Many problems at Lethem Hospital

Dear Editor,

One would have thought that with the building, two years ago, and three subsequent renovations, of the much touted state-of-the-art hospital at Lethem, the many health-related issues would have been solved. That is not the case; as a matter of fact, the situation has reached an all time low.

I have received information from residents of the community, and respected former employees of the institution who are in a position to know what is transpiring at the hospital. Some of these former employees worked at the old facility and agree that the services and aesthetics of the old structure are far superior to the present structure. Some of the information contained herein is the subject of my own investigation, but is largely obtained from persons mentioned.

I will start with the structure itself. There have been numerous complaints that the building, when built, did not cater for natural ventilation as was the case of the old hospital. Thus patients have to endure the air-conditioning units, which might not be healthy for all patients. Only now is an entrance for Accident and Emergency cases being constructed. The X-ray room is one of major concern, and I think the Occupational Health and Safety Authorities should investigate this. The X-Ray department is located in an enclosed room with no ventilation and no means of allowing toxic fumes to escape. This could expose the technician to dangerous fumes when dealing with the chemicals to process X-ray films. Several senior officials had promised to install extractor fans, but that remains a promise.

There is a water problem in this multi-million dollar facility. There has been no running water in the Lab, Recovery, Laundry and Theatre sections for more than three months now. The staff of these areas have to fetch water on a daily basis. The Lab in particular needs running water since tests are conducted on blood, stool and urine, among other things. The current practice is one member of staff pouring water from a container, while the other member of staff washes his/her hands and or utensils.

The kitchen was recently rehabilitated and new shelves and a storage room were constructed, but whenever it rains that part of the hospital is prone to flooding and the ceiling leaks like a sieve. It must be noted that the contractors received full payment for these works. Editor, is the Defects Liability Clause still enforced in contracts awarded by government? That seems not to be the case in relation to the works done at the Lethem Hospital.

There is a septic tank on the windward side of the male ward. With the current electricity fiasco, and due to poor ventilation at this facility, patients of this ward face a torrid time.

A brand new dental chair was acquired 18 months ago at a handsome cost – $1.8M. Because the region failed to install air-conditioning in the dental department, the hose and other rubber components of the chair were subject to dry rot due to the intense heat that is a part of the Rupununi, thus rendering the chair unserviceable. The two dental technicians therefore are forced to use the old chair in a cramped space that entails only one technician working at a time. If we calculate the man hours lost due to this management hiccup and put dollars to those hours, then we will get the picture of the amount of monies literally going down the drain. While we are at it, add the cost of the chair, and the opportunity cost of the lost chair and we get a picture of more millions wasted. Oh boy, are we rich!

There is a machine that does blood analysis that is being seldom used because of the irregular supply of reagents that are necessary to enable it to function. This machine works with a combination of reagents that are supplied by the Central Pharmacy in Georgetown. Several residents have complained that on several occasions they were told that they could not get their blood analyzed because reagents were not available to work the machine. Therefore these patients with chronic diseases like diabetes and hypertension were made to wait or seek the dialysis elsewhere, mostly in Brazil.

The Prevention of Mother to Child Transmission (PMCT) programme was introduced to the region in 2002 with the responsibility of Lethem to take it to the other four sub-districts. For the first three years, this programme was vigorously implemented, but because of poor management and the egos of some regional officials, it seems to have diminished. The implications here are very serious, and the representative Amerindian organizations ought to take this up as a matter of principle. There are a lot of mothers, and I dare say Amerindian mothers, who are giving birth to babies without the benefit of being tested for HIV/AIDS and other sexually transmitted diseases. To date, Lethem is the only part of this region where the PMTC programme is functioning.
In some of the villages the Health Huts have various quantities of expired drugs. A case in point is the Health Post at Yupukari in the North Savannahs. Some health facilities in the South Central Rupununi have very few basic drugs. Does the Regional Health Officer visit outlying areas? There is also a shortage of certain basic drugs right here in Lethem, and patients are being advised to acquire them at the local pharmacy. These drugs, I have been reliably informed, are available from the government pharmacy in Georgetown.

During the recent floods, a large quantity of drugs and medical supplies were delivered to the region to aid in the flood relief efforts. Were they delivered to the Regional Pharmacy as is the normal procedure, and were they documented and can be accounted for?

The standby generator is now unserviceable because the machine was run concurrently with the electricity supplied by the electricity company. Before this, the plant was run dry on several occasions. Now the hospital does not have the benefit of power in this ever-widening electricity crisis that has gripped Lethem since the flood days.

It is no secret that the ambulance is an abused facility. This vehicle is used for trips to Bon Fim across the border. When this happens, the hospital is left without its services. But as the adage goes: “nothing happen, nothing said.”  This is a dangerous practice since should there be an emergency, the victims will surely suffer the worst.

The hospital’s photocopier is installed at the home of an official. Staff wanting the use of this machine, have to go to the house.

The physiotherapy department was given a motor-cycle by the Ministry of Health to do outreach work to schools and shut-ins in the communities. This cycle was taken away, however, and the officer has to utilize his own resources to do his work.

A new programme to detect cancer in women at an early stage was launched on April 7, 2011 with the promise of regular follow-up clinics. To date there have been no other clinics, and the programme is in danger of petering out. At the launch it was promised that other staff would be trained in the use of the programme, but there is no evidence that this has happened.

There is no ward sister at the Lethem Hospital. The ward sister is required to guide nurses in the execution of their duties among other things. Very often when one visits the wards, unkempt beds are noticed. The old hospital had a ward sister that used to keep the nurses and other related staff on their toes. I made the point previously about the number of referrals to Brazil from this new facility. It is the general view of most residents that the doctors stationed here are too junior to deal with the many issues confronting the hospital. The general view is that a senior doctor, who must also be a surgeon, be made available to run the hospital if it is to really serve the purpose for which it was constructed.

A mortuary was installed a few years ago, but became unserviceable in August of last year. Despite several attempts at repair, the facility remains non-functional. This has resulted in the increased expense for relatives of the departed who have to acquire ice to preserve bodies until burial. There were several instances of decayed corpses because relatives could not afford the ice.

From my investigations, own knowledge and the corroboration of some ex-employees, some of whom worked in senior positions, the staff of the hospital are quite capable of executing their duties efficiently and effectively. However, given the many constraints,  the staff has become lethargic to the point where they just don’t give a damn what happens any more. In fact one of the more experienced and knowledgeable staff has tendered her resignation in disgust and in protest at what is passing at the hospital for management and patient care.

The health authorities in Georgetown should therefore conduct an honest and objective review of this facility if they are keen and serious about the people’s well-being.

Yours faithfully,
Carl Parker

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