SOUTHCOM ASSESSMENTS ON ST.LUCIA HOSPITAL

C O N F I D E N T I A L BRIDGETOWN 000660 SIPDIS SOUTHCOM FOR LTC JOSE ANDUJAR AND MAJ MARTE STATE PLS PASS USAID FOR LAC E.O. 12958: DECL: 10/17/2019 TAGS: EAID MASS PGOV PHUM PREL SL XL SUBJECT: SOUTHCOM ASSESSMENTS ON ST.LUCIA HOSPITAL DELIVERED TO PRIME MINISTER Classified By: POL/ECON Chief Ian Campbell, reasons 1.4 (b,d) -------------- Summary -------------- ¶1. (C) The three assessments prepared by SOUTHCOM on the effects of the fire at St. Jude's hospital in St. Lucia were completed and delivered to Prime Minister King October 2. These assessments, encompassing the entire Medical infrastructure of southern St. Lucia, provided a roadmap for rebuilding the recently destroyed hospital and sought to enlist support from SOUTHCOM for sourcing equipment and short-term medical care. St. Lucia has specifically requested a Modular Operating Facility and multiple ambulances to convey patients on the 75-minute drive from the south to the hospital in the capital. The strategy for redevelopment has initially been to rely on foreign support, but the government now has the opportunity to take the assessments and use them to solve immediate problems while crafting a master plan for future redevelopment. End summary. -------------- -------------- St. Jude's Hospital Destroyed Leaving Gap in Medical Coverage -------------- -------------- ¶2. (U) St. Jude's Hospital in St. Lucia was destroyed by fire September 9, with three individuals losing their lives in the tragedy. The fire destroyed the 2nd and top floor of a central structure housing the surgical ward. The first floor of the structure, which housed the laboratory, pediatric ward, supplies and laundry, was also severely damaged by water. In addition, the two wings on either side of the surgery were exposed to asbestos fibers from the burning roof, but were spared fire or water damage. Some equipment was salvaged from the site, but as none of the hospital's equipment was insured against loss, the equipment losses were more financially damaging than the loss of the structure. ¶3. (U) The hospital, a structure originally built by the U.S. military in the 1940s, serviced the southern portion of St. Lucia, to include the Hewanorra International Airport. The impact on the airport of losing an emergency care facility could be significant in the case of a serious accident as there is limited capacity to move people to hospitals in the capital. If left unresolved, the lack of adequate medical care nearby could threaten Hewanorra's status as an international airport, which would in turn have a potentially significant impact on tourism arrivals. -------------- SOUTHCOM Team -------------- ¶4. (U) A team of six experts from SOUTHCOM accompanied by poloff conducted a four-day assessment of all major sites, including St. Jude's hospital, George Odlum stadium as a temporary hospital, regional clinics in Laborie, Dennery, Vieux Fort, and Soufriere; Victoria and Tapion hospitals in Castries, and alternate sites for housing a temporary facility. The team consisted of a structural engineer and a director of medical plans from Miami and a team of a medic and three specialists based in Trinidad. During the trip, the team was briefed by a number of prominent St. Lucians, including Prime Minister King, Minister of Health Mondesir, Minister of Home Affairs Mayers and numerous other officials from the MFA, Ministry of Health, and local hospital administrations. Every effort was made to accommodate the team and provide access to sites and appropriate personnel. ¶5. (U) The assessment team concluded that it would not be cost effective to rebuild the structure, and that the asbestos needed to be removed from the site. The stadium now serving as a temporary facility lacks adequate water and electrical capacity, but otherwise is an excellent facility with wide hallways, adequate space, parking and easy access for the populace in southern St. Lucia. The stadium has two wings, but currently only the west wing is being used as a makeshift hospital. The east wing is thought to be more suitable as it houses the locker rooms with showers and better plumbing. Access to the west wing was granted by Prime Minister King on the morning after the fire, but permission to move to the east wing has been neither requested nor granted. -------------- - Alternative Sites: Good Politics, Bad Medicine -------------- - ¶6. (C) The team also surveyed multiple alternative sites, including Skyway Inn, a Free Trade Zone warehouse, and an empty plot of land. All sites had significant problems, and were potentially motivated by issues other than the interests of providing the best medical care. Skyway Inn has almost no guests, is in disrepair and should be shut down due to health reasons. The owner is behind in payments and the bank wants to get this liability off their books. The property is unsuitable as a hospital due to narrow hallways, no elevator, small rooms and a significant mold problem. It was suggested as a potential site more to get it off the balance sheet of the bank than as a real temporary site for a hospital. The Free Zone warehouse had different reasons for being unsuitable but was also selected as it was a gift from the Chinese government and is almost totally empty and has been unused for some time. ¶7. (C) The alternative site proposals also caused a stir among St. Lucians, pitting government administrators against hospital medical staff. The doctors, led by Chierry Poyotte, Medical Director of St. Jude's, thought that the search for alternatives to the stadium was a dangerous waste of time, and was being done more to preserve the fiction of the stadium as a real facility than in the best interests of the public. The stadium was built by the Chinese in 2003 but had deteriorated so rapidly that by 2008 that it required $7 million EC ($2.6 million USD) to refurbish. The high maintenance costs also prevent it from being used for anything but a significant event, so it sits empty for all but a few days a year. The desire to get the patients out of this facility, despite its utility, angered numerous hospital staff. It was only due to the multiple assessments pushing the stadium as the ideal temporary site that the PM granted them the right to stay indefinitely. -------------- Foreign Assistance -------------- ¶8. (U) Mondesir has made a request to SOUTHCOM for a modular (not mobile) operating facility and three ambulances. The cost of the modular unit is $1.5 million with new equipment, and potentially half that cost for refurbished equipment. If a modular O.R. is not available, Mondesir expressed interest in a portable tent facility. According to Susana Huang, a secretary in the Taiwanese Embassy, Taiwan has already made an offer to PM King to build a new hospital, but only if a fair amount of financial support comes from the St. Lucia government. This seems to be the best offer available, but has not yet been accepted. The French have offered to remove asbestos from the site. Teams from the UN and PAHO have also undertaken on-the-ground assessments of the sites, but these have not resulted in any decisions on provision of additional assistance. -------------- Comment -------------- ¶9. (U) St. Lucia is ill-prepared to deal with a disaster of this scope. The temporary solution of the stadium is adequate, but, going forward, the country will face difficulties acquiring equipment and managing other expenses. St. Lucia this month is receiving a psychiatric hospital from the Taiwanese in southern Castries, but no accompanying equipment. In addition, construction has just started on a new EU-funded hospital on the same site as the psychiatric hospital that should be finished in 30 months, but it, too, will be furnished but not equipped. Add in the costs of the replacing St. Jude's (since the EU hospital is not close enough to properly service Hewanorra) and St. Lucia will have to fund the equipping of three hospitals in three years. This would be a strain on resources in the best of times; in the current economic climate, it is unrealistic to think they will be up to the challenge. ¶10. (U) With significant assistance from the USG and others, St. Lucia has managed the short-term aspect of this disaster. In addition to the SOUTHCOM assessment team, Embassy's MLO secured an immediate $10,000 grant in Humanitarian Assistance Program funds from SOUTHCOM to cover immediate needs, and the Embassy was also able to redirect some recently-arrived medical supplies form a Denton shipment to the St. Jude's site as well. ¶11. (C) While the international community looks to solve the medical problems, the long-term aspects of recovery are exposing political cracks. With the Health Minister recently found guilty of customs violations and misleading the Cabinet about it, the government had hoped to be able to take quick and decisive action to renew confidence in Mondesir and the ruling party. Instead, the weight and complexity of this task is generating new rifts between the bureaucrats in the capital and the hospital administrators in the south. Meanwhile, the politicians have been unable to restrain themselves from trying to use the misfortune to feather their own nests through controlling the location of the new building. St. Lucia is also relying too heavily on foreign assistance for many aspects of the recovery, delaying their own domestic response. End comment. HARDT