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Jules Vasquez
"What you said at the Press Conference was that it was really a failure of management protocols, a failure of reporting protocols so am I to determine then that no one is to blame? No human is to blame? No one is accountable?"

Chandra Nisbet Cansino - Chairman, KHMH
"If you are asking specifically about the deaths of the newborns - at this time we cannot hold any one person accountable. We have had detailed discussions with the head of the Pediatric Unit and there response was really timely, they did what they were suppose to do and when they were supposed to do it. I think as Dr. Coye explained, he was aware of what was going on - unfortunately the CEO was not. We would have liked that the CEO knew about these events as they were unfolding and so we as a board plan to have a conversation with him probably to strengthen that area because as a board as well if there is a crisis in the hospital, we also feel that we should know. We definitely will have that conversation but our first concern was to ensure that the situation was handled correctly and that there was no negligence on the part of the medical professionals."

Jules Vasquez
"But just from a visceral prospective, when you hear the stabbing statistics of 12 deaths in 21 days even if they are premature and are high risk patients. As the Prime Minister likes to say 'heads have to roll'. You mean out of all of this nobody's 'head will roll'?"

Chandra Nisbet Cansino
"I'm not saying nobody's 'head will roll' but nobody's head is rolling at this time, today - so far."

That interview was conducted after the press conference which detailed the sequence of the deaths and the medical response. As the Medical Chief of staff explained, the tragedy started unfolding on May 10th: The explanation is a little lengthy, but it's important, so bear with us.

Dr. Adrian Coye - Medical Chief of Staff, KHMH
"The clinical course essentially happened where around the tenth of May it was recognized that a baby became unwell and this baby was screened and cultures did not show any positivity for any organism and the baby died as a result of sepsis, as presumed sepsis - thought no cultures were grown. It was recognized by the clinical team that babies were becoming septic and becoming unwell very quickly. So sepsis meaning that they stopped, they weren't feeding well, febrile, short of breath and it was recognized. All these babies that come to our unit were sick babies and they didn't just go into the unit for not being sick. The week before we had our first press conference, essentially was when more babies were becoming quite septic and dying. There was a lag in terms of us being able to identify an organism but on the ground, I was alerted that babies were becoming very septic. We went down to the unit with the head of Pediatrics and we looked at the area and talked about the cases with the head of infection control in our hospital as well and we analyzed the situation and we decided to do what we were doing in terms of adjusting the antibiotics, emphasizing the hand washing and making other measures in that area - including wearing gloves and other restrictions. Restrictions meaning moving out some of the equipment that we had in that area. Despite these measures they came the way that I described before and we made a continued antibiotic changes and the peak of it all happened on the weekend of last weekend when the majority of those babies who had the severe infection succumbed."

Reporter
"Even before the press conference was held - even before the first Press Released was sent out you had already agreed that babies were entering septic shock. Dr. Longsworth was not - he admitted in the last press conference that he learned about this by way of the media. What failed there? Shouldn't the hospital's CEO become aware that this was happening?"

Dr. Adrian Coye
"I'll start first. Yes I was aware and my pediatric team and the nursing staff, we were all aware that something unpleasant was happening and we made adjustments on clinical grounds. You may recognize something is happening but you have to make changes and also need supporting evidence so in the end we didn't have supporting evidence - it was a delay in some respects and we're able to say that it's that organism. I think Dr. Longsworth trusts me enough to make the kind of decisions on the ground at that time and I made the reporting as I could having dealt with this situation in the best way that all of us could have done in a team."

Reporter
"So the first death by Cloacae was on May 10th. In reading about it I have read that this bacteria is very deadly and recognizing that shouldn't have the NICU be closed then on May 10th?"

Dr. Adrian Coye
"If I closed the unit that has sick babies in a cluster that were most likely having the same problem - most likely."

Dr. Ricardo Bustamante - Infectologist, Ministry of Health Chile/PAHO
"Outbreaks are unfortunate events that happen not as maybe more often as we would like in any hospitals around the world. I come from Chile and in Chile we also have outbreaks. I think that the measures that were taken of the awareness of the authorities from the hospital and the Ministry of Health, from the country itself were done in a timely manner. Sometimes it isn't easy to identify an outbreak and here you had an outbreak that started in a very short span of time, we're talking about ten days where 6 or 7 newborns got infected and died. It's not always easy to be aware that this is an outbreak - most of the time it happens that doctors start treating them and giving them medications but none of them are aware that this would turn out to a certain common source of infection that they did. So I think that the approach that they did here was in a timely manner, unfortunately it created several deaths."

Chandra Nisbet Cansino
"That was our main concern as a board that the measures taken to address the situation was taken timely and with the interest of the patients first. Up to now we are convinced that that has been done and so far we don't have any reason to believe that anything was breached in the management of the cases that were with the present bacteria. We don't want to sit here and say that everything is fine - there are areas that can be strengthened, those have come out as the preliminary findings. There were issues that came up when we spoke to some of the mothers - perhaps the way they were spoken to in some of the wards, things nurses and doctors may have said or any other person may have said. We want the staff to know that we appreciate what they do but every single patient and family that walks into KHMH deserves the compassion and the respect and the courtesy and dignity that every human being deserves and we want to put them a notice that kind of behavior will not be tolerated; we need them to treat the people with the dignity that they deserve."

It was clipped out of the story, but after May 10th, no new babies were admitted to the Unit – as the medical staff tried to manage the cases that it had. For the time being, government is paying all costs to restore and re-fit the existing unit and the four newborns that were taken out of the unit are being cared for in a private room in the maternity ward. It will be another one to two months before the Pediatric Intensive care unit is re-opened. But, even then, it will only be temporary, as Government has committed to provide start-up funding for the new wings with a pediatric intensive care unit. The PM explained.

Dr. F. Gary Longsworth - CEO, KHMH
"This we anticipate will take approximately 18 months to two years to be fully completed. The new NICU - PICU will be fully completed and equipped and ready for occupancy for staff and patients."

Hon. Dean Barrow - Prime Minister of Belize
"What Government will now do is to find the first half a million dollars so that construction can commence immediately - I believe we have disbursed some of the money already Dr. Allen. That should see the project within the next few months while the promised donations are being unlocked and the entirety of the 3 million or so is gotten together to complete what will be the KHMH state of the art facilities for our babies and children."

As a closing detail, it is important to note that 13 deaths were recorded at the unit in May – and only 7 are being ruled as sepsis, or resulting from bacterial infection. The other six were due to prematurity and related conditions. On average, the unit records five deaths per month.

We'll have a little more from the press conference later on in the news as the Medical Chief of Staff makes a heartfelt plea for his hospital.