PROF. ARCHIE MCDONALD, Head, Department of Surgery, University Hospital of the West Indies (UHWI):
OVER A six-year period, there were just over 25,500 admissions to the surgical services at the UHWI and one-third of them, about 8,500, were due to injuries.
About 70 per cent of patients were less than 40 years old and males were three times more likely to be injured compared with females. Patients stayed in hospital between one and 370 days. About 255 of them required intensive care and they spent between one and 50 days in the Intensive Care Unit.
Violence-related injuries accounted for the majority of these cases (about 40 per cent). Fifty-one per cent of the injury-related cases were caused by stabbings and 22 per cent by firearm. There were 260 deaths, 43 per cent due to violence-related injuries. Over an 18 month period, from December 2003 to May 2004, injured patients were billed $24 million by the hospital. It collected a mere $5 million. Injuries accounted for about 14 per cent of the hospital's entire annual budget.
Trauma care is not good
For the 10-year period, 1991 to 2000, there were 7,966 murders in Jamaica, an average of 796 annually. The murder rate increased from 561 in 1991 to 887 in year 2000. The number of murders in Jamaica increased over 280 per cent between the decade of the 1970s and the decade of the 1990's. There were 2,686 murders in the 1970s, 4,860 murders in the 1980s, 7,621 murders in the 1990s...If we extrapolate that graph to the end of the present decade, we can expect well over 20,000 murders for the decade 2000 - 2010. I think we are well on our way to achieving this unless something is done to decrease the incidents of the graph.
Data available for implements used in murder (from the police) was only available for the years 1995 to 2000. The gun was used in 64 per cent of murders, knives in about 20 per cent.
Controlling injuries is not just a matter of prevention but we must ensure that those who are injured receive proper care. I think that trauma care, given to injured patients in Jamaica is not good, by world standards. We run a trauma training programme for doctors -- the Trauma Advanced Life Support course (TALS ) but our efforts to raise funds for this programme have been futile to date. The programme has been funded from the pockets of the instructors.
It has been shown in several areas in the USA, that murder rate declined when order and discipline is restored to society in general. Although we keep speaking about community policing, I do not think that we have taken enough time to determine what are the measures involved in these programmes. Community policing played a significant role in reducing the murder rate in New York but equally important was the zero tolerance policy implemented by then Mayor (Rudy) Guliani. In Jamaica we continue to ignore indiscipline and minor crimes. We need to restore order to our streets by prosecuting individuals for minor crimes, like traffic offences, blocking roadways, illegally occupying lands, illegal vending.
