The Tribune

By ADRIAN GIBSON

ajbahama@hotmail.com

LONG Island — Here comes Blue Water all over again! Certainly, that’s what most Bahamians must be thinking about the government’s sudden decision to divide the Bahamas Electricity Corporation (BEC) into two, privatising one of the proposed splinter companies.

This week, Prime Minister Perry Christie’s long missive on the evolution of BEC and how his government plans to foster an environment where people generate electricity and sell it back to government seemingly departed from the governing party’s own general election manifesto—Our Plan. In their manifesto, there was absolutely no mention of the privatisation of BEC—which I don’t object to—nor was a spin-off segmentation of BEC discussed. Coupled with the Stem Cell Bill that was recently passed, the midway-privatization of BEC was not included in the contract for which the governing party was elected and, since much of the promises set out in Our Plan have yet to be fulfilled, one wonders if the electorate has been subjected to a bait and switch manoeuvre.

Don’t get me wrong, I want to see BEC privatised and would love to pay lower electricity costs.....yes, I said love. However, the fact that the government is now asking for bids— whilst proclaiming that they would have a deal complete by December—suggests that they may have already made a decision on who will get the contract and are now merely going through the motions by putting it out to tender. One hopes that BEC is not being sold to any member of the “good ole boys” club!

On the face of it, the government proposes to split BEC into two sections—one focused on generation and the other focused on delivery. The overstaffed, money-losing part of BEC would continue to be owned by the government while the private equity partner would generate and sell power to BEC. Yes, it is obvious that for BEC to survive, it would need to take on a strategic partner with lots of cash. However, who would that partner be and would the bidding process be largely subject to the political processes/vagaries as opposed to a company’s experience and abilities? Is the government’s retention of one part of BEC an attempt to distinguish this attempt at privatisation from the Bahamas Telecommunications Company (BTC) sale? Are the government’s reservations about wholly selling BEC due to it seeking not to be accused of selling our national patrimony?

In a Facebook post that was copied and shared with me by FNM Deputy Chairman Dr Duane Sands, he wrote: “The PM prepares us for the sale of BEC. Let us see what kind of talk there is about the sale of the ‘national patrimony’ and/or the absolute requirement for 49-51 per cent this time.....Keep your eyes, ears and nose open.....Anticipate this to be a well-orchestrated deal!!!”

As it stands, there are lots of inefficiencies built into electricity generation, and the marketing, delivery and servicing of our nation. Whilst the public—including myself—will be happy for lower electricity rates, one hopes that it comes to fruition without the built-in obligatory grafts (if ya know what I mean). Whilst we’re privatising electricity generation to slash energy costs, let’s engage in a national educational process and, even more, get on with the business of legalising the generation of electricity outside of the grid, which could also be sold back to BEC.

Indeed, we should be offered a substantial stake in both incarnations of the power company. If Mr Christie seeks to engender a public offering in the new BEC, he must also follow-through on the FNM’s intent to offer shares in the more profitable BTC (nine per cent of the current 49 per cent that the government holds was set to be allocated as representative of a future proposed share offering to the public).

ORGAN DONATIONS IN THE BAHAMAS

According to cardiothoracic surgeon Dr Duane Sands: “When the late Winston Saunders was Coroner, he sent a subpoena out to lock me up, Dr Robin Roberts and several other doctors after we had made an arrangement for the University of Miami (UM) to harvest organs from a patient. This was about 12 or so years ago. I was a supporter of transplantation but we didn’t have the legislation to have it all done legally. However, that set the ball rolling and we have had a very significant, well-outlined approach to it.”

I have always wondered about the benefits of having an organ bank and the rate of organ donations in the Bahamas, particularly since consecutive government appear fixated on dialysis units and other treatments that would be greatly impacted if we harvested organs and conducted organ transplants, for e.g. the kidneys. Dr Sands told me that there have been instances where organs have been harvested by a UM team, stored in their organ bank and made accessible to Bahamians.

In the Bahamas, it appears that we lack the political will needed to have a progressive view of healthcare. We have made only slight advancements in our investment in healthcare, the biggest single investment being the Critical Care block at the Princess Margaret Hospital (PMH).

“A number of Bahamians have gotten hearts, livers and kidneys. Today, we have actually been participating in the American organ sharing system for more than a decade. Right now, there is a young lady (Bahamian) in Atlanta who is getting a kidney transplant and has access to these organs due to the work of a number of people, namely myself, Robin Roberts, Adrian Sawyer and so on,” the doctor stated.

However, Dr Sands sees any organ donation programme as facing problems that are multifactorial. Thus far, our healthcare system has not been able to sustain a reasonable transplant patient programme.

Dr Sands said: “There is a huge number of patients on dialysis, between 350 to 400 people. The local kidney transplant programme has faltered. The only real option is if they go abroad and that may not be an ideal situation particularly given the instances of kidney failure and the number of persons on dialysis. We have to change in terms of our approach to kidney failure. There are a number of individuals who wind-up brain dead, whose organs are essentially wasted because the organ procurement programme in the Bahamas has not been idealized—whether there are religious, superstitious, cultural or other reasons for such reticence.”

“Given the number of individuals with ocular (eye) problems, it is questionable why we don’t harvest more corneas or even skin. The current approach to healthcare certainly does not take into account the unfortunate reality of violence and non-communicable diseases that, while distressing and unfortunate, could lead to new opportunities for other Bahamians,” noted the country’s premier heart surgeon.

Sands told me that the “annual cost for dialysis, per public patient, is somewhere in the range of $50,000 per year, which we happily pay but at the same time we have not developed and sustained a transplant programme that leads to better patient outcomes at comparable or better costs.”

Lamentably, it seems that the Critical Care block will feature the opening of a few more dialysis units but what happened to being truly innovative and opening an organ bank?

There is a plethora of dialysis units/centres littered throughout the archipelago (predominantly Nassau), with several outpatient and inpatient dialysis units situated at PMH; Dr Adrian Sawyer operates one; Dr Ronnie Knowles has centres in Grand Bahama, Abaco and New Providence; and Doctors Hospital has an inpatient dialysis unit whilst utilizing a facility owned by Judson Eneas as its outpatient unit. That said, there has yet to be any clear emphasis on renal replacement therapy with transplantation.

“Cardiac transplantation is a simple operation. The real challenge is in the management of patients before and after transplants. It is very complicated. I think it is unlikely that we would be doing any heart transplants in the Bahamas, though we have done so as part of my training. Perhaps not in my lifetime! That said, we have had Bahamian patients having transplants abroad due to our participation in the UNOS system (United Network for Organ Sharing),” Dr Sands said.

It is a national disgrace that we don’t even have a national blood bank!

Dr Sands espouses the view that it is “shameful” that our country has yet to establish a national blood bank, stating that “there had been plans drawn and a property identified for a blood bank but it has yet to come to fruition.”

The trauma surgeon said: “The ball was dropped from Marcus Bethel’s tenure as health minister, where the establishment of such a bank seemed imminent. There is a challenge with meeting the blood needs of our nation and we are unable to achieve the level of efficiency and adequacy with the private, voluntary blood banks at PMH, Doctors and the Rand. Simply put, we don’t collect enough blood!”

“Given the level of violence in our country, much of the blood is used on trauma patients! This, however, could be remedied by a national focus on a blood bank. It must be an ongoing effort—a national effort—where all of the (hospitals) banks feed from the national blood bank and there would likely be much better public participation and less of the problems with the perennial shortages now being encountered,” Sands noted.

Thus far, both a national blood bank and national organ bank seems to not be a priority for either government.

According to Dr Sands: “If you look at the current infrastructural needs of healthcare in the Bahamas, in order to bring it to whatever standard is the acceptable minimum based on international norms, the current infrastructure and programmatic needs (supplies, equipment and manpower), is in the order of $750 dollars. And, this is only to cause healthcare in the Bahamas to come close to what exists in other mature jurisdictions!”

I couldn’t agree with the good doctor more!