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)


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Summary
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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.

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St. Jude's Hospital Destroyed Leaving Gap in Medical Coverage
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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.

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SOUTHCOM Team
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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.

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Alternative Sites: Good Politics, Bad Medicine
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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.

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Foreign Assistance
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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.

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Comment
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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