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Clinical Departments

SWRHA Departments

Departments

Department of Anaesthetics and Intensive Care

 

Head of Department: Dr. Crystal Seuradge (Ag)

 

Coverage includes the Intensive Care Unit and High Dependency Unit and the ten operating theatres at the San Fernando General Hospital, the Intensive Care Unit at Augustus Long Hospital and at present senior Anaesthetic coverage at the Point Fortin Hospital.

 

Our department covers two specialities: Anaesthetics (also known as Anesthesiology) and Intensive Care Medicine (also known as Critical Care Medicine).

Anaesthetists are specialist doctors who function to facilitate surgeries and keep patients safe during the perioperative period (before, during and after surgery). Once a patient is booked for surgery (planned or emergency), the anaesthetist reviews the patient to ensure that they are optimised and fit for surgery. This is known as the pre-operative assessment. A plan is then formulated which takes into consideration the patient’s medical condition and surgical procedure.

The anaesthetist provides a combination of analgesia (pain relief), hypnosis (a spectrum from sedation to loss of consciousness) and reversible muscle relaxation (to prevent movement), which facilitates surgery. This process is known as anaesthesia.

Anaesthetists care for patients of all age groups, from the new-born to the elderly. They provide anaesthesia for all surgical specialities, including a 24-hour Obstetric service. There are different types of anaesthesia. One of the most common types is general anaesthesia, which is commonly known as “going to sleep.” Spinal and epidural anaesthesia are other types of anaesthetic techniques in which local anaesthetic drugs are used to provide analgesia and muscle relaxation for lower abdominal and lower limb procedures. Local anaesthetics can also be used to provide anaesthesia and/or analgesia to a specific area of the body (known as peripheral nerve blocks). Once the patient is comfortable, surgery proceeds and the anaesthetist monitors the patient, ensuring that their vital signs remain at acceptable values. They continue to provide pain relief during the surgery and in the immediate post-operative period. At the end of surgery, patients are then transferred to the recovery room where they are monitored before returning to the ward for further post-operative care.

Anaesthetists also assist with sedation and anaesthesia for other services such as radiology and gastroenterology, and utilize their skill sets to assist other medical specialities as required.

Intensive care medicine provides monitoring and support for critically ill patients with potentially reversible pathology. Patients are managed in the Intensive Care Unit (ICU) or High Dependency Unit (HDU), depending on the severity of their illness and support needed. Both surgical and non-surgical patients are managed in our ICU and HDU. An important aspect of ICU and HDU is the high nurse-to-patient ratio and the continuous monitoring of patients, by specialised critical care nurses.

Intensivists are specialist doctors that are highly skilled in resuscitation, intubation, management of ventilation, vascular access and support of injured or failing organs. They review in-hospital patients on the ward as well as patients admitted in the emergency department, who may require their care. Some surgical patients are also admitted post-operatively to the ICU or HDU for further management.

Department of Cardiology

Head of Department: Dr. Kurt Furlonge 

The department of cardiology was established in November 2011. Started with Dr P. Ramoutar as the Specialist Medical Officer, with two registrars and two House Officers. With additional  training of staff by John Hopkins Medicine International via Trinidad and Tobago Health Sciences Initiative, which took place 2006-2014(JHMI) and the Chinese Medical Team Initiative 2014-2016(CMT). Since then the Cardiology Department has grown vastly into what it has today with advancement in the areas of Guideline directed medical therapy of cardiac conditions, cardiac catheterization, Electrophysiology, Echocardiography, other cardiac diagnostic and treatment procedures and preventive medicine. With twenty five beds on the cardiac unit as well as thirty four in the newly designated heart failure ward (old ward 9), and over fifty patients on the medical and surgical ‘outlying’ wards, over twenty non urgent referrals on and in excess of thirty on call referrals on a daily basis the Cardiology Department has become an invaluable asset to the SWRHA and its clients.

 

Services:

INPATIENTS

Daily

Admissions/ A&E Referrals: ≥ 30

Referrals: 

Including clearance for surgery, obstetric patients, 30 

non urgent Vscan (ESRD, CVAs, pedal oedema, LRTIs),

 tachycardia for Ix, etc

Daily census of patients throughout >50

SFGH, SFTH, ICU/HDU/Surgery/Orthopaedic/O&G Wards

 

Pacemaker Implantation 2 patients each week

Formal ECHOs 8-10 patients each day

Paediatric ECHOs 5 patients each week

Focused ECHOs in Clinic 10-15 on Mondays

10-15 on Tuesdays

Vscans 50 daily

ECG’s Accident and Emergency 120 daily

Wards/outpatient  30 daily

 

Invasive Procedures:

Insertion of emergency temporary pacing wire 2-4 weekly

Pericardiocentesis 4 monthly 

 

Clinics Comprises of (patients per week) 

2 General Cardiology clinics (COPC) 150 current /follow-up

30 new

1 Electrophysiology (HRDC) 25 current/follow-up

5 new

1 Adult Congenital Heart Disease (CIC) 20 current/ follow-up 5 new

1 Cardio-oncology Clinic (Friday) 10 current

5 New 

Additional Services:

Ward reviews on Wednesday 50 patients each day

Oncology/ Haematology: Focused ECHOs Friday      10 patients 

Exercise Stress Testing                    Daily                      4-10 patients each day

 

Dobutamine Stress ECHO               Weekly                  4 patients each week

 

24- Hour Holter Monitoring               Weekly                10 patients each week

 

Transesophageal Echocardiography      Weekly              2-4 patients each week

 

Currently on hold due to Covid 19 Pandemic:

Exercise Stress Testing/Training in Peripheral Centers: Couva and Siparia.

 

In process of implementing

Shared Care- Heart Failure Clinic with App involving primary care physicians, nursed in a multidisciplinary team approach. 

 

 

Department of  Ear, Nose and Throat surgery/Dental and Maxillofacial surgery

 

Head of Department: Dr. Naresh Armoogum (Ag)

 

Consultants

Dr. Gailann Jugmohansingh

Dr. Christian Beharry

 

Location/ward: Ward 8, San Fernando General Hospital

The ENT department comprises of doctors who provide both medical and surgical care to children as well as adults with a wide range of acute and chronic diseases of the Ear, Nose and Throat. These surgeons operate on patients with various ENT related pathologies including thyroid, parathyroid and parotid lesions. They also diagnose and manage many head and neck cancers. ENT surgery is a vital part of the difficult airway team. In addition, ultrasound guided fine needle aspiration cytology and hearing assessments are performed in the outpatients clinic. 

The dental unit is responsible for treating oral related problems such as dental caries and the drainage of dental abscesses. The management of acute trauma to the teeth and gums also forms part of their portfolio.

EMERGENCY DEPARTMENT 

 

Head of Department:  Dr. Ricardo Naraynsingh 

Location: Ground floor San Fernando General Hospital extension. 

There are 3 peripheral satellite emergency rooms at Couva, Siparia and Princes Town and an Emergency Room at Point Fortin Hospital all feeding into a central hub at San Fernando General Hospital.

SFGH is the biggest and busiest Emergency Department in the country. There are 60 acute beds split into a contagious disease and noncontagious disease pathway. Patients are prioritized according to a triage tool- CTAS
Level 1
Level 2
Level 3
Level 4
Level 5

Each peripheral center receives approximately 40 to 60 thousand persons per year and  SFGH deals with 80-100 thousands visits annually.

The department is led by a Head of Department , 5 senior Medical Officers, a  Department Manager, Patient Care Coordinator and Head Nurses.


We have 12 Registrars, 40 House Officers, approximately 100 Nurses, Patient Care Assistants and  Enrolled Nursing Assistants. Supporting staff include attendants, Customer Service Representatives, Clerical Staff, Security, Radiographers, Phlebotomist, ECG Technicians and Housekeeping staff.

The role of the Emergency Department is to stabilize unscheduled acute emergency medical, surgical and trauma patients including critical care management, diagnosis and referrals to specialist in- patient teams.  

We are equipped with advanced intervention treatment modalities for video laryngoscopy, intraosseous access devices and ventilators etc.  

Recently we have modernized our services to include electronic medical records. We are also equipped with point of care diagnostics such as bed side ultrasound, blood tests, x-rays and CT scanner.  

We are also prepared to deal with mass casualty incidents such as natural or manmade disasters.  

We have ongoing staff development and training such as CTAS, BLS and UNDP BEC courses etc.

As part of our ever evolving developments we have also started a daytime paediatric filter clinic and acute gynae service in the ED for streamline care for this cohort of patients and aim to have this 24/ 7 service. There is also an acute ambulatory care/ filter clinic service between the hours of 8am to 10pm whereby non urgent care (CTAS 4 and 5  ) patients are evaluated, treatment commenced and referred to the relevant outpatient or inpatient services for continued care and follow up.  

The Emergency Department continues to strive for excellence and the hard working team of clinical and allied staff will continue to work diligently to afford the best possible care for your acute emergencies.

Coming Soon....

Department of Internal Medicine

Head of Department: Dr. Neal Bhagwandass

The SFGH was opened in 1954 by HRH Princess Margaret.

The actual Department of Medicine was started under Dr. James Waterman. Dr. Waterman produced a landmark case series on scorpion sting morbidity /mortality between 1929 and 1933 (698 sting cases), establishing the department as a centre of research and teaching. He was the first to recognize in Trinidad and Tobago that the sting by Tityus Trinitatis (black scorpion) lead to a severe envenomation state which could be fatal. He was also the first to describe scorpion sting pancreatitis. Thus the department’s foundation for future research and publication was laid at inception.

 Dr. Theodosius Poon-King was the subsequent Head of the Department of Medicine from 1958 to 1988 and by then the Department consisted of four Consultants and three Medical wards. He established the Streptococcal Disease Unit at the San Fernando General Hospital in 1966 and after about 30 years of management and surveillance by this unit the incidence of post streptococcal glomerulonephritis and acute rheumatic fever fell to practically nil. In the 1970-s -1980’s, During Dr. Poon-King’s thirty-year tenure at the San Fernando General Hospital, he set up a Cardiology Clinic in response to the high incidence of rheumatic and other forms of heart disease. There was also a Diabetic clinic. He was awarded a Honoris Causa Doctorate of Science by the U.W.I. in 2013.

 

The subsequent Head of the Department of Internal Medicine was Dr. Samuel Ramdial who, together with Dr. Poon-King, recognized the high incidence of Myocardial Infarction in the East Indian population of South Trinidad. Dr. Krishna Persad, a Canadian Trained Cardiologist followed as Departmental Head and he conducted research on the cardiac effects of Chagas Disease (WIMJ 1993). He also instituted an ECHO service in the Department. Dr. Rasheed Rahaman, Cardiologist, assumed headship following Krishna Persad’s retirement. He was the first in Trinidad to use low dose insulin for diabetic hyperglycaemic coma. In addition, Dr. Rahaman inserted the first temporary pace-maker at the SFGH and together with Dr. Lall Sawh implanted the first permanent pace-maker at the SFGH in 1980. Dr. Rahaman also established the Cardiac Investigative Clinic at the SFGH and headed this clinic for about thirty years, even after assuming the Medical Chief of Staff Post at EWMSC. Dr. Rahaman, while Head of the Department together with Head Nurse Valerie Alleyne-Rawlins of the ICU organized a two-day training programme for the House Officers in the ICU. They received basic training in temporary pacing, CPR including defibrillation and ECHO’s, to better prepare them for their role in the ICU and the Department of Medicine. Certificates were awarded at the end of this training programme. Dr Kantapersad Ramcharan established the Neurology Clinic and has published extensively in peer reviewed journals.

Following Dr Kanterpersad Ramcharan’s retirement in 2017, Dr. Sean Perot assumed headship of the Department of Medicine until May 2019 and then Dr. Carlyle Lalla in May 2019. Subsequently, Dr. H. Dyaanand acted Head of Department from May 2019 to June 2019. Dr. Neal Bhagwandass, assumed duty as Head of Department in July of 2019 to present.

 Among our esteemed teachers and mentors in the field of Internal Medicine are the late Dr. Ramkhelawan Mahabir who established Renal Replacement Therapy in the form of dialysis and transplantation at the SFGH. He also was Medical Chief of Staff at the SFGH. The establishment of the first Intensive Care and Haemodialysis Unit at the SFGH was a collaborative effort between Dr. Ramkhelawan Mahabir Consultant in Internal Medicine/Nephrology and Matron Thecla Huggins-Maurice who was also a Nursing Instructor.

Matron Huggins-Maurice selected a core team of Nurses, developed a curriculum and initiated the first intensive care and haemodialysis training programme at the SFGH in 1975. In response to greater demand for renal replacement therapy, Dr. Mahabir released a cubicle of Ward 11 to be converted to a Haemodialysis Unit with space to accommodate four (4) haemodialysis machines and chairs. A donation of six (6) haemodialysis machines was received from the Trinidad and Tobago Nurses Association of America Incorporated.

1988 Dr Ramkhelaewan pioneered the first live-related renal transplants in Trinidad and Tobago performed at the SFGH under the auspices of the Departments of Medicine and Urology. This was a historical medical advancement for local healthcare.

To accomplish this Dr. R. Mahabir MCOS, Dr. Alvin Henderson Specialist Medical Officer (SMO), Mrs. T Huggins-Maurice and Mrs Valerie Rawlins-Alleyne, Head Nurse of the ICU mobilized the necessary support to refurbish Ward 16B which was built as a semi-private Unit to create the bio-safety conditions necessary for a Renal Transplant Unit. A team of Nurses were trained in Nephrology nursing and assigned to the newly established Nephrology Unit to care for the four (4) patients who were the recipients of live donors. Dr Alvin Henderson. Mr. Lal Sawh performed the four transplants on successive days assisted by Mr. Anthony Yip Hoi (Consultant Urologist). Dr. Mahabir led the post-transplant management of the patients optimizing immunosuppression therapy to prevent rejection. He was assisted by Dr. Alan Patrick who was based at the POSGH.One of the transplant recipients is alive today and involved in the supply chain business related to renal care supplies.

Other prominent physicians including Professor Courtney Bartholomew (Gastroenterology), Dr. Quamina (Dermatologist), Dr. Prem Rattan (Neurologist), and Dr. Winston Ince (Cardiologist) have graced the department and have left their mark with us.

The Dept of Medicine has evolved and expanded over the years to now include sub-specialty services. On November 16th, 2012 the Department of Cardiology was opened at the San Fernando General Hospital, under the leadership of Dr. Pravinde Ramoutar.

The cardiology department manages a 24-bedded Coronary Care Unit. There are four Out-patients Clinics weekly, a Device clinic, and two community based Stress testing services. A Cardiac Catherization Laboratory is being planned as part of expanding cardiovascular services.

 

Coming Soon.....

Department of Neonatal Intensive Care Unit (NICU)

Head of Department: Dr. Gregory John (Ag)

Location: 3rd floor San Fernando General Hospital

The Neonatal Unit at San Fernando General Hospital is responsible for the care of newborns requiring medical attention ranging from full term infants in need of minimal intervention for problems like feeding issues and jaundice to infants of Covid-19 affected mothers to the extremely premature infant requiring ventilatory support.

The population served by the Unit includes neonates delivered at Point Fortin Hospital, Private Facilities in the region and even hospitals outside of the region when the need arises. This unit is staffed by a cadre of dedicated medical and nursing staff, working together to ensure the best possible outcome for every neonate under their care.

Over the past 20 years the Unit has seen many improvements in terms of physical infrastructure and equipment, protocols and procedures, with attendant gains in outcome as evidenced by improved morbidity and mortality rates. The Unit continues to strive to maintain and even better the levels of care it has been able to achieve in the recent past. 

Cooming Soon 

Department of Oncology

Head of Department: Dr. Keshav N. Gyan 

Location: Oncology Unit Building, Torrance Mohammed Street, Paradise Pasture, San Fernando

The Oncology Department of the San Fernando General & Teaching Hospital is a specialized tertiary care service which provides cancer care to patients of the SWRHA. The Oncology Unit Building is a modern, state-of-the-art, fully-equipped, spacious cancer center on the campus of the hospital, dedicated to the latest in personalized medical and radiation oncology treatments.

We see all types of adult cancer i.e.  both solid tumor and blood cancers. The caring, dedicated and experienced clinical team consists of a medical oncologist, radiation oncologist, hematologist as well as oncology nurses, pharmacists, laboratory and support staff.

Out-patient services include:

-          Chemotherapy Infusion Suite

-          Daily On-treatment Review Clinics

-          In-house Oncology Dispensing Pharmacy

-          Laboratory/Phlebotomy Service

-          Weekly Oncology Out-patient Clinic

-          Bone Marrow Aspiration/Biopsy Procedures

-          Integrated Partnerships with Off-site Radiation and Palliative Care Services

-          Community Clinics

In-patient services include:

-          24/7 On-call Acute Oncology Consultations

-          In-patient Chemotherapy Service

-          In-patient Palliative Care

This year 2022 commemorates the 10th anniversary of the formal opening of the Oncology Unit at the San Fernando General & Teaching Hospital which took place on November 6th 2012. The Department now provides approximately 4000 chemotherapy treatments per year.

This department was the first service in the country to initiate community cancer clinics whose mission was to accelerate the transfer of knowledge about cancer care from tertiary medical centers to community healthcare delivery systems. These clinics are located at the Couva DHF, Princes Town DHF and Siparia DHF.

 

Coming Soon...

Coming Soon....

Department of Pathology 

Head of Department:     Dr Ryan Rattan

Location: Levels 1, 2 &3 BMQ Building Independence Avenue, San Fernando

The Pathology Laboratory of the San Fernando General Hospital offers a variety of laboratory services. These investigations are divided into seven major diagnostic areas: namely Biochemistry, Immunohematology, Histology/Cytology, Immunology, Microbiology, Molecular Biology and Haematology. Our services also extend to mortuary and blood banking services.  Phlebotomy services can be accessed throughout the RHA at our wards, (located in both the Teaching and General hospitals), out-patient clinics and thirty- one (31) health centres. Our courier services ensure samples get to the lab safely, promptly and in an appropriate manner. This preserves the integrity of the sample to ensure accuracy and reliability. A detailed description of the work of the various sections of the pathology department can be seen below.

1.    Clinical Biochemistry

This section is primarily concerned with testing of routine and urgent samples for metabolic and endocrine investigations, pediatric biochemistry, protein & lipid biochemistry, tumor markers and toxicological investigations. Samples include biological fluids such as blood, plasma or serum, urine.  Clinical advice is available through the Head of Department.

2.    Cytology

The services provided by cytology, focuses mainly on Pap smear slides-processing, staining and reporting.

3.    Histopathology

Biopsies and resections of human tissues are processed, blocked, sectioned and stained to allow examination under a microscope by a pathologist who provides a definitive diagnosis:  often the presence or absence of cancer.

4.    Non-gynecological   Cytology

Cytopathology is commonly used to investigate diseases involving sterile body cavities (peritoneal, pleural, and cerebrospinal), and a wide range of other body sites. It is usually used to aid in the diagnosis of cancer, but also helps in the diagnosis of certain infectious diseases and other inflammatory conditions.

5.    Haematology

Haematology services  provides routine coagulation, manual differential count, Erythrocyte Sedimentation Rate (ESR) malarial screening, sickle cell screening and Hb electrophoresis and specialized screening services for Haemoglobinopathies are located at SFGH under the guidance of Specialist Medical Officers/Consultants in the discipline of Haematology. A 24/7 routine coagulation screening (PT, PTT, INR) service is also provided by the Haematology Department located at SFGH.

6.    Immunohaematology/Blood banking

The blood transfusion laboratory provides pre-compatibility testing for blood products/components including blood grouping and antibody screening alongside preparing and managing blood products (red cells, platelets, fresh frozen plasma (FFP), and cryoprecipitate.  The blood transfusion team consists of Medical laboratory technologists and a clinical hematology team of SMO and House officers who work as an interface between the laboratory and clinical area to ensure that the clinical service is safe, transparent and timely, meeting the needs of the user.

7.    Immunology

This discipline of pathology investigates many auto immune diseases of the immune system. These include cardiolipins, double stranded DNA, extra nuclear antigen, monospot, testing for HIV leptospirosis is also done in immunology.

8.    Microbiology

Microbiology encompasses four sections; general microbiology, urinalysis, enterics, and a small amount of mycology analysis. The laboratory at SFGH is currently responsible for all microbiological testing at all SWRHA facilities. There is the intent to have services at PFH available in the near future. This section is primarily concerned with the culture, isolation, identification and susceptibility testing of bacterial, fungal and parasitic infections.  Methods used include microscopy, culture, and antimicrobial susceptibility testing. The department is supported by a Consultant Microbiologist and a House officer who interfaces with the clinicians giving guidance where necessary.

9.    Molecular Biology

The SWRHA, together with the Ministry of Health, collaborated to combat the spread of the SARS –CoV-2 in our country by providing nationwide testing for relevant persons.  This initiative was instrumental in the establishment of a Molecular Biology Department at our main pathology laboratory in September, 2020.  The introduction of Polymerise Chain Reaction (PCR) and antibody testing during this global pandemic is in keeping with the World Health Organization (WHO) and Ministry of Health guidelines for SAR–CoV-2 laboratory testing strategy recommendations. This department will also provide testing for HIV-1 quantitative (Viral load). 

10.    Mortuary Service

The San Fernando General Hospital Mortuary provides an efficient   mortuary service to patients who die either in our hospital or in the community. Bereavement services are also offered at the SFGH site where a Bereavement Counsellor is available (Monday–Friday). The Point Fortin Hospital (PFH) provides limited Mortuary service in namely receiving and holding of bodies, but no autopsies will be conducted at this time.  The pathology department strives to ensure that respect, dignity and compassion are shown when handling the deceased and in providing support to bereaved families whilst also ensuring strict health and safety guidelines are followed. (WHO/CDC guidelines). Our Mortuary provides a service involving around 2000 post mortems per annum from the hospital and local community. 

11.    Phlebotomy

Phlebotomy services are available in the primary care as well as the secondary care services throughout the SWRHA. The phlebotomists are responsible for the collection of the primary samples (pre-analytical) and the transport of these samples to the laboratory for testing.

12.    Point of Care Testing (POCT)

POCT is the provisions of diagnostics testing predominantly of bloods across a range of pathology disciplines to action immediate patient management decisions. This is Located within the Accident and Emergency department of San Fernando General Hospital (SFGH).

 

 

 

Coming Soon...

Department of Paediatric Surgery

Head of Department: Dr. Lakhan Roop

Location: San Fernando Teaching Hospital

Consultants

Mr. Rambachan Persad MBBS, FRCS, Head of Department, Associate Clinical Instructor (III) University of the West Indies

Mr. Lakhan Roop  MBBS, FRCS, FACS, Ag Head of Department, Associate Clinical Instructor (III) University of the West Indies, Secretary and Past President of The Society of Surgeons of Trinidad & Tobago 

Registrars

Dr. Fiaz Ali MBBS, MRCS

Dr. Sunil Soogrim MBBS

House Officers

Dr. Paige Ali, Dr. Helen Bissoon, Dr. Sarita Sudama, Dr. Reanne Rambarran, Dr. Ruth Kalliecharan, Dr. Sydell Wilson 

The Department of Paediatric Surgery provides surgical services for patients from birth up to age 16 years of age. The service is elective and emergency. These include correction of congenital abnormalities or birth defects, surgery for abdominal pain due to appendicitis, bowel obstruction and intussusception. Elective procedures include surgeries for hernia and penile disorders.

The department has two (2) clinics and an operating list. There are approximately 250 major operations and 200 minor operations per year. We accept referrals from the Paediatric Medical and Neonatal units.

The team provides trauma care for the unfortunate little ones involved in an accident.

The unit is housed on level 9 of the San Fernando teaching hospital and is a 24-bed unit. The unit was originally on the 1st floor of the main building of the San Fernando General Hospital but moved over to the new hospital in 2014.

Paediatric Surgery as a subspecialty in San Fernando General Hospital began in the late 1980’s under Mr. Trevor Anatol. He was followed by Mr. Barrie Landreth-Smith and subsequently Mr. Rambachan Persad.

The unit is actively involved in teaching and both consultants are Clinical Instructors in Surgery with the Department of Clinical Surgical Sciences University of the West Indies.

The department has presented research at national and regional conferences.

Recent journal publications include:

1)      Minimally Invasive Resection of Parathyroid Adenoma

2)      Retrograde Intussusception Secondary to giant Meckel’s Diverticulum

The unit has introduced pneumatic reduction in Intussusception under ultrasound guidance thereby reducing x-ray radiation in these patients.

A child with a surgical illness either emergency or elective requires dedicated care. It can be a difficult and trying time for both parent and child. The Paediatric Surgery Department at San Fernando Teaching Hospital strives to put your child at ease and provide a calming, caring setting for you and your family during this stressful time. 

 

Department of Plastic, Reconstructive Surgery and Burns

Head of Department: Dr. Ravindra M Lalla

Location: Burns ward, located first floor Plastic Surgery

Cases: General Surgical Ward Brief Description: 

The Plastic Surgery Service covers a full array of Reconstructive procedures. No cosmetic work is done at The South West Regional Health Authority as resources are focussed on the reconstructive aspects in conjunction with other services. The array is potentially wide, as the training covers a broad spectrum and as the SWRHA expands its resources more of the following services will be offered to the people:

1) All Burn care and management requiring specialist care, for both children and adults.

2) All Cleft lip and Cleft Palate cases, both in children and adults who unfortunately did not have the opportunity to have these fixed as a child.

3) The cleft lip nasal deformity. The nasal structures can be affected by bone growth disturbances and scarring.

4) Facial fractures and mandibular fractures, requiring both plating and mandibular wiring

5) Facial lacerations that require specialist intervention beyond the ER Department.

6) Prominent ear correction. Many children face teasing at school affecting school work and future endeavours. This can be addressed in the school years

7) Facial re-animation following facial nerve injury (Cancer resection)

8) Collaborative head and neck reconstruction with ENT following cancer resection

9) Brachial plexus injures

10) Peripheral nerve compression syndromes in the upper limb as these are soft tissue syndromes

11) All Skin cancers for excision and optimal reconstruction to produce the best final function and appearance

12) All hand infections.

.13) All tendon injuries from the wrist and into the hand. Forearm infections and muscle tendon injuries are addressed by general surgery and orthopaedics

14) Digit amputations that might be amenable for replantation.

15) All breast reconstruction as this is plastic surgery in all recognised international hospitals. 16) All gynaecomastia cases in male patients.

17) All Flap surgery for reconstruction following cancer resection eg: AP resection for rectal tumours

18) Lower limb reconstruction as part of collaborative work with orthopaedics.

19) All Skin grafting procedures

 20) Diabetic Foot reconstruction.

21) Microsurgical flap reconstruction.

PLASTIC RECONSTRUCTIVE SURGERY AND BURNS

These services 1 -21 are offered in the private and public sector, so the public patients should be given the opportunity to have these as well, and as the RHA administration improves allocation of resources, in the form of proper ward space, adequate staffing, secretarial support, multiple operating theatre time and trauma lists, optimum use of surgical services will be offered. The RHA determines what infrastructure they provide in the public sector for patients and current services reflects this.

Department of Psychiatry

Head of Department: Dr. Enal Maharaj

 

Before 1968, persons with mental health problems throughout Trinidad and Tobago in need of in-patient care were admitted directly to St. Ann's Hospital. In order to facilitate after-care of patients discharged from St. Ann's Hospital and who live in the southern part of Trinidad, an outpatient psychiatric clinic was commissioned at the San Fernando General Hospital in 1965. 

In 1966, a psychiatric in-patient ward (1) was opened at the San Fernando General Hospital. This was basically a holding ward until patients were seen by the psychiatrists from St. Ann’s Hospital during their weekly clinic visits and were eventually transferred to St. Ann's Hospital for in-patient psychiatric care. In 1974, the Head of the Psychiatric Department (HOD) was appointed.

Community Psychiatric/Mental Health Outpatient Clinics:

Nine (9) adult psychiatric outpatient clinics (POPCs) – All services have been operational during the pandemic, there are face-to-face sessions and tele-health/virtual sessions. The clinics are located throughout the south-western region in the following District Health Facilities and Health Centres:

 

 

Psychiatric/Mental Health OPCs

Location

Day of Clinic

1

San Fernando

San Fernando Community Mental Health Centre (located on the compound of San Fernando General Hospital)

 

Wednesday

2

Princes Town

Princes Town District Health Facility

 

Tuesdays

3

Couva

Couva District Health Facility

 

1st & 3rd Tuesdays (New and Follow up appointments)

 

2nd & 4th Tuesdays (New Patients)

4

Point Fortin

Point Fortin Hospital

1st & 3rd Thursdays

5

Siparia

Siparia District Health Facility

 

1st & 3rd Thursdays (New Patients)

2nd & 4th (New and Follow up appointments)

6

Gasparillo

Gasparillo Health Centre

2nd Fridays

7

Oropouche

Oropouche Health Centre

2nd Fridays

8

Cedros

Cedros

3rd Fridays

9

Rochard Douglas

Rochard Douglas Health Centre

1st & 3rd Wednesdays

 

 

Specialist

Psychiatric/Mental Health OPCs

Location

Day of Clinic

1

Child Guidance Clinic

Pleasantville Health Centre

Wednesday (New and Follow-up)

Friday (New patients)

2

Memory Clinic

San Fernando Community Mental Health Centre (located on the compound of San Fernando General Hospital)

 

Tuesdays

3

Substance Abuse

San Fernando Community Mental Health Centre (located on the compound of San Fernando General Hospital)

 

Mondays

 

Department of Radiology

 

Head of Department: Dr. Colin Premdas

At the time of the inception of the SWRHA circa 1995, the services offered were limited to plain radiography and fluoroscopy. Ultrasound services were also very limited offering mostly obstetric studies.

There were at this time only two Radiologists, two Sonographers and not more than ten Radiographers.

In the year 2004, the 1st CT Scanner was installed which at the time was a single slice scanner. In 2007 an MRI Scanner was installed.

Several Ultrasound Scanners were added from the initial solitary unit in 1995 and we now have ten machines at our disposal.

The CT service was gradually upgraded and we now offer CT scans via two multi-slice scanners.

 

In the years leading up to 2000 we gradually increased the number of Doctors in the department. In 1998 when UWI St. Augustine started the Post Graduate Program in Radiology, one of the two initial candidates in the program, started at SFGH Radiology Department. Going forward from that date SFGH in collaboration with UWI, the department produced no less than 15 qualified Radiologists. This project is ongoing.

Radiology services initially only available at SFGH were gradually introduced into the DHFs (general radiography and ultrasounds).

  Listing of Services

1.       MRI

2.       CT Scans (2 multi slice scanners)

3.       Ultrasound

4.       General Radiography

5.       Mammography

6.       Fluoroscopy (NPFH)

7.       Select CT and Ultrasound guided interventional procedures.

Significant Factoids – District Health Facilities

Couva District Health Facility – Conducts Ultrasound and General X-Ray Services. Princes Town District Facility – Conducts Ultrasound and General X-Ray Services. Siparia District Health Facility – Conducts Ultrasound and General X-Ray Services. New Point Fortin Hospital – Conducts all modalities excluding MRI services.

NB: Walk-in services for both Ultrasound and select CT procedures.

 

Only Service in Public Sector Providing 

 First in country to provide in public sector

1.     Stereotactic breast biopsy and wire localization.

2.     Breast MRI

 Largest department in the public sector

Largest Radiology Department in the public sector in terms of catchment population.

 

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Contact Us

  • Paradise Pasture, Independence Avenue, San Fernando
  • Regional Administration Centre - PBX Info: (868) 225-HEAL (4325), Customer Service Hotline 87-SWRHA(877-9742)
  • customerservice@swrha.co.tt