Senior Reporter
dareece.polo@guardian.co.tt
The Trinidad and Tobago National Nursing Association (TTNNA) is warning that more neonatal deaths could occur in this country. They allege that the health ministry has failed to fully implement the Pan American Health Organisation’s (PAHO) recommendations following the deaths of seven babies at the Port-of-Spain General Hospital’s (POSGH) neonatal intensive care unit (NICU) earlier this year.
Seven babies died from sepsis between April 4 and 9, leading to a class action lawsuit, spearheaded by attorneys from Freedom Law Chambers, led by Anand Ramlogan, SC, against the hospital for the deaths of 19 babies at the facility.
When contacted for an update on PAHO’s short, medium, and long-term recommendations, TTNNA president Idi Stuart stated that all NICU departments still faced a nursing shortage.
“The few nurses we are training continue to leave because the Government has refused to implement a single retention strategy even though it was recommended by WHO and PAHO to return your nurses as best as possible,” he said.
He specifically mentioned the North West Regional Health Authority (NWRHA), which he claimed is the only RHA that has nurses on temporary contracts. Stuart also highlighted inadequate spacing between NICU beds and further criticised Health Minister Terrence Deyalsingh for failing to introduce legislation in Parliament to establish the Trinidad and Tobago National Health Services Accreditation Authority.
He emphasised the need for an independent regulatory body to ensure that the ministry’s policies are being adhered to.
“Realising that the ministry of health is a poor regulator of itself ... now, if anything is to happen again going forward, then the Minister of Health must be held liable because he has failed to implement the one policy that is totally within his remit,” he said.
He further warned, “History has demonstrated it has happened before; it has happened on that occasion, and it will happen again. It is not if or but; it will happen again.”
Stuart alleged that the spread of infections within wards and the unnecessary loss of lives was occurring across T&T’s hospitals.
“The only reason it is not highlighted is because we as a population focus on two things—babies, if babies’ lives were lost or the mother’s life was lost. So, anything outside of that is kind of glossed over by the population,” he said.
“We have a tendency to cover up these deaths. And the families, often, their only resort is to go to court and spend lots of money and lots of resources trying to get another medical practitioner to say—well, yes, there was an error made,” he added.
Stuart acknowledged that this issue is not confined to the public sector, as it also occurs in the private sector.
Attorney: Most of PAHO recommendations implemented
Since a lawsuit has been initiated against the POSGH for 19 neonatal deaths, NWRHA CEO Anthony Blake declined to comment. However, the attorney representing the authority, Senior Counsel Ravi Nanga, asserted that most of the recommendations have been implemented.
He said this was the latest information he had gotten some time ago but assured that any recommendations not yet implemented will be in the shortest possible time.
“The majority has been implemented, and if there are still recommendations that have not been implemented, they will well be on the way to being implemented,” he said.
Despite this assurance, Nanga also expressed confusion regarding the origin of some of PAHO’s recommendations, as they had already been implemented.
One such item was the recommendation for hand-washing stations, which a source at the NWRHA, who spoke on condition of anonymity, insisted had already been operationalised.
The PAHO report highlighted 12 deficiencies within the POSGH NICU, notably an insufficient ratio of nursing staff to patients. It emphasised the need for the establishment of policies and procedures regarding the use of multidose medications in the NICU and advocated for the promotion of early breastfeeding. Additionally, the report recommended enhancing compliance with hand hygiene practices and discontinuing the shaving of surgical sites.