Major drug shortage at PoS hospital

A scarcity of “major drugs” at the Maternity Department of the Port-of-Spain General Hospital is putting women at risk of haemorrhaging and infections.

The supply of the drug Syntocinon which also goes by the brand name Oxytocin has been inconsistent although it is in high demand. It is used to help induce or strengthen labour and to reduce bleeding after delivery. It is used for high risk patients with high blood pressure, asthmatics, cardiac problems, and prone to haemorrhaging. A source said the supply of another drug Syntometrine has been “more non existent than occasional” although it is required for women who have high blood pressure. In the absence of syntocinon she said cytotec (which some women misuse to induce abortion) is being dispensed by the Pharmacy. The source said there were 25 postpartum haemorrhaging cases (women losing approximately 500 ml of blood) between October through December last year, and two deaths. 

A few boxes of syntocinon are supplied sporadically but the source said if one box contains five ampules then an entire box can be used on one patient. When there are no drugs nurses and midwives have to “rub down” the wombs of women who have delivered to stimulate contractions to expel all of the “products of conception.” This is an excruciating experience. “They fight, push away the nurse, things get physical. But it is either they bleed or allow the nurse to rub the uterus.” Women who go home with “tissue” remaining in their womb have to return to hospital for additional treatment because of bleeding. Patients who had vaginal infections at the time of delivery can go on to develop sepsis.

The source said intravenous AZT is not available at the PoSGH. “Many patients come to Port-of-Spain diagnosed with HIV and the hospital does not have the drugs to give them while they are in labour.” The Maternity Department has a supply of the drug nevirapine “now and then” otherwise patients who have their own AZT are encouraged to take their medication. “All the money being funneled into HIV somebody needs to find out where it is going,” she said. Valium has also been unavailable for the past few months. This sedative is given to women who go into convulsions are can suffer Preeclampsia Toxaemia—a condition developing late in pregnancy that is characterised by sudden rise in blood pressure, excessive weight gain, albuminuna, severe headache and visual disturbances.