Home' Trinidad and Tobago Guardian : November 27th 2015 Contents On Tuesday, a pedestrian
collapsed on a city street.
People walked by, police
officers looked on, no one
responded to the frantic cries for
help from the man s wife and 45
minutes elapsed before the man
was taken to a nearby hospital
where he died.
The circumstances which led
to the death of 63-year-old
amputee Keith Sitahal were not
only tragic but highlight yet
another of the failings in T&T s
public health system.
That an ailing citizen could
collapse on a street in the centre
of San Fernando and remain
there for the better part of an
hour is an indictment of the
country s medical emergency
services which have been oper-
ating well below par for a con-
siderable length of time.
Public complaints about the
slow response times from ambu-
lances are not new and the
heart-wrenching account of the
incident by Mr Sitahal s widow
should evoke an immediate
response from Health Minister
Terrance Deyalsingh and all
other stakeholders---not just
those directly linked to the
ambulance services but every
level of the country s emergency
An autopsy done on Wednes-
day showed that Mr Sitahal died
of a heart attack.
According to the American
Heart Association, brain death
and permanent death start to
occur in 4--6 minutes after
someone experiences cardiac
arrest but conditions can be
reversible if the patient is treated
within a few minutes.
Mr Sitahal was left unattended
on the pavement for 45 minutes
and his chances of survival were
reduced by seven per cent to 10
per cent every minute that he
was left there without any type
of life support intervention.
Medical data shows that few
attempts at resuscitation succeed
after 10 minutes.
Best practice in the US for
medical emergencies is a turnout
time of one minute, and four
minutes or less for the arrival of
a first responder---an objective
that has to be met 90 per cent
of the time.
In Tuesday s case, it is not
known if or when an ambulance
was ever dispatched since it was
a vehicle from San Fernando s
Disaster Management Unit
(DMU), summoned by Mayor
Kazim Hosein, that eventually
transported Mr Sitahal to hospi-
tal for medical treatment, that
was administered much too late
to save his life.
Following a recent public hue
and cry over the slow response
time by an ambulance, there
were disturbing revelations about
an inefficient system of dispatch
and response, with ambulances
and their crews often parked up
at hospitals waiting to properly
hand over patients at Accident
and Emergency departments.
There are also reports of not
enough vehicles or trained para-
medics to respond in a timely
fashion to emergency calls.
That this should be the state
of affairs in T&T, a country
which boasts of a certain level
of development, is unacceptable.
The health authorities must
act urgently to accelerate dis-
patch and response times.
A matter of minutes can be
the difference in life or death,
particularly in the most urgent
of medical emergencies, such as
heart attacks and profuse bleed-
Nothing can be said or done
now to ease the pain and
despair of Mr Sitahal s widow
and his loved ones.
However, every effort must be
made to ensure that this type of
avoidable medical tragedy never
Faster medical responses needed
Public complaints about the slow response times from ambulances are not new and
the heart-wrenching account of the incident by Mr Sitahal's widow should evoke an
immediate response from Health Minister Terrance Deyalsingh and all other stakehold-
ers---not just those directly linked to the ambulance services but every level of the coun-
try's emergency response system.
Iran and Russia are clear about how to
deal with Daesh (ISIS) and end the
conflict in Syria. Both allies agree that
Syrian President Bashar Al Assad
should stay if terror is to be defeated.
They have repeatedly snubbed efforts
by the West to force regime change in
Damascus. Russian President Vladimir
Putin met Iranian Supreme leader
Ayatollah Syed Ali Khamenei in Tehran,
the first such meeting in eight years.
The objective is to work more closely
with the Iranians and synchronise a
strategy to take down Daesh.
Tehran and Moscow's backing for the
regime in Syria means the United
States, Europe and the Arab states may
have to rethink their plan to dump
Assad and focus on Daesh.
Realpolitik demands that Russia and
the West should set aside the issue of
Assad for the time being and co-
ordinate their strengths to defeat the
bigger evil in the form of Daesh.
There is, however, a silverlining for the
West as Iran and Russia have hinted at
transition in Syria through elections
following a ceasefire. In other words,
there is no room for a dictated
settlement, as far as showing the door
to Assad is concerned.
Russia's renewed involvement in the
region and its military operation against
Daesh makes a convincing case for the
West to negotiate with the regime in
Damascus, and work out a long-term
political and geostrategic settlement.
Plunging the region into war and
uncertainty by opening two fronts
against terror is not an option.
Consensus must be reached on Assad's
role or exit in a future Syria. But before
that, Daesh has to be wiped out. The
West and Russia should find common
ground before it's too late.
---The Khaleej Times
SOUND-OFF: West, Russia must find common ground on Assad
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