Docs argue ‘would breathe easier’ with changes to QEH, Enmore

The Queen Elizabeth Hospital’s operating theatres and a coronavirus isolation facility were today declared substandard by a group of surgeons, who warned that the conditions pose a great danger to COVID-19 patients in need of surgery, the doctors and nurses who look after them and the entire hospital.

General Surgeon Dr Maurice Waldron raised the alarm on Monday when he insisted that QEH operating theatres need to be retrofitted with negative room pressure to prevent COVID-19 patients from contaminating other parts of the hospital while undergoing surgery.

Dr Waldron has also expressed concern about a make-shift operating theatre at the Enmore isolation facility, which has the required ventilation system, but in the opinion of surgeons is otherwise substandard and could potentially jeopardize the health of anyone treated there.

But the QEH’s Deputy Chairman Dr Abdul-Rehman Mohamed is adamant that although the isolation facilities are not  equipped to conduct “major” surgeries, the make-shift arrangements are the best that could be achieved with Government’s current resources.

While speaking on the Voice of Barbados radio call-in programme, Down to Brass Tacks, Dr Waldron explained that while the country’s general hospital is well equipped to conduct ordinary surgeries, it was not best to treat COVID-19 patients there due to the absence of necessary fittings, and also because infected patients are ideally supposed to be treated away from the Martindale’s Road hospital.

“The QEH is the only place unfortunately that has all of the support services on one site. It has radiology services, dialysis services and all of those services necessary to take care of patients in need of emergency surgeries… If you need a CT scan on the abdomen, support with dialysis etc., there are no facilities elsewhere and you wouldn’t want to move [COVID-19] patients because of the possibility of infection and the possibility to injure patients,” explained the surgeon of ten years’ experience.

“Our concern is that we looked outside of the QEH and the operating theatres that they wanted to use were not adapted to deal with all the emergency cases that may pop up in a situation like this. We, therefore, tried to adapt to a place which already has negative pressure, but which is way below the standards that we believe is safe for patients and personnel to perform surgery.”

Surgeons indicated to management that the makeshift theatre at Enmore Centre is “way too small” after a tour of the facility and later wrote a letter signed by numerous surgeons warning the QEH administration of the potential danger to patients and medics.

“When we toured the facility, it did not even have any operating theatre lights. They then brought in the lights that you push on the ground and we have not used those lights in years because we cannot see to operate which is very important when you are operating.

“They have retrofitted a patient room where we would be operating next to a toilet where trollies could not get in and out of the room and we had to lift a patient to get them into the room. The room also cannot hold all of the equipment that we need,” he explained while adding that not even the floor, walls or ceilings were outfitted to acceptable standards.

But the QEH’s deputy chairman argued that after numerous meetings with surgeons and Head of Infection Control Dr Corey Forde it was decided that the arrangements at Enmore were the best in the circumstances.

Defending the hospital’s position, he stressed that the hospital does not have the resources necessary to recreate brand new facilities like China.

“Of course it is not a cardiac suite, but it is a theatre that can manage simple stuff that come through from COVID positive patients. Mind you, we made provision for the long-shot possibility that a patient gets a problem with their appendix while COVID-positive. We also converted a room for recovery,” he argued.

While stressing that he was fully supportive of Government’s COVID-19 response, Dr Waldron nevertheless expressed disappointment that public health officials had not accounted for the possibility that some coronavirus patients at isolation facilities may need surgery.

While none of the country’s 84 confirmed patients has required surgery thus far, Dr Waldron was adamant that the country should be prepared for the possibility as it could mean the difference between life and death.

He said: “The surgeons have said we believe that patients, whether they have COVID-19 or not are patients and deserve a high standard and at least the minimum standard of care and we are unwilling to drop that standard below what we think is minimum.

“That is why I have stepped out here to speak with the public because I don’t want to say we were asking for this and something happens to a Barbadian and I feel guilty because I didn’t say enough.

“I could be one patient who is your father or your child or your best friend.”

kareemsmith@barbadostoday.bb