The lack of experienced doctors in the healthcare system has had an impact on the quality of care offered at some facilities across the country, Minister of Health Dr Leslie Ramsammy admits, and he has identified the antenatal programme as having suffered because of this.
But, he said, there was the deeper problem of experienced doctors who “do not show up” when they are called out and the corresponding issue of junior doctors who see serious cases and fail to inform their seniors or more experienced consultants.
Ramsammy told Stabroek News on Thursday that some high-risk clinics in the antenatal programme have succeeded in reducing the number of maternal deaths and complications within recent years. However, he said problems continue to plague the programme because of issues such as whether experienced doctors are available and how accessible they are to patients across the country.
“These are things we are working on in addition to addressing other issues that confront us. Training has been a major focus and we have stepped up training in the antenatal programme,” Ramsammy said. He pointed out that management within the hospital setting is also an issue because it involves the assignment of doctors among other critical things.
Clinical audits are currently being conducted to determine how certain things are being done in the health sector, Ramsammy said. He said such audits would look at issues such as whether every pregnant woman who enters the system for delivery is monitored in keeping with the rules, noting one of the key rules is that a pregnant woman should have her blood pressure checked every hour.
“If there are 17,000 deliveries in our hospitals for a year you would find around 3,000 cases where this rule was not followed. Whether they check it every hour or not the majority of women will give birth safely and will go home without any complication, but a case will come up that reinforces the need for it to be done in keeping with the rules,” the minister stated.
He said the rules are in place for the pregnant women that will turn up with complications including women with pre-eclampsia, which is pregnancy-induced high blood pressure. According to him, medical personnel across the country have to monitor pregnant patients and “do so constantly”. He said it is a challenge, but that the sector is working on it and he again emphasized that training is a major part of improving the system.
Further, he said an examination of how many blood pressure checks are done on every pregnant woman who enters a hospital for delivery is likely to indicate just over half of the required amount. “These are the details that are very important though they may seem excessive, but those are the rules,” he added.
Ramsammy’s remarks come in the wake of the death of a heavily-pregnant woman and her child at the Linden hospital
Thirty-five-year-old Tricia Winth and her full-term unborn baby died at the hospital in the early hours of Sunday morning.
Her husband Eusibo Winth told Stabroek News that he wants a full investigation to be launched into the circumstances surrounding their deaths as he believes that nurses were negligent in the care they administered to his wife.
Winth told this newspaper that his wife had decided to seek the advice of a private doctor after nurses had told her that the baby was in the breech position and would have to be delivered by caesarean section. “We decided to go to a private doctor because she said that she was feeling her baby in a normal position contrary to what they were telling her at the clinic. All that time she never had high blood pressure till around the last month of her pregnancy. They only thing was that she used to get really bad migraine headaches,” he said.
A post-mortem examination revealed that Winth died as a result of a ruptured blood vessel in the head.
