And so, the Minister of Health has funded young ten-year-old Christa Brumant to the tune of $620,000 to be treated at the Transverse Myelitis Centre in Johns Hopkins Hospital for the unfortunate inflammation of her spinal cord. I sincerely wish her the best but about that after she returns.

Let us talk briefly today about the Johns Hopkins Hospital. It is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine in Baltimore, Maryland, USA. I know it well and I have several professorial friends there, including Dr Anthony Kalloo, who was once my student, intern and research assistant, and is now professor and director of Division of Gastroenterology and Hepatology there.

Hopkins was first established in 1889 and is regarded by US News and World Report as the best overall hospital in America for 19 consecutive years. The Port of Spain General Hospital is of the same vintage and was built in 1858. But what a difference! Let us now compare Hopkins with the Port of Spain General Hospital, which, like the Mt Hope Hospital and the San Fernando General Hospital, is a "teaching" hospital for the University of the West Indies. Sorry, perhaps the word should be contrast rather than compare.

I will restrict the contrast today to staffing. The total hospital bed count in Johns Hopkins is 1025. At Port of Spain it is 577. At Hopkins 220 beds are assigned to the Department of Medicine (as opposed to, say, the Departments of Surgery, Obstetric and Gynaecology, et cetera). At Port of Spain, there are 153 beds in the Department of Medicine. Now, with respect to the staff/patient ratio, let me put it this way.The total number of medical staff (consultants, residents/house officers, interns) in the Department of Medicine in Johns Hopkins is more than the total 320 medical staff in the whole of the Port of Span General Hospital!

This reminds me of Prof David Kerr, who once responded to an advertisement in the international medical journals for the post of Prof of Medicine at the Mt Hope Hospital. David is a professor of international repute in London with a most impressive curriculum vitae. He flew to Trinidad to be interviewed and to see the new Complex. During the interview he asked certain questions. Suffice it to say that he came to my office afterwards looking quite forlorn and expressed to me his deep concern about many things, including, above all, the proposed staff/student ratio and staff/patient ratio. He immediately lost interest in the post as he was not prepared to leave his academic sanctuary in London not even for the novelty and excitement of starting a new medical school and hospital in the sunny Caribbean!

But notably and shockingly so, in this so-called "teaching" institution called the Port of Spain General Hospital, in this the year 2010 AD, there is no resident cardiologist, no neurologist, no endocrinologist, no local nephrologist, one local radiologist, and one gastroenterologist/hepatologist. In fact, this latter specialist is the only one in the whole of the government service institutions including San Fernando, Sangre Grande and Tobago, and with a burdensome workload. Meanwhile Dr Kalloo's Johns Hopkins Division of Gastroenterology has 22 full-time gastroenterologists! Please note that I have said nothing about the San Fernando General (teaching) Hospital.

Look, Hopkins is not involved in T&T for altruistic reasons. Johns Hopkins International is big business and expensive business to boot. Just try to get treated there free of charge. In fact, the Johns Hopkins entity is a US$3.3 billion healthcare system. That said, I do not want to know the cost of their involvement here, including the cardiac medical programme.

I am told that a new hospital is on the drawing board to replace the old Port of Spain General Hospital which certainly needs to be replaced. No doubt about that. I am informed that the contract was given to Johns Hopkins International and you can bet your bottom dollar that this is going to be an ultra expensive infrastructure. But from where is the staff coming?

Now, on Monday I read an article in the press with the headline: "Health Minister looks to Cuba." It stated that to date, 45 Cuban medical professionals have been hired and more are expected this month and that the Minister has spoken with the Cuban Ambassador about the previous arrangement. It is understood that the agreement that the Cuban medical professionals who came for three years and left without transferring knowledge will not be acceptable to the government anymore without such a transfer. But many are asking: "Transfer of what knowledge?" Most doctors tell me that the Cuban doctors in T&T are just average and moreover too many of them still do not speak English fluently enough!

Meanwhile, it was also reported that a local neurosurgeon at the North Central Health Authority has departed and that Cuba is coming up with a plan to help us with that. But what I want to know is why did he depart? That is the all-important question. And so, is it expected that our local doctors will depart and that the Cubans will then arrive? If so, then as I have said before, close down the ruddy medical school.

As the famous academy award-winning movie Bridge on the River Kwai, (starring Alec Guinness and William Holden) ended: "Madness! Madness! Madness!"

• To be continued

• Courtenay Bartholomew is UWI's first Trinidadian Professor of

Medicine and director of the Medical Research Centre