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<span style="font-weight: bold"><span style="color: #CC0000"><span style="font-size: 17pt">Two to a bed - No jubilance at Jubilee hospital</span></span></span>
Published: Sunday | December 7, 2008
Photos by Tyrone Reid
LEFT: Tight Squeeze: Two expectant mothers share a bed on the labour ward at the Victoria Jubilee Hospital in Kingston. There is not much room for turning.
RIGHT: Two mothers sit on a wooden bench at the post-natal ward at the Victoria Jubilee Hospital in Kingston, during visiting hours on November 4. The mothers said they had given birth earlier that day and had been waiting for close to two hours to be admitted to the ward.
Tyrone Reid, Staff Reporter
MANY OF the mostly poor women who have their babies delivered at public hospitals are forced to share a bed designed to accommodate one patient, with one, or sometimes two, other expectant mothers.
This violates the Ministry of Health's ideal patient policy of having one person per bed. Sunday Gleaner investigations have revealed that expectant mothers are sharing a single bed at both the Victoria Jubilee Hospital (VJH) in Kingston and the Spanish Town Hospital in St Catherine.
Sources pointed out that at times, two mothers and their newborn babies were forced to share a small bed at the Spanish Town Hospital. A covert visit to the maternity ward at that hospital proved the claims to be true.
Hardly any room to turn
Two mothers and their two babies were seen sharing a small bed. At least three beds on the post-natal ward had two mothers and their babies sharing the small space. There was hardly any room to turn in the small space.
Empty beds were also seen on one side of the ward. Our checks revealed that the section was reserved for mothers who had done Caesarean sections. These mothers were not required to share, a source disclosed.
At the VJH, while The Sunday Gleaner did not see two mothers and their babies sharing a bed, expectant mothers were sharing a single bed. And the VJH admitted to the situation.
Novlin Little, deputy chief executive officer of the Kingston Public Hospital (KPH), who has direct responsibility for the VJH, agreed that the sharing of beds was not ideal. "It is not something that we want to do, but we can't turn them away," she said.
Little refused to comment on whether the practice was unsafe for the expectant mothers. "I would not want to comment on the safety, but it is not the ideal thing to do," she explained.
The Ministry of Health also acknowledged that the risky two-to-a-bed arrangement did occur in public hospitals.
Rise in demand for beds
"Every August to December, (often called the 'crop period'), the Victoria Jubilee and Spanish Town hospitals experience an increase in deliveries.
"The demand for bed space subsequently rises and on occasions, a patient may share a bed prior to delivery," the ministry said in response to Sunday Gleaner queries.
With respect to delivered mothers sharing beds, the ministry said that did not happen at the VJH. However, the ministry failed to say if the practice occurred on other public maternal wards.
In its response sent via email, the ministry contended that barring the four-month "crop period, overcrowding is not the norm".
The ministry reported that steps had been taken to ease the congestion at the VJH. A section of the fifth floor at the VJH was opened late last month with 24 more beds, the ministry disclosed.
"Ideally, it is our policy to have one person per bed, hence the expansion. Even with this, we are still noticing an increase in deliveries as more women are opting to have their babies at the public-health facility because of the charge-free access afforded with the abolition of user fees," said the hospital's administrator.
Gov't aware of situation
However, Sunday Gleaner sources pointed out that the situation had been occurring for several years. "It has been happening for years and the Government is well aware of it. Sometimes you have to get a little 'kotch'," related a nurse at the KPH, under conditions of anonymity.
The nurse added that if patients refused to share the bed "they spend the night in a chair".
While some health practitioners say there is a shortage of beds, the health ministry denies this, adding that the real problem is the "limited physical space for expansion".
"VJH, in particular, has a plan to redesign the main maternal wards to facilitate more efficient use of the available space. This should become a reality in 2009-10, and subsequently, ease the burden on the bed requirement of the labour ward," the ministry disclosed.
<span style="font-weight: bold"><span style="color: #CC0000"><span style="font-size: 17pt">Dehumanising! Medical Association head condemns bed-sharing arrangement on public maternity wards</span></span></span>
Published: Sunday | December 7, 2008
Tyrone Reid, Enterprise Reporter
PRESIDENT OF the Medical Association of Jamaica Dr Rosemarie Wright-Pascoe has slammed the bed-sharing arrangement being employed on maternity wards in public hospitals.
Two, and sometimes three, pregnant mothers are forced to share a single patient bed. At other times, two mothers and their newborns also share a single bed.
Wright-Pascoe said this sleeping arrangement is dehumanising to women. "This is a practice that should not exist at all," she stated. "And, it dehumanises patients sharing a bed at a very vulnerable time in their lives when they are either pregnant or have just given birth."
Wright-Pascoe, in describing the situation as unfortunate, told The Sunday Gleaner that her organisation was aware of the bed-sharing at the Victoria Jubilee Hospital (VJH) in Kingston and the Spanish Town Hospital in St Catherine.
She added that while the sleeping arrangement was not particularly unsafe for expectant mothers, it posed a threat to mothers who had just given birth.
Practice not healthy
"The mothers who have just delivered are vulnerable and those mothers have relatively raw wounds (in their) private areas. And, therefore, the practice is not a healthy one."
She added: "It is also not appropriate for complete and absolute strangers to be sharing a bed in that intimate way. That is absolutely unacceptable."
Wright-Pascoe is appealing to the Government to conduct research geared towards identifying "the needs of the obstetrics and gynaecology ward" at the VJH and Spanish Town Hospitals.
Hot on the heels of that research, Wright-Pascoe suggested, should be a reasonable projection to have the needs met. "Find out what is the true number of beds you need within the next five years and provide them. And, they really should be provided. It is a practice that really should stop," she stated.
Wright-Pascoe also lamented that "the public-health sector is under-funded".
Edith Allwood-Anderson, president of the Nurses' Association of Jamaica (NAJ), argues that the bed-sharing practice is dangerous and could have serious repercussions.
"The NAJ's position is consistent with infection control, privacy and confidentiality as it affects the patients," advised Allwood-Anderson.
She added: "The standard of the professional code of conduct for nurses and the international codes of nurses clearly state that you must have a standard bed space, that not even the mother and the child should be occupying the same bed space."
Allwood-Anderson also stated that "patient confidentiality (and) dignity should not be breached at any time".
She disclosed that the reports of two mothers and two babies sharing the same bed were not recent developments.
"This, I can say, is not very new. We had managed to put that under some control. But, we note that (it) is not being looked at seriously," she stated.
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<span style="font-weight: bold"><span style="color: #CC0000"><span style="font-size: 17pt">Bed-sharing pains</span></span></span>
Published: Sunday | December 7, 2008
A look at one of the beds at the Victoria Jubilee Hospital.
Tyrone Reid, Enterprise Reporter
AS IF labour pains were not enough, many expectant mothers on the labour wards at public hospitals are forced to share beds with other pregnant women.
A 29-year-old mother of two, who gave birth to her second child on the morning of November 27 at the Victoria Jubilee Hospital (VJH), tells The Sunday Gleaner that without warning, she had to make room for another patient on the small bed she occupied before giving birth. "There was no explanation given," Wilson relates, describing the situation as "totally disgusting".
Frustration
"The beds are small ... They are twin-sized beds. That's what my son sleeps on. So imagine two adults who are pregnant," the mother says in painting a picture of her frustration with the public-health system.
She reasons that the limited space on the bed does not go well with the intimate demands of the birth process and adds more discomfort to the final stages of pregnancy.
The wait for a bed
On a recent visit to the VJH, The Sunday Gleaner saw mothers who had given birth earlier that day sitting on a wooden bench outside of the ward, waiting for an available bed. Two of the three mothers had their hours-old babies in their laps.
They revealed that they were waiting to be checked into the post-natal ward. One mother, who had given birth around noon, lamented that she had been waiting since 4 p.m. It was now minutes to six. Even after our team left around 6:30 p.m., at least one mother was still waiting for a bed to become available.
When confronted, the Ministry of Health denied that mothers had to wait that long.
"At VJH, patients are placed in a bed shortly after delivery. This is on average within half an hour.
The ministry explained that mothers sitting on a bench with baby in hand might occur for two reasons: "To process mothers upon arrival at the ward, or to administer the BCG vaccine (the first vaccine a child receives after birth). On either occasion, mothers do not wait for two hours."
But one of the mothers who had to sit and wait for close to two hours. was shocked by the ministry's denial. "Why dem keep on denying it and is true?" she queried during an interview after she had left the hospital.
# Decline in birth rate
THE REGISTRAR General's Department notes that some 45,000 children are born each year in Jamaica. The average number of live births between 1999 and 2007 is listed below:
No. of live births
1999 52,000
2000 56,100
2006 46,300
2007 45,000
Source: Registrar General's Department>
While the national live-birth rate is falling, figures from the Registrar General's Department remain high in the reproductive age group 15-19 and 20-24.
Birth rate per age group
# 2004 2005 2006
15-19 - 7,956; 8,267; 7,810
20-24 -11,596; 12,741; 11,704
Source: Registrar General's Department
According to the Jamaica Survey of Living Conditions 2006, most births in the Kingston Metropolitan Area took place in hospitals (94.4 per cent) as opposed to home deliveries. In the the rural areas, however, only 89.8 per cent occurred in hospitals. Registered nurses performed 64.7 per cent of home deliveries, while 32.1 per cent were performed by medical doctors. Nanas (uncertified birth attendants) delivered 0.8 per and the other births were unattended.
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