The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A Cabinet minister yesterday revealed that Hurricane Dorian was estimated to have inflicted $90m worth of damage on the public healthcare infrastructure, describing it as “a massive blow”.

Dr Duane Sands, minister of health, told Tribune Business that the government did not have “the luxury of unlimited time” to decide how it was going to rebuild public health facilities given that they were critical to facilitating the rebuilding effort and enticing persons to return to Abaco

and Grand Bahama.

He added that the “biggest challenge” was determining the way forward for Freeport’s Rand Memorial Hospital. While the total $90m restoration cost includes the $19m required to fix the the existing facilities, Dr Sands said the alternative was to allocate $30m-$40m for a new hospital - not an easy task given the government’s financial restrictions.

“We have - and I don’t want to call it a guesstimate - but the best possible estimate we have is $90m in terms of the healthcare facilities which have been destroyed, which have been damaged,” Dr Sands told this newspaper.

“That’s our current understanding of the extent of the damage. That number is going to have to be revised when we have structural engineers and contractors looking at it more critically. Bearing in mind we are four weeks in, we ought to get as good an estimate as possible, and $90m is where we stand.

“Most of the structures east of High Rock are destroyed; there’s literally nothing there. Vehicles and ambulances in Abaco have suffered and so forth. We don’t anticipate the Consolidated Fund is going to have to fund that entire amount.”

While donors have either pledged or financed the replacement of some vehicles and equipment, Dr Sands said the need to repopulate Abaco and east Grand Bahama could dictate the timing of rebuilding for Dorian-ravaged healthcare facilities.

“We may not have the population sufficient to support the rebuild of a clinic in a particular place, like McLean’s Town,” he warned. “This is very fluid, very dynamic, and we have to make some decisions as the field hospitals will not be here indefinitely. Their first engagement is only 120 days.

“We have the Rand itself, which suffered major damage from water intrusion and flooding and septic intrusion. It wasn’t just water; it was the sewage in the facility. That has led to serious problems of mould. Just today we had to shutter 80 percent of the square footage at the hospital.”

While all four healthcare facilities in east Grand Bahama had been destroyed or severely damaged, Dr Sands said Abaco’s mini hospital likely required at least $1-$2m worth of repairs due to water damage to the equipment and property.

While the mini-hospital’s structure had weathered Dorian well, the minister added that Abaco’s public health clinics had been left in various states of damage and disrepair throughout the island chain.

“Like the blow to the country, and Grand Bahama and Abaco, this is a massive blow,” Dr Sands told Tribune Business of the destruction wreaked on the public healthcare system in those two islands.

“The health infrastructure is a vital component of repopulation of these islands, and unless we have decent health infrastructure it is very hard to rebuild, particularly if you’re talking about construction, where people are prone to having lacerations and fractures. We need to rebuild our national health system. This is a major blow on a number of fronts.”

Dr Sands said the Government was “not averse” to employing modular, pre-fabricated structures as healthcare facilities in the short to medium-term, especially since they can be tied into utilities infrastructure.

“We are actively engaged in making a decision about many of these facilities,” he said. “The Rand is the biggest challenge. You rightly asked the question: Do we invest $19m to repair or build a brand new facility for $30-$40m. 

“This is not a simple question. The challenges for health are not isolated. They gave to be seen in the context of education infrastructure, re-electrifying, re-establishing potable water, restoring telecommunications. There’s a limit to how much money you have.

“The restoration in the US after Katrina cost $180bn. Certainly we don’t have $180bn at our disposal. Even if we had $10bn is that going to be enough?” Dr Sands said that with climate change and global warming, what might once have cost $100 would now cost $300 given the need for rebuilding to account for more frequent and powerful hurricanes.

He added that the Government would now have to make “serious decisions” without having the necessary time or data on which to base them. “People aren’t going to live in a shelter for ever,” he explained, “and the longer we take to clean up and repair these communities the less likely some people will be to return to them.”

Acknowledging the “tendency to second guess and Monday morning quarterback” any decision the Government made, Dr Sands continued: “We don’t have an unlimited amount of time to decide. There’s an intrinsic risk because of the pressure of time. The opportunity cost of inertia may be greater than potential waste.”