(Written in reaction to stories in this week's Chilliwack papers about possibly downgrading our maternity ward so any mats with any risk would have to go to Abbotsford, which could have quite a domino effect.)
Dear Editor,
Your story about the possible closure of infant nursery beds in the Chilliwack hospital and the effects this could have is welcome and timely. It gives us the opportunity to ask, as a community, what kind of hospital we want for Chilliwack. I hope that most would agree that we want one that welcomes babies and children rather than turn them away.
Many in the community will be aware that it has been some years since we have had access to pediatric beds in Chilliwack. Children who are taken to the Chilliwack emergency ward and who warrant hospitalization end up being transported to MSA Hospital in Abbotsford.
The lack of pediatric beds in Chilliwack has made it hard to attract and retain pediatricians, since they can’t provide in-hospital care to their patients and must refer to colleagues in Abbotsford, and also don’t get sufficient challenging experience to keep their skills current due to the fact that all difficult cases must be transferred.
My son went through an eight-month period in 2004/05 as a toddler when he was hospitalized for asthma four times. Each time, after we were examined by emergency physicians or a temporary pediatrician, we were sent via ambulance to Abbotsford for admission (except for once when we were in the city when he went into crisis).
While he received excellent medical care in Abbotsford, I as a mother found being removed from my community very alienating and difficult. I was removed from my support network. My friends couldn’t drop in to relieve me or bring me food. My husband could only visit once a day because of the time and distance involved and his work and childcare responsibilities. My general practitioner could not drop by on her rounds. We had a different pediatrician assigned to us every time we were admitted (based on who was on call) and I had to lobby each time to be reassigned to my “regular” Abbotsford-based pediatrician. My son has been cared for by 10 pediatricians in his short life. Not great for continuity of care. I spent long hours alone with my sick toddler, who was connected to oxygen and unable to leave the room. I was reluctant to leave his room because to do so I had to leave him in a “crib cage” for his own safety. Being isolated like this with nobody to relieve me made a very stressful situation even more difficult. We also had to endure a scary ambulance ride down the freeway at the height of his crisis each time. (Because of the health concerns and distance involved we were afraid to drive him ourselves and just head straight to Abbotsford from home.) Luckily the weather was always fair for this drive. That’s not always the case.
(During the times we spent in the Chilliwack emergency ward, being assessed or receiving treatment, we were in close proximity to people with stab wounds and head injuries due to fights, and people detoxing from drug overdoses. Not the most kid-friendly environment. The suggestion to create a kids-only area in our renovated emergency ward is a good one.)
While it may more efficient financially and organizationally to concentrate specialized pediatric beds in one community in a region, centralization is not the best model for a holistic type of health care that includes the family, community, and doctors who know the patient.
Since the time of my son’s health crisis, we as a community have been lucky enough to attract two new pediatricians to Chilliwack. This means that for his ongoing health monitoring, we visit a specialist in our own community, who will still have to refer us to MSA if he goes into crisis again.
Now I hear that our fragile situation of re-establishing the presence of pediatric specialists in Chilliwack is in peril again because the Fraser Health Authority may be closing infant nursery beds in the Chilliwack hospital.
Again, the excuse is being floated that we have a modern new hospital being built just down the freeway.
As I understand it after a conversation with my GP, closing these beds could have a domino effect:
Since most healthy newborns now room in with their mothers, the nursery beds are currently only used for babies who need pediatric care and monitoring.
• If we take a way the beds for newborn patients, any expectant mother with any sort of risk factor will be sent to Abbotsford.
• If there are no beds for newborns needing pediatric care, there is even less incentive for pediatricians to stay in Chilliwack.
• If the medium- and high-risk pregnancies are all referred to Abbotsford, there is less incentive for obstetrician/gynecologists to stay in Chilliwack (another specialty that we have had a hard time attracting and retaining).
• If the obstetrician/gynecologists leave, there is less work for anesthesiologists, leaving less incentive for them to stay in Chilliwack.
• If the anesthesiologists leave, the general surgeons won’t have access to them in order to do their work.
• If the surgeons leave, we are left with more or less a glorified residential care facility, not a small acute care hospital.
• If the specialists leave, it will also be very difficult to maintain the excellent relationship CGH has as a teaching hospital for UBC med students and residents (several of whom I encountered and helped to educate during my son’s medical journey).
• And if we allow only low-risk pregnancies to be admitted and deliver at CGH, there is less incentive and opportunity for local general practitioners to keep their maternity skills active.
How long before there’s no maternity care offered at all? I wouldn’t envy anyone who has babies as quickly as I do trying to speed down the freeway to get to a delivery ward, especially in the inclement weather we can get here.
We could face a future where we’re driving down to the big beautiful new hospital in Abbotsford for almost every medical procedure.
Is that the kind of community-based health care we want in Chilliwack?
We have one of the fastest-growing populations of young families in B.C.
We should have a hospital that reflects that status, one that provides a full range of health care and specialists commiserate with a community of this size, one where babies and children can be born and treated locally and hospitalized in their community when feasible.
If you agree with this vision, discuss it with your physician and ask what you can do to help us realize it. Lobby your MLA and make sure he’s aware of your concerns. Contact the Fraser Health Authority and tell them you believe in community-based health care, not a centralized model.
Regards,
Anne Russell
