St Helena Online

Tag: health

UK hospital agrees to operate on severely disabled Saint girl – but only after judge denounces three others that refused

Nuffield Orthopaedic Centre, by Steve Daniels. Published under Creative Commons licence - click the pic to learn more
Nuffield Orthopaedic Centre, by Steve Daniels. Used under Creative Commons licence: click the pic to learn more

A Saint teenager with “catastrophic” disabilities is to be given a desperately-needed operation in the UK – but only after three National Health Service trusts REFUSED to treat her.

St Helena’s chief justice, Judge Charles Ekins, said it was “shameful” that three hospitals apparently could not afford to take her, even though she was entitled to NHS treatment.

The 19-year-old girl, who can be referred to only as K, has severe deformities in her arms, “useless” lower limbs, and severe spasticity – among other conditions. Her profound learning difficulties mean she can barely communicate.

She was due to sail for Ascension Island on 21 April 2015 to meet a dedicated medical flight, but the judge said it would too dangerous to send her with no hospital prepared to receive her.

Only after she had missed the boat was a place found for her at the world-leading Nuffield Orthopaedic Centre, part of the Oxford University Hospitals Trust. The centre has a reputation for taking difficult and expensive cases from outside its own area.

She must now wait until 11 May 2015 to leave the island – where she could not safely have the operation she needs to amputate parts of her legs and ease her enduring pain.

K was discovered by Paul Bridgewater, a newly-arrived social worker, living in Barn View in Longwood, a “care home” used mainly for elderly people.

Mr Bridgewater had her moved to hospital but she was moved back to Barn View, only to be re-admitted – malnourished and suffering a serious ring worm infection.

Her condition is so severe she has to be kept lying down.

The island’s Supreme Court has been given responsibility for taking decisions about K’s care now that her mother is ageing.

A solicitor in England, Michael Trueman, has been appointed to act on her behalf. It was through his efforts, and the commitment of a consultant surgeon at the hospital, Mr Tim Theologis, that a solution was found.

K’s operation was recumbent by a visiting surgeon on St Helena, Sergio Villatoro Bran. He advised removing both her legs from above the knees – bilateral supracondylar amputation.

The hope is that it will make her more comfortable and reduce the risk of a fatal infection.

Judge Ekins pointed out that a protocol with Britain allows four St Helenians to be treated by the NHS each year. He made a point of saying that K is a British citizen – interpreted by some as a way to interest UK media in her case.

In a judgement issued on 23 April, he said: “Three NHS consultants had been approached by the date of the RMS St Helena’s departure.

“None would undertake to admit K. A response is still awaited from the last enquiries made.

“The risk to K of embarking up upon a passage to the UK without a hospital to receive her is unacceptable.

“I cannot think that the decision to refuse to admit K to the trusts approach is a clinical one… it seems to me to be likely therefore that the decision in each case is resource based.

“If that is indeed the case then the situation is a shameful one.”

He said the urgency of the case meant he would have to send her to South Africa if treatment is available there – “a much less preferable option in terms of K’s welfare.”

The High Court in England would take over responsibility for her in the UK. It is not clear what legal arrangements could be made in a foreign country.

K’s mother has been praised by the judge for trying to ease her daughter’s suffering, but he said she was “getting on in years” and there were concerns about her ability to take decisions about her daughter’s needs.

Judge Ekins said she had “been active over the years in doing her best to provide K with such suplementary comfort as she has been capable of.”

In 2012, Barn View, conditions at Barn View were severely criticised in a report by the Lucy Faithfull Foundation. Most of the report – on alleged abuse on the island – was kept secret, but a draft version was leaked.

It said a 16-year-old girl – thought to be K – was sharing a room with a dying elderly woman at the home.

Allegations of a cover-up of abuse, and the governance of the island, are now being investigated by Sasha Wass QC. She is understood to have asked for information about Barn View.

Judge Ekins included politicians in his criticism of K’s rejection by the NHS.

He said: “For some time now it has been claimed that the UK’s economy ranks amongst the wealthiest in the world. It is boasted that the UK’s economy ranks comfortably amongst the largest ten economies in the world.

“Political parties of every hue claim that the UK NHS is or will be safe in their hands.

“The two former make it even more shameful that it is apparently difficult, if not impossible, to afford treatment to a young British citizen with such catastrophic disabilities who is entitled to be treated by the NHS in the UK.

“The latter of the claims referred to frankly rings entirely hollow.”

Ship diverts 180 miles to pick up sick girl – after first offer of help was turned down

Big lift for a small girl: MV Traveller. Picture courtesy of BigLift shipping. Click the pic for a larger image
Big lift for a small girl: MV Traveller. Picture courtesy of BigLift shipping. Click the pic for a larger image

The Master and owners of a cargo ship have been praised for diverting to pick up a desperately sick child on St Helena – two days after being told their vessel was unsuitable.

The MV Traveller was the only ship to respond to a call for help put out by coastguards in the UK.

Update: sick child is ‘awake, talking and eating’

The ship’s Dutch owners, BigLift, waived all the costs of doubling back the 180 miles to St Helena, and then carrying the girl the 700 miles to Ascension Island.

The ship arrived in James Bay close to midnight on Friday, 6 March 2015, but the seven-year-old child could not be lifted aboard until 3.30 in the morning.

She was landed at Georgetown on Ascension at 2100 hours on Sunday, 8 March, and taken straight to a waiting military plane, arriving at Great Ormond Street Hospital in London on Monday lunchtime.

Martin Bidmead, senior maritime operations officer at the Coastguard Operations Centre at Falmouth, was on duty for most of the three and a half days of the evacuation effort.

He said: “Although the MV Traveller wasn’t the most suitable vessel, because she wasn’t very large, in circumstances that were fairly urgent it proved to be the best option.

“Despite being turned down initially, some time later they were asked to go back. Thankfully they were willing to turn round.”

Martin said a request for help from St Helena Radio was received in mid-afternoon on Thursday, 5 March – with the RMS St Helena five days away from the island.

“They sent a message to us asking for us to see if we could contact shipping to transfer a young female who was ill on St Helena to South Africa or Ascension for medical treatment.

“We spoke to South African authorities and there was nothing they could provide that could assist.

“We then did some satellite broadcasts, using our satellite tracking equipment for ships. There weren’t very many ships at all that could possibly help. In that part of the world the amount of shipping is fairly sparse, to be honest.

“One that did offer was a Dutch ship, the MV Traveller, a heavy lift ship.

“We spoke to the Traveller initially at 9.30 on the 6th. She responded to one of our broadcasts. We then spoke to St Helena Radio who said the vessel wouldn’t be suitable.

“She had a lack of accommodation and the medical personnel initially declined the offer. As time went on it became apparent the Traveller was probably the only option there was.”

At that point, the ship had already sailed past the island on its voyage from South Africa to the Virgin Islands, in the Caribbean, said Martin.

“I got hold of the owners in Holland and asked, would they be happy for us to turn the Traveller back to St Helena, because by this time she was nearly 180 miles to the north.

“They said they would, so I went back to the Master and asked him if he would return to St Helena, which is exactly what he did.

“The Master when I spoke to him said they were able to accommodate the casualty in their sick bay. I believe it was fairly small. The four person team who accompanied her I believe had to sleep in the saloon.

“All credit to them as well. I don’t know how they were going to get back.

“They took her to Ascension where an aircraft was waiting for her and flew her to London. They did it very professionally and very quickly.

“We were very grateful and I’m sure the young child’s family were grateful as well.”

The station at Falmouth, in Cornwall, is the international liaison station for the UK’s coastguard service.

“There is a team of four of five of us on watch,” said Martin. “We were all involved and all wishing this child a full and speedy recovery.

“The job was a little bit unusual because we tend deal with emergencies that involve shipping or leisure boats.

“It is reasonably unusual for us to have to assist someone who is on land and requires assistance from shipping.”

This was not the first occasion a call has been put out for shipping to take a dangerously sick person off St Helena, but it may be the last.

The mayday call went out only four months before a test flight is expected at St Helena’s first airport – due for completion in February 2016.

“We had a look on Google Earth and we could see it being constructed,” said Martin.

“It will be good for circumstances like this but it will effect lifestyles considerably. They will end up with people like me visiting.

“It’s one of the few places in the world I want to visit – I really do.”

  • BigLift, the owners of the MV Traveller, said in a statement that the ship was ten hours’ sailing time from St Helena when the request was made for the vessel to turn back to the island. “Her parents, a doctor and a nurse were taken on board. Assistance was requested and without hesitation, MV Traveller responded. The vessel was en route from Durban to the Virgin Islands so the deviation was relatively small. Despite the short notice we were pleased to assist and hope the girl will receive proper treatment and fully recover in time.”

Infants and old at risk as virus spreads through island

Click the pic see see an info graphic on RSV
Click the pic see see an info graphic on RSV

Large numbers of sick children on St Helena are reported to have been infected with a virus that can be serious for infants and old people.

Screen Shot 2015-02-19 at 10.31.07Many of those turning up at the hospital in Jamestown with the respiratory syncytial virus (RSV) have come from the same creches or other busy environments.

In the United States, the virus is the most common cause of bronchiolitis and pneumonia in children under one year of age, and a significant cause of breathing problems in older people.

A leaflet issued by St Helena’s health department on 19 February 2015 says:

“RSV is a respiratory virus that infects the lungs and breathing passages.

“Healthy people usually experience mild, cold-like symptoms and recover in a week or two. But RSV can be serious, especially for infants and older adults.

“Infants under six months old in particular can get seriously ill.

“The virus produces a thick mucus, which is difficult for the child to cough up.

“It does NOT respond to antibiotics.”

The virus spreads when droplets from a cough or sneeze come into contact with eyes, or when someone touches an infected surfaces and then touches their eyes.

Screen Shot 2015-02-19 at 10.30.54Symptoms include prolonged coughing, wheezing, mucus, and severe tiredness.

Patients may not have strength to eat, drink or cough.

The most important advice is to wash hands before and after contact with children.

The leaflet also encourages people to:

  • make children sleep in a cool room, with head raised
  • encourage drinking
  • avoid contact with infants
  • avoid smoking near children
  • limit visitors

St Helena Government has not disclosed the number of patients known to have contracted the virus.

Read more here

Medics perform St Helena’s first heart op

Medics on St Helena have saved a patient’s life by performing the island’s first-ever heart surgery, reports St Helena Government. 

It was carried out in at the hospital Jamestown by Senior Medical Officer Dr Attila Frigyesi and Surgeon Dr Carlos Soto on Friday 16 January 2015, assisted by the theatre nurses.

The emergency surgery was successful and the patient was doing well and recovering at home, said a press release. 

Dr Atilla said: “Friday’s operation highlights the fact that it is possible to perform relatively advanced healthcare on St Helena if we have appropriate trained staff and suitable equipment.

“I would like to thank all of the team involved for their efforts in saving the life of this patient.”

St Helena needs ‘new hospital and new health service,’ says Ian

Health leaders have been given six months to make a case for building a new hospital on St Helena.

But Ian Rummery, chairman of the island’s public health committee, has called for wholesale reform.

“The case we have to make is not just about a new hospital – it is about a new health service.”

He spoke at a press conference on the island’s annual aid talks, two days after a large number of patients left for medical treatment overseas.

UK negotiators toured the hospital in Upper Jamestown soon after arriving for the week-long Development Aid Planning Mission (DAPM).

The aide memoire signed at the end of the week encouraged St Helena Government to “develop an initial longer-term hospital plan within six months”.

It also supported planned renovations to the hospital.

“We had a full and frank look at the hospital infrastructure,” said Councillor Rummery.

“The hospital needs a new operating theatre. One of the reasons there’s been a spike in medical referrals is we are having to send people offshore because we can’t do a lot of operations here.

“It is clear that the new operating theatre and diagnostic suite is a priority.

“But in the longer term we really need to be working towards a new hospital. 

“Let’s be clear: it is not the green light for a new hospital but it is, ‘Let’s talk about it – ‘you present the business case and we will start to discuss it.’

“That is very good because the discussions a few months ago were that the door was pretty much closed on a new hospital.”

Mike Olsson of the St Helena Independent asked whether work on a new hospital plan might mean improvements to the existing building would be put on hold for six months.

Ian Rummery replied: “We can do two things at the same time. We need to upgrade the hospital.

“A new hospital can’t be built overnight. You are talking years.”

Maintenance had become an issue, he said.

“We are being driven out of the hospital building. In the next six months we make a business case, concentrating on the hospital now but then going forward by ten years to having a new hospital and a health service.”

He said there was no truth in a suggestion that a new facility was needed to meet the requirements of the island’s new airport, due to open in 2016.

Overseas care is straining family fund, says Indy editor

The St Helena Independent noted on 17 January 2014 that there was an usually large number of doctors on the island – “it must be six or seven”.

Editor Mike Olsson wrote: “We apparently do not have the facilities to enable our doctors to perform their skills in a safe way. Therefore we are sending more patients to Cape Town than ever.

“I know that the enormous number of referrals have put huge pressure on the Family Trust Support Fund. Many people on their way to Cape Town have no spare funds for these kind of eventualities.

“The funds of the Family Trust are depleted and they need urgent funds to be able to help people in a desperate situation.”

Hospital and child safety highlighted as aid talks end
The Risk Assessment: hospital team does ‘an amazing job’

St Helena Independent, 17 January 2014 (see Editorial, page 2)

Sailors welcome: but don’t leave any nasty gifts

Visiting mariners have been described as a potential health risk to people on St Helena – because of what they might get up to on shore.

The danger of them passing on diseases through amorous encounters has been identified as one of the impacts of the newly-approved plan to build a port in Rupert’s Bay.

Proposed measures to deal with the threat to community health include making free condoms available in the island’s bars, as well as health screening.

A risk of increased teenage pregnancy could be tackled with more sex education – though that would not benefit girls who have already left school.

Other measures include providing accommodation for seamen, and “strict controls on the import of drugs”.

The report includes a wry comment on the threat to local morals and health:

“This is not new to St Helena,” it says, “as the island has a long history as a port of call.”

LegCo set to debate health, housing and Lottery cash

The state of health care on St Helena is to be challenged at the first full meeting of the island’s Legislative Council since its inaugural session in July 2013.

Councillor Leslie Baldwin has called for members to debate the level of service when LegCo meets in the Court House in Jamestown on Monday, 14 October.

His motion says “that this Council believes that the current health service does not meet the needs of our community.”

The motion is one of nine put forward for debate.

A call for a “level playing field” for island media organisations could cause funding problems for the SAMS service set up by the government in early 2012.  – and bring state support for Saint FM Community Radio, which relies on fundraising and donations from listeners.

An other motion delivers on election promises to end the culture of secrecy within St Helena Government.

Ian Rummery’s motion calls for transparency in all government departments.

It says that “every reasonable effort will be made to make information available” except in cases of national security, legally sensitive material or personal information, or where commercial interests or criminal cases could be compromised.

Lawson Henry has called for continued support for an affordable housing scheme, and Councillor Baldwin has urged the reintroduction of a community work scheme for people claiming unemployment benefits.

Mr Baldwin also urges a lobbying campaign in London to enable British overseas territories to apply for funding from the UK National Lottery.

Derek Thomas has called for a review of the immigration law, to ensure it has the same effect on the government and the private sector when employing people from overseas.

Read more: LegCo Order Paper, 14 October 2013

Health and social services projects get top marks

Overall ‘A’ ratings have been awarded for two major projects run by St Helena’s Health and Social Welfare Directorate.

It means the Healthlink 3 and Health Strategy projects both funded by the UK for three and a half years, achieved their overall objectives when they ended in March 2012.

The main focus of Healthlink 3 was to ensure that key professionals were provided for St Helena and Tristan da Cunha. 

The Health Strategy project was aimed at developing overall health and social services provision on St Helena, with staff training and new equipment.

Wholly based on information from St Helena Government.

Island ‘could not cope’ with plane crash, warns medic

Dr Ahmad Risk
Dr Ahmad Risk

Medical teams on St Helena would struggle to cope with a major accident at the island’s new airport, a visiting doctor has warned.

Dr Ahmad Risk, who has been qualified for 40 years, has acted as a healthcare consultant as well as working as a civilian and military doctor, in the UK and internationally.

He praised staff at Jamestown’s hospital after working alongside them as a temporary locum doctor, saying they had to cope with inadequate facilities in challenging conditions.

He said massive improvements were needed in the next two years in order to bring healthcare on the island up to the standards tourists would expect.

And when asked about what would happen if there was a major accident at the airport, he resplied: “Heaven forbid.

“If we have a major incident, say a plane crash, without facilities it will be quite a struggle.

“I have to be frank and straight about it: with our current facilities on the island we cannot cope reasonably well.

“We will cope, to a certain extent, and people will put out all the stops and they will not sleep for days; they will do that because that’s what they trained to do. But the outcomes may not be as favorable as if you had a different set-up.”

St Helena Government said that plans were in hand for a major upgrade of the hospital and its facilities.

A detailed emergency plan was published as part of the original planning application for the airport. It can be found on the St Helena Air Access website.

The Risk Assessment: Castle responds to doctor’s comments

Dr Ahmad Risk ended a two-month stint as a locum medic in Jamestown’s hospital by telling Saint FM listeners his views on the state of healthcare on St Helena. He had high praise for staff, but also raised concerns about facilities, the airport, and the alarming number of people suffering diabetes and hypertension. St Helena Government has responded to his comments.

The doctor said young people were being led into the grip of some of the worst medical killers and that it was the duty of parents and schools to help them live more healthily. What role do schools currently play in preventing diabetes, obesity and hypertension?

SHG: The Education Directorate are concerned that young people make the best choices they can about their personal health.  This includes becoming informed about the effect of diet on health.

As part of the Personal, Social and Health Education programme, children are informed about healthy living.  For example, the health promotion coordinator regularly visits primary schools to give talks about healthy eating.

Schools have also advised parents and carers with regard to the best ingredients for healthy packed lunches, and the directorate is about to refresh the advice for parents and carers.

And sport and activities are of course a very important part of the school curriculum, and all of our schools encourage maximum participation in physical education.

The island has a very proud tradition of healthy competitive sport, as the recent highly successful Primary Athletics Day (won by St Pauls) demonstrated.

Is it true that the government reduced import duty on sugary foods and drinks from 40% to 20% in order to simplify the tariffs? 

(Awaiting answer)

Dr Risk also said that he had to insist of being given paper towels to dry his hands because the cotton towels used at the hospital were medically unacceptable – presumably, because of the risk of spreading infection. Could you comment, please? 

SHG: Paper towels are generally utilised in all clinical areas.  Sometimes stocks run out and occasionally towels need to be used, and these are changed and washed regularly in such instances.

He also said the island needed an intensive care unit, and much better capacity to deal with any major incident at the airport. 

SHG: Plans are in hand for hospital redevelopment which will result in improved intensive care facilities.

Children in danger from diet and poor exercise, warns medic
Children in danger from diet and poor exercise, warns medic