IN PLACE SEVERAL MEASURES TO IMPROVE DELIVERY OF SERVICE AND QUALITY OF CARE AT PUBLIC HEALTH FACILITIES. AS PART OF THIS WE HAVE PLACED RENEWED FOCUS ON INFECTION CONTROL AND SANITATION IN HEALTH CARE FACILITIES.
WE ALREADY HAVE STANDARD PROTOCOLS AND PROCEDURES IN PLACE SPECIFIC TO MATERNITY, OPERATING THEATRE, NEONATAL UNITS, INTENSIVE CARE AND ACCIDENT AND EMERGENCY (MONIA) TO GUIDE THESE PRACTICES.
IN ORDER TO STRENGTHEN INFECTION PREVENTION AND CONTROL PROCEDURES AND PRACTICES THE MINISTRY HAS ENGAGED A MEDICAL MICROBIOLOGIST AT THE CENTRAL LEVEL WHO IS CHARGED WITH VISITING AND WORKING WITH OUR FACILITIES TO ENSURE THAT THESE PRACTICES ARE KEPT AT A STANDARD THAT IS ACCEPTABLE.
WE WILL BE CARRYING OUT ROUTINE AUDITS FROM THE CENTRAL LEVEL THROUGH THE HEALTH SERVICE PLANNING AND INTEGRATION DIVISION OF THE MINISTRY TO ENSURE THAT THESE PRACTICES WILL BE MAINTAINED IN KEEPING WITH THE STANDARDS.
THE MICROBIOLOGIST AT THE UHWI HAS ALSO BEEN CONDUCTING TRAINING SESSIONS WITH THE TEAMS.
FOOT OPERATED HAND WASHING STATIONS ARE BEING INSTALLED IN SEVERAL HOSPITALS AS PART OF MEASURES TO IMPROVE INFECTION CONTROL.
PROMAC
WHILE WE CONTINUE TO ADDRESS THE DAY TO DAY ISSUES WE HAVE BEEN IMPLEMENTING A BROADER AND MORE COMPREHENSIVE PLAN TO SIGNIFICANTLY IMPROVE MATERNAL AND CHILD HEALTH WITH A FOCUS ON REDUCING MORTALITY.
JAMAICA HAS FOR YEARS BEEN WORKING TOWARDS MAKING MAJOR GAINS IN THE AREAS OF MATERNAL AND CHILD HEALTH AS PART OF ITS COMMITMENT UNDER THE MILLENNIUM DEVELOPMENT GOALS 4 AND 5 WHICH SEEK TO ACHIEVE IMPROVEMENTS TO MATERNAL AND CHILD MORTALITY.
WE KNOW THAT THE MAJORITY OF INFANT DEATHS OR 80 PERCENT OCCUR DURING THE NEONATAL PERIOD OR THE FIRST MONTH OF LIFE. EIGHTY SEVEN (87) PERCENT OF THOSE OCCUR DURING THE FIRST WEEK OF LIFE MAINLY DUE TO PREMATURITY AND OTHER COMPLICATIONS OF THE PERINATAL PERIOD.
THIS IS WHY WE HAVE BEEN WORKING TOWARDS EXPANDING NEONATAL AND MATERNAL CARE SERVICES TO IMPROVE THE QUALITY OF CARE GIVEN TO THE PREMATURE INFANT AND HIGH RISK PREGNANT WOMEN.
IN LIGHT OF THIS WE HAVE BEGUN IMPLEMENTATION OF THE PROGRAMME FOR THE REDUCTION OF MATERNAL AND CHILD MORTALITY (PROMAC) UNDER WHICH JAMAICA WAS ALLOCATED €22 MILLION OR ABOUT J$3 BILLION BY THE EUROPEAN UNION AFTER WE WROTE AND SUBMITTED A PROJECT WHICH WAS ACCEPTED.
I WANT TO THANK THE EU WHICH HAS REALLY BEEN VERY INVESTED IN AND DEDICATED TO THIS PROJECT. THEY ARE A KEY PARTNER IN ENHANCING HEALTH CARE AND HAVE PROVIDED THE BIGGEST GRANT EVER TO THE SECTOR.
WE KNOW THAT THE FACILITIES THAT WE CURRENTLY HAVE WERE PUT IN PLACE IN SOME CASES MORE THAN 50 YEARS AGO. IT MEANS THAT WE HAVE TO UNDERGO MAJOR INFRASTRUCTURE CHANGES IN ORDER TO BRING SOME OF THESE FACILITIES UP TO 21ST CENTURY STANDARDS AND INTRODUCE NEW TECHNOLOGIES THAT ARE NOW AVAILABLE.
THIS WILL BE ACHIEVED UNDER PROMAC AND WE EXPECT TO HAVE TRUE STATE OF THE ART NEONATAL AND MATERNAL HIGH DEPENDENCY UNITS WITHIN THE NEXT THREE YEARS. THE PROGRAMME ALSO PROVIDES FOR TRAINING FOR THE STAFF WHO WILL BE WORKING IN THESE AREAS.
THE OBJECTIVES OF PROMAC INCLUDE REDUCING THE INCIDENCE OF NEONATAL DEATHS DUE TO INADEQUATE ACCESS TO HIGH DEPENDENCY CARE AND REDUCING THE INCIDENCE OF MATERNAL DEATHS DUE TO INADEQUATE ACCESS TO EMERGENCY OBSTETRIC CARE.
THIS COMPONENT OF THE PROJECT SEEKS TO CREATE A TOTAL OF 45 BEDS IN NEONATAL HIGH DEPENDENCY UNITS (HDUs) AT THE CORNWALL REGIONAL, MANDEVILLE REGIONAL, ST. ANN’S BAY REGIONAL, SPANISH TOWN AND THE VICTORIA JUBILEE HOSPITALS AS WELL AS THE BUSTAMANTE HOSPITAL FOR CHILDREN.
IT ALSO SEEKS TO INCREASE THE CAPACITY OF OBSTETRIC HDUs IN THE 4 REFERRAL REGIONAL HOSPITALS AND VICTORIA JUBILEE HOSPITAL FOR A TOTAL OF 23 BEDS. ADDITIONALLY THE PROPOSAL INCLUDES THE REHABILITATION OF THE ENTIRE DELIVERY AREA AND THE MATERNAL-FETAL CLINIC OF VICTORIA JUBILEE HOSPITAL.
THIS PROCESS IS FAR ADVANCED. CONTRACTS AMOUNTING TO A TOTAL OF €1,792,943.69 OR CLOSE TO J$243 MILLION HAVE BEEN AWARDED AS FOLLOWS:
- €200,000 OR A LITTLE OVER J$27 MILLION FOR DESIGN SERVICES FOR THE MATERNAL AND NEONATAL HDUs AT VICTORIA JUBILEE, MANDEVILLE REGIONAL AND CORNWALL REGIONAL HOSPITALS.
- €270,000 – J$36.5 MILLION FOR BUSTAMANTE HOSPITAL FOR CHILDREN, SPANISH TOWN AND ST. ANN’S BAY REGIONAL HOSPITALS.
- €491,000 – J$66.4 MILLION FOR EQUIPMENT FOR MANDEVILLE REGIONAL HOSPITAL’S NEONATAL HDU & AMBULANCES.
- €99,943.69 – J$13.52 MILLION FOR TESTING EQUIPMENT FOR HDUS
- € 100,000 – J$13.53 MILLION FOR DESIGN SERVICES FOR 4 PRIMARY CARE CENTRES – SAVANNA LA MAR, ST. JAGO PARK, MANDEVILLE COMPREHENSIVE AND ANNOTTO BAY HEALTH CENTRES AND 2 COMMUNITY HOSPITALS – ALEXANDRIA AND CHAPELTON.
- €632,000 – J$85.5 MILLION FOR THE PURCHASE OF 6 AMBULANCES.
WE WILL BE HOSTING AN OFFICIAL CONTRACT SIGNING ON NOVEMBER 3, 2015. WE ARE ALSO MAKING THE NECESSARY ARRANGEMENTS TO PROCURE EQUIPMENT FOR TEN REMAINING HDUS AT A COST OF €2.65MILLION OR J$358.5 MILLION.
TRAINING OF DOCTORS AND NURSES IS ALSO BEING DONE TO SUPPORT THE UPGRADED SERVICES. A TOTAL OF 21 CANDIDATES ARE TO BE TRAINED OVER THE NEXT FEW YEARS IN NEONATOLOGY, MATERNAL FOETAL MEDICINE AND CRITICAL CARE.
FELLOWSHIPS INVOLVING SEVEN CANDIDATES ARE ALREADY UNDERWAY AT THE UNIVERSITY OF THE WEST INDIES. WE ALSO COMPLETED IN-SERVICE TRAINING FOR THE FIRST COHORT OF 25 NURSES FOR NEONATOLOGY AND 32 FOR CRITICAL CARE IN APRIL 2015. THE 2ND COHORT FOR NEONATOLOGY INVOLVING 22 NURSES COMMENCED TRAINING IN OCTOBER 2015.
CONCLUSION
THE MINISTRY HAS BEEN WORKING TO MAKE SIGNIFICANT IMPROVEMENTS TO THE WAY WE OPERATE IN THE PUBLIC HEALTH SECTOR. WE WILL NOT SEE SOME OF THE EFFECTS IMMEDIATELY BUT OVER TIME I BELIEVE THAT THERE WILL BE A NOTICEABLY MARKED IMPROVEMENT IN THE OFFERINGS AND QUALITY OF CARE AND SERVICE IN SEVERAL AREAS IN PUBLIC HEALTH FACILITIES. I WANT TO NOW HAND OVER TO THE TECHNICAL TEAM FOR THEM TO UPDATE YOU ON THE PRESENT ISSUES BEING EXPERIENCED AT THEIR FACILITIES.
THANK YOU.