By Tony Deyal
When I saw an article in the Trinidad Guardian “Port-of-Spain plagued with problems” I immediately felt that the plagues, like so many other health problems in Trinidad and Tobago (T&T), did not go to the hospital but most likely came from it. My friend Tom who told me that vagrants were sleeping in the entry to areas where people with serious injuries were being admitted, blamed the doctors. Even though it sounded far-fetched, he was adamant, “All of the doctors have their own private hospitals or make plenty money from them and this is why in the public hospital there is always a long wait for medical attention and surgeries, no beds available, and plenty hard talk from the doctors and nurses.”
I had learnt the hard way that “hospital” and “hospitality” are two vastly different things in T&T and never the twain shall meet, except at the bank. Worse, if you’re paying to be looked after in one of the doctor-owned facilities, you will find that even if you go to one because your bowels are locked tight, they still charge you for toilet paper. That is why I call them “Ho$$pitals.”
I know what these same big-shots can do to poor people who show up in the “government” facilities. There are some who charge a lot of money when you go to their offices and then arrange for you to be accepted in the hospitals so they can use the facilities for free. My unforgettable experience was when, riding my motor-bike at high speed, it refused to respond or slow down and instead was heading into a concrete wall. I tried stepping off backward while the bike was going forward but my slippers tripped me and I broke my left collar-bone. I was kept waiting on a trolley in the hospital for hours.
What made it worse was that several of my school friends had become doctors and each of them stopped, looked at me and then said things like, “Ah blasted old man like you riding motor-bike? You look for what you get!” and “You ain’t change. You still up to stupidness. If you want to dead jump through the window. We on the twelfth floor.” I got my own back with one of them though. He was the one whose job was to put me to sleep before surgery. He looked at me with a long hypodermic needle in his hand and said, “Just a little prick.” My reply was, “I know. I know. You haven’t changed since school days.”
In my days working for the Pan American Health Organisation (PAHO), I visited every hospital in the region. While the standards in Jamaica can vary in both the public and private facilities, it is 65 in the world for the effectiveness of its health care system. Trinidad and Tobago is at 88. Barbados, where my two younger children were born, has an amazing healthcare system. It has nine polyclinics, a public hospital, and a variety of speciality surgeries including an HIV clinic. The polyclinics specialize in providing primary care for every Barbadian, free of cost.
This is why, when the Trinidad Guardian newspaper in November 30, 2002, headlined: “Casualty back in operation with a skeleton staff”, I thought it was a brilliant idea. Skeletons are ideal for such an operation.
First of all, security would be boned-up rather than beefed up. Normal human beings, as well as the people who frequent hospital casualty departments would not be able to breach the hospital’s defence or gain entry unlawfully since only the people in charge would have skeleton keys. Those of us who complained about all the corruption, misspending, stealing of supplies and the covering-up of malpractice and negligence would no longer have to worry. One sure outcome of employing a skeleton staff is transparency. Make no bones about it, a skeleton staff guarantees transparency.
Skeletons might be numbskulls or boneheads but they are too smart to steal food from the cafeteria or towels from the laundry. Even though you cannot really pin anything on them, they still do not steal body parts to sell to private institutions since they know they will be easily discovered.
Additionally, by using a skeleton staff, the problem of the overcrowded mortuary will be ended. After all, skeletons are people with their outsides off and insides out. While skeletons have some difficulty in standing up for themselves, by the same token they do not bow to pressure or knuckle under despots, doctors or dictators. Although a few of them might be lazy bones, most of them work hard. On the downside, they can be messy. One of them went to the cafeteria and ordered a cup of coffee and a mop. Another refused to work at the hospital because its heart wasn’t in it. One refused to attend the welcome party put on by the Ministry of Health because it had nobody to dance with. And when one reached late for work and tried to lie, explaining that it was chased by a dog, its supervisor said, “Don’t try that. I can see right through you.”
On the plus side, skeletons are easy and cheap to maintain. Unlike the present hospital staff, they require no meals or meal allowance. In fact, they don’t use the cafeteria food because they have no stomach for it. It then takes anything at all if it is a soup with plenty of body and served in one-bone china. They never lose their cool or get angry the way the T&T hospital staff, especially the nurses and doctors do. No shouting and shooting us down by the skeletons. In fact, nothing gets under their skin. They are very studious and always boning up for exams. Even the few who might be tempted to get angry and make outrageous demands eventually back down. They don’t have the guts to fight.
On Sundays, the skeleton force stays on the job instead of going to church because they have no organs. Instead of using the government service to send out all their Christmas cards and run up major expenses which the government must pay, they send their mail by bony express. They don’t require any transportation allowance since, like vampires, they travel by blood vessels. They don’t take coffee breaks – they take coffin breaks and, after 21 years, they still do so. That is why, as far as I am concerned, the use of skeleton staff at the Academy and emergency department of Trinidad and Tobago, and any other country in the Caribbean except Barbados, would considerably reduce the present excessive demand on the limited resources of the hospitals.
Even though children in hospitals would be scared stiff, and adults might get ghoul stones or coffin fits, doctors would be in paradise since they would have more time for their private practice and their own money machines. In addition, the ministry of health will have more money to spend on really important medical issues such as attending far-away international conferences.
*Tony Deyal was last seen wondering why skeletons are so calm. He then realised that it is because nothing gets under their skin.