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  • By Vincent Taijeron Akimoto, MD

White  Albatross

I was cleaning the bathroom at the American Medical Center in Mangilao the other day when a thought popped in my head: toilets are like albatrosses in that they are both typically large-mouthed, porcelain white, heavy entities that are surrounded by a lot of poop.

Speaking of clean toilets, the ancient Chamoru must have been meticulously clean people with a pragmatic sensibility about sanitation. Visiting European scholars typically described the Chamoru as sturdy, handsome human beings with strong muscular men capable of moving tons of limestone in order to make durable Latte stone villages. Modern science has proven that it is hard to prevent disease and raise your kids to be big and strong if you can’t keep E. coli out of your ancient Chamoru drinking water.

Last I checked, the bathrooms at the Guam Memorial Hospital are not consistently clean. I have endured the verbal abuse of hospital critics who pontificate about how much GMH stinks and how they never touch anything at the hospital without first scrubbing the surface with baby wipes. People are all pissy about poor sanitation when it affects them personally, I have observed.

Last year, more than 10,000 GMH patients urinated in the Emergency Room bathroom. Some missed. Poor aim, inebriation, pharmaceutical diuresis, or explosive diarrhea. Whatever the reason, the GMH housekeeping staff has one of the dirtiest, most unrewarding, potentially dangerous jobs on Guam. Please give them a hug.

GMH lost Joint Commission accreditation two years ago because it repeatedly failed to maintain national healthcare standards for patient safety. Since last Christmas, GMH has failed to replace a dysfunctional, decades-old electrical panel that hospital officials claimed was a life-threatening liability. GMH has failed to hire sufficient nurses; patch its leaky roof; competently maintain patient elevators; and consistently cut the grass in its filthy parking lot.

On a good day, GMH has 130 beds to offer very sick Guam patients who are too sick to be cared for in their own bed at home. GMH claims that it has chronic nursing staff shortages thus justifying why it has been unable to keep open more than 50 additional beds.

GMH has also claimed that it has a staffing shortage of competent business people thus justifying why it has been unable to collect millions of dollars in unpaid medical bills. This has perpetuated hospital debt and forced increased taxes as well as created a series of unfortunate circumstances that threaten the safety of each and every island citizen.

With the exception of the reliably filthy bathrooms at Kmart, every hotel, every child’s school, every gas station bathroom on island reliably smells better than the ones at the Guam International Airport and, too frequently, GMH. These places are all busy and very often, the people who use all these bathrooms have poor aim. The people who work in places with the clean bathrooms have to perpetually work hard and embrace servant leadership in order to keep their places clean. The places which have reliably filthy bathrooms are bad corporate neighbors who have too rarely helped the GMH Volunteers’ Association help make Guam a better place to live and die.

GMH is a public hospital managed by the politicians of Guam. The Guam Legislature currently approves a politically bloated payroll of more than 7.5 hospital employees per occupied hospital bed. Actually, the legislature foolishly approved funding for even more hospital staff but GMH can’t find enough warm bodies. If the 986 full-time GMH employees were each given a motivational toothbrush to help keep the hospital bathrooms clean then maybe GMH patients and their visiting family members would have cleaner bathrooms to use than those in a Third World hospital.

Sanitation, like healthcare, is basic. The numbers of Methicillin-Resistant flesh-eating Staphlococcus Aureus crawling around your contaminated, overcrowded Emergency Room don’t lie. If your hospital is dirty, people are going to die.

In hospital talk, this type of unnecessary infections caused by the hiring of unnecessary political patronage employees is called Nosocomial. It means that the politicians who are running your politically corrupt government hospital don’t care enough about you or your children. Since our Guam politicians continue to perpetrate the crime of payroll politics, someone will likely die unnecessarily this Christmas. Likely, someone at GMH has already suffered and died unnecessarily because of the filth, political neglect, and medical disservice which continues unabated at our island’s only public hospital.

Funerals around the island in the coming weeks will be great places to assess the violence of the latest round of payroll politics. Orphaned children, extended families, and furious taxpayers can judge for themselves if all this past year’s ineffectual political posturing has contributed to the death of any poor patients at GMH. That, ladies and gentlemen, would be the definition of political manslaughter.

This Christmas, let us pray for the death of the “Me-First” attitude of previous Guam politicians. Our senators must have the moral fortitude to take back the $65 million in gross receipt tax exemptions to hotels, banks and insurance companies. Immediately give GMH the $60 million generated by the vicious tax increases done in its name. Regain accreditation. Fix the electrical panel. Fix the leaky roof. Make the hospital safe again.

De-fund special assistant and deputy director positions and use that money to fund pay increases for GMH nurses. Redirect the $45 million Tourist Attraction Fund to the GMH administration for capital improvement and continuous facilities maintenance expenditures at the hospital. Complete the long-promised OB ward renovations.

If our Grinch-like Guam politicians fail, then next November 2020, island voters get the chance to let their angry voices be heard. On Guam, degrees of separation are none. If the toilet needs to be cleaned, if the trash needs to be taken out, You have to do it yourself. Until then, GMH will continue to hang like a stinky dead albatross around all our necks.

Dr. Vincent Akimoto practices Family Medicine at the American Medical Clinic. Send feedback to


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