The introduction of heart surgery is welcome but basic public health still leaves a lot to be desired

Dear Editor,
 I refer to the piece in your newspaper in which congratulations to the Minister of Health from the Guyana Consumers Association was carried as a news items (Aug. 9, 2008) (editor’s note:  it was based on their press release). I do not believe that the SN is wanting of news, but the editor might have seen that the political innuendoes in the congratulations would be seen as cynical by the readership.

The Guyana Consumers Association (GCA), stated that Dr. Leslie Ramsammy’s “work in HIV/AIDS and immunization programmes have been recognized both in the Caribbean and abroad. The minister has quietly built hospitals throughout the country and has introduced procedures such as open-heart surgery, kidney transplant and dialysis. There is now a cancer clinic and a medical laboratory serving the public.”  Before, I am accused by the political buddy system of being an enemy of the Minister, let me state that I do believe that he has done reasonably well at the helm of the Ministry of Health, but it will bode him well to be more cautionary in his public pronouncements. The GCA ought to know that the Minister of Health is foremost a servant of the people of Guyana and it is his duty to serve with integrity. Among other duties, he is accountable to the people in ensuring that there is an effective immunization programme in the country. This is a very basic managerial responsibility. The fact is that across the health spectrum, we still do not have an effective immunization programme. Under Dr Ramsammy’s term, HIV/AIDS incidence and prevalence have not reduced. In fact, HIV/AIDS is one of the most under-diagnosed conditions in Guyana. So what, if there is now a cancer clinic and a medical laboratory? It is a shame and disgrace that this basic public health infrastructure is only now coming into existence. Assuming that these are both highly operational facilities, how many people outside of Georgetown have access to them?

The GCA should be concerned about health disparities in terms of geographical access. And, which hospital has Dr. Ramsammy built? The GCA  have forgotten than all public institutions in Guyana including hospitals have been built from taxpayers money. Yes, indeed, open-heart surgery, kidney transplant, and dialysis have recently been introduced in Guyana. These are routine procedures in most countries of the world. In Guyana, overseas-based physicians are flown in to conduct these procedures. I would recommend that the government invest in a comprehensive medical training programme for specialists.

 If the GCA examines the indicators for heart and kidney disease in Guyana under Ramsammy’s tenure as Minister of Health, they will see a dismal failure. It is rather ironic that a health system that cannot afford its women something as simple as a pap smear is bragging about a heart surgery and a kidney transplant performed by imported physicians. This is the same health system in which infant mortality rates are high and women continue to die of childbirth. For cancer, the situation is even worse. Let us not believe the snippets put out by the Minister in the newspapers that our health system is great. We have not even discussed the other aspects of public health – filth, urine, and garbage in the streets and major roads of Guyana. What about the public health aspects of the crime epidemic that has spiralled out of control?

Sensational innuendoes such as kidney transplants in the newspapers and TV stations that portray progress in public health are not going to help the sad realities of life for the vast majority of Guyanese who are burdened with chronic diseases and other conditions.

 Like the GCA, I too took great pride in learning that Dr. Ramsammy became the 61st President of the World Health Assembly of the WHO. However, the dynamics of the WHO rules and procedures governing the election need some clarification. First, the Committee of Nominations takes into consideration an equitable geographical distribution in proposing nominations for the President and five Vice-Presidents. Technically, it is more like a geographical rotating scheme. For example, the 60th President of the World Health Assembly was Ms. Halton from Australia; Prof. Garrido of Mozambique was the 59th President; Ms. Salgo of Spain the 58th President; Mr. Khan of Pakistan the 57th President, and so on. The President usually occupies the seat for one year. A representative from Guyana and the English speaking Caribbean assuming the Presidency of the Assembly has been long overdue. I am glad that the Guyana representative got it. It could have been any representative from Guyana credentialled by an authority such as the Head of State, Minister of Foreign Affairs, or Minister of Health. Usually, country representatives to the World Health Assembly are people with technical skills in a discipline of public health, not government ministers or politicians. There should be a culture in Guyana where highly qualified technical people (not political operatives) be given opportunities to attend international meetings where they can sharpen their skills and network with their counterparts so that they can return with innovative ideas to meet the challenges of the country.
 Yours faithfully,
Dr Somdat Mahabir