PHILIPSBURG--The need for more medical specialists in St. Maarten, staff shortages at St. Maarten Medical Center (SMMC) and the black market sale of medicinal products on the streets were some of the issues raised during the Philipsburg Mutual Improvement Association’s (PMIA’s) eight annual Lionel Bernard Scott Lecture Thursday evening.
Panellists agreed that a clear vision was needed for health care, as St. Maarten moves towards her new status as country within the Kingdom of the Netherlands.
Health Commissioner Hyacinth Richardson, who addressed the audience at the end of the over three-hour long lively discussion, said the issues raised had the attention of government and had his concern.
Medical specialists
Some members of the three-man panel spoke of the chronic shortage of medical specialists in St. Maarten, as well as the impeding crisis in the delivery of women’s health care, when two of the three existing gynaecologists stop operating by year end.
Gynaecologist Dr. Michel Petit, one of the panellists, will be retiring this year, while Dr. Tjon Kon Fat is expected to leave this year. This will mean that gynaecologist/obstetrician Dr. Randall Friday will be the sole gynaecologist to serve St. Maarten along with midwife Regina Janga.
The commissioner said the pending shortage of gynaecologist is being addressed, and another gynaecologist is expected to be recruited in a few months. He said, also, that government will be asking Dr. Tjon Kon Fat and Dr. Petit to remain a bit longer.
Panellist Dr. Glen Bryson, who runs his own clinic in Dutch Quarter and who has been operating as a general practitioner in St. Maarten for the past two decades, was very frank in his opening remarks. He painted a grim picture of the situation as it related to the delivery of medical care. He said health care needed more attention. Authorities who should be addressing the issues in health care, Bryson noted, appeared to be “happy,” “complacent” and satisfied with the status quo.
Bryson argued that while there are about 20 general practitioners operating here, the island territory “desperately needed” more: an eye specialist, urologist, neurologist, cardiologist, oncologist, gynaecologist, surgeon and midwives.
However, one of the medical doctors at American University of the Caribbean (AUC) School of Medicine, who said he attended the session to get an idea of the health care system on island, questioned whether it was feasible for St. Maarten to have a medical specialist in every area. He questioned whether this was justifiable given the island’s population. He also queried whether it would not be more practical and feasible for the French and Dutch sides to cooperate and make use of each other’s medical practitioners and services.
Panellists and moderator Eugene Holiday said the issue is a political one. While the French and Dutch sides have close ties historically, each side is governed by different laws.
Panellists also spoke of the difficulties encountered in attracting medical specialists to St. Maarten. Alluding to the difficulties encountered by Dr. Friday when he returned to St. Maarten to operate, Petit said certain issues were making it less attractive to start up here.
Richardson said he had been assured by SMMC General Director Dr. George Scot that medical specialists would be recruited for St. Maarten. He said Scot had indicated that this will be done in collaboration with a medical institution in the Netherlands. “I can tell you that we will be able to bring the specialists here,” said the commissioner.
Care at SMMC
The working environment at SMMC was one of the issues that drew much reaction from the audience.
While Petit was critical of the working environment at SMMC and said the service level at SMMC had dropped over the years, panellist Dr. Felix Holiday was in defence of SMMC, saying that the service is at an international level.
Petit said the hospital is severely short staffed which he said has a direct effect on the delivery of quality care. He said SMMC, in its attempts to lower its cost for profitability, is sacrificing care. He said he has seen the level of service at SMMC plummet over his 30 years operating in St. Maarten and there was a dire need for more staff. He said, for example, there were only two nurses assigned to one ward and if one of them went on vacation, it was a strenuous task on the other.
Touching on the issue of salaries, he said medical professionals abroad were also earning much more than at SMMC.
Orthopaedic surgeon Dr. Jack Bocher, a member of the audience, alluded to one case in which one person had been trained abroad in orthopaedic care, but subsequently left to work elsewhere where the pay was much higher.
Holiday stood up for the care at SMMC, arguing that SMMC treats many tourists, in addition to the local populace, and its service was at an international level. He said also that many cruise lines come to St. Marten because the SMMC is able to deliver quality care.
Taking a jab at Petit’s arguments, Dr. Bocher said the SMMC should not be ridiculed because of someone’s personal issues with Scot, an assertion that Petit dismissed.
Street sale
In his very candid presentation, Dr. Bryson spoke about the sale of drugs on the streets. He said antibiotics, birth control pills, and hormonal pills can all be purchased on the streets.
He also alluded to the wide use of detoxifiers and intestinal cleansers which he says people spend a lot of money for to “purge out” but which he said has little medicinal benefits.
Bryson said over the years the focus has been placed on tourism while health care has been neglected. “Health care needs to be developed,” he told the capacity crowd.
Other issues raised at the forum include the revamping of the medical insurance system and the need for a vision for health care.
One panellist also said that medical professionals should be included in the discussions for the National Health Insurance System (NHIS) being developed for Country St. Maarten.
Mental health
In response to statements by Mental Health Foundation (MHF) President Eileen Healy about the lack of attention to the MHF and the foundation’s need for land to develop and offer better services, Richardson said land has already been identified for the foundation in the vicinity of the St. Maarten Park (zoo). Richardson said he had asked Healy to follow up on the matter. However, if she did not, he will.
The commissioner, who said he had met with Healy about three times since taking office, said he is aware of the issues. He said over the past seven months, he has been working on several issues including averting a strike at the SMMC and assisting Dr. Friday to obtain his license.
On the issue of students returning, Richardson said, while in the past students who returned were told that they were overqualified, he has already brought back a health care professional who currently works at the Sector Health Care.
The Health commissioner told the capacity crowd that he has had several meetings with people in the health sector since assuming the health portfolio and their concerns had his attention. He stated would do whatever he could to iron out the problems that exist.
The forum, themed, “Health care in St. Maarten, its status and future,” was lively and informative.
