From all that has happened over the last six months, I feel compelled to rise in my own defense. In August 2006, I was asked to take up the duties of Hospital Administrator and after some discussion with co-workers, friends and family, I reluctantly accepted. Part of my consideration was that I had become convinced that with my extensive training in Laboratory Management and People Management, I was ready to confront the challenge. I plunged in with all my energies to do a great job.

Regrettably, support was never forthcoming!

Having left the laboratory, a unit that is built on very sophisticated management and technical systems, it seemed very logical for me to transfer that knowledge and experience which I gained.

The Alexandra Hospital Laboratory participated in the regional exercise (spearheaded by CAREC and sponsored by the European Union) to bring Caribbean laboratories up to international standards. So I grew accustomed to operating under very high standards. I particularly enjoyed that because it blended so nicely with my own personal attributes and values. I have always been convinced that our size ought not dictate the standards against which we operate.

At the laboratory, we expose ourselves to be tested by international agencies to confirm that the results which we deliver to our clients are correct. The preventive maintenance on our Instruments is done to ensure not only that a high standard is maintained but also to ensure that we maintain, at the very least, regional standards. Excellence is and has always been my watchword!

So the laboratory was my model. I figured that if the laboratory could rise to regional standards, then so could the hospital! The journey began! In retrospect, maybe I was too ambitious. What made me feel that the Alexandra Hospital could have risen to a higher standard of care? What made me think that the Alexandra Hospital could have adopted a quality management system?

At present there is a regional drive towards accreditation of health systems. This process is consistent with international standards for delivery of health care. In every developed country in the world such accreditation is critical in the delivery of health care to ensure that proper standards are maintained. Anguilla had its first inspection by a Canadian accreditation team approximately two years ago. Why is Nevis not interested? Are we prepared to wait until the First World advises its citizens to travel only to countries whose health systems are accredited to ensure guaranteed treatment? Why is mediocrity so meticulously tolerated?

A quality management system, very simply put, is a system which documents every process that takes place within an organization. There is a paper trail for everything! There must be policies and procedures! There must be training and continuous training! For example, systems are set up to prevent, let's say, the wrong body from being delivered to the funeral parlour.

There must be a system set up to recruit and retain staff. Why is there such a high turnover of doctors? Why are we not able to get our young people excited about nursing as a rewarding profession? Why is there a growing problem with clients not honouring their obligation to pay for services rendered?

A quality management system is designed to address all these issues. Nobody told me that on the priority list, these were less than important concerns.

In collaboration with a consultant, we (Heads of Departments within Health) worked assiduously on the Ministry of Health's Strategic Plan which is yet to be completed and adopted. I directed my attention to the system that employed non-established (NE) workers because of the fact that it needed some structure. We developed job descriptions with the subsequent launch of the handbook for the NE workers at the Alexandra Hospital.

A maintenance manual was drawn up for the Maintenance Unit. Up to the point of my departure, I was working on a procedure manual for the administrative office of the hospital. It has not been introduced because now it is unclear whether or not these procedures will be embraced. And of course, procedures change as changes take place.

So my vision was to take the Alexandra Hospital on a "quality" journey that had the potential to climax into something beautiful. Something which was intended to make all Nevisians proud! I thought that the Alexandra Hospital could become the model of the Eastern Caribbean. But guess what? Anguilla is leading the way! Kudos to you Anguilla!

We developed a system of recruitment of staff involving interviews and a system of placement at the Flamboyant Home involving the Social Services Department. The pieces seemed to have been falling nicely in place. And then I got a rude awakening! My style of management was described to be "too classic!" So while I was at the hospital and the authorities related directly to persons below me, instead of relating to me directly [and professionally], it was then that I understood the level at which they wanted to operate.

And when the authorities called the hospital and said "I need to get that woman out of the hospital by the end of the day," I understand the level at which these all puissant people actually operate. I have always been unable to operate at such standards. Is it because I was born under the zodiac sign of Cancer? I am haunted by these experiences.

If anybody were to ask me why this is so shocking for me, I would respond by saying that I held the members of the Nevis Reformation Party to a higher standard! How can we be satisfied with such low standards? Why does the Public Service continue to descend into meaninglessness? Why are the other countries in the region disintegrating just like ours? Maybe I should agree that this was prophesied centuries ago. It is nonetheless a tragedy.

My understanding is that the Public Service is supposed to be policed by the Public Service Commission. What is their real function? I have noted from my observation over the years how the Public Service Commission has been manipulated by the political directorate and really when I heard that my cousin and Great Teacher was appointed to that august body, I hoped..... I am now disappointed beyond words!
In my course of study the other day I read "Any religion is better than none!" Are these parallels fitting? Are they correct? Any politician is better than none! Any government is better than none! I see doom… I feel hopelessness… I see despair.
I have to pause for a moment and thank the Cabinet of the Nevis Island Administration for removing me from their trampling path. I remain eternally grateful for now I rest comfortably.

I will use this medium to challenge Nevisians as God fearing people and in all good conscience to rise up and speak out against injustice, unfairness, unethical behavior, unprofessional behavior, evil...........and the list goes on. We cannot and we ought not to allow these Politicians, one after the other, to heap coals of fire upon our heads and run this fair land of OURS into ruin.

I'm inviting you to post your comments and follow me on my blog @http://veetes.blogspot.com