DR Jacquiline Bisasor-McKenzie is a picture of calm authority when we see her at the weekly COVID-19 press briefings at Jamaica House, but beneath that composure is a woman fortified by tragedy and immense challenges. Dealing with the effects of major surgery last December, then the crushing pain of losing her sister to cancer on February 1, just a day before she returned to work, the chief medical officer (CMO) has maintained an unwavering grip at the helm of Jamaica's response to the dreaded pandemic.
“It is a challenge 24 hours for the day, but I think that all the experiences that I've had in life have prepared me,” she told All Woman in one of the few moments of respite she has had since the threat began encroaching on the island in early March.
“This is a major public health event and the CMO's position has to be a very strong position. If you are not a strong leader, then you will be led,” she said placidly. “I constantly feel as if I am in a boat going through a storm, and I'm trying to keep the boat on the right track, but there are many courses that can be taken and I have to hold tight to the wheel.”
But Dr Bisasor-McKenzie is not intimidated by the rocking ship and the rough seas.
“It's not easy but I'm not an easy person either,” she said, smiling. “I make sure to take the time to be informed and understand what is happening and why it happens. So when I advise, it's been well thought out, and there are many people who contribute to these decisions. I think that we are all here at the right time for this purpose, and certainly God has created a path for us to take.”
Her belief that the current events are being orchestrated by a higher power comes not just from her strong Christian faith, but also from her own personal journey. She confessed that she did not plan for any of her major milestones, but instead found herself riding the waves as they rose up around her.
“As each door opened I stepped in,” she said. “None of what I have achieved had I planned to achieve. None of it. I never planned to do medicine. I never planned to do emergency medicine. I never planned to go to the ministry, and I never planned to move through the different levels in the ministry. Yet it all happened.”
In fact, it was after she had completed her first degree in chemistry, with a minor in food processing, and after she had spent nearly two years in the manufacturing industry as a quality control chemist, that she set sail against the wind to pursue medicine.
“I really had no interest in medicine,” she admitted. “Chemistry and food processing was my first love, perhaps because my father was a chemist in the sugar cane industry. My brother was interested in doing medicine and he just filled out an application for me, and I remember he brought it to me just to sign it. I did; and next the thing I knew I was accepted.”
Despite being the youngest of the three siblings, each born a year apart, Dr Bisasor-McKenzie was the first one to have completed university and be in a position to help her family financially, so the decision to change course was a costly one.
“By that time my father, Vincent Snr, had been in an accident and was no longer able to work, so it was my mother, Icylin, who was a very strong and determined woman who was supporting us. She was a secretary,” she recalled. “It must have been a blow to them to hear me say that I wanted to go and do medicine at that point, but they were very supportive. University education was free at the time so the bulk of the expenses were living expenses and books. I saved every penny and applied for student loans and boarding grants.”
But having already benefited from a loan to finance her first degree, which she had not yet finished paying off, the Students' Loan Bureau was reluctant to offer her a second. It was an emotional call to Barbara Gloudon's Hotline that changed the winds in her favour.
“Actually, my batch ended up starting medical school late because of Hurricane Gilbert,” she recalled animatedly. “So that had an effect on our entire programme.”
She would go on to complete medical school after five years, then get married to Garth McKenzie, whom she met while attending sixth form at St Jago High. She had her two older children, Jordan and Kristen, while completing her internship at Spanish Town Hospital.
“After I finished I worked a little bit in the health centre, then went back to the accident and emergency department (A&E) at Spanish Town Hospital,” she said. “I really enjoyed the emergency department and I found that there wasn't an area of medicine that I liked more than any other area. I just really loved it all and wanted to do my best in every area.”
After spending another year in the emergency department, the doctor felt strong enough to steer a small vessel. She, along with a colleague, opened a private practice in 1996. She would soon master the oars enough to paddle on her own, and she went solo until she went on to further her education.
“I decided that I wanted to be able to do more for my patients so I applied to do the post-grad training in family medicine, only to realise they were no longer offering the programme. Somebody mentioned the doctorate in emergency medicine, which was a fairly new programme, and I did that instead,” she said, pointing again to an unseen hand steering her along.
Dr Bisasor-McKenzie spent the next four years in the post-grad programme, some of which were completed abroad, allowing her to develop a deeper sense of confidence in the training she had received locally. In her final year she got pregnant with her third child, Katherine.
“I had my daughter just before my exams,” she marvelled. “I said to myself that there was no way anybody would be able to say that it's because I got pregnant why I couldn't pass my exams. I made sure I passed them and did very, very well.”
The day after she got back her results, Dr Bisasor-McKenzie got a call from the then senior medical officer at Spanish Town Hospital, Dr Garth Alexander, asking if she would return there as the head of its A&E department. She took up the post, but upon her return was greeted by a deterioration in the culture of the town, and a woeful lack of facilities. Before she left the dock, she went about patching up her battered vessel.
“There was no equipment, nothing,” she lamented. “I went to ScotiaBank, and I was in tears pleading for assistance. They gave me two cardiac monitors, an ECG and a defibrillator.
“When I went back with the equipment I could teach, and we set up protocols. The doctors, nurses and even the porters and the janitors, were very willing to learn and many persons came to Spanish Town ER to work because they wanted to widen their emergency room experience. It was an atmosphere of learning and doing the best for your patients, and it was really great.”
She captained the A&E at Spanish Town for the next 10 years, weathering the changing tides of new political administrations, changes in policies, staff shortages, lack of resources and equipment, and poor coordination with other departments in the hospital.
Until she had enough.
“I got frustrated because it felt like no matter what we did in the A&E, if the other areas didn't pull up their game then all our work was for naught,” she said. “I applied for the position of senior medical officer at the hospital because that was really what I wanted to do. I wanted to transform the hospital.”
She did not get the spot.
“It was a disappointment for me, and I felt like I hit a roadblock,” she conceded.
From Emergency Room to Boardroom
She was denied the top spot at Spanish Town, but she was still very much interested in moving the country's health sector forward, and would gladly chime in on issues of national importance whenever she got the opportunity. So when the post of director of emergency medical services (EMS) was created in the ministry but was sitting vacant, she boldly jumped ship.
“That was in 2014, and at that time we were dealing with the threat of Ebola,” she explained. “Under the guidance of Dr Marion Bullock DuCasse, I got quite involved in the training of personnel, and was just trying to get infection prevention and control measures up. We started a lot of work in Ebola that has put us in a better place to now manage COVID-19. My own belief is that with each emergency that you have, you have to make sure that you recover better, so that when something else comes along you are not in the same position as you were before.”
As director of EMS, Dr Bisasor-McKenzie dedicated a lot of her time to the implementation of the North Coast Trauma Project, which was not taken on wholeheartedly in the long run due to a lack of funds. She managed, however, to rekindle interest in the Pre-hospital Emergency Service and expand the programme. After completing a master's in public health, she later assumed the role of principal medical officer and director of emergency disaster management and special services in August 2016.
“When we had a change in government, Minister [Christopher] Tufton came in and he was interested in what we had that was data-driven, and that we could improve on. At that time I was working on the streamlining of the processes in the emergency department, and how long it took a person to be triaged. Coming out of our preparation for Ebola, I had data from three different hospitals and I shared that project with him. We took that on as one of the major projects at the start of 2016 — decreasing waiting time,” she related.
She became CMO in 2018.
“Never in my life would I have thought that I would have become the chief medical officer,” she said. “Many persons were not supportive, because people like to know that the CMO is steeped in public health, and is coming from public health. I came out of the hospitals, then later got public health training. But I always thought that we needed to combine the two. The person who is in charge should have exposure in both areas.”
Anchored by her faith in her own abilities and preparedness, and confidence in her team, Dr Bisasor-McKenzie has steered through the stormy seas.
“There are so many things to try to deal with — many points of views, and many perspectives,” she outlined. “As the director of technical services, the decisions we take have far-reaching impact. A lot of people don't like making unpleasant decisions, but I don't consider them to be unpleasant decisions. I consider making the best decision, then dealing with the unpleasantness after.”
Having learned from storms such as ChikV, Zika, Ebola and H1N1, the CMO is focusing her binoculars beyond COVID-19, to see how the current crisis can be used to strengthen the country's primary and secondary health services.
“I have recognised several challenges that we've had over the years in our entire health system, and I just want to do my part to make it better by putting the basic systems in place,” she said. “We have been led by the emergencies in the past. There are enough emergencies and there are enough changes in political direction for you to completely forget about the building of the basics. For whatever period of time that I am here at the ministry, my focus will be on building and strengthening the foundation.”
And she is not building alone. Her two children who were born a year apart while she interned in the emergency room are now doctors in the emergency rooms of two local hospitals. The CMO rightly described them as a family fighting COVID-19.
“Any little thing that happens in the emergency departments that they're not sure about, I'm the one they run to for advice,” she said with a laugh. “I could be in a meeting and they will call to say there is a patient with this condition, and ask what must be done. I could be sitting in front of the minister, I am still their mother.”
Her youngest, who is now 15, is doing her part by distance learning; while her husband of 27 years has been a six-foot tower of support to the petite medical officer. With her sister's recent passing, Dr Bisasor-McKenzie has gladly welcomed her 23-year-old niece on deck, just before her own daughter Kristen tied the knot in March.
The CMO is yearning for another smooth sailing Sunday, when the most pressing challenge is to have her household ready in time for church, and make it back home to prepare Sunday dinner.
“I'm looking forward to just being able to cook and have my entire family together again,” she said simply. “My family likes to eat and they're all happy when food is in the house and Mommy is in front of the stove. I'd just like to enjoy that family time again.”
Although her father's work on sugar estates saw her hopping parishes frequently as a child, Dr Bisasor-McKenzie never felt as if she was venturing into uncharted waters, as she was blessed with a strong family unit. “My brother Vincent, my sister Angela, and myself were a unit. You didn't see one without the others,” she shared fondly.
She was born in Trelawny, then moved to Westmoreland, then St Catherine, then St Elizabeth, then back to St Catherine, to finally dock in Denbigh, Clarendon, until she started her own voyage. Her chest is filled with treasured memories from different parts of Jamaica, and she has no intention of leaving for clearer waters.
“I am a Jamaican,” she said. “I don't have any foreign passport. My motivation has always been the same since I started medicine — that everybody who comes into a facility is treated with dignity. That has always been my goal. My aim has always been to do what I can do, until I can do no more. No matter what happens here, until the water covers our head, we are not going under.”