THE Commonwealth of the Northern Marianas hospital is dying. Medical director Jeremy Richards, MD, confirmed the Saipan hospital has a “critically low” number of physicians for the island’s 50,000 people.

News reports reveal that the hospital has only 21 full-time doctors including only one Obstetrics and Gynecology physician, who has been handling all complicated newborn deliveries, emergency caesarians, and life-threatening female bleeding at the hospital around the clock for the past six months. Such OB-GYN coverage for a hospital serving a distressed population the size of the Northern Marianas is unacceptable and likely is resulting in unnecessary maternal injury and dead babies.

Over the past year, more than six hospital physicians have quit, including the former medical director Micheal Deary, MD, who resigned this past March. Dr. Deary left his post publicly citing frustrations over the many emergency issues at the hospital, including the lack of competent support from the Saipan government.

Last week, at least three medical clinics – Family Care, Women's Clinic and Children's Clinic – were closed after some physicians did not report for work, resulting in the immediate transfer of available doctors to essential areas such as the emergency room.

Hospital employees had been enduring the week after a “payless payday” (on Aug. 10) and a majority of them were also affected by delayed housing payments for several months. For the third year in a row, the CNMI governor declared the hospital to be in a state of emergency, and somehow $800,000 was found to pay toward the hospital’s mounting debts.

Dr. Richards, the current medical director, admitted that because of the ongoing uncertainties and instability in the hospital, there's always the possibility of losing more doctors. He described the situation at the Saipan hospital as a “slow death by attrition.”

If Saipan's current fiscal crisis does not miraculously improve soon, the hospital's death will not be slow. Monthly costs at Saipan's only hospital exceed $2.5 million and it has only been able to collect $750,000 a month for its services. Because of this spiraling cost overrun, payless paydays have occurred; the Retirement Fund has gone bankrupt; medical and life insurance premiums have not been paid; obligations to vendors have been neglected; and the hospital has continuously run out of medical supplies and equipment.

In his Oct. 20, 2009 emergency declaration, CNMI Gov. Benigno R. Fitial noted dutifully, “The Commonwealth is experiencing an increasing rate of deaths among community members that can be attributed to lack of health care.” Fitial observed that the government hospital had less than the needed numbers of physicians and nurses available to serve medical needs. To be effective, the hospital must have at least 45 doctors, Fitial said.

Already, the CNMI hospital's dangerous medical situation has resulted in malpractice claims for death and injury attributed to unsafe hospital care. One angry patient recently filed a medical lawsuit after his face was allegedly set on fire while he was undergoing an operation in Saipan's understaffed, underfunded hospital.

Amid all this uncertainty comes a possibility for positive change. Likely heretofore, most of Guam's people cared little and knew less about the troubles of Saipan's hospital. As a cynical but highly respected newspaper editor recently observed, unless Saipan's problems start to inconvenience Guam's people, then most of Guam will not have reason to care.

But Guam should care because the human tragedy occurring in Saipan today is similar to what Guam Memorial Hospital went through in the past and could likely go through in the near future for very similar reasons. Indeed, Guam and Saipan have much that we need to learn from each other and this healthcare crisis can be the impetus for collective problem-solving.

Last July, Fitial and Guam Gov. Eddie Calvo surprised us all by announcing that they are in serious discussions about reuniting the Marianas. It would be nice if the two of them could start by working together to straighten out our hospitals.

In the meantime, we should take the very good advice of the CNMI Public School System Food and Nutrition Services nutritionist and registered dietician Dianne C. Esplin to eat healthy and exercise regularly, in order to prevent non-communicable/chronic diseases such as cancer, diabetes, heart disease, high blood pressure, stroke, and kidney disease/failure. As Esplin points out cheerfully, preventing diseases and keeping healthy is one of the best solutions to our infuriating healthcare crisis.