Unhealthy public health sector

It should come as no surprise to anyone that senior nurses are speaking out about the malady affecting the operations at Guyana’s premier public health institution – the Georgetown Public Hospital (GPH). In fact, if anything, persons should be wondering what took them so long. Patients who, for want of the necessary funds or in circumstances beyond their control, use the GPH have had more hair-raising experiences than in the average horror house. And in way too many instances, these experiences have been fatal – taking the lives of loved ones and plunging families into grief.

High on the list of the things that are wrong with this institution is its ‘stellar’ contribution to Guyana’s depressingly high maternity death rate. This, along with all that has contributed to what the senior nurses referred to as a deterioration of health care and a dire situation, of course, did not just occur. The rot began decades ago and nothing was done to address it. Therefore, it metastasized, much like a cancer until mediocrity, lack of empathy and sometimes failure of basic care mostly became the rule – the flip side being the exception.

Maternal deaths were not the only casualty. There have been endless reports of sick persons waiting as long as 12 and more hours for medical attention. Much of this was captured first hand by a Stabroek News reporter who spent an entire day at the GPH’s Accident and Emergency Unit on December 3, 2003 and later reported on and published on December 30, that same year.

The investigative and candid report failed to have the desired effect. Not only that, reporters are for the most part now personae non gratae at the hospital. Medical and other staff, it seems, would rather not have their failings made public in a way that brooks no denial.

On December 25, 2007, this newspaper reported on a situation at the GPH the previous day, where several medical staff had shown up hours late for their shifts and the persons from whom they were to take over had left the hospital anyway. The result was that many very ill patients were forced to wait several hours for medical attention.

In May 2013, there was the harrowing case of Farida De Souza of Albouystown who died at the hospital after suffering three heart attacks while waiting for medical attention for some 12 hours in the emergency room. Her son, who had taken her there, had laid the blame solely at the feet of the ER nurses, whom he had accused of negligence.

Early in December that same year, an otherwise healthy four-year-old, Jaden Mars, died at the GPH after he was taken there with a cut on his tongue, sustained during a fall while he was playing. It was decided by medical personnel there that Jaden’s tongue required stitches and an anaesthetic was administered. He subsequently died. Just over a month later, GPH Administrator Michael Khan announced that an investigation had found no one culpable. The child’s mother Ms Nathalie Caseley had then mounted several protests outside the hospital and subsequently moved to the courts. These are just a few of the many deaths that have occurred at the GPH, where huge questions went unanswered.

The GPH is not all bad. It has its good moments. However, too often when these occur they reach the public in press releases that have been carefully scripted by hospital staff and approved by its management or via tightly controlled press briefings and tours. Members of the media are only too aware that the management of the GPH seems to hold itself somewhere above accountability and has often been unavailable to clarify issues reported to the press by the public. But perhaps this is about to change.

In the wake of the accusations of maladministration, Mr Khan has this week been sent on leave, though seemingly not in association with the allegations. According to Minister of Public Health Dr George Norton, Mr Khan’s leave is to facilitate an investigation into the procurement and storage of medical supplies at the institution, and that this was done at the suggestion of the auditors, who had carried out a forensic audit at the public health facility.

It must be noted though that the issues with the public health sector do not begin and end with the GPH. Dr Norton is fully aware of this as one of his first actions after taking office was to visit public hospitals around the country. Observations made during his visits confirmed many of the complaints made by long-suffering members of the public with regard to these facilities. Dr Norton found dingy and dirty areas, expired medicines, non-working equipment and inadequate medical care spaces, all of which point to exactly what the senior nurses have complained about – improper management. Dr Norton has promised to address these issues.

Since the GPHC is the country’s premier and largest public health institution and it has a critical role to play in offering medical care and saving lives, it is perhaps fitting that the treatment and therapy the public health sector so desperately needs starts here. But it must also extend to every corner of the country, to each hospital, health centre and clinic so that service to citizens is vastly improved.