TRHA travesty

There are about 60,000 people living in Tobago. Yet, there is only one general hospital. And that hospital is killing patients. That, in a nutshell, is the damning view of the High Court which on Thursday found the Tobago Regional Health Authority (TRHA) culpable for the death of a child in circumstances which were wholly avoidable. According to Justice Frank Seepersad, 17-year-old Zach Seeram’s demise was due to the most basic of failings: the lack of a scan. Zach visited the hospital on no less than three occasions after receiving stab wounds which punctured his left lung, right diaphragm, liver and kidney. Despite repeated complaints and a recommendation that he undergo a CT scan, he was discharged.

“It is unfathomable that, in 2010, a CT scan report which was ordered could sit on a desk at an off-site facility and no effort was made to ascertain the whereabouts of same,” the judge said. “Instead he was discharged…His death may have been avoided if his internal injuries were detected. The life of one of our nation’s children was lost. We have a responsibility to ensure that such a circumstance never repeats itself.” The judge lamented basic machinery is often not utilised because it is unavailable or not working.

“This court has had to deal with several medical negligence matters in Tobago and it is simply outrageous that in this island of 60,000 odd inhabitants, the only hospital is devoid of basic functioning equipment and staff,” said the judge. “How can this be? How can this island, in a time when economic diversification is desperately needed, be considered as a viable tourist destination when there is a lack of basic and essential medical services?” Our politicians, from all sides of the divide, all seek medical treatment at private facilities or at foreign institutions. Yet, what this tragic case lays bare is the stark reality facing the thousands of ordinary patients who depend on the public health care system in Trinidad and Tobago. One part of that reality is the very real problem of stigma and discrimination by medical officials in the triage of patients. It is disturbing that the TRHA, in its defence of the lawsuit brought by Zach’s family, said the minor was not in good health as he was a marijuana user and had a thyroid condition and, when he was first admitted to hospital, smelled of alcohol.

It would be very surprising if a perfectly healthy individual reported for treatment at any of the nation’s general hospitals. The fact of Zach having a pre-existing medical condition is no exoneration. Nor does it call for a relaxation of medical standards and ethics. On the contrary, the opposite is true. It is unfortunate that the care that was taken, post-mortem, to examine Zach’s health for the purpose of the formulation of this absurd defence was not taken when it mattered most.

Medical officials have a duty to treat all patients without discrimination. They are allowed to prioritise people for whom immediate intervention will result in a positive difference of outcome. But they are not allowed to arbitrarily turn away from treatment any patient whom they believe to be a drug addict or a consumer of alcohol. Assuming such patients pose no risk to fellow patients or staff, these issues should inform treatment not cut it short. Was the teenager smelling of alcohol and marijuana on all three occasions when he sought help from the people whose job it was to help him? Unless the lack of resources, mismanagement, negligence and prejudice are tackled, taxpayers will continue to die and continue to pay. Zach’s family in this instance was able to secure respected attorney Gilbert Petersen SC, but not every family will be able to retain Silk. What will happen to the officials who saw Zach? Will they face any disciplinary action?

Or will the travesty that is the TRHA simply continue? This is not a political issue. This is a matter that demands attention from the central Government, the Tobago House of Assembly, all political parties and civil society. This is a matter of life and death.