You can see it from afar, the main building perched on a small hill and fourteen stories high. Almost downtown Pointe-a-Pitre, located ten minutes on foot, along the Chauvel road which leads to Abymes, the most populous municipality of Guadeloupe. A huge portal gives on the entrance: two roads which go up towards the hill and the buildings. An old faded map warns of various buildings and services, but the indications it gives are probably no longer relevant, as the CHU, the only one in the Guadeloupe archipelago, has undergone modifications.
A symbol of decrepitude
“It was built in 1977,” recalls Gaby Clavier, secretary of the UTS-UGTG union (the health branch of the General Union of Workers of Guadeloupe) at CHU. A large concrete tower, and a smaller five-story tower, which at the time was called the “new hospital” and which joined the old small buildings of the 1950s. “But it never was. maintained ”, deplores Gaby Clavier. Today, worn by tropical spray, the concrete cracks, falls in whole patches in places.
It takes a full tour of the hill to access the emergency room, moved in 2017 following a fire that brought the hospital to its knees a little more – and the staff with it. For the 400,000 inhabitants of Guadeloupe, the CHU is the symbol of the feeling of abandonment of the State and the decay of public services.
Many health problems
11 %
The rate of adult Guadeloupeans with diabetes, making it the second most affected region in France
40 %
The rate of Guadeloupe adults affected by hypertension.
57 %
The rate of overweight adults in Guadeloupe. 23% are considered obese.
227 per 100,000
The incidence rate of prostate cancer in the West Indies, against 141 per 100,000 in mainland France, ie 50% more. Still very undervalued, according to Public Health France, it is one of the highest in the world because of chlordecone pollution.
100 000
The number of Guadeloupeans affected by one or more co-morbid factors, i.e. more than one in four.
–
Those who can go for treatment in the private sector, or even in metropolitan France. But for most Guadeloupeans, it is impossible. Because “here, the health and social situation is catastrophic”, recalls Rony Tillé, CGT delegate Guadeloupe: “There are 53,000 unemployed, young people are forced to leave”, which poses problems including training and recruitment. “Besides,” he continues, “the hospital has no more money to pay for staff training. “
A structural deficit of 49 million euros per year
As in the others hospitals in France , the main problem of the CHU lies in the lack of means. However, it was conceived as a “cutting-edge establishment”, specifies Brigitte Amacin, elected UGTGthe establishment technical committee (CTE), a hospital which has “all services, an MRI, two scanners, a particle accelerator, a hyperbaric chamber”. But the CHU lacks staff (it has about 2,500 regular caregivers, 600 precarious and 300 doctors), it “has a structural deficit of 49 million euros annually and a debt of the same order of magnitude”, according to Gaby Clavier. “We can say that the local companies are the bankers of the CHU …” euphemist Brigitte Amacin. Consequence: suppliers are often no longer paid and basic equipment is lacking.
Emergency care aide, Rony Tillé testifies to these working conditions “which have deteriorated in all directions and for many years. In the emergency room, we lack cloths and stretchers because many are broken, sometimes even garbage bags… ”It sometimes takes two days to find a place in a patient ward.
Delphine Isaac has worked at the CHU for fifteen years, “with my two hats: lab technician and staff representative”. She also tells about the “missing reagents”, thus preventing essential examinations from being carried out. And if she is aware that the lack of means affects all hospitals in France, she specifies that, “as islanders, we do not have access to the repairs of other establishments”.
A reduced capacity from 900 to 600 beds
On November 28, 2017, to add to this already gloomy picture, a very violent fire broke out. “He took in this technical room,” says Gaby Clavier, who points to a few windows on the first floor, just above the emergency room. A disaster that led to the evacuation of 1,200 people, including 700 patients, and the closure of emergencies, maternity, resuscitation, services transferred to other premises, even to the private polyclinic for the maternity.
In the only university hospital in the Guadeloupe archipelago, the equipment is out of order, abandoned … © Alain Cassang / Abaca
–
“We were severely affected by the fire, testifies Delphine Isaac, especially at the psychosocial level. Unusable, the operating room is then replaced by a mobile unit, unsuitable. Above all, the fire destroyed the air handling system and air conditioning. In the middle of the tropics… “Many patients have to bring their own ventilator,” points out Gaby Clavier wearily. From 900 beds, the capacity increases to around 600. With immediate consequences in terms of patient reception and working conditions.
In 2018, the Indigo firm was mandated to carry out an expert mission to finally inquire about these working conditions, of which the fire is a “catalyst”. According to the study, 10% of CHU staff are in a situation of psychological distress, and the experts conclude thus: “We strongly invite all the actors of the CHU to take the measure of the psychic catastrophe which is playing out before their eyes. Clear and chilling.
Strike and repression
This drop of water from the fire – so to speak – finally broke the camel’s back: between July and September 2019, several strike movements affected the CHU . Very largely supported by the population – 82% according to a survey of the time -, the caregivers mobilize: 6,000 people marching in the streets of Pointe-à-Pitre on August 1, 2019. The balance of power pushes the management to finally agree negotiations with staff to respond to the most urgent demands. But, on the other hand, Gérard Cotellon, the new director appointed in September 2018, attacks the staff, especially their representatives.
Water leaks, non-compliance with standards, missing products … suppliers who no longer deliver for lack of payment. Everything is going to ruin. © Alain Cassang / Abaca
–
This is the case of Rony Tillé, attacked in court for “death threats” against a director of service. The CGTGdenounces then a “file assembled from nothing after the long strike of two months which mobilized the nursing staff of the CHU”, as well as a “relentlessness of the management of the hospital”. Rony Tillé was released by the court in June 2020, and analyzes this episode through the prism of “recurring union repression”. And if he is the only one to have been judicially prosecuted, he mentions other cases of “colleagues summoned or (of) remarks”.
Since the beginning of March 2021, another staff representative, Eddy Fifi, a senior technician in post for twelve years but still on a contractual basis, has been the subject of a dismissal procedure. Management advances the desire to replace him with an incumbent, but, depending on the CGTG , it is his union activities that are in question. The organization recalls that Eddy Fifi “did everything to obtain his tenure”, but that “the management has always blocked his way by refusing to open this post to the competition of incumbents”.
Clusters due to “lack of space”
When does thecoronavirus epidemic,the situation is already alarming. But, for patients and staff, “Covid has added further to the arduousness, to the overload of work”, describes Delphine Isaac. The resuscitation capacities have been increased from 32 beds to 64 mobilizable (for nearly 400,000 inhabitants), and part of the emergencies is dedicated to Covid patients, but, according to Rony Tillé, “their reception is unacceptable”.
Already understaffed, nursing staff are exhausted. They can no longer take any leave. © Alain Cassang / Abaca
–
Several patients had to be transferred to Martinique, which was less affected at first. Already understaffed, agents can no longer take leave. There are more and more sick leaves, especially as several clusters have appeared, including one in the geriatric department. “But different departments have been affected”, specifies Delphine Isaac, for whom these clusters are above all due to “working time, (to) the organization, (to) lack of space”. Brigitte Amacin was also contaminated, fortunately without serious consequences. “Well, I was! »She cries today, laughing.
The new hospital awaited for 10 years
In Guadeloupe , the not so old CHUis already a lost cause for several years. Its future is mapped out: it must be razed. When? Soon, in 2023… if the site is on schedule. The case is dragging on: for nearly ten years, many hopes have been placed in the new CHU. But, off, some companies present on the site are rather counting on commissioning in… 2025.
Financed by the State to the tune of 580 million euros, it will be a large state-of-the-art hospital, following the same trend as in metropolitan France. But it will only have a capacity of 600 beds, and Rony Tillé fears that services will be cut and patients will have to turn to the private sector: “We have no assurance on what will be integrated there”, points he said, speaking of “a mirror with larks”. As for Delphine Isaac, she noted above all that the agents “hope not to move with the same problems, the same shortcomings”. Because the feeling of abandonment on the part of the State of the personnel and of all Guadeloupeans would be reinforced. Once again.
–
