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May 3, 2006

K.H.M.H. controversy questions state of medical care

Story PictureAnd while that investigation is confined to the case at hand, the controversy surrounding the two year old’s death on Saturday has become a lightning rod for all manner of problems afflicting the nation’s health care system, particularly the K.H.M.H. News Five’s Kendra Griffith reports.

Kendra Griffith, Reporting
The Karl Heusner Memorial Hospital is the biggest healthcare provider in the country, treating approximately sixty-five thousand people each year. Not surprisingly, it?s also the most controversial, with a sizeable number of complaints. Some of the more dramatic cases are well known: AIDS tainted blood, foetus in the laundry, and more recently the tragedy of baby Kimora. But most of what happens at the K.H.M.H.?good and bad?never makes the headlines … and if the institution is to progress, it is in those areas?finance, personnel, administration?that improvements must be made.

Dr. Alvaro Rosado, C.E.O. K.H.M.H.
?I think we have inherited a culture, the hospital grew up and the employees developed a culture that is not the best when it comes to public relations. I don?t think our patients are seen as our bosses, they are more seen as people begging for service and that is one thing we have been trying to change with the K.H.M.H. staff. We have been trying to say, these are the people who allow you to have a job, treat them with the respect that they need. I think that?s the biggest problem we have, the P.R. problem. The matter of not having a resource here and there, yes that is problematic, but that?s not unheard of in any hospital. I don?t know of any hospital that would have everything at any one time that they are needed.?

At a press conference on Tuesday, Medical Chief of Staff Dr. Curtis Samuels explained that the K.H.M.H. does the best it can with the little it has.

Dr. Curtis Samuels
?We have the general surgical department who are always crying out for equipment; we have the paediatric department we are in need of a ventilator; we have the special care baby unit, which actually is getting by on purely donated radian warmers and incubators and we have made requisition and Mr. Knowles, our acting finance director can tell you that we have on the list of equipment to purchase brand new radiant warmers and incubators. So all in all, it?s a juggling act whereby we try to purchase, wherever possible, equipment that are needed.?

?Medical equipment isn?t one cents. Medical equipment costs thousands and thousands of dollars. We?re talking about?as a matter of fact, that drill that we just bought the other day, sixty-three thousand U.S. dollars, it?s not chump change we talking about. The CAT Scan for a million dollars.?

C.E.O. Dr. Alvaro Rosado today told us that the majority of the money used to finance the running of the K.H.M.H. comes through subsidies from Belmopan.

Dr. Alvaro Rosado
?This year, 2006-2007, the budget of the K.H.M.H. will be in the region of seventeen million dollars. Of the seventeen million dollars, the government will be providing twelve million dollars in cash, another one million dollars in payments for utilities, they pay directly for water, electricity and the telephones, and another two million in pharmaceuticals and medical supplies. So it will be a grand total of seventeen million dollars that will be contributed by the government of Belize. There will be another one point seven million dollars that K.H.M.H. will have to raise internally to support the budget that it has proposed for this year. So the actual budget in fact is eighteen point seven million dollars.?

?About seventy percent of that budget, total budget goes to salaries; another five percent?the big chunks I am talking about?another five percent goes to materials and supplies, including pharmaceuticals that we buy outside of what we get from the Ministry of Health. Another five percent goes into contracts for laundry, for the yard, that kind of thing; and another five percent goes to the purchase of equipment and servicing of equipment.?

The one point seven million dollar internal budget is raised through services which include the private ward, specialist clinics and morgue fees. But according to Rosado, patients are not paying their bills, and more disturbingly, some doctors are referring patients to lucrative private medical practices.

Dr. Alvaro Rosado
?Well it has affected the K.H.M.H. as an institution in the sense that, we are not serving the population and collecting the monies that would normally come to this hospital. But I think the biggest effect is really on the patients who have to go to the private sector to pay for a much more expensive care than they would have to pay here at K.H.M.H. … The majority of the doctors are dedicated doctors who will go the extra ten miles to make sure that the people of Belize are served at K.H.M.H. The few that will do the luring and coercion are getting less and less and we are trying to wipe it out all together.?

?We were collecting less than thirty percent of the bills that were issued, less than thirty percent. We are now probably up to more like thirty-five percent. Not a big deal, but is it to us–when I say thirty percent I mean last year over the years. Previously, when we first took over we might have been collecting ten percent. In fact it was so bad we weren?t even billing. People were just walking out, there was no systematic building of patients. Now everybody that comes to K.H.M.H. gets a bill, but you get your bill when you leave so you are not refused service because you can?t pay.?

But while the hospital will try to clean up its act, they have also embarked on an ambitious plan to bring the entire institution up to scratch.

Dr. Rosado
?PAHO, the Pan-American Health Organization has developed a set of criteria that they say this is what the normal hospital should have and the level it should have. For example, they are saying that if you have a kitchen, then you must have at least give different means on a daily basis; one meal for people with diabetes, another meal for people with high blood pressure, another meal for people who can only take soft foods and so on, you have that five basic meals. The meals must be delivered warm, the kitchen staff must have a certain degree of training, and these are the levels they are saying if you reach this level, you are considered to be at level one for the accreditation purposes. If you want to go beyond that, then they?ll probably say you must have a trained dietician, you must have other things in place to get to level two. What we are doing now, the roadmap is to use PAHO?s level one accreditation and to look at every aspect of this hospital and say now, are you at level one? If you are not, then what do we need to do? We will take the monies that we have to purchase whatever it needs to bring that department up, so that everybody is on the same level. Those who are above level one, of course will be left there and will be maintained at that level at this time.?

Kendra Griffith reporting for News 5.

The Board of Directors of the K.H.M.H. consists of Dr. Alvaro Rosado, Dr. Curtis Samuels, Cecil Knowles, Angela Wade, Laurel Grant, Sister Delcie Lizama, and Mavis Palacio.

When asked about the Ministry of Health’s probe, Dr. Rosado says that the K.H.M.H. has no fear of the investigation and looks forward to the ministry’s determination of any wrong doing.

Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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