Parents do not want their child to be subjected to illness or accidents. Unfortunately, most children have to seek the help of paediatric medicine owing to the prevalence of infectious diseases in the Caribbean Islands. While infants within 1-4 years fall victim to gastrointestinal disorders, septicemia, and respiratory troubles. While older children and teenagers are more prone to accidents like burns, intracranial injuries, and poisonings. The final outcome of these child health issues is often death!
During the early 50’s, the child mortality rate averaged about 100/1000 infants throughout the Caribbean, while in Haiti escalating to 200/1000 infants. Thankfully, this mortality rate has declined in the past 50 years to approximately 10/100 infants as reported in 2005-2010.
The Caribbean Islands also boast lower neonatal mortality rates in comparison to other developing countries in the world. According to Guzman et al (2006), certain factors have played their roles efficiently to make child health care system shine in the Caribbean Islands: low cost health care, mother-child programs, extensive vaccination campaigns, and medical-follow-up. Certain socio-economic changes like proper education, improved sanitary systems, and better availability of clean drinking water have coincided with the primary health care reforms to make the Caribbean islands healthier for the children.
Is the Caribbean child health care system flawless?
Not really. Rather, it has more drawbacks than expected. Newborn death rates persist to be as high as 31/1000 live births in Haiti and regrettably doubles among the poor compared to the natives belonging to higher economic strata. Most people complain about the better accessibility of pediatric care facilities by the richer people compared to the poorer population but that’s not all. Flaws are also prominent in the primary and intensive health care systems of most Caribbean islands. The keys to these child healthcare drawbacks lie in the economic crises, lack of political support, limited economic sources, and the emergence of new diseases to name a few.
Only 22 intensive care beds are available throughout the four major Jamaican hospitals out of which only one in Kingston Public Hospital (KPH) and a neonatal intensive care unit at The University Hospital of the West Indies (UHWI) specializes in pediatric intensive care. Yet studies reveal that Jamaica’s health care system calls for at least 26 beds to run without a glitch. So in reality, most critically ill Jamaican children are denied proper emergency care owing to this discrepancy between needs and available resources.
The situation is not much different in other Caribbean hospitals as well. Thus, health professionals are forced to treat the ailing children in general Intensive Care Unit (ICU) or even general wards where medical facilities are constrained. Between the period of June 2001 to May 2002, UHWI received about 56 requests for ICU pediatric admission out of which 20% of them were refused owing to imparity between demand and supply. It’s a shame to announce that 50% of the refusals were also made owing to the lack of trained nurses in the ICU.
An internal audit held in September 2003 exposed that 95% of the residents in Doctor of Medicine (Paediatric) postgraduate program had Basic Life Support training, but the infant healthcare still remains at stake since only 38% of them had training and certification in Paediatric Advanced Life Support. Even skilled health professionals often fail to deliver high quality pediatric health care owing to lack of professionalism; blame it all to the ill-functioning health system and lack of necessary controls by the government.
Factors like lack of proper technological resources to diagnose diseases, limited knowledge about effective treatments of newly-emerging diseases, and few pharmacists all give rise to the failure to provide expert front-line health care to Caribbean children.
Bustamante Hospital for Children
The Bustamante Hospital for Children (BHC) in Kingston, Jamaica is the only specialist paediatric hospital in the English speaking Caribbean and caters to patients from birth to 12 years.This hospital provides a comprehensive range of diagnostic, preventative, curative, rehabilitative and ambulatory services offered in paediatric medical and surgical specialties and sub-specialties.
Is there any way out?
Yes there is! To begin with, optimal pediatric intensive care needs centralized tertiary care units. However, such infrastructures don’t come cheap. So the governments of Caribbean countries should employ special attention to provide maximum financial support to turn it into a reality. The governments should be stricter in controlling the professionalism among health professionals in Caribbean clinics and hospitals. Also, more extensive training programs should be provided to meet the dearth of skilled health providers in basic and advanced pediatric life support.
Apart from making them skilled in dealing with child health care, the training programs should help them think beyond the limitations of ICU when situations are adverse and implement protocols for effective care of pediatric patients. Even medical professionals residing in Caribbean health centers shouldn’t be kept away from such extensive trainings.
The children are the future of the Caribbean Islands. So it’s time to continue major improvements in public health policies and erase the flaws hidden in the Caribbean paediatric medical systems.
By: Liya Das