5 emergency doctors per day compared to 1 last July
We breathe better within the sanitary reactor. But until when? For several weeks, “the situation has been improving”, declares the management of the CHM regarding the number of emergency doctors who were sorely lacking last July. But its representatives wish to remain cautious. There are many new emergency doctors but they only establish themselves for short periods of one to three months, making it difficult to project numbers over the long term. “Currently, they work with five emergency doctors per day, at least four, while in summer, we only had one,” recalls the management of the hospital which has weathered several storms. “Fortunately because activity increased significantly at the start of the school year.”
Last June, the situation was such that the emergency doctor stationed in the Emergency Department was alone to manage several vital emergencies simultaneously, leading the management of the Mahorais hospital to implement internal inter-service support bridges, in particular with hospital intensivists, to jointly manage urgent and complex care. Currently, the situation has improved. “In practice, emergency doctors no longer need to manage emergencies directly with intensivists (…) because there are many of them but they often use the skills of intensivists for safety issues regarding care. » Despite everything, the CHM management remains on guard, particularly in the event of an exceptional health situation. “We have maintained a care unit that can be equipped to manage a possible epidemic risk.” If the circulation of whooping cough continues, as analyzed by Public Health France-Mayotte, at this stage, the health authorities are not yet talking about an epidemic. For epidemiologists, this context of significant turnover among emergency doctors and the persistence of an overall shortage of staff has led teams to abandon the coding of visits to the emergency room based on the number of visits and the pathologies concerned. Result: Public Health France is sailing blind and cannot produce data on the CHM emergency department.
“We keep the doctors for real emergencies”
For several months and until the beginning of October, the CHM only had a mobile emergency and resuscitation structure (SMUR) to help the Mahorais throughout the department. Thanks to the new personnel available, two SMURs are now armed. “We are once again protecting the population in terms of interventions,” declares Frédéric Lecenne, co-administrative director of the CHM emergency department. Furthermore, when the doctor-regulator of center-15 judges that the call received does not constitute a medical emergency, an emergency paramedical team (PMU) is dispatched. “This allows us to save time (…) we prioritize, we prioritize the most urgent patient (…) we keep doctors for real emergencies (…) it’s completely normal, it’s done everywhere in mainland France. »
Regulation that goes wrong
But the sky is not yet completely clear. The thirty-two emergency doctors at the CHM are still insufficient to absorb the entire regulation of center-15 in Mayotte. After several months of “resistance”, as she describes it, the CHM management accepted necessary aid from Reunion but received very bad press. Concretely, three-quarters of the regulation of the center-15 of Mayotte, day and night, are provided by two doctors stationed at the Saint-Denis University Hospital in Reunion. On the seahorse island, this subject is the subject of much tension, particularly among elected officials and unions.
A dangerous slowness of regulation
“This regulation of the 15th by Reunion does not pass, it is legitimate. » Lucid on this situation, the management of the CHM reports a lack of knowledge of the Mahorais territory and its geography by the two doctors based in Reunion, in charge of part of the regulation of center-15, making the logistical organization of care difficult. in Mayotte. “It’s not safe,” report the Mahorais medical regulation assistants (ARM). “You do the 15th in Mayotte, you come across a medical regulation assistant, but when you have to speak to one of the doctors (editor’s note: who is in Reunion), it takes 10 minutes, whereas it should be instantaneous. » To resolve this regulatory defect, the head of the emergency department of the Saint-Denis University Hospital is expected for a quick visit to the CHM.
“There is no question of us continuing to be regulated by Reunion Island,” maintains the management of the CHM, which is counting on the end of February 2025, so that the emergency doctors of the CHM can take full charge of the regulation of center-15 in Mayotte “serenely”. Always with the aim of protecting emergencies from real emergencies, the health authorities would like to remind you of the need to call the Mayotte center-15, before going to the Emergency Department, when possible.
Mathilde Hangard
