A disturbing upward trend of patients being dropped off and abandoned at two of Jamaica’s leading public hospitals has emerged as a growing public policy and social welfare emergency, with senior social workers sounding the alarm that a lack of urgent intervention will push the already strained system into a full-blown crisis. The alarming issue was brought to the forefront during a Friday seminar focused on urban homelessness in Kingston, hosted by the Kingston and St Andrew Municipal Corporation (KSAMC), which gathered more than 35 stakeholders to examine intersections between mental health, homelessness, and healthcare access for vulnerable populations.
Dianne Duke, a senior social worker assigned to both Kingston Public Hospital (KPH) and Victoria Jubilee Hospital, told attendees that rising abandonment of vulnerable patients is not merely a hospital operational problem—it is a deep-rooted societal dilemma that demands coordinated, systemic action far beyond hospital walls. “If this issue is not addressed quickly, it will reach crisis proportions much faster than many policymakers anticipate,” Duke warned.
As of the seminar, KPH is currently managing 23 active open social cases of abandoned or unclaimed patients. Duke outlined that these patients arrive at the public facility through multiple pathways: some are brought in by relatives, neighbors, or good samaritans, but a newly emerging and troubling practice sees private nursing homes transferring low-income patients to public hospitals and abandoning them when family members can no longer afford private care fees. Many of these abandoned patients were already experiencing homelessness before they fell ill, with some surviving by working informal odd jobs in Kingston’s public markets, assisting vendors with loading and carrying goods in exchange for basic support. Once illness leaves them unable to work or care for themselves, they are taken to public hospitals for care—and social workers say they ethically cannot discharge incapacitated patients back to dangerous street conditions. “If a patient cannot care for themselves or move independently, we cannot in good conscience put them out onto the street,” Duke explained.
To prevent the caseload from spiraling out of control, KPH has partnered with cross-sector stakeholders, including local non-governmental organizations, faith-based groups that offer long-term residential care, KSAMC leadership, and the national Poor Relief Department. These collaborative efforts have kept caseloads from growing even higher, Duke noted, but the underlying problem remains unaddressed.
The crisis is not isolated to KPH. Sherene Williams-Hemmings, head of Medical Social Work at the University Hospital of the West Indies (UHWI), told the seminar that her facility is currently caring for 20 abandoned patients ranging in age from 40 to 96 years old. Williams-Hemmings confirmed the upward trend, noting that abandonment cases have climbed steadily since the start of the COVID-19 pandemic. Ninety percent of UHWI’s abandoned patients are senior citizens, the facility is also currently caring for a teenage patient whose family has refused to retrieve him due to the complexity of his ongoing medical condition.
Like their counterparts at KPH, UHWI social workers have stepped in to provide full wraparound care, covering not just medical treatment but also social support and financial assistance, since no family or caregiver is available to take responsibility. Ethical barriers also prevent discharging vulnerable patients to unsuitable living conditions or the street. “We cannot simply put these patients out on the road when they have no family to accept them, or when their pre-hospitalization living situation is unsafe and unsuitable,” Williams-Hemmings said.
While the hospital has partnered with the Poor Relief Department to place abandoned patients in long-term care facilities, progress has been glacial due to overwhelming demand for limited affordable housing and care spaces. To date, only two of UHWI’s abandoned patients have been placed in permanent residential care. Missionaries of the Poor, a local faith-based charity, has offered support, but the system is stretched to breaking point: every existing residential facility is at full capacity, and new openings only become available when a resident passes away. “This is an extraordinarily complex and complicated situation that we are facing as homelessness and patient abandonment rise across the capital,” Williams-Hemmings added.
The seminar, which also explored the growing challenges facing low-income and vulnerable residents of Kingston and St Andrew, ended with a call for expanded cross-sector collaboration to develop long-term sustainable solutions to the root causes of homelessness and patient abandonment.