I was happy to read about President Jagdeo’s concerns about the poor state of medical care in Guyana (‘Jagdeo urges value for money in health facilities,’ SN, February 1). The President is correct in expecting major improvements as the government continues to invest in the health sector.
Recent events in the country including the death of Dr Desrey Fox highlighted the poor state of medical care in the country. There were other recent hospital-related deaths that got media attention, and several women died during childbirth at the Georgetown Hospital. Other medical-practice related deaths have been reported in the media over the years, including the recent case of a woman who reportedly sued after a physician performed a hysterectomy on her without her consent (‘Woman sues Cuban doctor after uterus removed without consent,’ SN, January 10). The premenopausal woman lost her ability to bear children. Several possible cases of doctor-related deaths are not reported in the media and are not part of statistics. Again two illustrative examples: My beloved first cousin, very compliant with visits to a doctor went in to a Guyana hospital for childbirth and several hours later, without warning she was dead. The doctors and nurses refused to talk to the desperate family. One of my aunts died a week after a fall from the stage of a tractor, even after promptly seeking medical care.
Of course, not all physicians/surgeons are bad potatoes. But the bad ones make the entire barrel smell bad. Also, not all botched medical procedures and treatments result in death. But they may cause unbearable suffering to the victims. I spent over a month in a Guyana hospital after an appendicitis operation due to sloppy surgery and poor after care. Two other illustrative examples: A doctor examined a teenage boy allegedly tortured by police, made several errors from basic record-keeping to treatment recommendations, and the Guyana Medical Council found it to be professional misconduct. An Australian man in Guyana was shot at a Georgetown bar and rushed to the Georgetown Public Hospital where he received surgery to remove the bullet. He was later discharged and then had to be readmitted to a hospital because his condition deteriorated.
The country is crying out for accountability. The country needs patient advocates. Patient advocates are well organized and well-funded groups in other countries. Questions should be asked about the number of deaths potentially caused by medical malpractice. I have been told that the following are the principal reasons why the problem is so prevalent in Guyana: 1) incompetence; 2) performance of tasks for which physicians do not have the requisite skills set; 3) conflict of interest; and 4) greed. President Jagdeo himself recognized that doctors on the payrolls of public institutions spend “half their time working at private hospitals or clinics.” The President was right when he said: “But don’t cheat the people at the public institutions because you are not there – and it is a form of cheating.”
Some may argue that Guyana is a poor country and the resources are simply not there for a better system. I disagree. Ordinary people have shown tremendous good will to the health sector. An illustrative example: The Ministry of Health has reported that Swami Aksharananda, the Hindu monk and unsalaried Principal of Saraswati Vidya Niketan, organized the largest blood donation drive in Guyana. Providing blood so that others can have life, demonstrates the resilience of the Guyanese people.
Is it too hard to ask those who took the Hippocratic Oath to emulate the good deeds of those ordinary people who provided their blood to save others?
I recommend the following short-term actions: 1) Government needs to become a facilitator of independent checks and balances in the medical system, and not be perceived as the judge, jury, and executioner of the system; 2) Guidelines for standards of care and protocols need to be developed; 3) Data emanating from the Ministry of Health should be publicly accessible for independent analysis; 3) The Medical Council of Guyana needs be strengthened and empowered as an independent body comprising mostly physicians, but should also include at least an epidemiologist and a statistician (this should be the group to discipline physicians and review medical malpractice, but they have to work on their image because there is a popular perception that doctors rarely expose the malpractices of other doctors); and 4) Publish and regularly update a list of the names of physicians, their expertise, place where they received their medical degree, graduation date, place whether they did their residency and date residency completed, whether they have any special certifications, or whether they were involved with any malpractice.
Yours faithfully,
(Name and address provided)
