Unclean hospitals?

WE REMEMBER, not too long ago, when the over-crowded mortuary of the San Fernando General Hospital was invaded by a legion of rats which crawled in at night to feed on the toes of cadavers, following a breakdown of the department’s air conditioning system. This situation provoked our outrage, although the “victims” had long since passed the stage of suffering. Now we are hearing of more insidious invasions, bacteria and blue flies, in our hospitals which can pose a threat to patients, including newborn babies, and we are forced to wonder about the standard of quality control being enforced at these public institutions. It has always been taken for granted, in fact, that the highest levels of sanitation are maintained at our hospitals, for quite obvious reasons. Now it is quite alarming to learn that this has not always been the case, particularly in the care of newborn babies who are most vulnerable to infection from contagious bacteria.

The most disturbing evidence of this failure was revealed last September when the neonatal unit at the Mt Hope Hospital had to be closed and ten babies transferred following the discovery of an increase in cases of enterobacter bacteria infection. Following an internal investigation into this outbreak, Newsday learned on Wednesday that Jenny Gobin was dismissed as Vice President of Quality with the North West Regional Health Authority. Commenting on this, a source told Newsday: “In the end, she was head of quality and it was a quality issue to the extent that no quality controls were in place to deal with it.” We have not seen the investigating committee’s report but, whatever Gobin’s culpability may be, we hope that all the regional health authorities, particularly those responsible for the country’s major hospitals, would now realise the importance of maintaining the highest standards of sanitation in these institutions, especially in the neonatal units where highly vulnerable new-born babies may be fighting for their lives. Even in the most aseptic of circumstances, we are told, nosocomial or hospital-acquired infections among babies at Intensive Care Units are not uncommon. An outbreak above the norm, however, would indicate that quality measures may be deficient or may have broken down.

Last week, the Mt Hope Women’s Hospital was accused of “a blatant cover up” by Dr Jehan Ali, Head of the Obstetrics and Gynaecology Department at San Fernando General, who told Newsday that the death of Anisa Ramdial’s seven-week-old baby at the Mt Hope neonatal unit was due to septic shock from septicaemia, a bacterial infection, and not as a result of disseminated intravascular coagulopathy as the NWRHA had stated in a release. Equally disturbing is the statement made last Tuesday by Medical Chief of Staff Dr Esau Joseph who is reported to have said that  enterobacter was detected in two babies admitted to the Mt Hope neonatal unit. Could this be true? Was Dr Joseph correctly reported? As we understand it, the neonatal unit’s function is to take care of babies born from mothers at the Women’s Hospital. Are babies coming from outside admitted to this unit? Is this not asking for trouble. If what Dr Joseph said is true, then infected babies were brought into the unit without examination and they could well have triggered off another enterobacter outbreak. All of this tells us that a serious problem of quality control exists at our hospitals and must be remedied. Also, why is the infestation of blue flies, which has caused the SFGH radiology department to be closed, causing such a mystery? Are blue flies attracted by sanitary conditions?