In 1986, my 46 year old brother died from lung cancer. Dating back to that time there was no proper medication for pain in Trinidad and Tobago. Pain relief came from a mixture of very ordinary drugs, referred to as a “cocktail”, which kept him relatively free from pain. Had he lived much longer and the pain increased, we were told we would have to get permission from the Ministry to import stronger drugs.

Now 26 years later, governments have changed more than once, and the state of treatment for pain relief remains the same. Hereunder is a plea from Dr Jacqueline Pereira Sabga, vice chairman TT Cancer Society; Chairman and medical director of Vitas House, for all cancer patients in the country.

“Over the past four years, repeated pleas for assistance from our respective ministers of health to adjust the importation of medications for pain in this country have fallen on health deaf ears. Despite repeated meetings and letter writing, there has been little or no initiative to rectify this most embarrassing and grievous situation where cancer patients, and to a larger extent, the people of this country are left in agony to bear not only an inefficient system, but a system that cannot facilitate the relief of pain. So patients are left with both emotional and physical pain and disease that a failing medical system cannot amend. This must be unacceptable.

The recurrent pleas are that the government revise the repertoire of medications that are imported into Trinidad and Tobago for pain; not only are the quantities deficient, but the delivery systems and diversity of medications are grossly deficient. On many occasions the limited supply of pain medications are rapidly depleted and there are gaps where sub standard regimes are hatched in an attempt to keep patients relatively pain free.

In a health system that has at its disposal impressive anti cancer medications that are in fact saving lives, we are failing to realise that as our patients live their treatment may consist of long term pain management, and for those that are not as fortunate, we must also facilitate a death that is humane and dignified and pain free.

This situation is quite distressing and undoubtedly sad as the ability to allow Trinidad and Tobago proper importation falls in the hands of those unwilling to do the right thing. The influx of medications that continually fall short of acceptable quantities and types of delivery systems cannot be tolerated any longer. In any humane society it is the people’s right to have a proper health system, and that includes delivery of efficient medications and medical professionals that make a difference, not only in disease outcome but in the lives of all the patients that we treat. There are exceptionally gifted doctors in this country, who are true heroes, but as healers we must rally against a medical system that obstructs our ability to function to our full capacity. Patients suffer.

I reluctantly bring this into the public domain, but the absolute inactivity to rectify this situation has driven me to do so. I am interested not only in pointing out this inherent deficiency but to be part of the solution; but it means that the Minister of Health and his learned team of persons must act on this immediately. This situation cannot and must not be allowed to continue to cause unnecessary suffering to the people of Trinidad and Tobago.

We as physicians are pledged to relieve suffering and pain and to respect the dignity of life, even in its terminal stages.”

Source: http://www.newsday.co.tt/features/0,153116.html