Radiation leak among ‘deficiencies’ snagging Cancer Institute’s operations

- standards won’t be compromised, says minister

The Guyana Cancer Institute has been refused a licence to operate over the last year because of “deficiencies” that need to be addressed and Minister of Health Dr Bheri Ramsaran says these include the leakage of radiation into adjoining rooms and the corridors from its radiation therapy machine.

“It will take investment, it will take some time but we would not compromise standards,” Ramsaran told the Sunday Stabroek recently, when approached on the situation, while revealing that the ministry has engaged the Pan American Health Organi-sation (PAHO) in an effort to improve the operational standards at the institute.

The Guyana Cancer Institute, which began its operation in 2006, is located in the compound of the Georgetown Public Hospital Corporation (GPHC).

Ramsaran said that contrary to what many believe, the ministry has not just been refusing to give the requisite signature to the institution; rather, it has been working with it to ensure that the minimum standards are achieved.
Recognising the importance of the service provided, he added that the ministry has been in close contact with Chief Executive Officer of the Institute George Nella and also the management of the St Joseph Mercy Hospital, where the Institute operates a branch.

Sunday Stabroek attempted to get a comment from the institute but was told that Nella is the only person authorised to speak and that he was out of the country. An email address was provided but Nella has not responded to an e-mail sent by this reporter.

However, a report in last Sunday’s edition of the Kaieteur News quoted a statement from the institute as saying that over 80 patients are now affected due to the institution’s inability to operate. It said last year it took the decision to install a new machine, which was done in October, and that PAHO oversaw the operation of the machine and “confirmed that the machine met with international standards.”
“We love this service and we want to work with it, but there are still deficiencies that have to be addressed,” Dr Ramsaran, however, maintained.

He added that while the service is needed in Guyana, the “government is firm on certain standards that would protect the patients, the workers involved and the general public.” He noted that radio therapy is “serious business” and revealed that over a protracted period of more than a year the ministry has been engaging the institute in trying to work out ways in bringing the facility up to standard.

According to Ramsaran, the ministry engaged its most reliable technical partner—PAHO—to work with the institute and it presented a report on certain findings, including deficiencies. “These findings were brought to the attention of management of the institute and certain rectifying measures were supposed to be taken. Recently, we had another visit by another team to check how things were going and so we are making progress. The ministry is not satisfied that the progress is as complete or as fast as we would require,” the minister, however, stated.

He maintained that the ministry would not “compromise on standards,” especially in such a service and given the implications that it could have for the patients. He gave the example of the Brian Lara Cancer Treatment Centre in Trinidad, which was faced with 223 patients receiving overdoses of radiation during the period 2009 to 2010. The centre has said that the overdoses were within acceptable limits.

According to Dr Ramsaran, apparently a machine was brought in to replace an older piece and that machine was checked and found to be in order after some interventions. But he said it is not just the machine that needs to be in order, but there are other regulations that need to be in place coupled with requisite human resources. Apart from PAHO officials, the ministry also had its own officials working with the institute and conducting reviews and investigations.

St Joseph Mercy Hospital
Meanwhile, Ramsaran said apart from looking at the institute’s GPHC’s location, a comprehensive examination was also done of the branch located at the St Joseph Mercy Hospital.
“We found, and this is based on reports from my technical people, that there are some difficulties there that need to be addressed,” he said, while revealing that nurses in an adjoining room or those who use the corridors outside the area that provides the service could be in harm’s way.

“So we have noted certain things that need to be done at the St Joseph Mercy Hospital branch. We have shared this information with the head of that hospital and from my initial discussion with them they did not seem to know… the full scope of things that they should know,” the minister said.

As a result, the ministry’s technical people were sent to the hospital with the report to share with them so that everyone is in the loop.

When contacted, acting Chief Executive Officer (CEO) of the hospital Marjorie Park explained that it is the Cancer Institute that is responsible for that service, after it had asked and was given space to carry out radiation services along with the MRI and CAT scan services. The agreement was brokered with the then CEO Sis Sheila Walsh and the requisite safety requirement was adhered to.

Park said she is not clear about the present situation but she knows Nella and other persons had visited with the substantive CEO.  She said recently she was personally contacted by Dr Ramsaran, who indicated that the institute’s service was suspended and two persons were sent to the hospital and the situation was brought to the attention of the board of the hospital. Because of what they heard, she said, they decided that until they are totally satisfied that the requirements are met, the institute’s services would not be provided at the hospital.

She said she is unclear about whether radiation leakage was proven and as a result they have to wait on the findings of the ministry and until the ministry gives the green light, the service would not be available.

Reviews
Meantime, according to Ramsaran, reviews were made of the reports from all the technical teams that worked with the institute to ensure all participants were singing from the same sheet.

He said that they will continue to work with the institute and any other provider who may come forward to provide such services to ensure that both the personnel and patients are safe.

Meanwhile, he added that the ministry has observed that some prominent citizens who access the institute’s services are being misled into believing that the ministry does not want to sign the requite documentation to get the institute operational and that is all that is needed.  “This is either wittingly or unwittingly misinformation. I know, for example, a very highly-placed person, who worked in the judiciary before, is receiving the service and his family has been approaching me and I understand from them that is the impression they have been given. I understand [there are] even senior persons in the administration who have apparently been given that impression,” the minister disclosed.

However, he said that the  Cancer Institute has been found wanting and the ministry is working with its management to resolve the situation. He also maintained that any private partner, who can bring similar services up to the standards required by the country’s laws and regulations, would not be barred from doing so. And while the ministry will not intervene into the business model of the institute, the minister suggested that there might be other models of machines they might want to explore which will ensure that there are no radiation leaks.

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