Caura Hospital in disarray

She said the news was a "sorry state of affairs" and "unfortunate." Security was one of the major concerns of workers when they met with the commission at the hospital.

Caura provides treatment, counselling, and rehabilitation for people diagnosed with tuberculosis and others with substance abuse problems.

Nursing administrator Mary Taitt-Alexander said there was a security risk for staff "based on the clients" at Caura. This was reiterated by thoracic medical director, Dr Dottin Ramoutar, who said Caura had been "trying hard" to get more security guards. The Health Ministry had been contacted about the need, but nothing had changed. He said among the patients at Caura were people who used "hard drugs" like cocaine, marijuana and alcohol, and they behaved in an abusive manner. The commission was told by a security representative that there were two or three guards on duty for each shift.

Limited bed space and staff shortages have also impacted on treatment programmes. Dr Winston Gopaul, head of the Substance Abuse Prevention Programme, admitted that the "waiting period" for follow-up treatment for in and out-patientstreatment programmes caused the facility to lose many patients "because we can’t offer treatment immediately."

The in-patient substance abuse rehabilitation programme is only six weeks. Accommodation can only be provided for 18 patients —12 male and six female. He provided statistics illustrating the increase in patients from 228 in 2000 to 362 in 2004. Gopaul said the number of cocaine addicts seeking treatment has surpassed alcoholics during the past three years.

Occupational therapy (gardening, craft, woodwork), although "essential," has declined because the department lacks equipment.

Several requests have been made but have received "no favourable response." Gopaul said the ten-member staff (including one head nurse and two mental health nurses) was insufficient for the services being provided. Hospital manager Grace Nidhan said a shuttle was needed for staff since the old ambulance used to transport workers (from Caura junction) was prone to mechanical and electrical malfunction. Nidhan said this resulted in increased absenteeism and lateness by staff. The Pathology Department was not fully functional, so samples were sent to other facilities for analysis. She said additional lab equipment, including a machine to do HIV testing, was required.