Dr. Trevor McCartney, chairman of the Medical Council of Jamaica and senior medical officer, Kingston Public Hospital at The Gleaner's Editors' Forum on the State of the Nation's Health, held at the Jamaica Pegasus Hotel in New Kingston.
JAMAICA HAS a comprehensive health service with a highly developed primary health care system provided through a network of 331 Government health centres and 24 hospitals. Most, over 90 per cent of hospitals beds, are in the public sector. Private health centres, an increasing number of private family practitioners have increased considerably in recent years, and has had a significantly positive impact on the standard of primary care offered across the island. And, if we look at this private involvement in primary care, private ambulatory visits have increased from 30 per cent of all ambulatory visits in the 1960s to 75 per cent in the early 1990s and have declined somewhat to about 50 per cent in year 2002.
HEALTH SECTOR HAS GROWN
The number of private pharmacies, laboratories and diagnostic facilities has also grown considerably. We must not forget the contribution of non-government organisations, particularly the churches, as they play an important supportive role in health in a limited number of areas, by the use of their church clinics.
Alternative and complementary health options have increased considerably in recent years. There are some concern that this sector is largely unregulated and offers a wide range of untested modalities, but they appear to have a broader feed amongst the population. We must not forget that many persons, especially in rural areas, also visit traditional healers. When the Jamaica perspective was developed in 1978, the focus of the primary care programme was on the prevention and eradication of infectious diseases and the diagnosis, treatment and prevention of malnutrition. This has been a very successful programme and today Jamaica is free from small pox, polio-myelitis, malaria, yellow fever and yaws, and the incidence of pertosis, hooping cough, tuberculosis, diphtheria and tetanus is very low. Measles is on the verge of elimination.
NEW INFECTIONS HAVE EMERGED
Over the past decade considerable progress has been made in controlling vaccine preventable diseases and eliminating polio-myelitis, measles and rubella, including congenital rubella, syndrome, rates of infectious syphilis, congenital syphilis and gonorrhoea, although we are worried about the rising incidence of chlamydia, herpes, and the the HIV epidemic. This growing concern sees approximately 25,000 Jamaicans estimated to be living with the HIV AIDS virus at this time.
CHALLENGES REMAIN
There remain several challenges. Many infrastructure and maintenance problems remain; shortages of drugs and medical supplies are common, and development programmes are curtailed due to budgetary constraints. Personnel problems continue to be a major concern as we grapple with the fledgling budget, and this leads to some amount of demoralisation, demotivation, disillusionment and frustration in members of the health team. Nevertheless, they are striving to produce the level of health care that the people expect.
Dr. Trevor McCartney, chairman, Medical Council of Jamaica, Association of Government Medical Consultants
