By Klao Bell, Senior Staff Reporter
The cramped space of a male ward at the Manchester Infirmary - Ian Allen/Staff Photographer
THE STRONG odour of urine hits. Beds and people are scattered within and outside of rooms of decrepit wooden buildings. This is the home of 71 elderly, mentally ill and disabled men and women.
This is the Portland Infirmary.
But this description also fits that of several other infirmaries across the island. In fact, official reports fall just short of describing them a clear and present danger, both to the inmates and staff.
A 1999 report on the status of infirmaries, commissioned by the Programme Co-ordinating and Monitoring Unit (PCMU) at the Office of the Prime Minister (OPM) is explicit:
"The health care services are less than desirable as the human resources available are grossly inadequate to deliver the quality services desired. The physical conditions of the plants require immediate and significant refurbishing and renovation. The infirmaries are not being provided with adequate financial resources to cover the necessary and inescapable recurrent and capital expenditures."
The report called for the urgent overhauling of the facilities of the 13 Parish Council-run infirmaries which house about 1,500 people. The findings do not apply to the exemplary Golden Age Home in Kingston, which is run by a board of directors and an administrator.
A later report in 2002 showed that "renovation or expansion would be uneconomical. The management systems are ineffective e.g. poor record keeping" and that "the Ministry of Local Government has consistently failed to provide the funds needed to operate infirmaries at desirable levels."
Most infirmaries struggle financially as Government subvention is often way below the operating costs of the facilities. For example, the expenditure for the St. Catherine Infirmary for April to August 2001 was $1.4 million while the Government subvention of $800,000. Under this arrangement, there seems to be a tacit expectation that civil society would assume the shortfall. As a result, a part of the matron's implicit duty is fund-raising and soliciting.
"If it wasn't for the church groups, the service clubs, Food for the Poor and others, I don't know how we would manage," explained Matron Hilda Richards.
The report acknowledged that "infirmaries with a strong and dynamic matron usually get greater and more consistent support from their community." But the spin-off from inadequate funds is poor quality meals, low salaries, inadequate staff and unsuitable health conditions.
In eight of 13 Parish Council-run infirmaries, the ratio of toilet and shower facilities per patient is way below the Ministry of Health standards."The situation of large numbers of residents being required to share toilet and bathroom facilities is unhygienic and a threat to good health."
INADEQUATE FACILITIES
At the St. Thomas Infirmary, the ratio of toilets available to male residents is 66 to one, while 44 women share one toilet. At the Manchester Infirmary, the ratio of bathroom and a shower facilities per female resident is 14 to one, while 60 men share one bathroom and shower. The Ministry of Heal-th's standard is eight to one.
"The conditions are not suitable, the place is small, too congested. You can't have sick people so close together. The situation is not good," said Matron Ivy Williams of the Manchester Infirmary.
Meals at some infirmaries look like a mush of rice, grease and chicken. Residents complained to The Gleaner team that the food was either bland, or "same thing every day."
"Sometime if I raise a little money I pay the cook extra to cook my thing with little seasoning," one resident disclosed. "Every day is the same thing, rice and chicken back," another whined. Matrons however, insisted that nutritious meals were being served.
The residents occasionally get a reprieve when service clubs or church groups treat them to a special meal. But outside of this, the reports confirm what their taste buds suspect.
"The Ministry of Health... recommends... meals shall be of sufficient quantity, proper form, consistency and temperature...The amount spent on food... is not sufficient to satisfy these."
The average meal costs between $7.58 (St. James Infirmary) and $17.49 (St. Thomas Infirmary) to prepare. In Clarendon, the cost of each meal was $9.41 while St. Mary spent $9.26.
The 1999 Survey of Living Conditions "indicates that the mean consumption on food annually in rural areas is an average of $25.66 per meal," for the general public. The report found therefore that most of the infirmaries spent on average less than $10 per meal. St. Catherine, however, had the highest standard, spending $35.16 per meal.
"Some might complain about the same meal too often, but we do try to vary the food. The fact is chicken and fish are easier to prepare for them, given their age. We also prepare separate meals for those who are diabetic," explained Matron Hilda Richards of the St. Catherine Infirmary.
The report said St. Ann, Man-chester, St. Catherine and St. James offer "more balanced meals."
Ultimately, the recommendations of the report point to one conclusion: that the existing facilities need to be razed and the way cleared for new facilities, a new management structure and a sustainable way of operating.
"The study of the infirmaries provides overwhelming evidence that the existing system is failing to satisfy any of the Ministry of Health's regulatory standards, demonstrates weaknesses in management systems and structure and projects an institutional image that requires significant overhaul."
