When she is old enough to understand, Lateisha Julene Clark will probably not know whether to believe her mother when she tells her of the strange circumstances in which she was brought into the world.
But as the Caymanian Compass reported 5 October, her birth on the cabin floor of a Kingston, Jamaica bound Cayman Airways flight was real – dangerously real.
For her mother, Shellesha Woodstock’s, who was only 29-and-a-half-weeks pregnant, the drama began when she visited the Cayman Islands Hospital in the early morning of 1 October, soon after her water broke.
After being assessed by a doctor and nurse at the hospital’s maternity ward, Ms Woodstock was told it would be too expensive for her to have her baby in Cayman and that she should travel to Jamaica for the delivery.
She would tell the Compass days later ‘When I got to the hospital, they told me they don’t want to take the baby, so what they [are] going to do [is], they [are] going to send me to Jamaica. What they [told me] … was that it was too expensive but I didn’t tell them anything about any money.’
Ms Woodstock was given a doctor’s note stating it was safe for her to fly, while her boyfriend, Laflin Clarke, tried to book a ticket on the next flight to Kingston that day. They purchased the tickets but missed the flight, returning to the Cayman Island Hospital where, according to Ms Woodstock, she received virtually no medical attention until she left the hospital the next morning.
With over 24 hours having passed since her water first broke, Ms Woodstock and her partner left the hospital for the airport, this time making the early morning Cayman Airway flight to Kingston, Jamaica.
Just 20 minutes after taking off – to the shock of mother and all on board – Lateisha was brought into the world on the floor by the cockpit door.
The plane made an emergency landing at Montego Bay, where Ms Woodstock and baby were rushed to hospital.
When the Compass reported what had happened on 5 October, it prompted outrage on talk radio and in the community. It spread to Jamaica, after the Gleaner picked up on the story.
The HSA responded by claiming an internal investigation had found that staff had acted with ‘professionalism and due concern for the welfare of the mother and her unborn child.’ The statement went on to claim the mother had chosen to travel to Jamaica and that ‘membrane rupture’ (broken water) in early pregnancy ‘is not a contraindication to travel.’
The later assessment drew scorn from obstetricians. One told the Compass that turning the woman away from the hospital fater her water broke, let alone letting her fly, was unthinkable, not to mention highly dangerous.
Health Minister Anthony Eden, who had been at a conference in Washington, returned to a storm. Clearly unsatisfied with the HSA’s internal investigation, Mr. Eden announced an independent investigation into the incident. He commissioned two Pan American Health Organisation affiliated doctors from Jamaica to do the investigation, telling them to leave no stone unturned.
The Health Insurance Commission (HIC) and the Jamaican Consulate also announced investigations of their own. The Jamaican Consulate in turn passed on documents from its investigation to the Ministry of Foreign Affairs in Kingston, Jamaica, the Cayman Islands Office of the Complaints Commissioner, the Cayman Islands Human Rights Committee and Governor Stuart Jack.
On 4 December, the clinical audit that Mr. Eden had commissioned laid the blame for the incident squarely at the feet of the HSA. At a press conference announcing the fining of the audit, Mr. Eden offered a personal apology to Ms. Woodstock, adding that he had met with her boyfriend that morning to inform him of the outcome of the investigation.
‘I am saddened that it happened but we have learnt a lesson,’ Mr. Eden said. ‘We will be dealing with this; we have some very positive plans coming up for reforming healthcare in the Cayman Islands.’
Dr. Santosh Kulkarni, one of the report’s co-authors, told the press conference it was an error of clinical judgment to allow Ms Woodstock to fly. Contradicting an earlier HSA claim, the audit found that Ms Woodstock was most likely in active labour when she left the hospital on the morning of 2 October.
‘Staff concentrated on the financial aspects when counselling the patient and relatives rather than on the clinical consequences of the obstetrical condition that was presented before them,’ Mr. Kulkarni told the press conference.
‘Indeed, she was not given a balanced view of the risks in order to make an informed choice, as babies at the gestational age can be safely delivered at that hospital based on the available resources and have done so in the past with good survival rate.’
A separate HIC investigation found that Ms Woodstock’s employer had allowed her health insurance policy to lapse, but this was not directly relevant to the care she received because hospital staff never checked if her insurance policy was valid.
The HIC has said it is now pursuing legal action against Ms Woodstock’s employer.
The story had a brighter moment on 11 December when baby Lateisha, whose mid-air birth had led to confusion about which country she was legally born in, finally received Jamaican citizenship.
Jamaican Authorities concluded that the birth had taken place in Jamaican airspace, above Jamaican waters.
Meanwhile, Ms Woodstock told the Compass in early December that baby Lateisha is doing well. For her part, Ms Woodstock says she is unsure whether she will return to Cayman.