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Why do the elite in Trinidad and Tobago refuse to subject themselves to our healthcare system? Why do our political decision-makers seek medical care outside our borders? Why is the number one concern of the people of T&T access to good healthcare? (MFO 2017).

I learned the answers to these questions in the worst way imaginable.

On January 3, 2017, my brother Daniel passed away in the ICU POSGH. He was 48, father of four and had never been seriously ill. He was hospitalized since November 18, and diagnosed on November 20 with infectious endocarditis. The postmortem report lists infectious endocarditis as a cause of my brother’s death but this is not even one quarter of the experience which has forever changed my life and that of

Daniel’s family, friends, colleagues and many more who were praying for his recovery. None of us has yet been able to grasp the fact that Daniel is truly gone. It is simply unbelievable.

Unbelievable, that although Daniel repeatedly sought medical attention from doctors in the private health system complaining of no appetite, difficulty breathing, a persistent cough, weakness and fatigue, serious weight loss and eventually swollen feet he was misdiagnosed and mistreated for over four months from July to November 18, 2017.

Unbelievable that, in a country boasting one of the highest GDP (PPP) in the Americas, we do not have the resources, expertise and capacity to perform open heart surgery within the public health system, and so we procure such services from private institutions and teams.

Unbelievable that, when Daniel suffered heart failure at the POSGH on November 23 and every breath was a struggle, his body wasting away and his systems shutting down, he was put through a “means test” to prove that he did not have the money to pay for open heart surgery.

Unbelievable that this process took so long that by the time Daniel did receive his surgery on December 5, his kidneys and liver, previously declared to be fine, had begun to fail.

Unbelievable that when 11 days after his surgery Daniel began to bleed there was no endoscopist at POSGH available to ascertain the source of bleeding and as his blood count dropped, there was no blood on-site to perform a transfusion.

Unbelievable that after another surgery on December 16, to stop internal bleeding, Daniel’s entire colon was removed, but bleeding persisted.

Unbelievable that when on December 18, an edoscopy was finally performed, it was ascertained that Daniel was bleeding from a stomach ulcer, resulting in another surgery.

Unbelievable that the ICU POSGH could not do some blood tests nor did they have magnesium, nor vitamins which my family eventually had to source privately.

Unbelievable that after all of this Daniel defied the prognoses of death, and continued to fight to live. From December 18 until Christmas day, Daniel improved so much that doctors planned to move him from ICU, indicating he was no longer critically ill.

Unfathomable that when Daniel took a turn for the worse and his blood count and platelets began to drop, we were informed that Daniel had contracted dengue in POSGH.

Suffice to say, I now understand why our financial and political elite mostly stay clear of the healthcare system here and I do not blame them.

Questions of access to high standards of healthcare in society are closely related to how that society views justice, equity and the protection of fundamental human rights. Public expenditure decision-making is an exercise in distributive justice and for too long, this important correlation in how we spend money has been either ignored or punctuated as a subsidiary issue. New dialogues and collaborative action on healthcare system justice, reform and innovation must be undertaken engaging not only stakeholders in institutional and business sectors but with the patients, their families, and the people whom the system is designed to serve.

Margaret Rose Goddard

Margaret Rose-Goddard is a lawyer and public procurement specialist. She is currently a doctoral researcher at the Institute of Policy Research, University of Bath, UK and is the founder of the U-Solve School of Empathic Leadership & Entrepreneurship. contact@u-solve.org

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