WHILE we constantly hear about the big issues affecting Jamaica’s public hospitals, such as the lack of equipment or them being out of service, there is also a very basic need that has a major impact on the day-to-day operations of these health facilities.
According to Dr Albert Lue, head of the Ophthalmology Department at Kingston Public Hospital, the provision of linen for surgery is one of the very basic issues affecting his department and, probably, other departments that share the operating theatre.
“We need linen for patients to wear, linen to put on operating tables, linen to make up the instrument trolley for the surgical procedure,” Dr Lue told the Jamaica Observer in a recent interview.
“We need linen for the surgeons and the nurses to change into for each procedure. This is one of the biggest ‘little things’ that is holding us back on a day-to-day basis,” Dr Lue told Your Health Your Wealth.
He recounted an incident that occurred on the day of the interview, where a patient was scheduled for surgery at 9:00 am. However, the procedure was delayed by some two hours because there was no linen in the operating theatre.
“So there is two hours (spent) waiting for the linen to be delivered,” Dr Lue said. “In those two hours, we could have done at least two operations. And if this is going on every day, you can imagine how inefficient the system is.”
He explained that though the needs are great in terms of equipment, attention should also be given to the smaller things that are needed.
“We always hear about equipment being short and equipment not functioning, but sometimes it is just as simple as something to wear into theatre,” the doctor, who has led the Ophthalmology Department for 15 years, said.
Kingston Public Hospital sees more than 300,000 patients annually and the Opthalmology Department has the largest clinic at the health facility, seeing more than 1,000 patients each month. Dr Lue, in an effort to also highlight the “big” needs of the department, pointed out that a special interest group are diabetics.
He pointed out that a vitrector is needed to assist these patients.
“You see these patients going blind — getting worse and worse at each consecutive visit — and there are times when there is nothing you can do about it because of complications that are developing in both eyes because of the diabetes,” Dr Lue explained.
Some of these complications include haemorrhage inside the eye, development of abnormal membranes that will tug at the retina and will cause the retina to be detached, and fluid escaping into the retina causing the retina to be swollen, among others.
The consultant ophthalmologist also said that hypertension and dyslipidemia (high cholesterol) with diabetes can further compound the problems for diabetics, causing them to lose their sight faster.
He said, though, that the vitrectomy machine can be used to correct some of these complications, especially if they are in their early stages.
“So patients with bleeding in the eye, which is one of the big complications with diabetes, or with these traction bands that are pulling on the retina, there is an equipment that you could use to remove the blood, cut away those membranes and allow the retina to fall back in place,” Dr Lue explained.
This, he said, would help to improve sight in most cases.
“It may not be enough to cause the patient to read again, but enough to cause the patient to see better and can function at home rather than them being dependent on a relative,” he shared.
The head of the Ophthalmology Department admitted that the issue with the vitrectomy machine is that, by itself, it will not do much. He said it will also need a laser machine as well as other consumables to support it.
He said this could incur an estimated cost of about US$1,000 per patient.
“The majority of patients, I would say, would need laser treatment… (and) probably about 20 per cent of our diabetics could benefit from the vitrectomy machine and the laser,” Dr Lue said.
Since the department’s vitrectomy equipment has not been functioning for some 15 years, patients who need vitrectomy are directed to other institutions. In the meantime, KPH uses its laser machine to deal with some of the problems it encounters.
But what about those patients who need the procedure and are not able to get it elsewhere?
“The only thing patients in that situation can do is to try to get their blood pressure under control, keep the cholesterol and sugar under control. There is nothing else,” Dr Lue said. “Because, if there is haemorrhage in the eye, you cannot see anything in the eye to laser, there is nothing to do except for that procedure.”