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Friday, April 18, 2014
Trinidad & Tobago Guardian Online
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Deficiencies in public health sector put Surgeons under pressure
Deficiencies in the public health sector can be seriously tackled with one major input—communication between senior doctors and the administration. So said president of the Society of Surgeons of T&T James “Jimmy” Ramdass. Ramdass, one of the people behind the publication of a book on the history of surgery in T&T, said the authorities were not paying much attention to the views of his group. And did you know that surgeons were originally barbers?
Q: Dr Ramdass, can you tell us why should the average Trini be interested in the Society of Surgeons of T&T (SOSTT)?
A: (In a relaxed mode at his La Baja, Maracas, St Joseph, home on Wednesday afternoon) We are the professional body representing the surgical community in this country, in all the specialties.
Before calling you last week, I wasn’t aware of the existence of your group, which I understand has been around almost 60 years. Why this lack of knowledge of the SOSTT by the general public?
This society was started in the 1940s but fell into inactivity and was revived by a group of younger surgeons in the 1980s—Drs Vijay Narayansingh, David Toby, Prof K Butler, Celestine Ragoonanan, McDonald Jorsling (now deceased), Martin Haynes and, in particular, Rasheed Adam and Lall Sawh who, since then and up to today, have been secretary and treasurer, respectively…27 years.
We are a very modest group, and we became defunct because there were so few people back in those days, but we are now running with the ball, as they say.
I imagine you will also be engaged in updating your membership on developments in the sector?
Of course, and among our goals and vision since the society’s inception are the advancement of the art and science of surgery within our country, to promote education and training relating to that activity locally as well as abroad, and to promote and monitor the standard of surgical practice within T&T.
In keeping with your group’s goal of lifting the standards of your practice, why is it so difficult to get doctors to testify against their colleagues in litigation matters?
(Crossing his legs while scratching one knee) That is a difficult question to answer because surgery and medicine is a very complex thing. Surgery from thy kingdom come...in the medieval days, surgeons were called barber surgeons, which is why I have this piece of paper in front me called The Worshipful Company of Barbers in England, right? Back in those days surgeons were barbers.
Why barbers and not, let’s say perhaps, teachers, publicans, or even scavengers?
(Smiles while delving into some British medical history) OK, you see there were two groups of people. Essentially backtially back in those days, surgeons were barbers, and in order for people to have a lump removed from their bodies or to have an abscess or a cyst drained, the physicians were the people who knew about medicine and would prescribe the tablets, they wouldn’t do procedures like that, but the barbers used to do it.
They were allowed to do it because they had skills with their hands, and surgery will always remain a craft unlike other fields because it does involve hand and eye co-ordination skills.
So was it because barbers were very skilled at cutting people’s hair that they were so endowed...
(Another smile) In those days, they did not have any doctors, and King Henry the Eighth in 1540 formed what you called the Barber Surgeons Company of the Royal College of Surgeons of England. Later on, one became a doctor and then became a surgeon afterwards in order to improve quality of care. That is why surgeons are today referred to as Mr, because barbers were not doctors.
Is this group a regulatory body or a social club?
Until earlier this year, we were totally unregistered. Only when we realised we were not registered, we revised our constitution which was incorporated as a company.
Is this a rival body to the Medical Association of T&T?
No, the association is a body which represents all doctors in T&T, and our members can also join the association.
Dr, what’s your opinion on the standard of healthcare in the country today in the public and private sectors?
There is a lot of complex work in the general hospitals, and I think that some of the deficiencies in the system are caused by the lack of communication with the administration and the senior doctors.
If we need a certain test done, it is not that easy as there are a lot of procedures before they can be carried out.
Dr Ramdass, to the average layman, it would seem that communication should be something that can be easily implemented, why is that such a difficult task in the public health sector?
(Perplexed) I cannot understand that myself.
Bureaucracy and red tape in the public health sector?
Yes. And if you look through this file that we have since (browsing through the pile of mostly discoloured pages accumulated over many years)...we have always been inviting guest speakers from all around the world here. People who could teach, and we hold regular meetings to improve every aspect of surgical procedures. We have had all these great speakers coming and helping us, and they regularly train our young doctors. But we have very little impact on the local authorities.
Why is it that nobody is listening to your pleas?
They have no need to listen to us (cynically), because we are just a group of surgeons.
What about the Minister of Health?
He is a member of the society (pointing to a photograph the minister took at a 2013 function of the SOSTT).
Yet you are all making him get away with this treatment?
He never had direct contact with me as president of the society, but he has had contact with other people, and he attends our meetings occasionally.
The society has not been able to put him down and explain the difficulties that you all are experiencing?
So why this kind of treatment from a minister who I know is very approachable by all, especially to those in the health sector?
I don’t work in the ministry, and they don’t communicate with me or any other consultants at my hospital. Most of the time we go to work, ask for things and it goes via a letter to whoever in charge and it comes back a few months later. It puts a lot of stress on the doctors who have patients coming to you with their problems.
Doctors are a very conservative people, is that the reason why you all may not want to pick up placards and parade outside Park Street?
(A huge chuckle) It is difficult to do that, eh. But you only hurt the system if you do that. And we will continue to fight for the improvement in the standards of healthcare based on our goals, because that is the only way we can continue to develop and implement a higher degree of healthcare in every level of the system.
Can we look at some of the positive achievements the society has been able to make over the years?
Before going there, let me hasten to add that we are convinced that Minister Khan would soon pay us a little more attention, because we know he has the healthcare system at heart.
So he is not that bad after all?
No. He means very well. He is a nice man, a good-looking man, too, if I may say so myself (loud laughter).
I gather that you all have formed the Regional College of Surgeons (RCOS), does this mean you are going to replace the England-based Royal College of Surgeons?
It will not replace it, but there will be a Fellowship of the Caribbean College of Surgeons for people who are qualified. I am not sure if they will form their own exam, but that is what they are thinking of doing. And one of our roles is to build links with the RCOS.
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