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Shortage of physicians, limited hospital capacity among woes

By Mar-Vic Cagurangan

HAGATNA, Guam (Marianas Variety, Sept. 30, 2008) - Shortage of specialty physicians and nurses, a staff deficit, limited bed capacity, inadequate hospital supplies, crumbling infrastructure and "unhealthy" ventilation.

These are among the problems that put the Guam Memorial Hospital in a quagmire and expose patients to danger, according to a September report prepared by the Department of Interior’s Office of Inspector General.

"A lot of people are dying because they can’t get healthcare when they need it," the OIG report stated, quoting an unidentified GMH official.

These healthcare knots, according to the report titled "Insular Area Health Care: At the Crossroads of a Total Breakdown," are common among U.S. insular territories.

"The insular areas are unable to provide comprehensive healthcare services to their citizens and as a result, critically ill-patients are boarding planes and crossing thousands of miles of ocean for services they are literally dying to receive,” stated the report, which was handed out among the participants in the ongoing Healthcare Summit hosted by DOI in Hawai΄i.

GMH administrator Peter John Camacho described the report as "extremely flawed, filled with inaccuracies" and "incorrect statements."

Camacho was upset that the report didn’t even mention the availability of state-of-the-art technology at the hospital including the new multi-slice scanner. "It doesn’t even say anything about the open heart surgeries that we have performed at the hospital," he said.

He also complained that the report "made it appear that we only have one hospital and two clinics" without mentioning the presence of private clinics that offer specialty medical services.

The report -- which compiles the healthcare profiles of Guam, the CNMI, Federated States of Micronesia, American Samoa, Palau, Marshall Islands and U.S. Virgin Islands -- was based on interviews conducted with healthcare officials last June.

The report on Guam was presaged by the chronicle of a patient suffering from a bleeding in her brain, who had to be flown to Hawai΄i due to the absence of a neurosurgeon on island. The patient did not survive.

"There are additional factors that can inhibit patients’ abilities to access off-island specialty care," the report said. "Patients seeking off-island care must be in a stable enough condition to fly."

GMH continues to face the challenge of luring specialty physicians to come to Guam, according to the report.

"GMH physicians noted that legally, Guam can only employ US-licensed physicians which means its main source of employees reside 6,000 miles away," the report said. "They also stated that physician salaries in Guam are much lower than those of physicians in the United States."

The report also cites an acute shortage in the nursing staff, forcing nurses to give up their day off and work up to 12 hours in one day.

"You can add 10 more beds, you can add 100 more beds but we just don’t have enough staff for it. You can only overwork your staff so much," the report quoted an unnamed hospital staff employee.

Further straining GMH’s limited capacity is Guam’s obligation to provide healthcare services to citizens of freely associated states.

The report also noted that some expectant mothers fly to Guam to give birth on island so that their children could acquire citizenship that would entitle them to available benefits.

Although Guam receives Compact impact funds from the federal government every year, the amount of the grant "does not sufficiently recuperate the costs incurred" from treating the FAS migrants, the report said.

"Our intention has not been to embarrass or criticize the good work of insular area healthcare providers and administrators," OIA said. "Rather we wanted to develop objective observation and identify trends that would enable the secretary and insular area officials to focus strategically on solutions to the unrivaled challenges this unique population experiences in the delivery of healthcare."

While enumerating everything that it thinks wrong with the healthcare system in insular areas, OIA concluded that there are "no simple solutions."

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