Vision fades while the health system fails

SHAL­IZA HAS­SANALI

Se­nior In­ves­tiga­tive Re­porter

shal­iza.has­[email protected]

Hun­dreds of pa­tients across Trinidad and To­ba­go’s pub­lic hos­pi­tals may be wait­ing in lim­bo for crit­i­cal surg­eries—some for months, oth­ers for years.

Now, a com­mit­tee ap­point­ed by the Min­istry of Health is try­ing to put hard num­bers to those de­lays.

Tasked with au­dit­ing the back­log of surg­eries across the five Re­gion­al Health Au­thor­i­ties (RHAs), the com­mit­tee is al­so doc­u­ment­ing how long pa­tients have been wait­ing for var­i­ous pro­ce­dures—in­clud­ing cataract and oth­er eye surg­eries.

The find­ings will be com­piled in a re­port to be de­liv­ered to Health Min­is­ter Dr Lack­ram Bo­doe by the end of the month.

In a What­sApp mes­sage to the Sun­day Guardian on Wednes­day, Bo­doe said the da­ta would help the min­istry un­der­stand the scope of the back­log and guide fu­ture in­ter­ven­tions.

The com­mit­tee, Bo­doe said, would have to come up with “rec­om­men­da­tions on ways to ex­pe­dite these surg­eries where nec­es­sary”.

The Min­is­ter of Health’s com­ments came just af­ter Pauline Bharat shared her frus­tra­tion over months of fu­tile clin­ic vis­its at the Er­ic Williams Med­ical Sci­ences Com­plex, Mt Hope, where her eye treat­ment seemed to be go­ing nowhere.

Af­ter no clear an­swers were forth­com­ing, Bharat gave up.

The 62-year-old woman found her­self stuck in an end­less loop of ap­point­ments and de­lays—un­til frus­tra­tion fi­nal­ly forced her to walk away.

Bharat’s ex­pe­ri­ence is not unique as she was one of hun­dreds of cit­i­zens wait­ing long pe­ri­ods for elec­tive surg­eries—cas­es that the Health Min­istry’s re­view is now try­ing to quan­ti­fy and ad­dress.

She is al­so no stranger to pain and per­se­ver­ance, hav­ing en­dured unimag­in­able loss in 2006 when her six-year-old son, Sean Luke, was mur­dered. An au­top­sy showed US-born Luke died of in­ter­nal in­juries aris­ing from be­ing sodomised with a cane stalk. The mur­der, which at­tract­ed na­tion­al and in­ter­na­tion­al at­ten­tion, was record­ed as one of the coun­try’s most grue­some.

Fac­ing yet an­oth­er kind of strug­gle, she tried to nav­i­gate what seems to be an over­whelmed pub­lic health sys­tem.

Bharat’s eye trou­bles be­gan in 2023 when she yanked a crow­bar from the ground and it slipped from her hands, strik­ing her left eye and leav­ing it swollen and blood­shot.

Her vi­sion lat­er be­gan to fail.

Last year, Bharat was ex­am­ined by two eye spe­cial­ists at Mt Hope, one of whom rec­om­mend­ed that she pur­sue pri­vate treat­ment.

“The doc­tor told me they don’t do any­thing in the hos­pi­tal,” she re­called.

She nev­er re­turned to the pub­lic hos­pi­tal, in­stead spend­ing her life sav­ings at a pri­vate eye hos­pi­tal in hopes of restor­ing her sight. Doc­tors di­ag­nosed her with di­a­bet­ic mac­u­lar oede­ma (DME), a con­di­tion where ex­cess flu­id builds up in the mac­u­la, caus­ing it to swell and re­sult­ing in vi­sion loss.

“Each vis­it cost me $1,000,” Bharat said, but her eyes showed lit­tle im­prove­ment.

Un­able to con­tin­ue her sewing work, Bharat was forced on­to the bread­line. To make mat­ters worse, her ap­pli­ca­tion for a so­cial dis­abil­i­ty grant was re­ject­ed, she said, be­cause she still re­tained some vi­sion in one eye.

“They said I was not blind enough,” Bharat ex­plained. “I tru­ly be­lieved that they did not care. It was a cru­el and vin­dic­tive act.”

From los­ing her son, her job, and her hopes, to go­ing par­tial­ly blind, de­spair and dark­ness took over Bharat’s life.

The pho­tographs of Luke, which she had held close for 18 years to com­fort her aching heart, be­gan to ap­pear hazy.

Al­though Bharat had crossed the age of 60, she was not en­ti­tled to a month­ly $3,000 NIS grant as she nev­er paid con­tri­bu­tions. And she would have to turn 65 to qual­i­fy for a se­nior cit­i­zen grant or pen­sion. There seemed no way out.

“I felt hope­less,” an emo­tion­al Bharat said dur­ing a re­cent in­ter­view with the Sun­day Guardian. Bharat said she had to turn to God for courage and strength be­cause she could no longer cope.

Last No­vem­ber, Bharat shared her plight in the Sun­day Guardian.

Her sto­ry moved Sam Bas­deo, man­ag­ing part­ner of Eye­sTT, who stepped in to of­fer eye treat­ment at the com­pa­ny’s ex­pense.

“Sam helped me in my dark­est hour,” Bharat ad­mit­ted.

Af­ter four months of treat­ment cost­ing over $20,000, her eye­sight be­gan to im­prove.

“Some­thing in me shift­ed. I knew then that there was some­thing I could do to make a dif­fer­ence,” Bas­deo re­called.

“She has been see­ing bet­ter. It is still a work in progress. We tried to re­move all her fi­nan­cial bar­ri­ers so that she would have a fight­ing chance of re­gain­ing, im­prov­ing and pre­serv­ing her ex­ist­ing vi­sion.”

Bas­deo not­ed that Bharat has suf­fered sig­nif­i­cant vi­sion im­pair­ment in both eyes due to di­a­betes.

“It is my opin­ion that it is very dif­fi­cult for her to be able to sur­vive in­de­pen­dent­ly and safe­ly. From a clin­i­cal and hu­man­i­tar­i­an stand­point, in­di­vid­u­als in her sit­u­a­tion of­ten ben­e­fit from ad­di­tion­al sup­port, whether it be com­mu­ni­ty as­sis­tance or so­cial wel­fare pro­grammes.

“While we do not make de­ci­sions on el­i­gi­bil­i­ty, we do hope that her case is giv­en thor­ough, thought­ful con­sid­er­a­tion by the rel­e­vant agen­cies. Any as­sis­tance giv­en to her could have an as­tro­nom­i­cal im­pact on her dai­ly life.”

Eye­sTT’s chief oph­thal­mol­o­gist Dr Do­ri­an Dwari­ka pro­vid­ed Bharat with di­ag­nos­tic scans, laser pro­ce­dures, and in­trav­it­re­al Avastin in­jec­tions.

Dwari­ka ex­plained that Bharat had “a lev­el of what we call the two blind­ing char­ac­ter­is­tics for di­a­bet­ic eye dis­ease; some­thing called bleed­ing where there’s ac­tu­al fresh blood in the eyes and some­thing called swelling, where di­a­betes caus­es the back of the eye in a mi­cro­scop­ic lev­el to swell”. This, he said, could lead to de­creased vi­sion.

He added that Bharat was at a crit­i­cal stage where treat­ment was nec­es­sary, “or else it could have long-term ef­fects in caus­ing her to lose more vi­sion”. One of her eyes, he said, was in the legal­ly blind cat­e­go­ry.

“Legal­ly blind is not that she can’t see at all, but it means that lev­el of func­tion was be­low what we con­sid­ered to be a lev­el that is con­sid­ered blind­ing.”

Dwari­ka con­firmed they were able to sta­bilise the di­a­bet­ic dam­age.

Fresh eyes on Bharat's plea for help–MP Jear­lean John

On Tues­day, the Sun­day Guardian con­tact­ed Bharat’s Cou­va North MP, Jear­lean John, re­gard­ing her case.

John said she was aware of Bharat’s mat­ter as her rep­re­sen­ta­tive.

“I have seen Sean Luke’s moth­er twice. So I am aware. Now that there is a change in the regime, maybe I want some­body to look at it (file) with a fresh pair of eyes. I am go­ing to flag it to present to the min­is­ter,” John said, re­fer­ring to Van­dana Mo­hit, Min­is­ter of the Peo­ple, So­cial De­vel­op­ment and Fam­i­ly Ser­vices.