The Tribune

The name has been changed in this article to protect the identity of the senior doctor involved. She has worked in the PMH for more than 20 years.

Dr Gina Saunders spends her life caring for our sick, holding the hands of patients as they battle through illness, struggling to do the best she can in a health service desperately in need of resources.

Her life revolves around Princess Margaret Hospital, in ordinary times a place which poses an immense challenge to all those who work there.

Today things are different. For Gina the PMH has become a place she is seriously concerned about walking into.

Her words are very clear and should strike a chilling chord for all those in government whose job is to steer up through the COVID crisis strangling The Bahamas.

“If you didn’t have to go into the PMH for your job would you step foot in there?” Insight asked her.

“Not me,” she replied.

“I go because I have to go. If there was no reason for me to go there, I would avoid it.

“I was there today and the minute you walk through the door you feel dirty. Even with a face mask and all the other things you do to protect yourself, just walking down the corridor you have the feeling that you are going to catch it.”

Gina fears she is not alone and that the vast majority of staff working at the PMH have the same dread that it’s only a matter of time before their names are added to the list of infected - and possibly worse.

At the start of the COVID crisis it wasn’t like this at the PMH.

Gina said in the early stages morale in the hospital was “pretty good”.

“The management seemed to have everything under control,” she said.

“They were making plans. They were building an area for COVID patients to be housed separately, exactly what you would expect them to do.

“Initially they were having a lot of trouble getting in Personal Protection Equipment (PPE) but there was a major rush for this stuff all over the world. As time went by this appears to have been sorted out. There are occasions when we run short on something but this is generally the exception rather than the rule.”

As we know the number of positive cases in The Bahamas stayed relatively low along with the number of deaths.

On July 1 the government then threw open the borders allowing tourists to return and - calamitously - Bahamians to travel abroad. Hundreds selfishly and stupidly headed straight to the shopping malls in Florida and returned bringing disaster with them.

Cases of infection soared, deaths mounted, the PMH’s ability to cope crumbled before Gina’s eyes.

How the hospital should have coped as the crisis exploded was being shown to its management just a few hundred yards down Shirley Street at Doctors Hospital.

“Doctors was screening everyone at the point of entry - and they still do. Temperature is taken, the door into the hospital is opened for you to stop any transmission onto door handles as people come in, shoes are cleaned, hand washing...” said Gina.

“PMH was slow in taking this stuff on. They had left a lot of entrances open so people could enter the hospital from wherever they wanted.

“There were no strict controls on hand washing and taking people’s temperatures. People started to complain and they eventually started to improve things but it still wasn’t strictly enforced, either for staff or patients.

“They closed all the entrances except for the main one at the front of the hospital. The problem now is you have everyone lined up, no real social distancing and everyone using the same soap dispenser to try and clean their hands - all pressing the same button to get soap. Imagine how easy the infection could be spread.

“Once you get in the hospital there are alcohol dispensers throughout the building but on many occasions there is nothing in them. I have been told people have been stealing the bags of alcohol inside. It’s certainly been an issue on them running out on occasion.

Initially there was screening for patients once they arrived into the hospital but that has now been totally abandoned, said Gina.

“They would screen all patients, take nose swabs, try and identify who had the virus,” said Gina.

“The problem was the volume of tests got so big they couldn’t cope so they stopped it.

“There is no general screening anymore.

“Basically patients are coming into the hospital and screened after admission only on the basis of them clearly having a fever, a cough or one of the other obvious COVID symptoms.

“You have patients come in who are asymptomatic, showing no signs of COIVD but then after a few days you discover they have the virus. For days they’ve been lying there, next to other patients, being treated by staff who have no idea the virus is right there in front of them.”

As the weeks have gone on and - despite the government’s move to ease lockdown - the numbers of infections is still stubbornly high.

“Inside the PMH the problem is now finding places to house COVID patients because we are running out of room,” said Gina.

The situation is so dire Gina knows of one current situation where COVID positive patients are in beds next to another patient who is negative.

“They shouldn’t be anywhere near each other,” said Gina. “But what can we do? There’s nowhere to move people to and even if that happened without screening you could be just moving someone next to another patient who just happens to be asymptomatic - just as infectious as someone is who has visibly got the virus.”

Astonishingly the hospital is also having to cope with the problem of patients being stuck in the hospital because their families refuse to take them home.

“By doing that they are blocking beds which someone else could be using,” said Gina.

Inevitably nurses and doctors have become infected, others placed in quarantine. Manpower is further pressured by staff being diverted out of the PMH to work in community clinics.

“For the life of me I don’t know why the government hasn’t invested more in screening. It should be a matter of routine,” said Gina. “Every patient, every time, should be screened. If for some reason that is not possible they must be treated as COVID positive until it’s proven otherwise.

“The government really is not doing it. Everyone knows they need to be screening coming . That’s not happening so we’re left struggling to deal with the situation we’ve been landed with.

“Personally I don’t feel safe at all. Nobody is in there cleaning the door handles, the bathrooms. Just think - anyone who walks into the hospital and pushes a door handle has left COVID on the door.

“It doesn’t cost a lot of money to put this right. From where I sit the allocation of funds seems to be wrong. You don’t need to be a rocket scientist to fix this.”

Gina fears that unless there is an urgent change in how the crisis is being handled at PMH - mandatory screening, separation of COVID patients, cleaning - the situation could implode with the health service overwhelmed - as the Prime Minister has feared since the crisis first began.

“It is going to come to that if things stay the same,” said Gina.

“I know one staff member has just been tested positive. That means all her immediate colleagues have to go into quarantine. This is not an isolated case.

“Theoretically you could wipe out the entire medical staff. That’s a threat to the whole country. If the PMH collapses where do people go - Doctors Hospital, how many really can afford that?”