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Friday, October 09, 2009
Malia Zimmerman :: Townhall.com Columnist
Life and Death Medical Challenges in Maui
by Malia Zimmerman
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Ellen Bellerose rushed to Maui Memorial Medical Center's emergency room on her cardiologist's recommendation after she felt severe pain in her neck, chest and arms. As the pain intensified over the next two hours, she walked up to the counter three times to report difficulty breathing. She was told there were no beds available. "I was becoming terrified that I could die, unattended, in the emergency room." Although registered as a patient for 27 hours, she never entered the main hospital that February 7, 2006, but was billed as if she had.

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Bellerose is one of many Maui residents with complaints about Maui Memorial, the island's only acute care hospital. She along with several dozen other Maui residents and medical professionals shared their agonizing stories in 2006 with the Hawaii State Health Planning and Development Agency (SHPDA), a division of the state Health Department, in hopes the agency would agree to allow competition for the island's only hospital. But SHPDA blocked the plan to open Malulani Health and Medical Center, a 150-bed acute hospital facility, largely at Maui Memorial's insistence, because Maui Memorial claimed competition would put the state hospital out of business.

Today, as debate rages nationally on whether healthcare should be controlled by government or the free market, the battle continues over what healthcare should encompass on Maui - an island with a growing population of about 140,000 people and another 2 million visitors annually. Should there be just one acute care hospital to service an island of 727 square miles, much of the land remote and accessible through just one road?

The current hospital system's supporters say yes, including Maui union-backed lawmakers. However, many Maui residents are deeply troubled by the conditions at the 231-bed hospital, managed by the Hawaii Health Systems Corporation (HHCS), an entity created in 1998 by the state Legislature to manage a dozen state-owned hospitals.

While most in the community don't disparage the hospital's doctors and nurses, they are critical of the old facilities, outdated and broken medical equipment and mediocre management.

Whether it's the smell from the morgue contained by a towel stuffed under the door, battles with toxic mold, the aged, out-of-date medical equipment or the archaic record-keeping computer system, several medical personnel question whether the facility is "safe.”

Wes Lo, CEO of Maui Memorial, maintains his hospital is safe, that national benchmarks are met, that his staff does its best to provide quality care, that the hospital has passed quality and accreditation tests and that they are working to improve.

That doesn't stop the island’s medical personnel from criticizing Maui Memorial for poor fiscal and patient management, overcrowding, and the administration’s hard fought battle to keep private competition out.

The lax management and unwillingness to work with doctors frustrates Jane Kocivar, an MD in private practice who is on call at Maui Memorial.

Jeffrey M. Drood, M.D., private practitioner and cardiologist and electrophysiologist on staff in the Maui Memorial Medical Center Department of Cardiology since 1999, says every hospital makes errors, but there are an inordinate number at Maui Memorial.

They note that at a cost of millions of dollars, a new cardiac unit was established this year when patients can be flown to Oahu for better care. "Cardiac surgeons are hired and are not doing any work, yet we don't have basic services and supplies like beds that work, oxygen monitors, blood pressure cuffs, recliner chairs, utensils, napkins, and paper towels for the nurses," says Kocivar.

FACILITIES SUFFER FROM 'OLD BUILDING SYNDROME’

Medical staff members complain about working conditions, particularly in the old wing of the hospital constructed in 1952, where a perpetual battle with mold continues.

Some staff have been reassigned to other hospital areas because of health issues that have arisen likely due to exposure to mold. They are also being treated by physicians for respiratory symptoms similar to what patients experience if they breathe in black mold spores.

Lo agrees Maui Memorial does encounter mold issues from time to time, but makes its best effort to validate and mitigate concerns immediately and was recently cleared. Continued...

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About The Author
Malia Zimmerman is the president of Hawaii Reporter.

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Important information about mold
The following is part of the message that has been sent to hundreds of elected officials throughout the country.

1. “Can Mold Contamination of Homes be Regulated–Lessons Learned from Radon and Lead Policies”? The answer is YES.

http://pubs.acs.org/doi/full/10.1021/es0620585

2. The State of California issued mold remediation guidelines.

http://www.library.ca.gov/crb/06/01/06-001.pdf

3. Several states have passed laws designating September as toxic mold awareness month.

http://www.leg.state.nv.us/75th2009/Bills/ACR/ACR7_EN.pdf

4. The U.S. Surgeon General just announced the federal government’s new Healthy Home Initiative.

http://www.surgeongeneral.gov/topics/healthyhomes/calltoact iontopromotehealthyhomes.pdf

5. The Center for School Mold Help and Homeowners Against Deficient Dwellings have a lot of good information about mold.

http://www.schoolmoldhelp.org

http://www.hadd.com/

6. Three of the experts who have been leading the way are James Craner, M.D., Jack Thrasher, Ph.D. and Ritchie Shoemaker, M.D.

http://www.drcraner.com

http://www.drthrasher.org

http://www.biotoxin.info

7. The following links are from military textbooks.

http://www.envirochex.com/Downloads/Chapter34_Military_Medi cine.pdf

http://www.rand.org/pubs/monograph_reports/MR1018.5/MR1018. 5.chap4.html

8. The University of Connecticut published a handbook in 2004 titled “Guidance for Clinicians on the Recognition and Management of Health Effects Related to Mold Exposure and Moisture Indoors.”

http://oehc.uchc.edu/images/PDFs/MOLDGUIDE.pdf

Toxic mold is a very serious health threat, and we need to do everything we can to help protect all Americans.

Travel Nursing
What a great eye opening article! I've been a travel nurse on Oahu twice. I was interested in travel nursing on Maui. So glad I read about Maui Memorial. Definitely this is not a stop for me. What a medical risk for Maui's docs, staff, patients & visitors. Thanks, Malia, for all the enlightening info.
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