Sat | Oct 20, 2018

Garth Rattray | CRH mess lacks accountability

Published:Monday | May 28, 2018 | 12:00 AM
Cornwall Regional Hospital.

The mess at the Cornwall Regional Hospital (CRH) is not new. Opened in 1974, it is a Type A, 10-floor, 460-bed facility housing a variety of specialist services. Years of neglect along with a chronic failure to perform repairs and upkeep have led to very toxic and dangerous environmental conditions within the building. One public figure blamed the 'No User Fee' system.

The sick building was dying and it was taking the occupants along with it. The health problems relating to poor air quality dated back to 2009. But the problem blossomed when "... the number of visits to the staff clinic moved from 71 in February 2017 to 2,000 in February 2018". The non-clinical departments on the lower floors (accounts, human resources and maintenance) were the first to experience problems. Remedial actions were taken, but the trouble moved higher up the building. Attempts at intervention ended up blowing particulate fibreglass, dust and fungal spores into the clinical areas.

Beginning in September 2016, the presenting symptoms of the initial 35 'victims' were: headache, sore throat, burning skin, burning tongue, difficulty breathing, cough, chest pain, nasal congestion, skin rash, fatigue, itchy skin, swollen eye lids, metallic taste, dizziness and drowsiness. Complaints began coming from the medical staff in operating theatres and even the Intensive Care Unit (ICU).

In February of 2017, restricted air sampling was eventually extended to incorporate the higher floors. The initial survey found that most locations encouraged mould growth. High microbial counts were found in the ICU and fibreglass was identified in over 80 per cent of the duct system.

 

Inspection report

 

A thorough workplace inspection report was submitted by Dr. Alverston Bailey and Mr Michael Wilson on March 19, 2017.

The team of inspectors, from the University of Technology, was comprised of Professor Winston Davidson (head of school), Professor Homero Silva (lecturer and environmental engineer), Dr. Alverston Bailey (toxicology lecturer and occupational physician) and Mr Michael Wilson (lecturer and industrial hygienist).

Their findings, apprehensions and recommendations (as far back as early last year) are far too many to list here, but the synopsis includes concerns with mould, airborne fibreglass, various toxic gases and sewerage issues.

They labelled the CRH as a 'very sick building' and recommended further investigations, staff evacuation and relocation (except for the essential services) until the sources of airborne toxicants could be found. They also recommended that personal protective equipment be worn by all staff, visitors and patients until the problems were resolved.

The Pan American Health Organization submitted an extensive 61-page Environmental Hygiene Assessment of the hospital on March 23, 2017.

They also had a plethora of conclusions - water leaks, fungal contamination with toxic and allergenic moulds, damp building related illness, high ultra-fine particulate counts, and widespread ventilation system problems.

Besides epidemiological studies (separately for patients and staff), remedial actions should be undertaken, isolative and phasic renovation/cleaning, investigating and treating those affected.

Obviously, the problems at CRH are chronic and serious. Yet it took increasing illnesses, protests and widespread publicising of the problems to see this headline on April 3, 2018, 'Patients at Cornwall Regional Hospital to be relocated amid air quality issues'.

It's troubling that so many people suffered and so much time elapsed before something was done about that untenable health situation. Our country is beset by problems with transparency and accountability.

The citizens of Jamaica deserve answers. Who was responsible for inspections and repairs? Did they report their findings, and to whom? Who knew what, and when? Despite the long-term, major breakdown of several systems at that premier hospital and the resultant illness of patients and staff, I wager that no culpability will be assigned. This is why Jamaica is struggling ... and that's a shame.

- Garth A. Rattray is a medical doctor with as family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com