Aguadilla has only one city physician to attend to the "dispensary'' and to visits to sick in their homes in the town and country and in the municipal hospital. The hospital is installed in a concrete building with capacity for 15 sick, but with very poor resources. The establishment has a kitchen in very bad condition and has no water-closet, sanitary washstand, nor sink, etc. It has no bathtub, and the sick when they wash use the same tub in which the clothes of the sick are washed. At the present time five persons are under treatment, and the cost of maintenance does not exceed 13 or 14 cents for each daily, including soap, charcoal, etc. From the meals prepared for the sick the employees of the hospital also eat. According to a statement made to us, it is planned to close up this hospital. As will be noted, in the ordinary budget $480 were assigned for the municipal pharmacist and only $240 for medicines, an amount which was necessary to increase in the extraordinary budget with $360 more, of which total there were expended in the first three months 50 cents and in the second trimester $95.57, and accounts to the value of some $200 are pending payment. It is not understood why this pharmacy with an assignment for medicines of $600, of which up to December last there had only been expended $96.07, has been able to dispatch an average of 1,048 prescriptions monthly from July to December, especially when the $95.57 expended in the last three months were not expended for the purchase of medicines for the pharmacy, but for prescriptions to the poor dispatched by a pharmacy in the locality and which could not be attended by the municipal pharmacy. Upon inspection of the pharmacy we found that it presented a very poor appearance and was lacking in sink, washstand, filter, and other necessary supplies. As far as drugs are concerned, it is lacking those most necessary in a pharmacy, such as naphtha, thymol, iodide of potash, ampules, ether, chloroform, alcohol, distilled water, etc. The greatest deficiency which was noted in the service of Beneficencia in this town is that the prescriptions given by the physician to the sick poor can only be filled during three days of the week. It has a first-aid station which is clean and furnished with the most necessary articles, but the rooms assigned for sick poor had for their entire equipment two old beds without bedding of any kind. In this building we found a great many old rags hanging from the beds. The municipality of Lares has attended very well to the service of medicines to the sick poor and continues to do so. Each patient has the right to take his prescriptions to any of the pharmacies in town and these charge a price whose average is 20 cents a prescription. However, attention is attracted to the ruinous condition in which we found the municipal hospital. It is a wooden building with capacity for 22 sick, but the walls as well as the floor are in an exceedingly bad condition, and lacking water, sink, fly proofing, sufficient bedding, household goods, etc. The attendance of the hospital is given by a woman and a peon, both persons very poorly fitted for these services. As neither one of the two knows how to read or write, the book for the register of sick in the hospital is kept by a neighbor. The cleanliness of the building as well as of the bedding is exceedingly badly attended to. In one of the rooms there was quartered a person suffering from tuberculosis. The sweeping is done dry. According to the report of the woman in charge, the visits of the doctor to the building are one every two or three days or when he may be called to attend some urgent case, and the practicante only goes when there is a severe wound, the dressing of ulcers and wounds being done by the woman in charge. San Sebastian has sufficient personnel to satisfactorily attend the service of beneficencia, but is lacking in resources for medicines and for the necessary attention of its hospital. The poor, knowing this, only consult the doctor in the early part of the month in order not to be deprived of medicines if they should go later on. The average of prescriptions filled in the first six days of the month of August was 27 daily and in the 24 remaining days only 24. In the first three days of the month of September there were 41 prescriptions daily dispatched and in the rest of the month the average was not even 2 a day. The same condition was noted for the remaining months. The hospital is a wooden building constructed not long ago, but already it is to be noted that the floor of the balcony is rotted and there is a great lack of paint in the building. The kitchen has no sink and is not fly proof. All the water for the daily supply is two tin cans which are brought from a distant point. Although the building has a capacity for 25 sick, it is only possible to attend to 10 or 12 daily with the resources at hand. On the day of our visit there were six men, three women, and two insane, with an expense of $10 or $12 a week, including soap, laundry, and gas for the hospital. The immediate attention upon these sick is under the charge of a woman and a peon. Just as those in charge of other hospitals, these are persons without any hospital experience. In order to be able to change the bedding they are obliged to wait for the return of the weekly wash. The filter which exists in this establishment is the same which I destroyed two years ago because it was useless. Aguada has a small hospital of concrete with its operating room, drawing-room, and two wards, one for men and the other for women, in each one of which two sick can be admitted. It seems that the intention was to utilize it for emergency cases, but the day of our visit the inmates were two wounded, an insane, and two suffering from tuberculosis, and it is to be noted that in the same room in which were the two tubercular cases they had placed one of the wounded, who was necessarily exposed to contagion. We noticed that the supply of clothes and bedding for the hospital was very scarce and also that from the appropriation for purchase of furniture and clothes for the hospital a transfer had been made of $25 for other purposes of the municipality. Materials for operations and patent medicines. 40.00 Maintenance of sick poor and operations in the hospital of another municipality. 30.00 Expenses of childbirth cases in pay patients. 20.00 Collins.... 40.00 Interment of poor deceased. 15.00 785.00 Total. 1,085.00 This town has no hospital nor first-aid station nor resident physician, nor does the pharmacist in charge of the medicines to the sick poor reside in the locality. A physician from another town makes a visit weekly to prescribe for the sick poor. From the appropriation in the budget it can be appreciated how poorly attended is the service of Beneficencia in this municipality. The municipality authorizes the dispatch of five prescriptions daily. The following appropriations were already exhausted on the day of our visit, namely, expenses of relief ward, medicines not included in the contract, supplies for hospital and from the appropriation, "Relief to sick poor," there only remained for the six following months the sum of $6. The hospital is an old building, lacking in water stand, wash basins, sink, etc. The latrine is a wooden tube which discharges to a ditch covered with a loose sheet of tin and empties in a cement deposit loosely covered with a sheet of tin. Of the attendance on the sick there is no need to speak. It is enough to say that the woman in charge of the hospital is without the slightest idea of cleanliness and is dressed in rags and tatters. Besides the sick in the hospital it is to be noted that there live also another woman, the mother of the one in charge, and her niece. 1 cook, 2 laundresses, 1 nurse for insane, 2 enfermeras, 1 male nurse for insane, and 1 man in charge of the dressings.. 336.00 11, $30.20 Clothes for poor in the asylum and bedding for that establishment and for the insane in the jail. 127.00 Repairs of some place or rent of it in which to install the relief ward of La Playa... 150.00 12,944.40 Total.... 24,774.60 This city has two charitable establishments-one the San Antonio Hospital and the other the poorhouse. The San Antonio Hospital, a building of masonry with capacity for 100 sick, which, as a rule, is full, although not of modern construction, presents sufficiently good conditions for the purpose to which it is assigned. Although certain deficiencies may be noted which could easily be corrected, such as the repair of some of the wooden floors, the change of wooden floor of the dressing station for an impermeable floor, and also of the laundry and yard set aside for the drying of clothes, both of which are in very bad condition, and also the lack of a sufficient supply of water, at times it being the case, as happened the day of our visit, that the watercloset and other sanitary apparatus were not working for lack of water. There is a tubercular ward situated in a central part of the building which constitutes a danger for the other persons who are sheltered in that establishment. The day of our visit there were quartered 13 cases of tuberculosis. The cleanliness of the building is well attended and the care of the sick is good. But one thing deserves the harshest censure for the management of the establishment, and that is that the milk given to the sick was adulterated with water. The municipal pharmacy is installed in the same building as the hospital, and there all medicines are dispatched for the poor, including those of the sick in hospital, under charge of a pharmacist; but, for unknown reasons, it seems that the sisters of charity are the ones that attend to the filling of prescriptions. There are prepared in this establishment about 74,000 prescriptions a year not including the ones for the sick in hospital. The poor house is installed in a masonry building with capacity for 100 persons. This establishment has certain deficiencies, such as wooden floors in bad condition, passages, aisles, and other floors of cement are cracked; a lack of showers in the bathroom which had been closed for the lack of water. On the day of our visit there were 102 inmates; but we noted that patients, children, and old people were mixed in the same ward, and also that the cleanliness and order of this establishment left a great deal to be desired. The appropriation for clothes of the inmates and for bedding is very small, and to this perhaps was due their scarcity in the establishment. In one part of the building there were confined 18 crazy persons. Some of the cells were found to be very deficient in light and ventilation, and the inmates sleep on wooden benches. The personal of this asylum consists of six sisters of charity, a woman for attendance upon the insane, two cooks, two laundresses, two male attendants for the sick, one male attendant for insane, and a man in charge of dressings. Medicines to sick poor.. 600.00 Conveyance of wounded and interment of poor deceased-coffins, etc.. 75.00 75.00 1,380.00 Total... 3,036.00 Supplies and other attentions: Relief to sick in hospital. Las Marias has also a hospital, but like the majority of these establishments is located in an old house and is lacking in everything that is most indispensable for an efficient service. On the day of our visit there were five sick. There is no first-aid station. There is a resident physician. |