Dominica Healthcare Remains on Life Support

Abandoned Marigot Hospital

Health care services have been deteriorating in Dominica over the past 10-15 years. A system that once proudly encompassed a highly efficient and effective secondary component (consisting of an extensive network of health centers) has been reduced to a shell of its glory in the 1980s and 1990s. Rather than a lack of skilled professionals, the  primarily culprit has been poor governance, lack of focus by central administration and confused priority. The system has deteriorated to a level where patients have suffered and  others have been adversely affected; in some acute cases death may have resulted due lack of appropriate medication. The flagship Princess Margaret Hospital in Goodwill is a mess and, for reasons known only to the Minister of Health (Dr. Darroux) or to those who can decipher his 'Simbot' style language, the New National Hospital being constructed on the same site is at a standstill.  Portsmouth Hospital is a shell of its former self and the Marigot Hospital has been abandoned for the past 3 years due to termite infestation and mold overgrowth. Without a doubt, healthcare in Dominica is gasping.

So, it was incredulous to learn that Health Minister Dr. Darroux on March 28th 2018 stated at a press briefing that he was still waiting for the designs from the United Nations Office for Project Services (UNOPS) for the construction of the new Marigot Hospital. Haven't Dominicans heard this tune before? Yes! They have heard multiple variations on the same theme many times; the last time it was in Wesley, on Wednesday 19th April 2017. At that community meeting, Darroux said that, at the request of Mexico the funding party, UNOPS would be engaged to prepare designs for the Marigot Hospital.  At that time Dr. Darroux said that UNOPS could deliver that Hospital by August 2018. Work was supposed  to  have started by June 2017.  He even said that Marigot Junior school would be remodeled into a three level health center with the Assistance of funding from PAHO Smart Health Care facilities Fund. Are those plans still in the works? Now we are in April 2018; Dominica is still  awaiting the designs from UNOPS! What happened? Did Hurricane Maria blow them away? 

Inevitably, Maria will get blamed for the colossal lack of responsibility towards taking care of the health matters of a Nation. For heavens sake,  even if there may have been some hiccups on the part of Mexico, the Labor Administration could at least have started working ahead. If they were genuine, they could have proceeded with demolishing the old hospital and preparing the grounds for building the new Hospital. It is obvious that this Labor Administration is not able to "walk and chew gum at the same time".  So, the question remains.  Will UNOPS be in charge of implementing the Marigot Hospital project? Or, will this be another case of awarding no-bid contracts to cronies?  

The sincere hope is that UNOPS will be contracted to execute the whole project because of their experience. Here are the reasons why. UNOPS, an operational arm of the UN, work with governments and funding partners all over the world to implement their development goals. They provide expertise in infrastructure, project management, procurement, financial management and human resources all within the values and principles of the United Nations. They have extensive  experience in managing large donor funds, because they offer a sense of transparency and comfort to such donors. For example, working with the Government of  Myamma, they manage some of that country's largest Funds. Since 2014, UNOPS has built 82 health centers in that country, some of them in the most hard to reach areas. In 2016, UNOPS handed over 44 health clinics to the Government of Myamma.  Some of those clinics can also provide a place for women with high-risk pregnancies, who are located in rural hard-to-reach areas to give birth, instead of in their homes. It seems that Dominica is in need of such a partner. Therefore, in order to take Healthcare in Dominica off life support, it is imperative that the Administration partner with UNOPS. How much longer can Health Care in Dominica continue to endure the trauma of incompetent governance before succumbing to its injury? 

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