Our baby was recently diagnosed with Pneumonia. When our paediatrician referred us to one of Jamaica’s main public hospitals (University Hospital of West Indies) for some nebulisation, I had no idea what to expect…
The cough had started after my husband and I had a bout of it during our summer visit home to Ireland. Our little boy B never showed any other symptoms and remained in relentlessly good form, but after too many doctor’s visits here in Jamaica, I was beginning to get a bit worried. He was wheezing slightly and the endless prescriptions of antihistamines were making no difference. We went to get a second opinion from the excellent Dr Judy Tapper, and after a week of me giving the poor soul a lot of ventalin (which turned him into HYPER BABY and me into a zombie mum, which coincided nicely with Hurricane Sandy) Dr Tapper suggested I take him to UWI for nebulisation.
My only experience so far of Jamaican hospitals had been Andrews Memorial Clinic, where I spent two happy days when I delivered B. The maternity wing there was clean and friendly and I felt I was in very good hands. UWI was a whole different story! Even as I arrived at A&E’s boarded up windows, and long queues for registration, I could feel my heart sinking…
After the initial nebulisations (which he screamed his way through like I was gassing him) and a chest X-ray, they admitted B for what I thought would be a maximum of 2 nights. I was fairly distressed after one look at the children’s ward, where B was going to have to sleep in an awful kind of cage/cot and me on a chair next to him. Even that I could have managed, but the ward was full of mosquitos. At least half of the 20 or so children in the ward had Dengue Fever, a dangerous disease that recently reached epidemic levels in Jamaica, spread through mosquitos. While some of the kids had mozzie nets over their beds, they didn’t get nets unless they had a ‘diagnosis’. As results can take a couple of days to come back, meanwhile everyone else was at risk. Combine that with no toilet paper, soap or handtowels on the ward or in the toilets, and I was really very frightened about B catching with Dengue… or worse.
All of this equated to zero sleep for me. I watched B intently, checking for mosquitos, trying to protect him from banging his head off the aluminium bars of his cot, which he kept propelling himself painfully into, as he’s just at that stage of trying to crawl. And every time he got to sleep, some other poor child would start yelling, or the nurses would drag chairs around, or wake him up to take his vital signs, which nearly drove me to distraction.
After 3 nights, his wheezing mainly gone, me feeling insane from sleep deprivation, B was started on a 4 day antibiotic and they told me we had to stay for the duration. I tried to persuade them to let us leave and come back every day for a check up, that I could do his medication at home, that I was worried about cross infection etc but they absolutely refused, due to poor follow up with most outpatients. Then they insisted testing the baby, myself and my husband for TB, which is apparently on the rise in Europe, and often presents in infants as a persistent cough with no other symptoms. Luckily none of us had it, and I didn’t dislocate B’s arm trying to hold him still while they did the skin test!
Overall, the standard of treatment was excellent, perhaps above and beyond what was necessary; keeping us in for so long and the TB testing etc. But the hospital’s hygiene is appalling even though you’d think providing the basics would save the hospital a fortune in cross infections and readmissions. I was told parents steal toilet paper and soap, so they just don’t bother any more.
Many of the staff are just doing the best that they can. The doctors overall seemed very competent, though assume you are an alien if you ask too many questions. Most of the other mums didn’t seem to know what was wrong with their child, or when they were likely to get out, and in a way I envied their trust in the doctors and stoic acceptance of the hours drifting endlessly past. The nurses were a seriously mixed bunch, as I guess you find anywhere. About half were helpful, gentle and friendly with the baby, the rest were unbelievably sullen and brain meltingly slow.
The other maddening thing, was not having access to hot water, a kitchen or even a fridge. At home, B is on 4 bottles of formula a day, but with the constant disturbances and lights in the hospital was waking frequently and looking for less milk more often. Trying to calculate how much milk he would need in a day, then give the formula to the nurse in the morning with enough clean bottles to last him 24 hours was pretty impossible! Particularly on one occasion where I literally had to wait more than 2 hours before the milk came back, and then was given to me too hot to use for half an hour.
H (my husband) was away on business for most of the week, and I don’t know how I would have managed at all without Auntie C (our nanny) who came in every day, so I could rush home, shower and wash bottles and zoom back in again. Other mums, who lived further away and didn’t have the support I did, had to just leave their babies to cry in the ward, for however many hours it took them to get what they needed and come back. More disturbingly, there were two profoundly disabled children in there, possibly suffering from cerebral palsy, who it seemed no one visited at all.
Anyway, apologies for this rant, but I thought it might be valuable to share my experience. While I found Andrew’s Memorial Clinic excellent, this week in UWI of poor hygiene, mistakes with even basic medication and lack of information, makes me feel that I’d had any trouble at all with the birth of B, I would have had a much rougher time.
On a brighter note, B thought the whole thing was a 24 hour party. Panting and bright eyed from the ventalin, with other kids constantly running around and poking him, lights on 24/7 and with my undivided (paranoid) attention, I say he’d choose to go back in a shot!