Kingston Public Hospital bears much of the crime burden. Last year, more than 800 patients were admitted for treatment of gunshot wounds at the Accident and Emergency Unit. - File

THE OVERWHELMING burden of crime and violence continues to bleed Jamaica's health-care system.

Last year, some 842 patients were admitted for treatment to the Kingston Public Hospital's (KPH) Accident and Emergency (A&E) unit with gunshot wounds. Sixty-two were admitted with severe stab wounds, and 99 were victims of blunt trauma.

Dr Hugh Wong, emergency physician in the A&E, told The Gleaner the unit receives, on average, 30 gunshots cases each month, with one a day or more. This number does not include those who are pronounced dead on arrival.

Dead on arrival cases

Between January and September 2008, there were 324 cases which were dead on arrival.

"It's obvious that, if you remove the gunshot cases - a large proportion of which require surgery and is time consuming, then more resources would be available to medical cases," Wong said. "When these cases come in, they take a large number of staff and a long time to sort out. Other patients have to wait.

"The patients with gunshot wounds spend weeks in hospital beds and sometimes they also require rehabilitation. The resources assigned to these cases is just overwhelming.

"Between January and Sep-tember, we used 4,000 sutures, ordered 33,000 X-rays and 122 CT scans. We do see more medical cases than patients whose injuries are caused by violence, but the resources assigned to them are disproportionally high," he explained.

A 2007 United Nations Development Programme study on crime and its cost in the Caribbean claims that violence has reached such high levels that it puts a substantial strain on medical care.

Meanwhile, results from the Estimation of the Cost of Inter-personal Violence Study, which was conducted by the Ministry of Health (MOH) in conjunction with the Pan American Health Organisation and World Health Organisation (2007), indicate that violence (directly) costs the Jamaican health sector $2.2 billion every year (40 per cent of the recurrent hospital budget from the MOH).

In 2007, a study of hospital-based data suggested that violence was the chief source of injuries in Jamaica.

More than 1,200 people have been murdered every year over the last three years. Scholars at the Mona campus of the University of the West Indies estimate that the cost of criminal violence to the country alone is between four and five per cent of gross domestic product.

The Estimation of the Cost of Interpersonal Violence Study said that the burden of injuries related to violence "translates into the cancellation of one in every three elective surgeries at our major trauma hospital which is the KPH".

Additionally, other studies conducted at the MOH reveal that 73 per cent of hospital-referred injuries are caused by simple fights or arguments.

In 2006, approximately 13,150 violence-related-injury visits were recorded in the A&E departments of eight government hospitals - namely Cornwall Regional, Kingston Public, Savanna-La-Mar, May Pen, Mandeville, Bustamante Hospital for Children, Annotto Bay and Spanish Town, representing 37 per cent of all other visits.

St Ann's Bay Hospital is the only hospital not represented in this data.

In the KPH Tertiary Intervention Homicide Reduction Action Research Project, in which 260 people were interviewed, the data suggested that many of the cases of violent victimisation were preventable and that interventions aimed at secondary prevention might have considerable promise.

This is further supported, the KPH report suggests, by the fact that most victimisation is the result of interpersonal violence.

Through its violence prevention programme, MOH has stated its intention to implement several mitigating strategies, including the implementation of leadership training involving parents.

Developing strategies

They will also be developing strategies for communities to create leaders within specific settings with a view to reduce high-risk behaviours, continue support of community cluster sporting competitions and remedial camps and use backyard gardening and animal rearing as a means of income generation for high-risk youth.

The MOH said it was also planning accelerated participation in the strengthening of structured, supervised after-school activities (through the Learning for Life Literacy Programme in collaboration with the Dispute Resolution Foundation) in Spanish Town. The activities are aimed at allowing youths to empower themselves as well as their communities.