A New NICU for KHMH following Baby Deaths Print
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Written by Shane D. Williams   
Thursday, 06 June 2013 00:00

Prime Minister Hon. Dean Barrow at KHMH Press ConferenceThe Karl Heusner Memorial Hospital (KHMH) held a press conference on Thursday, May 30th, to give an update on its investigation into an outbreak in the Neonatal Intensive Care Unit and the medical professionals’ response to that outbreak that caused numerous neonatal fatalities.

At this point in the investigation, Chairman of the Board of Directors of the KHMH, Chandra Nisbet-Cansino, believes that no individual could be blamed for the unfortunate incident. She said, “I'm not saying nobody's head will roll but nobody's head is rolling at this time.” Cansino elaborated, “We have had detailed discussions with the head of the Pediatric Unit and their response was really timely, they did what they were suppose to do and, when they were supposed to do it.” Director of Medical Services at the KHMH, Dr. Adrian Coye, explained his team’s response. He said, “Around the tenth of May it was recognized that a baby became unwell and this baby was screened and cultures did not show any positivity for any organism and the baby died as a result of sepsis.” This was alarming because there was no positivity for any organism. No new patients were admitted into the Neonatal Intensive Care Unit after that day because, according to Dr. Coye, “It was recognized by the clinical team that babies were becoming septic and becoming unwell very quickly.” After speaking with the head of Infection Control at the hospital, they decided to make changes to the antibiotics being used and close the unit to new patients. Dr. Coye said it would not have made sense to close the unit and move the patients since they were already in a controlled environment. They then restricted visitations and emphasized the wearing of gloves, proper hand washing and other sanitation measures. Despite the continued antibiotic changes, seven babies died as a result of the outbreak.

Dr. Ricardo Bustamante is an infectologist from Chile who is representing the Pan American Health Organization in the investigation at KHMH. He said, “Outbreaks are unfortunate events that happen in any hospitals around the world. I come from Chile and in Chile we also have outbreaks.” He continued:

“I think that the measures that were taken of the awareness of the authorities from the hospital and the Ministry of Health - from the country itself - were done in a timely manner. Sometimes it isn't easy to identify an outbreak and here you had an outbreak that started in a very short span of time, we're talking about ten days where 6 or 7 newborns got infected and died. It's not always easy to be aware that this is an outbreak - most of the time it happens that doctors start treating them and giving them medications but none of them are aware that this would turn out to a certain common source of infection that they did. So I think that the approach that they did here was in a timely manner, unfortunately it created several deaths."

While outbreaks are inevitable and blame cannot be placed on an individual, Cansino believes the situation was handled poorly; specifically in terms of reporting to hospital superiors. She said, “We would have liked that the C.E.O. knew about these events as they were unfolding. And so, we as a board will have a conversation with him probably to strengthen that area. As a board as well, if there is a crisis in the hospital we also feel that we should know.” The hospital is also reviewing its policies to better control the environment for patients. They will be strict on visitation rules. The rule is one visitor per patient. However, that is often ignored because of a culture. Dr. Gary Longsworth, C.E.O. of KHMH, refers to it as “apply to everybody but not me”. He says the rule will be fully enforced going forward. Secondly, vendors will be moved further away from the hospital. The short term plan for the improvement of the Neonatal Intensive Care Unit requires the ward to be closed for six to eight weeks for sanitizing and upgrading. The main challenge for the unit is that the ward is designed for ten patients and it is regularly required to treat much more, often double that amount. The long term plan for improvement of pediatric care will address that situation.

On June 13th, 2011 Douglas Jackson, President/CEO of Project C.U.R.E., Hon. Pablo Marin, Minister of Health, Alan Gobie of the Gobie Foundation and Dr. Francis Longsworth, CEO of the Karl Heusner Memorial Hospital, joined Kim Simplis-Barrow, Special Envoy for Women and Children, to break ground on the hospital’s own Pediatric Intensive Care Unit. On one of her visits to the KHMH, Mrs. Barrow saw the need for a pediatric ICU. She raised funds by holding charity banquets and presenting her ideas to other philanthropist. The Pediatric ICU will cost over three million dollars. Alan Gobie of the Gobie Foundation pledged an extremely generous donation of $1 million, Douglas Jackson said Project C.U.R.E. would donate over a million dollars in medical supplies and equipment and other organization made pledges as well. However, there have been delays in actually receiving the donations because of the technicalities involved with such donor agencies. Therefore, Prime Minister Barrow announced that the Government of Belize will provide $500,000 for the construction of the structure to commence. This will get the ball rolling and perhaps prompt donors to speed up their transactions.

Dr. Longsworth said that the pediatric ICU will take eighteen months to two years to complete. The need for a pediatric ICU and overall greater focus on children’s health in Belize cannot be over emphasized. There is something like 1 pediatrician for every 25,000 children in Belize. Pediatricians are very important players in the healthcare system of a country as children are the most vulnerable patients and they need specialists’ attention. Any organization or individual wishing to contribute to the establishment of the facility can make out a cheque to the Karl Heusner Memorial Hospital Pediatric Intensive Care Unit (KHMHPICU) or make donations directly to the special Envoy’s office at the Whitfield Tower on Coney Drive in Belize City.