IDB finds New Amsterdam Hospital in shocking state

Aug 21, 2022 News

After 18 years of no upgrades, maintenance…

– Surgical room has mould and fungus-infested walls
– Complex without proper working toilets
– Patients being treated in stockroom
– equipment outdated, structures dilapidated

By Kiana Wilburg

Kaieteur News – The New Amsterdam Regional Hospital (NARH) which treats approximately 200 to 300 patients daily, has been found to be in a most deplorable state.

According to an August 2022 report by the Inter-American Development Bank (IDB), the hospital has not received any maintenance or needed upgrades since its establishment 18 years ago. As a result, many of its facilities, equipment, and structures are out-dated, and in certain cases, dilapidated.

The financial institution noted that parts of the hospital, including the surgical room which has three tables, have mould on the walls, which is a result of the condensation of hot air trapped in the ceiling and the cool air rising. The bank noted that fungus is also noticeable on the external walls of the various buildings located in the complex, adding that this can be a result of a botched paint job or incorrect paint for the physical environment of the hospital.

At its inception, it was noted that the New Amsterdam Hospital offered two specialised medical services, and as such the clinic examination rooms were designed to accommodate one doctor and one patient at a time. However, the hospital now offers 16 specialties, and there has not been any additional space allocated to the clinic examination rooms. To accommodate the increased number of clinics and patients, the bank said the rooms have been divided into sections by non-medical grade blinds to accommodate three doctors and three patients at any one time.

Additionally, patients’ wounds are dressed in a stockroom due to limited space for outpatient care.

It was also observed that the current patient waiting area is small, overcrowded, loud, dark, poorly ventilated, and has uncomfortable seating. The financial institution said patients sometimes have to wait outside the hospital due to a lack of space. To paint a better picture regarding lack of space, the bank disclosed that the hospital has one three-bed Intensive Care Unit (ICU) and a seven-bed A&E department.

Further to this, the bank said the hospital currently has a three-bed operating theatre, which services the catchment areas of the hospital. It said the surgery room is a sterile area, however, the walls and ceilings of the room are covered with mould. The bank said this is the result of a design flaw that created a large space between the ceiling and roof of the building, resulting in condensation. It added that a moist environment is prone to mould and mildew.

Noting more damning observations, the bank said the ICU room has a two-bed capacity, which is often inadequate for the needs of the hospital. There is also no high-dependency care units (HDUs) so patients that are too critical for the general rooms and not critical enough for the ICU are kept in a place not suited for their condition. The bank said this leads to overcrowding and underutilisation of resources.

Additionally, the institution found that there is a sterilisation unit with two sterilisation machines at the hospital, however, only one is functional and working at maximum capacity. The other sterilisation machine is out of commission and needs maintenance.

The vacuum/suction system it said, is an important piece of equipment in the delivery of patient care, as it is responsible for clearing airways and removing body fluids. However, the vacuum system that exists at the hospital is out of commission and non –functional. While the system had undergone a number of rehabilitation measures, the bank said it was never restored to a fully functional efficient system. Though the hospital currently utilises a portable suction system, the bank said due to the nature of the equipment, it is not sufficient to meet the needs of the hospital.

Importantly, the bank pointed out that the hospital does not have a Waste Management Plan, and as such, waste is handled on an ad hoc basis. Wastewater and other liquid waste are disposed of through the sewage system of the hospital, which consists mainly of septic tanks. The septic tanks are emptied by a private waste collector. Discharges from the septic tanks flow directly into the Canje River. There is no further treatment to the discharge before being pumped into the river.

Additionally, the IDB said the hospital has 14 sanitary blocks with toilets connected to a septic tank system. The bank said some of the toilets, like the ones in the A&E Department, are not in working due to poor maintenance. The institution said in no uncertain terms that the toilets are inadequate to meet the needs of the current flow of patients and doctors of the hospital.

Other troubling findings listed include the fact that the hospital does not have a working water purification system. The hospital is also without an efficient laundry department as it was found that the dryer is not functioning. In light of this, materials and clothing are washed and placed on a line in the compound to dry.

Finally, it was found that the hospital does not have a formal Fire Prevention and Protection Plan. In fact, firefighting equipment was found to be outdated and therefore ineffective. What has also alarmed bank representatives is that the hospital does not currently have a functional health and safety plan or protocol that guides the operation of the hospital. Matters of occupational health and safety are therefore resolved on an ad hoc basis and according to the nature of the complaint or issue.

There is also no health and safety officer that ensures that there is compliance with the national legislations and standards. Instead, matters are addressed by the CEO, the Matron, and other managers.

The bank has since loaned Guyana US$160M, part of which will be used for critical upgrades at the New Amsterdam Hospital, Linden Hospital and the Georgetown Hospital Corporation.