HAGÅTÑA (The Guam Daily Post) — Gov. Lou Leon Guerrero met with a full room of health care workers Monday night for an informational meeting on the medical complex, one of several such meetings the governor has held to drum up support for the project.
While many in the health care field, including the Guam Medical Association, have expressed opposition to the governor’s plan for a medical complex, the opinions given Monday were more varied, with several supporting the proposal.
The medical complex has been a longstanding initiative for the governor’s administration, with Leon Guerrero, now in her second term, hoping to break ground by the end of next year. The complex is planned to include a new public hospital facility, as well as other medical facilities.
With the Guam Memorial Hospital building deteriorating, there is little question whether a new public hospital is needed on the island. But that doesn’t mean the medical complex project has evaded controversy. In fact, much of the concern has been over location.
Where to build
Initially, the governor’s administration eyed federal property at the Eagles Field area of Mangilao, which ultimately fell through due to various issues. The governor is now proposing to construct the complex on Guam Ancestral Lands Commission property in the Barrigada/Mangilao area, also known as Eda Agaga. But many doctors oppose that plan, preferring that the project be scaled down to just a new hospital and to build that facility at Ypao Point in Tamuning.
Opponents of the medical complex have argued that most medical facilities and personnel already are located in Tamuning, and they say that factors in to response times. Proponents, on the other hand, argue that a full complex will help expand services on Guam, and its proposed location will better serve southern residents.
Two competing measures are now before the Guam Legislature. Bill 184-37, submitted by the governor, will facilitate the sale or lease of the GALC land for the construction of the complex. Bill 185-37, introduced by Sen. Chris Barnett, will ensure that any hospital built under the previously enacted Guam 21st Century Healthcare Center Act will be built in Tamuning.
Doctors opine
Dr. Annette David, one of the doctors in attendance at Monday’s informational meeting, noted that most health care services are located in Tamuning, Tumon and Dededo, leaving a “very large desert” for central and southern regions. Future planning for health resilience will need to close those gaps, she added.
“I was looking at the comments and some of the testimony against the location. In many cases, it was more about locating the hospital where already there are so many health services available, which seems, to me, not very strategic in terms of future thinking. What also struck me was that a lot of the issues raised had to do with the convenience for physicians and health care providers. Respectfully, I think, at the end of the day, we need to rethink what is most important for our community. And that has to be closing the gaps to ensure that equity for health care services is assured for as many people as possible,” David said.
Based on existing data, David said it was clear to her that the governor’s proposed location “makes the most sense” for the community.
But right after David spoke, Dr. Teresa Underwood commented that Guam will need to have doctors come to the hospital.
“And so, you need to have the hospital where most of the patients are going to be. So, it doesn’t make any sense to move the entire hospital to a place for these small communities with less access. You need a community clinic out there, but you don’t need to move the hospital there,” Underwood said.
Still, after Underwood, Dr. Teresa Borja, a local podiatrist, stated that medical professionals arguing against the medical complex may be retired by the time the complex is up and running, including herself.
“I want this opportunity for a medical complex. … I want that for myself. I want that for my 14-year-old son. I want that for my mother, who is 85,” Borja said.
She also stated that placing the new hospital at Eda Agaga won’t be a problem for her.
“It’s 20 minutes from my Tamuning location from where I will be living,” Borja said. “Think about the people that are opposed to this Eda Agaga location. They’re older than I am. They’re like ten years older than I am. Think about the future. This location will address people that don’t have the access.”
Standard of care
A few others also commented in favor of the medical complex project, while others commented on improvements that needed to be made on Guam regardless of where a new hospital is built.
Dr. Ellen Bez said Guam should aim for the standard of care seen in the states regarding specialties.
“The standard of care in the U.S. is to have specialties in-house now. … I think we should aim for the standard of care to build this wonderful medical complex that a lot of places in the states have said that this is the wave of the future,” Bez said.
Tiyan suggested
Dr. William Weare said the primary reason for the south being a “health care desert” is the salary structure and job descriptions for physicians in public health on Guam. Weare, who just returned from a medical conference, said starting salaries for primary care physicians in the states is about twice as much as on Guam.
“I think there are some issues that we really need to look at in addition to new buildings. We have a great clinic down in the south, but it doesn’t have doctors. And building a building … does not mean they will come. There are other things involved,” Weare said.
He added that Guam does need a more centrally located public hospital, and he suggested that officials possibly should look at Tiyan.
Issues with Ypao
As with other informational meetings, Monday’s meeting included a presentation by the governor’s office.
Krystal Paco-San Agustin, the governor’s spokesperson, said the administration’s team met recently with geotechnical engineers, who validated what the administration had been saying about fault lines in the Tumon/Tamuning area.
“They talked to us about Ypao Point and the threats that exist (there). And that’s slope stability. So, the ground movement, rockfall, seismic fault and sinkholes. We’re not saying that it’s impossible to build at Ypao Point. But we’re saying it’s going to be a costly expense with a lot of planning. And the higher we’re building, the more expensive it’s going to be,” she said.
According to Paco-San Agustin, those threats will need to be mitigated by a slope offset, engineered walls and earth-retaining structures. The caves below Ypao Point also present challenges to structural integrity at the location, she added.
Dr. John Taitano asks a question during a meeting for medical professionals about the proposed Guam medical complex held Monday, Nov. 27, 2023, at the Hilton Guam Resort & Spa in Tumon.
