Poor Hospitals Conditions - Jamaica's Kingston Public Hospital

A plaque located on an outside wall at Kingston Public Hospital (KPH) shows writing in recognition of its 240 years of providing medical services in Jamaica. The public hospital was founded during the slavery era in 1776. During that period, the downtown Kingston hospital catered to the white population only until it began accepting Black residents in 1838 after the abolition of slavery. Undoubtedly, attention was paid during the earlier years to the historic hospital’s development to prolong its longevity.  However, while red-brick colonial buildings remain and newer buildings were constructed to accommodate the hospital’s rapid growth, poorly maintained interiors during the later years confirm a lack of consistent upkeep. In addition, efforts have been made to upgrade equipment with the latest technology, but too often critical care machines break down leaving patients’ health in jeopardy. Customer service practices have also drastically diminished throughout the year thereby implanting a bad reputation on KPH’s medical staff for discourteous attitude and treatment towards patients.

A typical day for a person who goes to KPH’s emergency room is an unforgettable experience. While waiting, it is not uncommon to hear people wailing in pain. One young girl screamed incessantly that she had severe head pains. Her screams and cries of others did not seem to bother the medical staff who appeared uncaring and numb to the sufferings of those in the emergency waiting area. Also, a man who was referred by his personal physician for heart attack symptoms, arrived at the emergency room at 1:30 PM. At 6:30 PM he, like others who arrived earlier, were still waiting to receive any type of acknowledgement. His personal doctor's referral letter meant nothing! After a series of miscommunication by emergency staff on whether his x-rays were completed, he was eventually assigned a bed in a ward at 3:30 AM the next morning. This typical lengthy wait time at KPH may result in critical consequences as was the case of a lady who was transported by an ambulance to the emergency unit but died in her sister’s arms while sitting in the waiting area to be attended to. Arriving in an ambulance meant nothing! KPH’s medical staff makes it quite clear to those waiting that their priority is to attend to the gun-shot and knife wounded victims from the surrounding, volatile inner-city where shootings and gang retaliations are the norm. So, persons with medical conditions such as heart attacks, possible brain aneurism, etc. will take a back seat to those who frequently arrive in speeding cars that stop abruptly at the emergency entrance where occupants quickly exit the vehicles while yelling, “Gunshot”!! “Gunshot”!! 

The procedures for visitors is another aspect at KPH that seems unusual to the standard practices of any hospital. The visiting time is from 11:00 AM to 12:00 PM. and from 4:00PM to 6:30 PM. The first step for a visitor is to line up at the information center to get a worn-out cardboard which is called a pass. When requesting the pass, the only expectation for visitors is to provide a name and ward number to the service personnel sitting in an encased-type room. These service personnel do not inquire or even have the ability to check if the name and ward number provided to them is valid. So, security procedures at this point is non-existent since service personnel hands out passes to anyone. After getting the cardboard pass at about 10:45 AM, the next step for visitors is to wait in a second line to be processed by private security workers whose only gratification seems to be that they are in control of visitors entering the main hospital compound. They are responsible for checking bags to make sure no items on KPH’s restricted lists are brought into the wards, and that includes every type of food and drinks except fruits and water. They also are entrusted with a metal detector that seems more symbolic than useful. An absurd practice is that security will not allow ladies to pass through the gate to visit their loved ones if they are wearing sleeveless blouses or dresses. As a result, the hospital projects an impression that, in the gun-ridden neighborhood, harassing women wearing sleeveless garments is more of a priority than focusing on the slack security procedures of handing out visitor passes to anyone who requests one. Nevertheless, as security usurps their limited powers, they will not begin their visitor processing duties until precisely at 11:00 AM, 4:00 PM or thereafter. So, the visitors will lose some of their visiting time while going through the prison-like entry process. But, the wait time is never boring in this lively atmosphere where intriguing residents, living in the politically charged neighboring community, use the hospital premises as their main walkway. From their residences, they walk nonchalantly onto the hospital compound; boldly pass the hospital’s police sub-station; and proceed to downtown Kingston and back. It is also common to see sellers passing by and haggling their products such as water, fruits, phone cards, and even a male vendor walks by selling women’s half-slip undergarments. Waiting is frequently interrupted when security opens the tall, heavy gates to allow the entrance of luxury vehicles driven by doctors or other personnel who haughtily hold their heads high as they drive through. Further, if visitors know someone connected to the hospital, communicating with a guard at the gate often results in entry to see loved ones without standing in line. Waiting visitors may even get caught up with the loud outbursts of people with mental health issues who walk around aimlessly on the premises. Visitors could also witness a commotion from family and friends who are mourning loudly and uncontrollably over the loss of a loved one who they accompanied to the emergency unit but never survived gun shots or knife wounds. 

The outpatient clinic waiting process is an all-day fiasco. Since a computerized patient system does not exist at KPH in this 21^st century, the outpatient courtyard is overcrowded with people sitting and waiting for their names to be called so that they may move on to the next step in their effort to see a doctor. Noise and confusion abounds as people must wait for their dockets, or medical files, to be located and brought by foot to another building where the out-patient must go after leaving the courtyard in order to see his/her specialists. Others may be immediately directed to crammed rooms where they need to make appointments, obtain consultation from a nurse, or see a specialist. People must arrive during the wee hours of the morning at KPH’s patient clinic to ensure that they are attended to by a doctor since their appointment wait time could be as long as six months in between visits. But, outpatient inconveniences also extend to patients while they are admitted in KPH wards. Broken, life-saving medical equipment requires patients to get tests outside the hospital. But, the lack of ambulances to take patients to other public facilities mean that a patient must make their own personal travel arrangements to leave the hospital on a doctor’s authorized pass to get the tests at private facilities, if they can afford to pay exorbitant testing fees. If patients cannot afford the fees for private tests while admitted at KPH, then they will be released without obtaining important medical exams.

The buildings and common areas are reminiscent of a great many years of neglect that has result in dilapidated conditions. Such appearance makes visitors wonder if they are actually inside a hospital because cleanliness and order are nowhere to be seen. As visitors enter a building, they are confronted with peeling paint on dirty walls. Concrete, uneven and uncovered slab floors intermingle with worn-out linoleum covered floors. Hidden, dingy stairways in poorly lighted locations are the only way to access upstairs floors since out-of-the-way elevators are restricted to patients who are transported in wheelchairs or on hospital beds. Untidy, deplorable conditions are seen in workers’ maintenance rooms where all is visible with wide open doors or no doors. The conditions of some patient wards are unspeakable as an unmistakable, lingering stench confronts a visitor’s nostrils on approaching the entrance. The stained concrete floors are lined with rows of old beds with malfunctioning headboard recline levers attached to them. The large, open 30-bed or more wards also include limited number of rusty storage bedside cabinets with stuck doors for patients’ use. Bathrooms with no doors clearly expose a couple of cracked sinks with aged faucets and two walled urine stalls for the 30-bed ward or more capacity. But, more concerning is that ceiling fans and open windows and doors are expected to keep patients cool throughout the days and nights in the hospital’s dangerous, downtown neighborhood where even staff sometimes have to run for cover at the sound of a barrage of gunshots. When it rains, leaking ceiling and the open windows and doors cause some wards to be flooded which results in the need for patients to be moved elsewhere in the overcrowded ward. The appearance of the doctor/nursing station is consistent with the rundown conditions of some wards. The poor conditions will make anyone curious as to where all the millions of dollars donated by worldwide NGOs and international governments have gone not only for this squalor hospital but other government hospitals in even worse conditions.  

The 240 anniversary of KPH was celebrated with fanfare. The photos with stakeholders celebrating the milestone and, on different occasions, photos that highlight KPH’s receipt of generous donations from foreign entities or the handing over of medical equipment, etc. serve as a façade to the underlying crisis that plague the hospital but are swept under the rug. KPH’s vision, “to provide service by qualified, efficient, courteous and highly motivated work teams in a clean, secure and attractive environment.” will not be taken seriously until efforts are made to provide patient with friendly services and an environment to compliment medical needs.

KPH Emergency - Dirty, Neglected 236-Y-O Hospital Struggling On
Public Hospitals in Jamaica Have Become Like Death Traps

6/19/2018
Here we go again!! The improper disposal of the bodies of neonates is another problem to add to the hospital's poor performing record.
SERHA board member to lead investigation of improper disposal new-born babies at KPH