标签： Jamaica

Three years after an initial audit identified systemic problems at Jamaica’s National Blood Transfusion Service (commonly referred to as the Blood Bank), insiders and labor representatives are sounding the alarm that the dangerous gaps in operations have never been fixed — and have likely grown far worse, putting public health at severe risk.

A confidential 2023 internal audit conducted by Jamaica’s Ministry of Health and Wellness, obtained exclusively by the Jamaica Observer, lays bare dozens of high-risk failures across every core function of the Kingston-based facility. The audit, which assessed operations between March 2022 and March 2023 as part of the ministry’s routine annual risk-based oversight, examined everything from blood supply planning and donation processing to compliance with Caribbean regional health standards, record-keeping, and inventory management.

Auditors uncovered a cascade of critical violations that directly threaten patient safety. Among the most alarming findings: 79 blood donors who tested positive for infectious diseases had their results never marked on official processing records, meaning there was no clear tracking of which blood units should have been discarded. In another incident spanning three months in 2022, 995 bags of collected whole blood had no independent review of their processing records, and four contaminated units were only marked “Do not use” in pencil with no formal follow-up.

More than 900 whole blood units collected during that same period were not tested for pathogens within the mandatory 24-hour window after collection, with delays ranging from one to 10 days. Additional gaps included 1,027 blood request forms missing key details such as the requesting medical officer’s name, signature, registration number, and blood unit expiry date; 25 forms with incorrect laboratory identification numbers; and a poorly maintained inventory system with no evidence of required daily physical counts, leaving 246 daily inventory reports unsubmitted for review.

Sixty-seven blood units and components were released to clinical settings with no formal request on file, and informal telephone requests for blood were never logged. Form adjustments were made regularly with no documentation of which staff member made the changes. Records also showed a 386-unit discrepancy between the number of blood units logged as released and the number verified as released, with no explanation for the unaccounted for units.

On the administrative side, 22 out of 25 reviewed standard operating procedures (SOPs) had expired between April 2022 and March 2023. One core SOP for blood collection has remained stuck in draft form since 2018, 10 SOPs were never signed, reviewed, or approved by responsible leadership, and the facility has no active steering committee to guide organizational decision-making. The Blood Bank also failed to adhere to the Caribbean regional requirement that SOPs be reviewed annually, instead following an unscheduled three-year review cycle that violates regional standards.

Last week, frustrated Blood Bank workers spoke to the Observer on condition of anonymity, with others conveying their concerns through their trade union representative. Insiders said they decided to speak out after years of failed attempts to push leadership to address the gaps, with public frustration boiling over following a recent incident: an infant born with cancer reportedly contracted syphilis via a blood transfusion at Kingston’s Victoria Jubilee Hospital.

A senior Blood Bank source argued that persistent systemic flaws like those that led to the infant’s infection stem from unqualified personnel being placed in critical roles, particularly in the Quality Control Department. “Because of the lack of experience in the Quality Control Department, the Blood Bank started to struggle. They should have been implementing strong measures to ensure that the system functions at the highest level. What happens is that people are learning on the job,” the source explained.

The insider called for an independent special audit to assess whether any of the 2023 report’s serious flaws have been fixed, and to trace how many contaminated blood units may have already entered the public supply. “You may come to now find that by going back through all the documentation that you have more than one positive unit of blood that may have left the Blood Bank, and we need to find out how widespread the problem is,” the source added. “Somebody needs to be held accountable.”

Multiple attempts by the Observer to get official comment from Blood Bank leadership and Health and Wellness Minister Dr Christopher Tufton were unsuccessful. Tufton is scheduled to deliver his 2026/27 Sectoral Debate address to Jamaica’s House of Representatives the day after the Observer’s reporting.

St Patrice Ennis, general secretary of the Union of Technical, Administrative & Supervisory Personnel (UTASP), which represents Blood Bank employees, told the Observer that staff warnings about operational failures have been ignored for years. “For a prolonged period various members of staff have written complaints and expressed concerns about the operating procedures at the Blood Bank and had warned about the potential for the occurrence of this kind of situation,” Ennis said, referencing the infant’s syphilis infection.

Ennis said he is outraged by the incident, noting that no official has yet given public assurance that current blood testing and distribution processes are free of dangerous flaws. “While we may know of this incident, we can’t say with certainty that this is isolated. They [staff members] expressed that the procedures were not being followed and the warnings for the potential of such occurrence were ignored. These problems are solvable problems, and that is what makes it frustrating and makes one feel angry. These are problems that can be solved and not at any great expense,” Ennis said.

“We know what is to be done and it is just to hold people accountable. Until we start to do that we are going to have recurrences of problems and we are going to seem alarmed only when it reaches the public domain. We are not even sure if after that case which we are talking about, if proper measures have been put in place to correct it. This can affect any one of us,” he added.

On the occasion of International Nurses Day, the Pan American Health Organization (PAHO) issued a clear call this Tuesday from Washington D.C., urging Caribbean nations to implement bold, targeted measures to reinforce and scale up advanced practice nursing across the region. PAHO officials frame this move as a foundational strategy to expand access to critical health services and build more resilient, community-focused health systems that better serve population needs.

Across the Americas, including the Caribbean, nurses make up the single largest segment of the regional health workforce, totaling nearly 7.4 million practicing professionals. These frontline workers carry core responsibilities across every area of public health: from proactive health promotion and disease prevention to long-term management of chronic conditions, and ongoing support for vulnerable communities. Their work is particularly vital in rural and remote regions, where access to physician care is often extremely limited.

Dr. Jarbas Barbosa, PAHO’s director, emphasized that advancing the role of advanced practice nursing requires four interconnected actions: integrating these professionals more deeply into primary health care systems, embedding innovative digital tools into nursing practice, expanding nursing education opportunities, and increasing nurse representation in public health policy development. All of these steps, he noted, are critical to boosting the accessibility, quality, and long-term sustainability of health care across the region.

Advanced practice nurses are defined by PAHO as highly trained specialists with the qualifications to take on expanded, autonomous clinical responsibilities. This includes full scope of work from patient assessment, diagnosis, and treatment to ongoing monitoring of both individual and community health outcomes. Globally, more than 100 countries have already adopted these expanded nursing roles, with the United States and Canada operating long-standing, successful advanced practice nursing models. Several Latin American nations have already begun rolling out updated regulatory frameworks, specialized training programs, and new person-centered care models, but much of the Caribbean still has progress to make.

Extensive global evidence, PAHO reports, confirms that when advanced practice nurses receive sufficient autonomy and institutional support, they directly improve population access to care, strengthen continuity of treatment for patients with chronic conditions, and boost overall patient satisfaction through a more compassionate, individual-centered approach to care delivery.

Despite these proven benefits, widespread adoption of advanced practice nursing in the Caribbean still faces notable barriers. Outdated regulatory frameworks that restrict nursing scope of practice, a persistent shortage of specialized advanced nursing training programs, and systemic resistance to shifting traditional models of health care delivery all slow progress toward expansion.

To address these challenges, PAHO has launched targeted regional support initiatives, working directly with national governments to update health workforce planning, foster collaborative interprofessional health care teams, and develop modern, person-centered regulatory frameworks that accommodate expanded nursing roles.

In closing, PAHO reaffirmed that expanding advanced practice nursing is not just a measure to improve health system efficiency—it is a strategic, once-in-a-generation opportunity to move the region closer to universal health coverage, while building health systems that are more responsive to the actual evolving health needs of populations across the Americas.

MADRID, SPAIN – In the wake of a fatal hantavirus outbreak aboard the cruise vessel MV Hondius that prompted a full evacuation of passengers and crew, World Health Organization Director-General Tedros Adhanom Ghebreyesus has emphasized that the global public health threat remains low, even as vigilance must be maintained to contain the rare virus. The incident, which has claimed three lives and left one French passenger in critical condition, has triggered international public health coordination, alongside diplomatic negotiations over repatriation and care for those exposed. As of this week, health authorities are working to prevent further spread, while stressing that the outbreak does not mirror the early days of the COVID-19 pandemic.

Three passengers have now died from the Andes variant of hantavirus, the only strain confirmed to transmit between humans. There are currently no licensed vaccines or targeted antiviral treatments for the pathogen, making monitoring and quarantine the primary public health interventions. As of Tuesday, an AFP compilation of official data places the total number of confirmed cases at seven, with one additional probable case, all among the ship’s passengers and crew. Exposed individuals hold citizenship from six nations: the United States, the United Kingdom, France, Spain, Switzerland and the Netherlands.

One French national over the age of 65 with pre-existing underlying health conditions remains in intensive care on mechanical ventilation, according to Dr. Xavier Lescure, speaking at a French health ministry press conference. The patient is classified as having a severe case of the rare disease, Lescure confirmed, without providing further personal or clinical details.

The full-scale evacuation of more than 120 passengers and crew from the MV Hondius was carried out over Sunday and Monday off Spain’s Canary Islands, after the vessel was denied entry to Cape Verde. It had previously anchored off Cape Verde’s capital Praia, where three infected people were airlifted to Europe for emergency care last week. After Spain agreed to allow the ship to anchor for evacuation, the regional government of the Canary Islands publicly and strongly opposed the decision, creating tension between national and regional authorities.

In a joint press conference with Spanish Prime Minister Pedro Sanchez held in Madrid Tuesday, following the completion of evacuation operations, Tedros pushed back against comparisons to the emergence of COVID-19. “There is no sign that we are seeing the start of a larger outbreak,” he stated, though he cautioned that vigilance is far from over. “But of course the situation could change, and given the long incubation period of the virus, it’s possible we might see more cases in the coming weeks.”

All repatriated individuals are following public health protocols aligned with WHO guidance, which call for a 42-day quarantine period and continuous monitoring for high-risk contacts – a timeline matched to hantavirus’ maximum six-week incubation period. The Netherlands, which received 26 evacuees on the first repatriation flight Sunday, reported all passengers tested negative for the virus after thorough medical screenings. All 26 are still required to complete quarantine, per public health rules, and two subsequent flights carrying an additional 28 evacuees have also arrived in the country, with all passengers entering isolation.

Tedros noted that while the WHO encourages all nations to adopt the organization’s recommended guidelines, individual countries retain the authority to set their own public health measures. Speaking at a summit in Nairobi, Kenya Tuesday, French President Emmanuel Macron said his country has the situation fully under control, and called for strengthened coordinated action between European nations and the WHO to manage the outbreak.

The incident created unexpected diplomatic friction, as nations negotiated over responsibility for receiving the vessel and caring for exposed passengers and crew. In his remarks, Sanchez defended Spain’s decision to allow the evacuation off the Canary Islands, framing the choice as an act of global solidarity. “The world does not need more selfishness or more fear. What it needs are countries that show solidarity and want to step forward,” he said.

After the full evacuation was completed, the MV Hondius departed Tenerife Monday with only a minimal skeleton crew on board. It is scheduled to arrive in the Netherlands this Sunday, where it will undergo full disinfection protocols.

Hantavirus is naturally transmitted through contact with the urine, feces, and saliva of infected rodents. The Andes variant is endemic to parts of South America, including Argentina, where the MV Hondius departed on its transatlantic cruise bound for Cape Verde on April 1.