By MURIEL LIGHTBOURN

Healthcare is not just a medical issue — it is a political one. Every decision about funding, staffing, infrastructure, and access is shaped by political will. Our leaders must recognise that the health of the nation is inseparable from the policies they enact. When hospitals are underfunded, when promotions for nurses are delayed, when mental health is sidelined, these are not accidents of fate — they are the consequences of political choices.

I urge policymakers to act with urgency and courage. Invest in our healthcare infrastructure, prioritise fair treatment of healthcare workers, and commit to prevention and education as national strategies. The time for speeches has passed; the time for decisive action is now.

A System at Breaking Point

There is a growing chorus of concern surrounding the state of our healthcare system. From the community clinics that serve our neighbourhoods to major hospitals like Princess Margaret, the signs of strain are undeniable. Overcrowded wards, long wait times, and exhausted healthcare workers paint a troubling picture — one that demands our immediate attention.

Structural Concerns: A House in Disrepair

At the heart of the crisis lies the physical infrastructure of our hospitals. A hospital is, in essence, a house — a building constructed by human hands. And like any house, it requires regular maintenance, care, and investment to remain safe and functional.

Yet many of our facilities were built decades ago to serve a much smaller population. Today, they are expected to accommodate a growing and aging populace with increasingly complex health needs. The result? Leaky roofs, outdated plumbing, failing electrical systems, cramped layouts, and overcrowded emergency rooms where patients wait on gurneys in hallways. These are not mere inconveniences — they are hazards that compromise patient care and staff efficiency.

Social Ills: The Hidden Drivers of Overcrowding

Beyond bricks and mortar, social challenges are silently fuelling the crisis. Violence is one of the most alarming contributors. Gunshot wounds, stabbings, and other violent injuries demand immediate, resource-intensive care, diverting attention from other patients in need.

Other social ills compound the problem:

• Chronic diseases linked to poor lifestyle choices continue to fill hospital beds.

• Mental health crises often go unaddressed until they escalate into emergencies.

• Poverty and inequality limit access to preventive care, forcing many to seek help only when conditions become dire.

• Low health literacy leads to poor self-management of illnesses, resulting in avoidable complications and hospital visits.

No discussion of healthcare can be complete without addressing the alarming shortage of nurses. Recent reports highlight a deficit of some 500 nurses in our system — a staggering figure that should be sounding alarms in the halls of government. This is not just a local challenge; nursing shortages are being felt across the globe. Yet despite the deficit, nurses continue to leave the profession, and their reasons must be taken seriously.

• Some nurses voice their displeasure at the unfairness in promotions, feeling overlooked despite years of service.

• Others leave in search of better pay and improved working conditions, frustrated by stagnant wages and unsafe environments.

• Still others depart because of the disrespect they experience on the job, a wound as deep as any financial grievance.

• And of course, many reach the mandatory age of retirement, yet even here the system fails them. While workers in other government entities retire and return to service within weeks, nurses often wait months knocking on doors, eager to contribute but left sidelined.

This is unacceptable. If we are serious about strengthening healthcare, we must face these challenges head-on and with purpose:

• Make promotions a fair and transparent process.

• Improve salaries and benefits to reflect the value of nurses’ work.

• Ensure safe working conditions and provide the necessary tools to do the job effectively.

• Engage retirees before their retirement to explore their interest in continuing service, ensuring a smooth and efficient transition.

You have heard the saying, 'nurses are the backbone of the healthcare system.' However, a wise woman nurse said we are not the backbone, rather we are the brain of the healthcare system. Without nurses, hospitals cannot function, patients cannot be cared for, and communities cannot thrive.

Addressing this shortage is not optional — it is urgent, and it is a moral obligation.

Solutions: Prevention, Education, and Empowerment

While infrastructure investment is essential, it must be paired with a robust focus on public education and prevention. Prevention is still better than cure.

We must launch a sustained campaign to improve health literacy and empower citizens to take charge of their well-being.

This includes:

• Using social media to educate the public on conflict resolution, chronic disease management, and when to seek care.

• Engaging families and caregivers to create a more informed and supportive environment.

• Rethinking delivery methods: if current programs aren’t reaching people, we must change how we deliver them, not the message itself.

• Educating in waiting rooms — turning idle time into learning time with videos, posters, and health talks.

• Expanding community health programmes, especially those led by nurses who meet clients where they are. Their work is vital and deserves greater support.

Mental Health Integration: A Critical Piece of the Puzzle

Mental health must no longer be treated as an afterthought. Integrating mental health services into primary care is not just compassionate — it is essential.

We must:

• Place mental health professionals in clinics and hospitals to provide immediate support.

• Train general practitioners and nurses to recognise and respond to mental health concerns.

• Normalise mental health conversations to reduce stigma and encourage early intervention.

• Establish mobile crisis teams to respond to psychiatric emergencies in the community.

• Support school-based mental health programmes to build resilience from a young age.

By addressing mental health proactively, we can reduce psychiatric emergencies, improve overall health outcomes, and ease the burden on our hospitals.

Final Thoughts: A Call to Unity

The challenges facing our healthcare system are urgent, but they are not insurmountable.

We must act now — not only by repairing buildings, but by healing the social fractures that send so many to our hospital doors. Investment in infrastructure must go hand in hand with education, prevention, and community empowerment.

But above all, we must unite. Policymakers, healthcare workers, and the public must stand together in recognition that the health of the nation is the wealth of the nation.

And as we move forward, let us never forget to honour those who hold the line every day. To our nurses and healthcare workers: thank you for your compassion, your strength, and your service.

Muriel Lightbourn is a Senior Trained Clinical nurse with 42 years of experience. Mrs Lightbourn is president of the Bahamas Nurses Union (BNU) and 2nd Vice President of the Commonwealth of the Bahamas Trade Union Congress(CBTUC). 

"The views expressed in this editorial are solely my own. I do not speak on behalf of any institution, organisation, or other individual.”