In the practice of medicine, as in all aspects of life, mistakes are made. After all, it’s human beings who are involved, not robots. In the provision of healthcare, however, mistakes can result in death. There is a big difference also, between an honest mistake and an error made because of inadequate training, improper equipment or supplies, or a lack of compassion or attention by healthcare workers.
Over the years, there have been numerous suspicious deaths at the public health facilities in Guyana, especially at the Georgetown Public Hospital Corporation (GPHC), the largest and busiest hospital in Guyana. In particular, numerous pregnant women have died during and after delivery of their babies, making Guyana the country with the second highest maternal mortality rate in the Caribbean and Americas region. Yes, there have been some improvements and reduction in maternal deaths in Guyana over the years, but the rate remains disturbingly high.
Part of the problem is that too many women still aren’t receiving proper prenatal care (evidence of a lack of education and public health outreach). However, many deaths have occurred because of inadequate or incompetent care by staff at the public hospitals. Women have been forced to deliver vaginally when they had been advised to have Caesarean sections, or have not been monitored properly, or berated and ignored when they cry out. Preventable deaths from ruptured uteruses and haemorrhaging are too common.
Others with minor injuries have also died unexpectedly while receiving care at the public healthcare facilities. Four-year-old Jaden Mars died after going to the GPHC with a cut tongue. Not long ago, a man who was shot in the jaw and another man shot in the buttocks—both non-life threatening injuries—died while patients at the GPHC. Recently, I heard about an otherwise healthy woman who suffered a broken ankle after being knocked down by a car. She also died unexpectedly at the GPHC. Misdiagnoses are also relatively common. A friend’s mother recently died of lung cancer; the doctors in the public health system had misdiagnosed her symptoms and were treating her for tuberculosis. These are just a few of the numerous cases that have been reported over the years. In hinterland and out-of-town facilities, staffing and quality of care are often poorer than in Georgetown and incidents are less likely to become public.
However, this is not an indictment of all staff at all public healthcare facilities in Guyana; I know there are many dedicated, competent, and caring professionals. The system though, is seriously flawed. The fact is that there are many healthcare workers in Guyana who are not adequately trained. The failure rate of trainee nurses, for one, is exceedingly high. The Guyana Nursing Council has been complaining, for several years now, of political interference in their operations, alleging that the Minister of Health forced them to accept more students than they could properly educate. Stories are also commonplace of doctors missing from duty, of facilities being locked when patients try to access care, of the lack of running water, medication and supplies (like rape kits), of expired medication, of patients being forced to share beds, families having to clean and tend their loved ones while staff engage in conversation and other personal business, of patients being disrespected and their confidentiality breached, of services not being offered, of families seeking answers being ignored and given the run around; the list of abuses is long.
Many doctors working in the public health system also operate private practices. This is their right but it becomes problematic when services that should be provided in the public sector aren’t, so that doctors can make money privately from patients. Medical termination of pregnancy (abortion) is one glaring example. Abortion has been legal in Guyana for two decades, since 1995. Regionally, our laws about abortion are among the most progressive in the region. However, only recently has the Ministry of Health implemented this law, and just partially at that. Abortions are currently only being done at the GPHC. Women in other parts of Guyana who need this service but who are unable to travel to Georgetown, are left to fend for themselves still, pushing foreign objects into their wombs, drinking unknown concoctions, and going to unlicensed bottom-house clinics where they are regularly injured and killed.
Two women have already died for 2015 – 23-year-old Athina Kennedy, a mother of two in Bartica and 22-year-old Kamili Arjune, a mother of four in New Amsterdam.
The doctors who performed the abortions which resulted in these deaths are both employees of the MOH, working in the public hospitals, but neither was officially trained or licensed to perform abortions. They did it privately for years though, making money. However, like the doctor who was implicated in the death of 18-year-old Karen Badal, mother of two, in 2011, also from an illegal bottom-house abortion, these doctors remain unpunished.
There is a body—the Medical Council of Guyana—responsible for licensing and disciplining doctors. However, reports of political interference in the work of this body have emerged in recent years. On more than one occasion, pressure has been put on the Council (by the Minister of Health, allegedly) for it to revise and water down disciplinary recommendations. The case of the doctor who participated in the police torture of the teenage boy at the Leonora Police Station in 2009 is one example of this; instead of being fired immediately, he simply received a slap on the wrist. The Medical Council also only acts when it receives a complaint from someone who has been victimized, or a relative of the victim, or if the Chief Medical Officer orders an investigation (he has never done that). Most Guyanese aren’t even aware of the existence of the Council, its location, contact information, or complaint procedures. Clearly, the Ministry of Health does not really care about holding staff members accountable, providing the best quality care to the people of Guyana, or ensuring that those who have been mistreated receive justice. This must change.
Sherlina can be contacted at firstname.lastname@example.org