It is logical and common sense and widely accepted that to occupy the highest position in any organization — political, religious, military, etc., the individual must be well-trained and possess the expertise in the matter to be dealt with and resolved. At the same time, one must also possess wide vision of the present, and a long projected view of the future. The present administration has indicated some awareness of this principle by assigning the Ministry of Agriculture to an agronomist. Likewise, an architect was appointed as Minister of infrastructure. A lawyer, however, was illogically designated to be the Minister of Health and Wellness (MOHW).
Belize is actually under the BRUTAL attack of a biological hurricane: the Covid-19 pandemic. This has clearly shown to the public eyes how fragile and DYSFUNCTIONAL our public health system is. For decades Belize has suffered from the absence of a well-trained expert in the medical field at the head of the Ministry of Health. Lawyers, accountants, doctors of philosophy, ELECTRICIANS etc. have held that IMPORTANT office in our society. None of them have possessed the vision to develop long-lasting healthcare plans, or the ability to improve medical technology, medical infrastructure etc., for a simple reason: They are not trained in medical practice, have no experiences in complex situations in hospitals and polyclinics, and totally lack epidemiological knowledge etc.
The results are entirely now open to public view: lack of hospital beds, lack of medical technology (ventilators, infusion pumps, monitors etc.). We also lack new hospitals, and we lack well-trained physicians in ICUs in each regional facility, because right now the only physicians trained in intensive care are all localized in Belize City. We lack state-of-the-art technology at our Central Lab, and there is a shortage of nurses, novel medicines etc. Another factor that contributes to the general dysfunction of this important social service is the placement of the famous political appointees in leadership roles as regional managers and administrators of hospitals and polyclinics, although they have no real knowledge or experience to execute with quality the tasks involved in those positions. A classical example is the Southern Regional Hospital (Dangriga) that actually is in chaos.
Demographically, Belize has grown. In simple words: our population has increased, and so have the needs for medical attention as well, but due to a lack of a projected view towards the future, there is only one national public tertiary hospital for references, the KHMH. At this facility, there is complete STAGNATION, due to a lack of infrastructure, beds, modern technology, higher-level ICU facilities, and specialists such as rheumatologists, toxicologists, hematologists, infectious disease experts etc. The situation is so dire that sometimes patients have to wait days at the emergency room for available bed in the wards.
To make things worse, the “autonomy” that the KHMH enjoys has made it an “almost private facility”. This has created an institution that is a “7-headed monster”, virtually independent from the MOH. The KHMH is so free that practically it does not use the Belize Health Information System, thus avoiding scrutiny by the rest of the medical community.
Let’s look at examples of lack of vision in dealing with current realities. Tuberculosis is a social disease, because it is linked with poverty, malnutrition, alcoholism, poor housing, drug addiction, HIV etc. Tuberculosis is totally present in Belize, because the root causes mentioned are present among us. In despite of this real situation, the nation does not have a quarantine hospital for the temporary admission of the TB patients during the first phase of treatment in order to prevent the spreading during the sputum positivity. When the patient becomes sputum-negative, the patient may be discharged for ambulatory treatment under the supervision of the proper medical facility.The lack of that facility makes it very complicated to control the transmission of the disease to siblings, friends and the community in general.
It is painful to observe patients affected by psychiatric diseases wandering freely in the streets without masks and searching for food in the trash. It is obvious that this type of patient can be easily spreading COVID-19 or TB bacilli. Why do we have this painful spectacle? Because we do not have a REAL PSYCHIATRIC hospital to house them and give them proper treatment. The facility at the Belmopan hospital is not adequate.
Let me describe the anguish and pain of the relatives of cancer-affected patients. Those mentioned are soliciting money in the streets, selling raffles, selling BBQ etc., in order to get funding to take their sick relative to Merida or Guatemala City, because in Belize resources are limited. As my learned friend put it, we have a very fragmented referral and treatment system. We have a problem with care continuity due to inadequate communications among clinical providers that has resulted in little disconnected islands of care delivery. WE need a more integrated system so that patients do not fall into the cracks. In other words, the system is totally DYSFUNCTIONAL, and the most affected are patients and their relatives. It is logical and necessary to carry out a profound reform of this system in order to provide a better service for the patients suffering from cancer.
Another questionable matter is the importation of the Ministry of Health’s supply of medication, and the quality of that medication. This aspect of the Ministry of Health’s operations was covered by a “dark cloud “ during the last administration. A deep look at that aspect would be good.
It is obvious that what is necessary is a profound reform of our public health care system in order to provide better service to our common population. I believe that the attorney-at-law Mr. Michael Chebat undoubtedly is a competent lawyer and will be an excellent legislator and politician. But at this specific moment, he is not the right person to occupy the commanding bridge of the MOH. We have in our country several competent and well-trained physicians who are certainly able to assume the responsibility of the top position of the MOH at this turbulent time.
With deep respect, many of us question what medical qualifications and experience in the management of complex administrative situations in the public health care system does the new CEO in the Ministry, Dra. Deisy Mendez, possess, that will enable the CEO to carry such a great responsibility, specifically at this critical moment facing the nation.
Dr. Eduardo Carbonell