Heat and overcrowding severe problems in GPH children's ward
Bacterial infection was factor in several deaths

By Samantha Alleyne
Stabroek News
June 28, 2001

Concern has been expressed that the furnace-like condition of the children's ward in the Georgetown Public Hospital and overcrowding contributed to several preventable deaths.

In three cases, a bacterial infection was found to be a contributory factor in the deaths.

Medical Superintendent of the Hospital, Dr Madan Rambarran yesterday told Stabroek News that steps will be taken to improve conditions in the ward. He, however, said there is no evidence that the bacterial infection detected in the area resulted in any deaths.

Some twenty children have died since April when the paediatric ward of the Georgetown Public Hospital moved over to another part of the hospital which has been described as a "furnace."

Various officials and concerned persons who spoke to Stabroek News feel that five of the deaths could have been avoided if more attention was paid to the poorly ventilated ward which is also overcrowded.

However, Dr Rambarran, said that the patients are better off than they were in the other section of the building which he said had become dilapidated.

Dr Rambarran, when contacted by Stabroek News said that the hospital had been advised not to repair the building since it would be like "throwing good money away."

The ward, which was located in another section of the hospital, recorded seventy-six deaths for last year and for this year thirty children have already died, twenty occurring after the move.

But Dr Rambarran said that for the same period last year the ward recorded a 7% death rate while for this year it is actually one percent less.

This newspaper was reliably informed that an internal investigation by the Quality Assurance section of the hospital was launched into the deaths of the children and after a sampling was done of the area a bacterial infection was found in three of the cases.

This was acknowledged by Dr Rambarran who however, pointed out that while the Quality Assurance report said that the bacterium, called klebsiella, could have been a contributory factor to the children's deaths, they died from varying ailments. The infection could be transmitted by touching someone or their clothing and can cause a series of illnesses including pneumonia.

He said that the hospital is working on implementing the recommendations in the report which suggested that the air flow be improved and that there be better hand-washing procedures for patients and the nurses among other things.

Stabroek News visited the ward recently and had a first-hand experience of the heat in the area which is also humid and has an unpleasant smell. The conditions made it difficult for sick children to breathe and they could be seen walking about listlessly in an effort to ease their obvious discomfort.

The beds are so close together that one child could touch the other by the mere stretch of a hand and this, according to officials in the ward, could be dangerous for the patients.

The ward is equipped with just eight fans which simply circulate the hot air.

Extractor fans were promised before the move but this has not become a reality and the officials are calling for air conditioning units to help keep the area cool.

Stabroek News also observed that the children are allowed to eat in one area and they share their meals with each other even though some of them might have communicable infections. But as space is limited, the children try to make the best of their conditions.

This newspaper was told that not only the place is hot but there is no sink for mothers to wash their children's dishes and baby bottles.

Another problem is that the room where the dirty linen and bed pans among other things are washed is in close proximity to the ward.

The ward issue is reportedly brought up at every conceivable meeting held at the hospital but no action is being taken and the nurses and doctors in the ward are said to be frustrated.

But Dr Rambarran denies this stating that the issue is being addressed and he disclosed that come next week the ventilation problem should be addressed. According to him the ward is no smaller than the previous one and pointed out that the admission rate is actually lower than before. He contended that the facilities in the present ward are actually better than what was being provided in the previous one. He blames the ventilation problem on the way the building was designed and acknowledged that the fans are not solving the problem.

Plans are afoot to address this dilemma by creating vents in the skylights which will assist in getting the hot air out and cool air in. This is expected to be completed by next week.

This newspaper was told that the ward is so hot that some of the student doctors fainted when they were making their rounds while the ward doctor who suffers from a sinus problem has to interrupt her rounds ever so often in order to get fresh air.

An incident was related to Stabroek News where the bottles of rubbing alcohol given to the ward burst one day because of the intense heat in the area. Fortunately no one was injured as the room where the alcohol is stored was empty.

It was explained to Stabroek News by a source that sometimes there are just about two nurses to supervise some twenty patients.

The isolation section, which is separated from the other parts of the ward by a wall with a doorway, is only equipped with one fan.

The nurses are given the additional task of regularly sponging the children who have high temperatures in an effort to relieve them of the heat discomfort.

Another sore point in the ward is the surgical room where nurses dress the wounds of the patients. Because of the heat, the nurses perspire and sweat sometimes drops into the patient's wound increasing the risk of it becoming infected. It was explained that because the nurses' hands have to be sterilized before dressing the wounds, they are unable to mop their faces.

One source noted that the nurses and doctors work hard but their reputations are at stake because of the deaths in the ward some of which it is felt could be avoided.

But if that is not enough the nurses have to contend with a 12-year-old abandoned child in the ward who sometimes physically assaults the nurses and patients. According to reports the child sometimes goes on a rampage and destroys patients' flasks and dishes all of which have to be replaced by the hospital. She also eats the other children's food and when she cannot get her own way she becomes violent. Reports say that the nurses acknowledge that the child needs love and attention but they pointed out that they cannot dedicate their time to her as there are so many children that have to be dealt with. They want the authorities to get the child into a home where she could be cared for.

Questioned about this, Dr Rambarran said that the child has a behavioural disorder which the pyschiatric ward is dealing with and noted that they are working on finding a home for her. He is aware of some of the things she does but pointed out that they cannot just put her on the road. He said they usually locate homes for the abandoned children but at the moment they are finding it hard to secure a home for two children, which includes the disturbed child.