Privatization in Canada’s Health Care System is Killing People

March 22 2012

Poor hospital cleaning revealed as major problem

‘Some hospitals are a real freaking disaster’

The health of hospitalized Canadians and their visitors is being seriously put at risk by hospitals that have cut corners in cleaning budgets to a Marketplace investigation has revealed.

The program took hidden cameras inside 11 hospitals in Ontario and British Columbia. What they found in many of them were surprisingly inadequate cleaning regimens – in short, dirty hospitals that could make you sick.

In many hospitals, Marketplace staffers applied a harmless gel to places that many people would touch – hand rails, door handles, light switches, elevator buttons.

DIRTY HOSPITALS

The full story, Dirty Hospitals, can be seen on CBC-TV’s Marketplace tonight at 8 p.m., 8:30 in Newfoundland.

The gel glows when seen under an ultra-violet light. But most of the time – and this was true in every hospital where Marketplace carried out gel tests – the gel was still there more than 24 hours later, meaning the surfaces had not been cleaned at all.

The program talked to cleaners, supervisors, nurses, doctors, and hospital administrators to get a handle on what has become a major problem at Canadian health-care facilities – a shocking number of hospital-acquired infections.

While Canadians love to crow about their first-rate health-care system, it also leads in one area that doesn’t get the same glowing reviews.

About 250,000 Canadians come down with life-threatening infections while in hospitals every year. That’s the highest rate in the developed world. As many as 12,000 people a year die.

Denise Ball’s husband Gary became one of those statistics last year.

He was admitted to Niagara General Hospital for treatment of pancreatitis. While there, the 63-year-old retired school teacher contracted C. difficile – a life-threatening superbug that is all too common in Canadian hospitals. It ended up playing a role in his death a few months later.

Denise Ball remembers the cleaning regimen in her husband’s room was less than adequate, saying the cleaners would spend only 10 minutes on a room everyone knew was infected with C. difficile. She says a proper cleaning would have taken much longer.

“This has to stop,” she says. “This is Canada.”

More with less

Time and again, hospital insiders told Marketplace that cleaners were being asked to do more with less. “We used to have one person to one wing of a hospital to clean,” one cleaner said. “Now, we have three floors to clean.”

A cleaning supervisor at one hospital told Marketplace host Erica Johnson that it’s “common practice” for cleaners not to change the cleaning solution in the bucket when mopping up. “They just don’t have the time,” the supervisor said.

‘Some hospitals are a real freaking disaster.’—Infectious disease expert Dr. Michael Gardam

Sometimes there aren’t enough cleaning supplies. A nurse, whose identity Marketplace protected, said she’s seen a cleaner mopping common areas after having mopped the rooms of infected patients because she didn’t have enough mops to change. “She’s just cross-contaminated the whole area, so there’s no area that was actually clean.”

Sometimes, only one cleaner would be on staff in an entire hospital during night shifts. “That kind of day-night difference is very common, and it makes no sense,” says Dr. Michael Gardam, an infectious disease expert at the University Health Network in Toronto.

Gardam has seen enough in his time looking at hospital cleaning practices to know that some hospitals are worse than others – much worse. “Some hospitals are a real freaking disaster,” he told Marketplace.”They’ve been told to actually cut their number of housekeeping staff by outside auditors who are trying to help them balance their budgets.”

In recent years, many hospitals have cut the portion of their budget that is devoted to cleaning. Sometimes, they’ve done that by contracting out cleaners or their management.

C. difficile outbreaks common

It’s not like we haven’t seen the devastating results of hospital-acquired illness. Newscasts and newspapers have been filled with stories of hospitals under quarantine because of C. difficile outbreaks. In the last decade, outbreaks have hit hospitals in most provinces. A huge outbreak in 2003 and 2004 led to as many as 2,000 deaths in Quebec.

Last year, there were outbreaks in at least 10 hospitals across Ontario alone. One of the worst was the Niagara Health System in Ontario. More than 100 cases were diagnosed and the infection was a factor in the deaths of 37 patients, including Gary Ball, the patient mentioned earlier in the story.

The man appointed by the Ontario government to get the Niagara outbreaks under control, Dr. Kevin Smith, denies that hospitals have been cutting back on cleaning. “I think they’re experimenting with new models of cleaning,” he says.

When informed that workers in the Niagara hospital system told Marketplace that they still don’t have the time or resources to do an adequate cleaning job, he says, “I haven’t heard that message,” saying “everybody” feels rushed in health care these days.

The outbreaks are officially over in the Niagara Health System. But when Marketplace showed Smith several areas where researchers had applied test gel in three hospitals he supervises, most of the surfaces showed no evidence of cleaning. The ultra-violet light showed uncleaned hand rails outside an isolation room, uncleaned support rails in a public washroom and uncleaned hand rails in a ward with highly contagious patients.

“I’m obviously very disappointed to see that. That is a less than optimal cleaning opportunity. We need to fix it,” Smith said.

There’s something else that some observers think is helping to drive the pressure to skimp on cleaning. In Ontario and British Columbia, for example, hospitals are given bonuses for turning over beds quickly – hundreds of extra dollars each time a hospital gets a patient out of a room before a certain time. More money is dangled for quickly transferring a patient from the emergency ward to a room. Hospital CEOs, already well-paid, receive bonuses that depend, in part, on reducing wait times.

While the goal of such rewards may be admirable, critics say the actual effect has been to speed up cleaning to an unhealthy degree.

“They just don’t get it,” says Denise Ball. “And maybe until one of their loved ones that went in healthy and … a few months later … they’re going to their grave. Maybe that’s what will wake them up.” There is a video at the Source

Related Stories

8 tips to ensure you won’t get a hospital-acquired infection

FAQs: What is C. difficile?

Opportunistic superbug present in most hospitals

Since the cleaning services have been privatized, the problems began.

The ones now doing the cleaning are not trained well. Poorly paid and over worked. They have to much to do and not enough time.

It is actually costing Canada more to use private companies.

A lesson leaned the hard way. Remember:

About 250,000 Canadians come down with life-threatening infections while in hospitals every year. That’s the highest rate in the developed world. As many as 12,000 people a year die.
The Ontario Ombudsman is the only provincial watchdog in Canada restricted from investigating and resolving issues/complaints in hospitals, long-term care, children’s aid. And there are serious issues that are not being resolved. Please check out how Ontario compares to the rest of Canada:

http://www.ombudsman.on.ca/About-Us/The-Ombudsman-s-Office/Who-We-Oversee/MUSH-Sector.aspx

Please download a copy of this petition and speak to your MPP about expanding the mandate of the Ombudsman to ensure the public is protected and issues of mistreatment, abuse, poor care are addressed properly in these institutions.

http://ontariocfa.com/documents/ombudsman_petition.pdf

http://ontariocfa.com/

Pass this on to all your Canadians friends.

Don’t let Harper privatize any more in Health Care and the privatization that has taken place, must be reversed to save lives. The life you save may be your own.

Update March 27 2012

CBC’s ‘dirty hospital’ report sparks changes

Niagara health authority ends relationship with private U.S. cleaning company Aramark

March 26, 2012

A CBC investigation into unsanitary conditions at the nation’s hospitals has sparked a change in policy by Canada’s biggest health authority and a flood of email messages from concerned viewers.

With hidden cameras, including Canada’s first hidden camera glow-gel test, the consumer show Marketplace visited several hospitals in Ontario and British Columbia, secretly applying a harmless gel to high-touch surfaces, then returning 24 hours later to see whether the gel had been removed, which would indicate the surface had been cleaned.

The program revealed many instances where cleaning had not been carried out, and that sparked a response from the Niagara Health System (NHS), the biggest in the country, whose hospitals have suffered a recent Clostridium difficile outbreak. It has decided to end its relationship with the private U.S. cleaning company Aramark.

NHS authorities wouldn’t specify why they made the move, but did tell CBC News they will be adding “the equivalent of 18 new full-time cleaning positions.” It has been suggested that Aramark was at least partly to blame for the C. difficile outbreaks.

“They made decisions around staffing levels,” Eoin Callan of the Service Employees International Union told CBC News. “They made decisions around what was cleaned, what was not cleaned — how frequently things were cleaned. And they also had an incentive to use cheaper diluted cleaning chemicals that were not as effective because it allowed them to pad their profit margins.”

Ontario Minister of Health Deb Matthews wouldn’t talk on camera, but told Marketplace: “We expect our hospitals to make the best decisions to protect patient safety in their communities.”

The NHS decision may be good news for those awaiting a hospital stay, but cold comfort to people such as Ken Hough, who returned home three weeks ago after a stay at St. Thomas Elgin General Hospital in St. Thomas, Ont.

“You really wouldn’t believe it, unless you’ve seen it,” Hough told Marketplace reporter Erica Johnson, describing rooms where he says dirty bandages and plastic needle covers littered the floor.

The bathroom was the worst, he said.

“Feces on the back of the toilet,” he recalled. “You’d go in to use it, and you’d pivot. I put on rubber gloves to use the toilet seat and just thought, no, I’m not doing this.”

Emails from across the country echoed Hough’s observations.

“The waste baskets in the bathroom were overflowing,” an email from Vancouver read. It took “three days to clean up vomit,” a Calgary viewer wrote. And an email from Winnipeg described “feces left on the floor” for days.

About one-third of hospitals in Ontario outsource their janitorial services, CBC News has learned, and that figure is higher in British Columbia and some other provinces. With files from the CBC’s Erica Johnson Source

That is good news for a change. Now if they could get all the hospitals cleaned up.

With the number of deaths and those who got sick, because of the filth, there were no savings.

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Poverty crushing the People of Haiti

By Dawn House
November 28 2008

Poverty is so crushing in Haiti that a simple cut or broken bone can become so infected in slums plagued with filth and raw sewage that the only remedy is amputation.

Adding to the misery in the Western Hemisphere’s poorest nation are hurricanes — Fay, Gustav, Hanna and Ike this year left 790 people dead and hundreds more injured, and now facing life-threatening infections.

But amputation can be a death sentence in Haiti, which depends on manual labor for survival, said Salt Lake City physician Jeff Randle, who has treated Haitians for a decade. It’s not uncommon for impoverished families, sometimes believing the injured are under a voodoo curse, to abandon disabled adults and children in the streets.

Randle, who first witnessed such despair while on an LDS Church mission, founded Healing Hands for Haiti in 1998. The nonprofit charity, based in Salt Lake City, has become the only agency in Haiti to provide wheelchairs, prosthetic limbs and braces for people who have lost limbs or were born with a disability.

The group needs donations, medical supplies and health-care professionals willing to volunteer a week or two to help staff its clinic in the capital city of Port-au-Prince.

The first year, 14 volunteers headed by doctors and social workers from LDS Hospital in Salt Lake City paid their own way to Haiti, where they provided rehabilitative therapy for more than 300 patients in 10 days. Despite political unrest and corruption in the country, almost all signed up to go the second year.

In the ensuing years, Randle has been joined by medical teams from 16 states. Most, including Randle, pay their own way while donations help with travel costs for the younger professionals. Last year, 21 medical workers from Canada raised $39,000 to finance their trip and fund treatment and training projects. The volunteers filled 42 large hockey bags with equipment and supplies and used 112 donated teddy bears as padding.

Healing Hands for Haiti has grown to a paid staff of 40 at its 7-acre compound in the foothills of Port-au-Prince. The group supports a clinic, school and shop where Haitians are trained to make prosthetic limbs and provide therapy for disabled adults and children. The group also conducts classes for workers from orphanages in taking care of their disabled charges, and lobbies schools to accept disabled children.

The annual budget is $180,000, “and each year I have no idea where the money is going to come from,” said Randle, who chairs the foundation. “But somehow, it comes.”

Said the group’s executive director, Jim Stein of Minneapolis: “Our most immediate need is money to support our staff in Haiti and to buy equipment and supplies.”

Last year alone, 399 wheelchairs were distributed throughout the island. And recently, an anonymous donor gave $250,000 to help jump-start the construction of what will be Haiti’s first rehabilitation hospital.

Recently, Healing Hands gave seminars after the November collapse of a ramshackle school on the outskirts of Port-au-Prince, where more than 90 people, many of them children, were killed and more than 160 were injured. Haitians were taught about evacuation planning, survival skills and managing emotions in a country where little attention has been paid to building codes.

The need is desperate.

In October, a top United Nation’s official warned that the devastation from this year’s hurricane season has dealt a severe blow in efforts to combat poverty, according to the U.N. News Service.

Emergency Relief Coordinator John Holmes said that the four successive hurricanes have left an estimated 1 million people needing humanitarian relief and major recovery assistance.

Even before the storms, 80 percent of the island’s population lived under the poverty line and more than half in abject poverty, according to a report from the Central Intelligence Agency.

Two-thirds of all Haitians depend on small-scale subsistence farming and remain vulnerable to damage from frequent natural disasters made worse by the country’s widespread deforestation in lands cleared for food and fuel. The report said that inadequate supplies of potable water and soil erosion remain major environmental problems.

Source

They need a lot more help then they are getting.

Don’t turn your back on girls – Sexual violence in Haiti

27 November 2008

Sexual violence against girls in Haiti is widespread and pervasive and, although already at shocking levels, is said to be on the increase. While information on the true levels remains scarce, there is much evidence of sexual violence both in the family and within the wider community, particularly by armed gangs.

Public security and the legacy of sexual violence
Against a backdrop of kidnappings, criminal violence and gang warfare, violence against women and girls in the community has soared. One trend is the prevalence of rapes involving groups of armed men.

For the three years that followed the military coup in 1991 when President Jean-Bertrand Aristide was ousted, rape was used as a political weapon to instil fear and punish those who were believed to have supported the democratic government. During this time, there were widespread reports of armed men raping women.

Since the fall of the military regime, this has become a common practice among criminal gangs. In run up to Haiti’s annual carnival in February last year, 50 cases of rape were reported in just three days in the capital against women and girls in the capital Port-au-Prince.

Violence in the family is also prevalent and often hidden. Children often lack the resources and support they need to report violence in which family members participate or collude. The result of the failure to acknowledge and address this problem is a social climate in which violence in the family is seen as normal and inevitable.

Poverty in Haiti is extreme and plays a major role in putting girls at greater risk of sexual violence. Girls are bribed to remain silent by perpetrators, who are able to give them money to pay their schools or accommodation fees. Others who go in search of a public place with lighting by which to do their homework because their home has no electricity are attacked by groups of men.

Girls who become pregnant as a result of sexual violence find themselves at risk due to the lack of adequate healthcare. Only one in every four births in Haiti is assisted by qualified health personnel and large numbers of women and girls are dying as a result of pregnancy related complications.

The consequences of sexual violence on girls are profound and lasting. In addition to immediate physical injuries, survivors may have to face unwanted pregnancy; sexually transmitted diseases; and mental health problems such as post-traumatic stress disorder, anxiety and depression.

These consequences can have particularly series long term effects on girls, who are at higher risk of dying during childbirth or pregnancy and may also find their education disrupted, or find themselves excluded from school due to pregnancy.

One girl who raped when she was eight years old said: “I was going to school, but I left after I came here [to a shelter] because my father raped me. I was in the first year. I loved copying the lessons, writing. When I grow up I would like to be a doctor.”

Barriers to justice
Girls are often unwilling to report cases of rape, largely due to shame, fear, and social attitudes that tolerate male violence. Another major disincentive to reporting is the lack of confidence that girls will experience a positive and supportive response from law enforcement officials.

In some rural areas, the sole representative of the justice system is the justice of the peace. It is not uncommon for the justice of the peace to encourage girls who have faced violence accept an “amicable settlement” with the family of the perpetrator.

The justice system in Haiti is weak and ineffectual. The Police unit in charge of protecting minors is woefully under-staffed. In March 2008, the unit had 12 officers to cover the entire country and not a single vehicle. It is not surprising that so many of those who attack girls are never brought to justice, and so many girls feel there is no purpose in reporting crimes of sexual violence.

The authorities in Haiti have taken steps in recent years to address the problem of violence against women and girls. The Ministry of Women’s Affairs was established in 1994 and has been involved in important initiatives to address the problem.

In 1995, a National Plan of Action to Combat Violence Against Women was adopted. If implemented, this could bring about significant improvements in prevention and punishment.

The Haitian authorities face major challenges posed by the ongoing public security crisis, a succession of humanitarian disasters, and high levels of poverty and marginalization. These important concerns cannot be allowed to drown out the needs of Haitian girls.

Amnesty International is calling on the Haitian authorities to take immediate action to safeguard the rights of girls:

  • Collect comprehensive data on the nature and extent of violence against women and girls. The lack of data currently stands in the way of devising effective solutions;
  • Investigate and prosecute all complaints of sexual violence;
  • Ensure that police provide a safe environment for girls to report sexual violence, and ensure that all complaints are promptly and effectively investigated.

Source

Sanctions have played a role in the poverty. Recovery could take decades or longer unless outside help is increased.

Haiti Sanctions

Study Says Haiti Sanctions Kill Up to 1,000 Children a Month

By HOWARD W. FRENCH,  November 9, 1993

International Sanctions on Haiti Fueled Repression, UN Official Says

By Don Bohning,  March 1, 1999

Seems to me Sanctions are a form of extermination, of innocent people.

Economic sanctions are a “Weapon of Mass Destruction”

Published in: on November 29, 2008 at 5:09 am  Comments Off on Poverty crushing the People of Haiti  
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