Chaguanas residents tell JSC of health issues

COMPLAINTS about the availability of medication, difficulty in getting appointments and recordkeeping were some of the issues raised at the third town hall meeting on Public Health Care Services and You.

Hosted by Parliament's Joint Select Committee on Social Services and Public Administration, it took place at the Centre Pointe Mall, Chaguanas on March 7.

One man said health facilities were underutilised, as they closed at 4 pm, but the community was bustling outside. He said many cases people had to go to Couva or Montrose. He said the building usage could be maximised, as people get sick at any time.

Devanand Shridath said dispensing medication was a problem, as the procedure for collecting prescriptions had changed so that patients now spent two-three hours waiting for medication. He said in most cases, the pharmacy didn’t have some of the medications and he had to travel to several different health centres to get them. This meant additional stress as well as transport costs, and he explained this was the norm for him and others.

Shridath said he had had surgery in December, went to clinic in January, and his next clinic appointment is in September 2025.

Councillor for Enterprise South/Longdenville North Brenda John said the waiting time at accident and emergency departments was too long, especially for the elderly. She asked why the Sangre Grande hospital was at a certain level in terms of healthcare and the borough was not.

She said the fight against non-communicable diseases should start in schools, including exercise and banning sweet drinks. Eating healthily was expensive, she said, and fast food was easy to access.

She also said pharmacists could tell patients which facilities had the needed medication if theirs didn’t have it, rather than having people waste time and money travelling around.

Another participant said certain pre-tests were only available to the public when the regional health authories hosted mass events, such as International Women’s Day, and only on certain days and during certain times. She said the costs of private tests was prohibitive.

She said she was admitted to the hospital twice in a week, the first time after being taken by ambulance from the health centre because of chest pains, when she was asked to stay overnight to see the specialist cardiologist, but didn’t have clothes or anything to eat or drink. The second time she was discharged with a prescription for several medications, told to join the cardiac clinic and given an appointment in June 2024, without a diagnosis being made or seeing the cardiologist. She also had to wait two hours to fill her prescription.

Concerned Parent Teachers Association president Clarence Mendoza said school canteens were not being examined for what they were providing to children.

“We cannot be using a document from 1984 to run our cafeterias. We’ve been asking for a meeting with the Education Minister since last October, and keep being told it will happen.

"Our children must be taught about non-communicable diseases in school. Don’t wait until they’re 50 and 60 to realise they have diabetes and high blood pressure. They need to be taught and tested, check them twice a year.”

Another lady said she had glaucoma and cataracts, and had had the cataract surgery privately.

“I have glaucoma, but the medication is not on CDAP (the Chronic Disease Assistance Programme). I’m type 3 asthma, and the pharmacists will tell you, 'We don’t have it on CDAP but you can get it privately.'

"Similarly, with the medication for anxiety and depression, I had to pay $1,200 to get my medication, because it’s unavailable under CDAP at the places I went to, and nobody can say where to get them.”

Another participant said their father was assaulted on the ward in 2012 in the San Fernando General Hospital by someone on staff and the person had not been identified to date. He called for conspicuous uniforms to distinguish permanent from temporary staff members.

Insurance salesman Parasram called for accountability on the part of the RHAs after he said his uncle was allowed to wander off a ward twice despite being restrained because he was suffering from alcohol withdrawal syndrome.

He said another friend had an accident and was taken to the accident and emergency department at San Fernando, but was not seen by a doctor despite being there for six hours. A year later, he said, the same friend was having headaches, went to a private doctor for a CT scan referral, went to Mt Hope, where he wasn't seen, and paid $1,500 for the scan privately.

“A client of mine needed scrotal hernial surgery, which would have cost him $30,000 to do privately. He was scheduled for surgery in 2025 in Mt Hope, even though my company was willing to grant him 24-hour insurance approval.”

Ramsaran said instead of building new hospitals, the current hospitals needed to be managed better, including better scheduling.

He said there should also be taxes on alcohol on tobacco, which were destroying the nation.

Another speaker said the policy on monitoring lipid profiles and kidney and liver function for certain non-communicable diseases was every six months, but patients only got annual referrals.

He called for the unique identifier on the birth certificate to be used in conjunction with patient records so the government would know how many people suffered from NCDs and their medication needs.

He said the CDAP list was 30-plus years old and needed to be updated.

A woman said the attitudes of staff in the NCRHA sometimes left much to be desired. She said often waiting times at the pharmacy were five-six hours.

She was disappointed with the health facility and the expectations at Chaguanas.

“We have the worst health facility in the country. Where is the hospital for Chaguanas? The health centre used to be a gym and there’s no elevator. Who consulted with us in Central?

“During covid19, the one main street was clogged with tents, and there was no parking close to the facility, so in the parking lot they opened up, you had to tell the security what was wrong with you to be able to access the parking.”

A representative from the Geriatric Society of TT (GSTT) advocated for the creation of special clinics, wards and care for elderly people, as they were in need of more care the older they got, especially those who were bedridden or lived alone. He said in addition to NCD treatment, they also needed mobility and social interaction.

GSTT founder Dr Lavanya Thondavada said there needed to be a comprehensive assessment every three months of people over 65 by a multi-disciplinary team (psychologist, dietitian, therapist) to assess mind, mobility, multi-complexity, what matters the most, and medication.

Another participant said the allocation of CDAP drugs was problematic, as it ran a specific date month-to-month rather than when the patient ran out of the drugs. He said often when he went to a pharmacy, he was told they didn’t have the drugs, only to discover they would put aside an allocation for their regular customers.

TT Residential Care Association president Caroline Ruiz said the hospital system had improved over the last couple of years, especially regarding the discharge of patients to the care of homes.

Another participant said the fight against NCDs needed to be a multi-sectoral approach, including the Health Ministry, the Ministry of Tourism, Culture and the Arts, the Education Ministry and the Ministry of Social Development and Family Services.

Vanessa Haynes Cuffie of the Association for Professions Related to Medicine said people were more likely to make changes if they thought the government cared. She called on the health ministry to have more health fairs in communities rather than large one-day events.

Gail Morris from the Diabetes Association called for proper file management, as her files had been lost twice, including surgery records.

Another participant called for legislation to make digital files mandatory, as the paper files currently being used were difficult to access, presented storage problems and deteriorated.

Kerry Edgehill from the Radiographers Board said there should be a move away from prescribing medication for chronic diseases, as it could lead to kidney deterioration and dialysis. She said if patients were able to join lifestyle clinics early, they could be taught how to cook, exercise and look after their health.