Right Steps & Poui Trees


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Chief Medical Officer’s Covid-19 Update for Oct 7, 2021

Jamaica’s Ministry of Health & Wellness (MOHW) had established a practice of weekly Covid-19 press conferences, usually held on Thursday evenings. For the past few months, however, this weekly practice has been less reliable, with gaps of a week or more occurring between press conferences. This was particularly problematic during the height of the current wave of the pandemic; fueled by the Delta variant, it has been the worst of the three waves Jamaica has experienced.

Yesterday was Thursday and I tweeted the MOHW a question about whether there would be a Covid Conversation (what the press conferences have been called for some time) and they responded saying no. This actually wasn’t much of a surprise, given that there had been a press conference last week and that the Ministry had been facing a lot of pressure and criticism from the public and in Parliament this week.

What was a surprise was to learn last night, via a Twitter thread by Gleaner journalist Jovan Johnson, that CMO Dr Bisasor-Mckenzie had given a recorded Covid-19 update, which was sent to the media by MOHW. This is not a common practice.

I am glad that this update was given. It is not a true substitute for a live press conference, but it does give the public some additional important information. Neither the text nor the video recording of the update has yet been posted online on the MOHW website. It was said that the video recording would be released by the Jamaica Information Service(JIS), but I have not seen a link on the JIS website. This all shows immediately the difference in access by the public compared to when MOHW press conferences are carried live by Public Broadcasting Corporation of Jamaica (PBCJ) and immediately posted on their YouTube channel. PBCJ has actually used some of the CMO’s recording in their news roundup today and in a special report.

I have posted here a copy of the text of the CMO’s update:

To illustrate the way in which these updates add to the information given in the daily MOHW Clinical Management Summaries, I will refer to this chart I compiled using some of the figures given in these summaries.

The hospitalization numbers in the daily reports show a strong downward trend but in her update yesterday, CMO Bisasor-McKenzie noted that daily hospital admissions have been increasing in the past week.

And she made the added comment, “This means that despite the trending down of hospitalizations, if the trend for admissions going up continues, our bed occupancy will increase.” This changes the perspective of our current situation somewhat.

Also of particular note in yesterday’s update are the comments about the delay in the availability of the 2nd dose of the Pfizer vaccine.

With so many ongoing issues, questions and concerns, it would be useful for MOHW to return to regular, weekly press conferences.

For convenience, I have included the statement below as well.


Covid Reflections: With Public Hospitals Accepting Emergencies Only, We Have Entered Another Phase in Our 3rd Wave

Yesterday Jamaica’s Ministry of Health and Wellness issued a press release stating that the country’s public hospitals would be accepting emergency cases only, until further notice. The large number of people confirmed with or suspected of having Covid-19 who need hospitalisation has resulted in the hospitals exceeding their Covid-19 isolation capacity. So other hospital spaces and resources have to be dedicated to treating people with Covid-19. General hospital service has been suspended, including elective surgeries, and people who can be cared for at home are being discharged. The Chief Medical Officer (CMO), Dr Bisasor-McKenzie, is quoted as saying that “The rising demand for oxygen also threatens to overwhelm the supply.”

Curiously, this press release has not (yet) been posted on the MOHW website.

This decision by the MOHW signals that the country has entered into a new phase in the 3rd wave of Covid infections in Jamaica but it does not come as a surprise if you have been following the news and numbers in the past couple of months. And the news and numbers over the last week or two have clearly shown the deepening crisis.

People in government and outside of government have been speaking about the increasing numbers of Covid-19 cases, the increasing numbers of hospital admissions, the pressure for space within the hospitals, the pressure on staff within the hospitals. These comments and information have come through official statements at government press conferences, through media interviews, in press releases, on social media.

A small sampling of examples…

Dr Melody Ennis of MOHW was speaking with Dionne Jackson Miller on RJR
Nurse Patsy Edwards-Henry, President of Jamaica Nurses Association, was speaking with Sanjay Lewis on Power 106
MOHW PS Dunstan Bryan speaking with RJR
Slide shown at OPM press conference on August 9, 2021, while PM Andrew Holness spoke & said “I want us to pay attention to this graph. It shows our daily confirmed cases of Covid-19 in blue, while the red line shows the 7-day moving average of new hospitalisations. You can see that our daily hospital admissions are now at the same level as our previous peak in March/April 2021. We now have approximately 500 of 700 beds allocated for Covid-19 occupied islandwide and a number of our large hospitals are over capacity.”
(Transcribed from PBCJ recording of OPM press conference, August 9, 2021.)
Slide presented at MOHW press conference August 12, 2021. CMO Dr Bisasor-McKenzie said: “We can see now, compared to last week, that our bed occupancy now is at over 600 beds occupied with both confirmed cases and suspected cases…Our peak, March/April, we were at just over 700 and now we are just over 600.”
(Transcribed from PBCJ recording of MOHW press conference.)
In a report on August 17, 2021, JIS covered this point made by Dr Bisasor-McKenzie, where she said “We are fast approaching that peak, which will put us in a very dangerous zone in terms of the care for COVID patients in our hospitals. It puts us in a very high level of pressure on the hospital system.”
Dr Andrew Manning, Medical Association of Jamaica President, in a news report on RJR, August 16-8-21 – MAJ Alarmed at Record High COVID Positivity Rate
Slide showing hospital capacity – OPM press briefing on August 19, 2021 – CMO Dr Bisasor-McKenzie said. ” And this is what is happening in our hospitals. Across the regions, what we are seeing is that the four regions are in an alert phase in terms of Covid capacity. For the southern region, we have gone over the capacity for Covid beds; we’re at 162% occupancy. For the western region, 142%. For the north east region, 125% and for the south east region at 97%. It means that most of our major hospitals, our main hospitals, are really full….As you can imagine, our health care workers are tired, they’re frustrated, they’re overworked, they’re stressed.”
(Transcribed from PBCJ recording.)
This week Wednesday (August 25, 2021) All Angles on TVJ did a special report about the Savanna-La-Mar Hospital, which is struggling with an influx of Covid-19 patients. Dionne Jackson Miller interviewed members of staff – doctors, nurses, a porter, the CEO – about conditions at the hospital. It was a harrowing and moving programme.

And today a number of media houses have carried reports that there is a severe shortage of medical oxygen in the country, which is now affecting the supply to hospitals, some of which are said to be out of oxygen. There has not at this point been an official statement on this from the Ministry of Health & Wellness.

There is an urgent need for a press conference to be held focusing on the dire crisis in the hospitals. Despite the many warnings that this was where we were heading, now that we are here, the public of Jamaica deserves a full update. This is particularly urgent in light of the fact that the Dr Karen Webster-Kerr, National Epidemiologist, has said that this 3rd wave won’t peak for another two weeks. That thereafter it is likely to take several months to come down from that peak. That, although she is reluctant to give predictions about deaths, we are likely to see 140-150 deaths over the next week and an additional 10-20 on top of that number the following week. (She was speaking in an interview on Nationwide News Network on Thursday, August 26, 2021). This means that the pressure on the hospitals is likely to continue for weeks to come, increasing further before it decreases.

It is Saturday night. The curfew started at 6pm. For the next 3 days, Jamaicans are under 24-hour curfews, with the curfew ending at 5am Tuesday morning. Tomorrow – Sunday – would be a good time to hold a press conference. Let us know what time. Most of us will be at home…


Jamaica’s Chief Justice Speaks to the Nation

On Sunday, March 10, 2019, Jamaica’s Chief Justice, Hon. Justice Mr Bryan Sykes, made a national address that was widely carried in the electronic media. The Chief Justice’s address has been described as unprecedented and both the fact of the address itself and its contents have been the subject of much comment and discussion.

JIS photo of Chief Justice Bryan Sykes

Chief Justice of Jamaica,  Hon. Mr Justice Bryan Sykes (JIS photo)

I welcome the Chief Justice’s decision to speak directly to the people of Jamaica in a broadcast of this kind and his willingness to give these public commitments for improvements in the justice system, including some very specific ones with timelines, for which he can be held accountable. There is obviously some concern about whether the commitments made can actually be accomplished, given that they have to do with longstanding issues of delays and backlogs.  I assume that Chief Justice Sykes has assessed the challenges and thinks that they are surmountable. He has asked for the support of all stakeholders in working to achieve these goals and the public nature of the commitments increases the pressure on those with direct control and responsibility to carry out their roles assiduously. If any of the commitments is not met, his national address has set a paradigm of transparency which would require him to come back to the people to explain exactly what happened to prevent its achievement.

Some of the specific commitments and timelines are:

  • In divorce matters, once the documents are submitted error free, the decree absolute will be issued within 16 weeks.
  • By December 31, 2019, there will be no outstanding divorces.
  • In relation to matters of probate and letters of administration, that is, establishing the validity of wills and dealing with the estates of persons who died without a will, once all documents are submitted error free, the Supreme Court Staff will ensure that these take no longer than 12 weeks.
  • By December 31, 2019, all outstanding judgments in the Supreme Court will be delivered.
  • As of 2020, a judgment should be delivered within 90 days, and in exceptional cases, 180 days following completion of the case

We are more used to members of the Legislature or the Executive making national addresses; to have the head of the Judiciary make such an address is new. Hopefully the promise of this address will be fulfilled.

Text & Video of Address

JIS CJ Sykes speech

The text of the address is posted on the Jamaica Information Service (JIS) website and below it on the website is a video of the address. I have posted the full text here:

Chief Justice of Jamaica, Hon. Mr. Justice Bryan Sykes OJ, CD: Address to the Nation

Good evening Jamaica. I am Bryan Sykes, your Chief Justice. When I took the oath of office, one year ago, it was with a deep sense of gratitude and humility.

I understood the complexity, as well as the magnitude of the work that needed to be done to transform the judicial arm of government with excellence and efficiency at its core.

It was also with the recognition that if Jamaica is to achieve vision 2030, the Jamaican Judiciary must remain strong and maintain its integrity. In this regard I must recognize the contribution of previous Chief Justices and Judges.

I am making it my mandate for us to have excellent courts. Excellent courts rest on three pillars. First, trial and hearing date certainty.

This means that the trial or hearing takes place on the day it is listed to begin. We no longer set multiple trials for each courtroom as this always lead to adjournments.

Unnecessary delays will not be accommodated.

We must get to the point where matters begin on the day they are scheduled, and move away from the culture of multiple adjournments and mention dates. The culture shift has begun to produce desirable results in the Supreme Court and Parish Courts.

The Court of Appeal should also increase its disposal rate as, since January 2019, there are now three additional judges with three more to be added later in this year.

The consequence of hearing and trial date certainty is that cases are disposed of within stated time standards.

In Jamaica this means disposing of cases within 24 months of entry into the courts.

In some Divisions of the Supreme Court, the Gun Court and Parish Courts that statistics show that more than 100 cases are being disposed of for every 100 cases filed.

For the first time last year seven Parish Courts had a clearance rate over 100%. This has set the platform for us to clear the current backlog within six years.

Secondly, excellent courts are efficient. Time, human and material resources are properly utilized to produce the best outcomes.

It is our goal to decrease the waiting time for the adjudication of some matters. For example, in divorce matters, once the documents are submitted error free, the decree absolute will be issued within 16 weeks. By December 31, 2019, there will be no outstanding divorces. That is our commitment to you.

In relation to matters of probate and letters of administration, that is, establishing the validity of wills and dealing with the estates of persons who died without a will, once all documents are submitted error free, the Supreme Court Staff will ensure that these take no longer than 12 weeks. That is our commitment to you.

Thirdly, excellent courts mean that we have a culture of service among staff and judges. Research has shown that the perception of court users is influenced by how they are treated and not only by the outcome of their cases.

Therefore, as our customer service charter states, court staff will be courteous, respectful, fair and prompt. We have ongoing training for court staff to improve their basic customer service and stress management skills. This will continue as we aim for first world standards.

My vision is for our Judiciary to be the best in the Caribbean Region in three years and among the best in the world in six years beginning March 1, 2019.

To support this vision, I give my commitment to put in place measures so that by December 31, 2019 all outstanding judgments in the Supreme Court will be delivered. As of 2020 a judgment should be delivered within 90 days, and in exceptional cases, 180 days following completion of the case.

Courts will start on time and trial time productively utilized. All stakeholders – judges, court staff, witnesses, jurors, attorneys at law, police officers and others, despite the many challenges they face, must resolve to come to court to assist in the administration of justice.

The Judiciary that I lead will ensure that Jamaica is the place of choice to live, work, raise families, do business and retire in peace and safety.

Join the Judiciary and partner with us, as we work to strengthen the rule of law in Jamaica land we love. Thank you.

Additional Document of Interest

Parish Courts of Jamaica 2018 report coverTHE CHIEF JUSTICE’S ANNUAL STATISTICS REPORT ON CRIMINAL MATTERS IN THE PARISH COURTS 2018

 

 

 

 


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Barbican Square Roadworks: An Example of Government Disregard for People’s Safety

Whether or not the construction going on in Barbican Square will bring the promised benefits is not the subject of this blog post. What I want to consider is whether the situation I saw last week Thursday night and Friday afternoon is indicative of government that values the safety and well-being of its citizens.

JIS March 2017 release re Barbican roadworksThe Barbican Road Improvement Project has been going on for many months now. This release from Jamaica Information Service (JIS) in March last year described the scope of the planned work and indicated the timeframe for some of the phases. It included the following advice from Manager for Communication and Customer Services at the National Works Agency (NWA), Stephen Shaw:

Mr. Shaw urges persons to exercise caution as they traverse that area.

“There will be difficulties and challenges while the project is ongoing, but it will be for a greater good; and so, we are asking persons to work with us as we work to complete what we are hoping to be a very successful project,” he says.

In the ensuing months, there has been much comment about the ongoing roadworks in both traditional and social media and I have seen numerous photos posted online by fellow blogger Dennis Jones documenting various problems he has seen.

This image from Google maps shows the area and roads involved. East King’s House Road is marked with an arrow and the numbers indicate some points I will mention as I go along.Google map - Barbican Square with numbers

Barbican Square is not a route that I have to use routinely and with the ongoing construction I have consciously avoided the area. So when I had to use the route last Thursday night to access somewhere via Birdsucker Lane, I did so with a sense of unease. I had seen something about the closure of Birdsucker Lane, but had paid little attention to the timeline for it and wondered if it was still closed. I assumed that if it were, there would be some signs indicating the appropriate detour. I discovered that Birdsucker was open, but the absence of any proper signage or safety precautions was appalling. When I eventually reached home, I tweeted about the experience.Barbican tweet - 8-3-18

I approached the area via the East Kings’s House Road route, joined the usual lines of traffic going past Loshusan plaza, taking the right lane, as I normally would to head for Birdsucker. I saw a police car parked across the road from the exit (at 2 on map) from the plaza, obviously trying to discourage the usual boring that takes place just before the concrete median barriers at that point. There were no signs at the intersection of the roundabout road with Barbican Road (at 3 on map). In fact, I saw no signs directing traffic at any point in the roundabout area that night.Barbican tweet - 8-3-18 - 2Barbican tweet - 8-3-18 - 3The situation I mentioned in tweet #3 was along the stretch labeled 6 on the map.Barbican tweet - 8-3-18 - 4The woman with the small child I mentioned in tweet #4 was approaching the Jack’s Hill intersection, coming from the direction of the Square.Barbican tweet - 8-3-18 - 5

I was really troubled by my experience on Thursday night and wanted to see what the situation looked like during daylight, so I went back on Friday afternoon and spent about an hour walking around the area. What I saw confirmed my impression that there is a disregard for the safety of those who have to traverse the area either by car or on foot.

Along the stretch labeled 6 on the map, there were some barriers in evidence where an excavator and some men were working. However, further along the stretch there was nothing marking the edge of the trench being dug, to highlight the danger for motorists.

There were no signs to direct traffic flow at the intersections of Barbican Road with the roundabout road (3 on the map), with Birdsucker Lane (4 on the map) or East King’s House Road (5 on the map). There seemed to be a reliance on a few barriers and luck.

The only sign I saw directing traffic flow in the area of the Square was on East King’s House Road, near the Losushan traffic lights. And even that wasn’t very clearly placed. And nowhere did I see any flag men or women helping to guide drivers.Barbican Square - Losushan traffic light - 9-3-18 The hazards to pedestrians were many….uneven surfaces, with exposed unfinished construction and holes…

…sidewalks under construction which end abruptly and have uncovered holes, with no attempt to place warnings for pedestrians…

…protruding steel, with no covering and nothing to warn of its presence…

…a drain hole in a sidewalk, with a makeshift and inadequate covering.

The dangers are bad enough during the day, but imagine the additional risks at night and the additional risks to someone who is blind or who has a mobility impairment.

The government has a duty to protect people when construction is taking place on the public thoroughfares. Are there regulations, protocols, guidelines, standards governing such safety measures to protect users of the spaces during such construction? If so, what are those guidelines? Are they being met? Are they included in contracts being issued? What are the monitoring responsibilities of the NWA? Is the NWA satisfied with the safety provisions in Barbican Square roadworks?

These issues have been raised before, quite recently with an accident on Mandela Highway in which lives were lost. New roadworks have begun in Constant Spring and are promised for Hagley Park Road. But clear answers do not seem to be readily forthcoming. On Friday morning I made an Access to Information request to the NWA for “written regulations/guidelines/protocols/requirements for the provision of warnings/ precautions/etc during road work/construction/repairs.” Today I had an acknowledgement of my request. I will share any information I receive.

The JIS report I mentioned earlier stated that “Mr. Shaw urges persons to exercise caution as they traverse that area.” I would hope that Mr Shaw also urges the public officials at the NWA and other responsible government departments to exercise their duty to protect people’s safety as they traverse the area.


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Queen Victoria on Parade: Weekly Photo Challenge – Weathered

“This week, show us the effect of time and the elements.”

On East Parade in downtown Kingston, inside St William Grant Park, there is a statue of Queen Victoria.

Queen Victoria a

It’s been in the Park (which used to be called Victoria Park) for nearly 120 years and has weathered somewhat over that time.

P1200529

It has even lost its left hand….

P1200524

The statue was unveiled in 1897 as part of the Diamond Jubilee celebrations; it was a replica of a statue sculpted by Emanuel Edward Geflowski and still bears the inscription: “Queen of Great Britain and Ireland, Empress of India, and Supreme Lady of Jamaica.” The photo below shows the unveiling ceremony.

Queen Victoria statue - National Library of Jamaica photo

“Unveiling the Queen’s Statue in Jamaica,” National Library of Jamaica Digital Collection , accessed January 10, 2018, http://nljdigital.nlj.gov.jm/items/show/1724. © Copyright NLJ. All Rights Reserved

They say that the statue shifted on its stone base during the 1907 Earthquake, which you seem to be able to see in this photo.

Queen Victoria statue - National Library of Jamaica photo 2 (2)

“Statue of Queen Victoria,” National Library of Jamaica Digital Collection , accessed January 10, 2018, http://nljdigital.nlj.gov.jm/items/show/1725. © Copyright NLJ. All Rights Reserved

A Jamaica Information Service release in the Sunday Gleaner of April 26, 1970 mentioned the story of the statue and the earthquake:

Gleaner Sunday April 26 1970 - statues of Queen Victoria and Sir Alexander - JIS report

Sunday Gleaner, April 26, 1970,  page 1 -“Sir Alex’s Statue to Replace Queen Victoria’s”

On May 12, 1970, Queen Victoria’s statue was moved from its original position on South Parade to make way for the statue of National Hero Sir Alexander Bustamante.

Gleaner May 14 1970 - statues of Queen Victoria and Sir Alexander

Gleaner, May 14, 1970, page 1

The statue was later placed in its current location, where it remains to this day.

P1200536 black & white

Weekly Photo Challenge – Weathered

 

 

 

 

 


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Births Fall in Jamaica in 2016…Because of #Zika Warning?

RJR birth decline in 2016 report - 4-5-17I heard the tail end of a report on RJR’s 5pm newscast yesterday (May 4, 2017), which said that there had been a significant decline in births in Jamaica last year. This seemed interesting in the context of the warning to delay pregnancy issued by the Ministry of Health (MOH) in January 2016, in advance of the country’s first confirmed case of the zika virus.

 

MOH warning to pregnant women 1-2016

During his Sectoral Debate presentation on May 3, 2017, Minister of Health Christopher Tufton tabled the first edition of Vitals, a new quarterly report published by his Ministry, which contains the following information:MOH reduced births 2016 chart

MOH reduced births 2016 text

(p.12, Vitals: Quarterly Report of the Ministry of Health – April 2017)

 

This 28% decline in the 4th Quarter of 2016 – nine to twelve months after the zika warning was issued – does on the face of it seem related to the warning. It certainly invites further study to understand how women and their partners responded to the warning and what part various factors, such as discussions and planning, increased use of contraceptives, access to abortion, for example, played in the subsequent decrease in births. It would also be interesting to compare this decrease in Jamaica with other countries which issued similar warnings. I also wonder whether there has been another recent year in which Jamaica has seen an annual decrease in births as large as 7.4%. (The RJR report mistakenly stated that the 28% decline was for the entire 2016, rather than only the 4th Quarter.)

Zika Update

The issue of Vitals also gives an update on the situation with zika in Jamaica up to the first week of April 2017:MOH zika update - Vitals 4-2017

It also reported on the cases of pregnant women with zika infections and the babies with suspected or probable cases of Congenital Syndrome Associated with Zika Virus (CSAZ).

There were 827 cases of notified Zika virus infection in pregnant women reported as at 10th April, 2017; 698 have been classified as suspected Zika based on the case definition. Of the 698 suspected cases, seventy-eight (78) have had positive PCR results confirming Zika virus infection. There were 170 notifications received regarding babies suspected as Congenital Syndrome Associated with Zika Virus Infection (CSAZ), 50 were classified as suspected cases of CSAZ (46 Microcephaly – 35 non-severe, 11 severe; 4 other congenital abnormalities). Three infants based on Pan American Health Organization/World Health Organization were classified as probable cases of CSAZ.

(p. 17, Vitals: Quarterly Report of the Ministry of Health – April 2017)

There is obviously more to be said about the cases of babies suspected to have been affected by the zika virus, including why the numbers were fewer than initially feared, how the cases of microcephaly compare to previous years in number and severity and how the programmes to support the babies, their mothers and families are proceeding.MOH Vitals 4-2017

Vitals – A New Publication by the Ministry of Health

 

When he introduced the new publication during his Sectoral Debate presentation, Minister Tufton said that he hoped it would be a source of information and a tool for accountability.Tufton sectoral debate presentation 3-5-17 Vitals

I welcome this new quarterly report and think that it can indeed be a useful source of information about a variety of topics that are part of the remit of the Ministry of Health. I hope, however, that it will be easily and widely available. I found the link to it on Minister Tufton’s Twitter account. Up to the time of publishing this blog post, it wasn’t available on the MOH website or via the Jamaica Information Service website. I hope it soon will be.