Long wait for care

For more than two months now, Deangelo Cooper, a 36-year-old construction worker originally from Long Island, has been waiting for someone from Princess Margaret Hospital (PMH) to contact him regarding a procedure he needs to identify why his blood count got so dangerously low that he collapsed on the job site in Exuma and had to be flown in on an emergency flight to New Providence on June 1.

But with the COVID-19 pandemic placing an unprecedented strain on the public healthcare system, Cooper is among those non-COVID individuals who are finding it difficult to access care.

Those with COVID and suspected COVID cases from the Family Islands are also being told by PMH that there is no space left at the facility, which is buckling under the weight of an unrelenting surge in cases.

There have been more COVID cases confirmed in The Bahamas this month than any other month since the start of the pandemic.

But while we place the daily spotlight on COVID, as is the obvious thing to do given the current crisis, we do not talk often enough about individuals like Cooper who need to access the health care system for desperately needed care, but are unable to do so. 

In some cases, doctors have told us, this inability to access care has led to early demise.

“Looking at the deaths in 2019 and comparing them to the death rate in 2020, now we will have another year where we can look at the death rate in 2021 and see that more people are dying,” said Dr. Marcus Cooper, the former president of the Medical Association of The Bahamas, who specializes in internal medicine and gastroenterology.

“People are dying from COVID, but we also have a lot of people who are dying because they just can’t get into the healthcare system; so his case is only one of many of people who have non-COVID related illnesses, whose care is being delayed and others who are totally unable to access the healthcare system.” 

But Cooper, the construction worker, is determined to fight to save his life, although his frustration is evident.

He told us that after he collapsed and was taken to the clinic in Exuma, the doctor told him he needed to travel to New Providence for urgent care. He could not go on a regular flight though.

“They were afraid if I [went] in the air [on a regular] flight I might lose consciousness,” said Cooper, adding that the emergency flight cost $2,500.

“I had to pay half of that for them to even consider me to get on it.”

Cooper told National Review that once at PMH, he waited an entire day before he was tested for COVID-19. 

He said after he tested negative, he was put in another room to await attention from a doctor.

Two and a half weeks after he was admitted, Cooper, who had been awaiting the needed procedure and had prepped for it, said he was told by the hospital that the procedure would not be possible at that time.

“They said they had to discharge me, but I’m not from Nassau. I’m from a Family Island and I have no family in Nassau to stay by so the doctor said he would talk to me,” Cooper said.

“Later on that night, another doctor came and I was sleeping. The nurse [woke] me up and said, ‘you know you discharged?’ I said, ‘discharged’? She said a doctor came and discharged me and I need to leave tomorrow.”

That meant Cooper left the hospital with no knowledge of what was causing his low blood count, nowhere to live, and no guarantee on how long he will have to await his procedure.

He said since his discharge on June 17, he has been paying $150 a week in rent, paying for taxis to get around to go to the pharmacy and to buy food, and just waiting and hoping that someone from PMH reaches out to advise when he will be able to have his procedure.

“The doctor told me to [stay] around until they get sorted out, so I thought it would be two weeks or three weeks, but now it’s been months,” Cooper said.

“It’s hard to go back and still don’t know what’s wrong, what the root of the problem is. [But] it’s only so long a person can do without working.”

He said that prior to his illness, things had already been tough.

Three years ago, he moved from Long Island, where the economy was slow, to work in Exuma.

When COVID hit last March, everything slowed down. He was getting work two days a week, so paying for an emergency flight, paying for medication, and supporting himself in New Providence has been especially difficult.

That it is an indefinite situation has made it even more taxing.

“If I did not hear from them the end of the month or the first of September, I was going back to Exuma by myself and try to work to make some money and come back and go private because I checked private and most of private is $2,500,” he said.

That he considered returning to Exuma despite being advised by a doctor to stay put in New Providence, speaks to the tough circumstances he has faced in the long wait for care.

CHALLENGED

His challenges are amplified across the healthcare system, Dr. Cooper told National Review.

Princess Margaret Hospital has canceled elective surgeries, as has Doctors Hospital. PMH has also indefinitely suspended specialty clinics.

“All of these things are going to result in people who are going to get a lot sicker, people whose disease is going to progress and they are going to present with late stage cancers when initially it was stage one or stage two, and then people who are going to die because they’re going to end up with stage four cancer or they’re going to bleed out or they’re going to have heart attacks, whatever the case may be, that are not being attributed to COVID, but it’s really the result of what’s happening and the inability to facilitate these people,” Dr. Cooper said.

“We have limited resources and they are all being consumed by people with COVID.”

He said the refusal of so many people to get vaccinated against COVID-19 is making it harder for non-COVID patients who should be receiving care to prevent their illnesses from progressing.

“They’re going to the hospital with COVID, they’re getting admitted and they’re getting on oxygen and these people (non-COVID individuals) who need to be admitted and go to the hospital can’t go. It’s sad and it’s very unfortunate that we’re in this situation,” Dr. Cooper said.

“We’re just going to continue to tell these people you can’t have your surgery; you can’t have your procedure done. We cannot get this breast lump out until next year.

“We can’t address your cancer. We can’t diagnose it, although we see it on the cat scan. Are we just going to continue to tell them that we’re waiting for this thing to blow over when all of the experts are saying it’s not going anywhere anytime soon?”

For now, many like Cooper are being told to hang on – and there is no indication when hanging on will end for the better.

“And so, I’m calling these people who have problems and telling them to hold on; let’s see what it looks like in three months and if it’s not better in three months, hold on,” Dr. Cooper said.

“Let’s see what it looks like later in the year. But when you are facing what you think may be death in the eye, that’s not comforting. Minutes seem like hours when you’re waiting that long, weeks and months.”

He said the oncology center is overwhelmed and is not taking any new patients, particularly patients who don’t have cancer, although they, too, are in urgent need of attention.

So, is there a solution to bring relief to the hospital and to help individuals like Cooper access care?

Dr. Cooper acknowledged that there is no easy fix, and that the blame game is unhelpful. He said the hospital needs to look at outsourcing some of its services.

“We don’t need to have hospital-based clinics,” he said.

“Find some place for the specialty clinics to see patients that are outside of the hospital. I don’t think it’s acceptable to say that clinics are canceled indefinitely. Find the space.”

He questioned, “Why aren’t we finding a way for some of the hospital-based diagnostic services to be done in some of the private facilities at a discounted rate?”

In the meantime, Dr. Cooper has been trying to accommodate some public patients where he can, privately, with the full knowledge that they do not have the means to pay for that private care.

While he still had no word on when his procedure will take place or how it will be paid for, Cooper, the patient, was recently contacted by Dr. Cooper, who agreed to see him in his private practice this week.

The two have no known relation, but Cooper said perhaps it is a divine sign that the two share the same last name.

The call from Dr. Cooper has given him hope that perhaps he will finally get the medical attention he desperately needs, and deserves.

The post Long wait for care appeared first on The Nassau Guardian.

source https://thenassauguardian.com/long-wait-for-care/