AmbergrisCaye.com Home Forums The Cayes Ambergris Caye The care and emergency treatment of Mr. Fred Somes

Apparently it isn't just a case of acquiring nurses, but rather that the nurses then need housing, and the housing needs to be ideally near the clinic (not 2 miles away) etc. etc.

That's correct, unless San Pedro is their home town.When I was employed by GOB, housing was not provided for me.

At the weekends you will need 3 nurses doing 8 hours each, that is if they can work on thier own. You could need 6 nurses if 2 at a time have to be on duty.

Granted. However I don't see doctors willing to be at an emergency center 24 hours a day by themselves, waiting for an emergency to come in.Somehow I don't think an ER will be effective or continue to endure on just a voluntary basis. Volunteers cannot be required to make sure someone is there.I think it's time for GOB to step up and provide a functioning ER for a town the size of San Pedro and a major tourist destination . I think that GOB will not do so until pressurized by the public..Believe me ,all of the medical workers of San Pedro have been trying their utmost to obtain this for many, many years,but it needs to come from the public.Assistance could be offered on a voluntary basis to encourage this.

How many Doctors are there in San Pedro and is there a need for more?

There are many models to provide reasonable emergency careas discussed. Once again, a 24 7 model ,whether staffed by nurses or paramedics (who have different and very complementary skills) and a doctor sitting in a physical space is ideal. This is expensive and requires a lot of staff but is an important goal. An early starting point however, is to have after hours/weekend coverage (and then constant coverage)for serious emergencies only. This would mean a doc available and a paramedic/nurse in the designated location or very close by, both carrying a dedicated cell phone. A phone call to the nurse/paramedic would activate the doctor if needed (based on nurse paramedic judgement). This would not be activated for minor issues. This "call" could be covered by local docs if they could work out a fair schedule and could be supplemented by volunteers. When I have worked in remote northern canada, I spent little time at the hospital at night and on weekends b. But I was always on the cell phone and within 10 minutes, ready to run in if need be to the place where the equipment was situated. I would in some cases keep an emergency bag with me to respond to situations in the field. My point is that an "on call" system can be a segway to a dedicated ER and may be easier to achieve in the short to medium term.

Cheers again to Nathalie for all the work she has done and of course not surprised to see her ongoing dedication to making people healthier on AC!

The one situation I see arising from a 24 hour ER is the overload of sniffles and stomach aches wanting to be treated.

If that ER is open in conjuction with an existing facility it would eliminate a backlog of patients.

I had presented a plan to Mayor Paz about four years ago that would work something like this;

The SP town council takes control of the local fire department. It is curently a division of the National Fire Brigade. Have a Chief and 9 full time trained FF/EMTs to provide 3 full time FF's on duty each day. Augment this with a volunteer force of well trained residents. Provide a fire boat that would be equiped for fires and medical emergencies up and down the island. Augment this with the ACER team.
When an accident occurs the responders could treat and transport the patient to a local medical facility for stabilization and then airlifted to Belize City.
A local "EMS" board made up of local medical folks could oversee the training, equiping, co-ordinating and quality of the system.
With the connections that many of us here have I think we could pull it off with funding from the GOB, local business assistance and donations.
I am able to donate a nearly new fire engine, equiped with fire and EMS gear. I may even be able to get a fire boat partially donated. something like this...

http://www.responsemarine.com/pfrs.htm

Hose can be hooked to the fire pump and extended to a structure, getting water or medical care anywhere on the island in MUCH faster manner.

Just food for thought from an old 30 year FF/EMT.

I am a great believer in starting small and growing on success. So I see this in 4 simple parts that are cost effective:
1. Clearly define target group
2. Develop on call schedule for docs and have on call communications system. i.e. radio
3. Get the polyclinic open for ER nurse rotations and keep crash cart there.
4. Implement a seamless system that starts with front line acers who are trained and already doing the work, bringing in patient, alerted ER nurse call doc who is waiting at polyclinic, he/she does stabilization and can arrange transfer to KHMH or private hospital as requested by patient or family.
After that is in place and totally functional, then look to expand IF necessary.
All you would want in SP is stabilization and transportation.

To add, most of this exists and it is a matter of developing seamless linkages

Agreed. The only thing really missing at present is the Polyclinic having it's doors open at night and weekends for emergencies. They do have a rotation for on call doctors, but as I stated before, valuable time is lost looking for where to take an emergency.Sometimes there is only one of the doctors left in town and they can hardly be robots working 24/7. Knowing how the community reacts when there is an emergency, an open ER is vital. This is how they function in other towns in Belize, why not San Pedro? When there is an emergency, people rarely call ahead, they show up with a patient on a golfcart, in a taxi, or in a pick up. When they get to a clinic where no one is available, then they start calling----IF they have credit on their cell phone.Valuable time is lost. ACER, BTW, do call ahead to have the doctor standing by.
Having a nurse, or paramedic, at the clinic to tend to the patient while waiting for the doctor on call frees the doctor from sitting in the ER. The nurse or paramedic would also be able to evaluate to see if the patient indeed has an emergency, thereby conserving the doctor's vauable time.I strongly feel the public must have a place available to take an emergency for immediate attention, no matter what time of day or night, and it should be in one location.