Medical Missions Enhancing Service Delivery at Bustamante Hospital for Children

Medical missions have been an important feature of service delivery at the Bustamante Hospital for Children (BHC) over the 60 years of the hospital’s existence, and the institution continues to benefit tremendously from the support of external medical teams.

Consultant Anaesthetist and Head of the Department of Anaesthesia and Intensive Care at BHC, Dr. Cleopatra Patterson, tells JIS News that medical missions typically supplement the expertise, staff numbers or equipment and disposables at the facility.

She points out that the most consistent external support to the BHC comes through cardiac missions.

Dr. Patterson explains that the care of children with heart conditions – that they are either born with or acquire during their life – is delivered at BHC through the local teams as well as visitors from outside of Jamaica.

“It is a major undertaking, both from the level of expertise and equipment and disposables, and this care is administered in collaboration with the Government of Jamaica and several organisations,” the Department Head acknowledges.

“The major one is Chain of Hope, a United Kingdom-based organisation, which assists with congenital heart disease services around the world, and Jamaica is one of the countries in which they are active,” she says.

She says that Chain of Hope organises cardiac missions to the facility approximately three times per year, noting that the relationship spans 20 years.

Some of the other donors include Gift of Life, Rotary International, and Cardiac Kids Foundation out of Florida.

Dr. Patterson informs that there is a non-surgical intervention called cardiac catheterization, and that is done under the sponsorship of Chain of Hope as well as Gift of Life.

“Many of these bodies have come together, not only to donate their time but also to do training. They sponsor training for all categories of staff that participate in the care of children with heart disease. These include nurses, radiographers, imaging technicians, echo-technicians and the cardiologists, the cardiac surgeons and the cardiac intensive care and cardiac anaesthesia personnel as well. There are also local corporate sponsors such as Carimed, which donates financial resources,” she tells JIS News.

Minister of Health and Wellness, Dr. the Hon. Christopher Tufton, in highlighting the importance of the cardiac missions to the hospital said that “the partnership with the Chain of Hope team, which comes a few times a year and performs these life-saving procedures working with the Bustamante staff, is impatient of any debate around its value. Its contribution is not just to the institution and the objectives of the institution but is a signal of the value of partnership”.

In addition to cardiac missions, the hospital also benefits from support in other specialties.

The Consultant Anaesthetist explains that the hospital receives visitors in orthopaedic surgery, and particularly, to perform corrective surgery for complex spinal conditions such as scoliosis with the support of the United States-based Straight Caribbean Spine Foundation (SCSF).

The team, which has been supporting the facility since 2006, visits twice per year.

“They bring equipment, supplies, expertise and we do the operations at BHC. We provide anaesthesia services for this group, so most of the time they don’t have to bring an anaesthetist, but the surgeons come along with quite a few nursing and monitoring staff,” she points out.

She notes that BHC also accepts visiting missions for children with cerebral palsy.

They come in and perform a procedure called a dorsal rhizotomy to help those children who need surgical intervention to reduce muscle tightness and subsequently make their care easier for their caregivers.

Dr. Patterson points out that there are interventions in the area of general surgery as well.

“We do get visitors that support liver transplantation, which is more recent. So, we have a group out of Delaware that comes to Jamaica, and we are working at making it more sustainable. We want them to start coming to us every three to four months. This, Dr. Patterson adds is another collaborative effort with the University Hospital of the West Indies and Kingston Public Hospital.

“They support the surgery of the donor who is an adult and then we have the expertise coming out of Delaware to support the recipient. This is also done at the BHC, and we’ve done a few of these transplants over the years,” Dr. Patterson notes.

The Consultant Anaesthetist contends that every medical mission comes with a skills transfer component and that the cardiac missions are a good example of this.

“When cardiac services through Chain of Hope started to come to Jamaica, they were focused on getting the work done,” Dr. Patterson informs.

“Over time, skills training and capacity-building have become more of a priority, so we are now at a stage where at Bustamante we do cardiac surgery for children without the visiting surgeons,” she adds.

She says that for the more complex or advanced work, the hospital gets support in the form of expertise, but notes that a more sustainable programme has been developed.

Dr. Patterson highlights that BHC now has cardiac services being delivered by Jamaicans for Jamaican children, both in the form of cardiology and cardiac catherisation as well as cardiac surgery.

“We get support in terms of augmenting our staff numbers to allow a greater number of surgeries to be done and interventions for children with heart disease,” she explains.

In the area of scoliosis surgeries, Dr. Patterson notes that there is significant skills transfer in the area of preoperative preparation where the surgeons are learning alongside the visiting surgeons.

Dr. Patterson tells JIS News that the children of Jamaica benefit significantly from medical missions by accessing expertise and procedures that are sometimes outside of the financial reach of their families.

“So not only do they save on the cost of travelling overseas but also on the logistics of transfer as well as trying to recover in an unfamiliar environment, which is also quite taxing. So, we do get the opportunity to give the children a much more pleasant experience even though it is healthcare,” she points out.

The Consultant Anaesthetist says that when these charities come and offer their time and effort, the local team also gets to share their skillsets with the visitors.

“When they come, they get to see pathology that sometimes does not happen frequently in First-World countries…” she points out.

“There is an exchange of knowledge as they see how we manage certain advanced illnesses. They bring their expertise to the table, and we can share our experience with them as well. The ultimate beneficiary is the patient,” she adds.

Dr. Patterson informs that all donations and arrangements for medical missions are handled by the National Healthcare Enhancement Foundation (NHEF) on behalf of the Ministry of Health and Wellness.

Information on donations, such as equipment, expertise or time, are channeled through the NHEF, which will match the resources to the needs within the public health system.