'Opening a can of worms'

Health Minister Terrence Deyalsingh at the North West Regional Health Authority health fair, Mt Hope/Mt Lambert Community Centre, San Juan on June 29. - Faith Ayoung
Health Minister Terrence Deyalsingh at the North West Regional Health Authority health fair, Mt Hope/Mt Lambert Community Centre, San Juan on June 29. - Faith Ayoung

Good things happen during the rainy season. WASA reservoirs fill up despite warnings of drought. Rains provide not just green grass in the Savannah, but good hunting grounds.

As a girl, I used to go out on warm, damp nights with my friends to collect earthworms, which one of the boys would then sell to fishermen to use as live bait.

There is a technique for catching earthworms. They come out of their holes in the earth at night, especially after rainfall. You must shine a flashlight at the worms as they emerge, to locate them before they slither back. You have to move quickly and grasp the worm firmly but gently, making sure your hand covers the pale band that goes around their middles.

Too gentle and they get away; too firm and they break apart in your fingers, leaving a squishy mess.

Once caught, the worms must be put in a closed container with small holes punched in the lid for air. As the jar gets full (we used empty mayonnaise jars), you have to take great care in opening the lid, because once a jar of worms is opened, the worms crawl out with frustrating speed. That is why political or business exposés are referred to as "opening a can of worms."

Two recent examples are the publication of the analysis of SEA results – not the results themselves, but the trenchant analysis by experts in the press of what those results had to say about the state of government-determined education in primary schools, and what they portend for the future business of running a country. This country.

The worms slithering out include the quality of teacher training to match the socio-economic changes we are experiencing, the curricula in government primaries and annual compulsory updates in teacher training, or lack of it, to enable socialisation for children in the "targeted" schools.

Once again experts warned that those who achieve less than 35 per cent in their exams and those who, to cover their shame at being labelled "stupid," turn to bullying or violence to achieve status among their peers. Curricula targeted to provide remedial help and conflict-handling exist, but most teachers are not trained in how to use them.

Primary school students participate in the Eastern Credit Union's SEA motivational workshop at La Joya Complex, St Joseph on March 1. - Faith Ayoung

Then there is the other, even larger, can of worms, labelled management of health institutions.

Those worms had names – PAHO report, medical staff absenteeism rate, contracting-out of management internal functions, sanitisation products and procedures, supervision of administrative functions, food for patients allocated to staff, and so on. PAHO never even knew all the worms that slithered out. They went home with patients and visitors, though, and ended up in gossip on the streets.

Those worms were picked up by people anxious for answers, and there were as many of them as there were worms.

Health Minister Deyalsingh pointed out that taking the PAHO report as the be-all and end-all and seeing it alone as the total reality condemning the entire hospital was unfair. He was right, of course. While there are certain aspects the general hospital is deficient in – and nearly all hospitals are – such as a one-to-one nurse-to-baby ratio, or nurse-to-elderly ratio, in other areas the preemie unit scored 80 per cent.

On the flip side to that, the staff union president, Idi Stuart, also had a valid and very human point when he said that when staff in that unit know an inspection is scheduled, a mass cleaning is scheduled, the "good" bedsheets are brought out and more staff brought in. That happens.

However, although the PAHO inspection was known about weeks before, deficiencies were still found in the hospital generally, as well as in the unit.

Staff cannot be blamed for understaffing. No wage negotiations have been done for nine years and counting, according to a trade union ad in Newsday on June 16. If true, that may have had something to do with it, as it sends our nurses abroad to work in understaffed hospitals in the UK.

And that, of course, leads to another can of worms, about the national perception of public-service deficiencies in performance and the 20-year cry for public-service reform.

The health surcharge attached to salaries in 1984 led patients who go to public health clinics to expect a level of performance that is seldom experienced.

In many public clinics, staff doctors don’t turn up. So many are busy working (unimpeded) in private practices, while still on the public payroll, leaving patient care to the one or two overworked doctors faithful to their hippocratic oath. The best and most caring physician I have ever known worked in our public service.

The lack of forex limits the availability of new cancer drugs to give to patients who cannot afford to go to Barbados to get them. The lab in our Ministry of Health was told to approve all new drugs, and it either refused, did not have time or access to foreign exchange or was closed for repairs.

The patient was told by the lab, without examining him themselves, that the old drug "would do." The patient died and the doctor went into private practice.

Another worm slithered out of the old mayonnaise jar and spread a message of despair.


"‘Opening a can of worms’"

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