{"id":119925,"date":"2014-06-27T13:18:38","date_gmt":"2014-06-27T17:18:38","guid":{"rendered":"http:\/\/dominicanewsonline.com\/news\/?p=119925"},"modified":"2014-06-27T13:18:38","modified_gmt":"2014-06-27T17:18:38","slug":"delivery-quality-health-services-dominica-slippery-slope","status":"publish","type":"post","link":"https:\/\/dominicanewsonline.com\/news\/homepage\/features\/commentary\/delivery-quality-health-services-dominica-slippery-slope\/","title":{"rendered":"Delivery of quality health services in Dominica on a slippery slope"},"content":{"rendered":"<figure id=\"attachment_118061\" aria-describedby=\"caption-attachment-118061\" style=\"width: 278px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-118061\" src=\"http:\/\/dominicanewsonline.com\/news\/wp-content\/uploads\/2014\/05\/pascal.jpg\" alt=\"Dr. Irvin &quot;Eipigh&quot; Pascal\" width=\"278\" height=\"242\" \/><figcaption id=\"caption-attachment-118061\" class=\"wp-caption-text\">Dr. Irving &#8220;Eipigh&#8221; Pascal<\/figcaption><\/figure>\n<p>The less than inspirational management of both the Chikungunya epidemic and the Marigot Hospital closure raised grave concerns for the future delivery of health care services in Dominica, These tepid responses are but further\u00a0 signs of our declining ability to overcome the major challenges of health care financing, improved management of the complications of chronic non communicable diseases (CNCD) or \u00a0the rehabilitation of our Primary Health-Care System.<\/p>\n<p>Our responses at present reflect not only the lethargy, weakness and apathy of the leadership in our health system. They also confirm the presence of more lethal symptoms including a lack of\u00a0 purpose, leadership, creativity, resources(financial &amp;personnel) and vision, which are diagnostic of decaying organizations and institutions.<\/p>\n<p>In 1979 Hurricane David left our health system in shambles. However, the insight commitment, creativity hard work and clarity of vision of the then leadership delivered our once renowned \u00a0Primary Health Care System\u00a0 now unacceptably \u00a0decapitated and in disarray. The present lack of urgency and effective leadership in responding to these recent challenges is palpable.This state of affairs\u00a0 requires an<strong> urgent enquiry<\/strong> to prevent and limit further morbidity and mortality for citizens.<\/p>\n<p><strong>A hospital building is not a health care service!!!!<\/strong> \u00a0It is my view that the proposals for the re-construction\u00a0 of the hospitals at\u00a0 Marigot and Goodwill have confused the two entities.. How else does one explain the lack of the inclusive consultation and pertinent stakeholder contributions to the process of preparing the proposals? Where is the clarity of vision supported by <strong>medical research<\/strong> that demonstrates how these\u00a0 new structures will impact\u00a0 our challenges of financing our health care services\u00a0 or improving the control of CNCD\u201ds .<\/p>\n<p>In Marigot, emergency funds should be made available to temporarily relocate the hospital services \u00a0to the Marigot Foundation High School or similar compound . A comprehensive plan should then be developed for the delivery of <strong>modern<\/strong> health care services in the district. The plan should be informed by massive public and professional stakeholder \u00a0participation. \u00a0\u00a0Provisions must be made\u00a0 for adequate number of professionals trained to deliver \u00a0emergency and post disaster services\u00a0\u00a0 given the proximity to the Melville Hall airport.<\/p>\n<p>Finally it would be a dereliction my national and medical duty not to publicly question the\u00a0 decision to reconstruct Princess Margaret Hospital in the form proposed at the already congested Goodwill location. As far as I am aware, this decision was not research or evidence based, neither was it informed by broad public and professional stakeholder consultation . It seems to me that the initial decision was influenced mostly by toxic doses of political and economic considerations, more to the benefit of sitting politicians than of future patients. This is not the forum for a detailed submission. However, I propose that like our predecessors after Hurricane David\u00a0 we use the appropriate\u00a0 research to reevaluate our delivery of present and future hospital services especially how they can impact our major challenges. Our findings could very well result in an innovative model that uses <strong>ALL<\/strong> of the fifty million dollars to convert the\u00a0 institution at Goodwill to house the following 1) a properly equipped and staffed modern trauma and emergency care centre inclusive of a helicopter service \u00a02) the Directorate of Primary Health Care Services,\u00a0 3) the Roseau District\u00a0 Primary Health\u00a0 Centre, 4) An Upgraded Psychiatric\u00a0 Unit and 5) a Rehabilitation and Social Care Services Unit. I would complement this with the decentralization of our secondary and future tertiary care services crucial for the management of the complications of CNCD\u2019s to another location (e.g. Warner). This could be done in collaboration with our offshore medical schools\u00a0 and other private sector stakeholders\u00a0 thus concretizing the much touted public\/private sector cooperation so crucial to financing future health care services.<\/p>\n<p>If like our predecessors in 1979, we are to fullfil\u00a0 our mission of delivering\u00a0 quality health care services to our present and future citizens we need to reevaluate our purpose, function and methods. The time has come when those who <strong>can\u2019t<\/strong> or <strong>won\u2019t<\/strong> stop the slide should step aside\u00a0 or\u00a0 be held accountable.<\/p>\n<p>May the spirits of the ancestors be pleased.<\/p>\n","protected":false},"excerpt":{"rendered":"The less than inspirational management of both the Chikungunya epidemic and the Marigot Hospital closure raised grave concerns for the future delivery of health care services in Dominica, These tepid responses are but further\u00a0 signs of our declining ability to&#8230;","protected":false},"author":15,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_cbd_carousel_blocks":"[]","footnotes":""},"categories":[13],"tags":[],"class_list":["post-119925","post","type-post","status-publish","format-standard","hentry","category-commentary"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Delivery of quality health services in Dominica on a slippery slope - 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