Emergency Medical Services

The world today is beset by many calamities, both man-made and naturally occurring. This year’s multiplicity of storms and earthquakes has shocked the world and killed hundreds worldwide. In the Caribbean, accustomed to annual storm systems, there has been widespread destruction in several islands on a scale never before experienced. Mexico alone has experienced over 300 earthquakes in a matter of weeks with the largest four registering 4.2, 6.1 and two at 8.1 on the Richter scale.

Guyana has largely been spared natural disasters, apart from extreme flooding in areas such as Mahaica/Mahaicony/Abary (MMA), George-town and the East Coast of Demerara, and Regions 7, 8 and 9 in Essequibo among others, and even then it must be conceded that some instances of flooding are caused by human negligence.

Manmade disasters, however, are not in short supply here in Guyana, with the most destructive of these being fires, road accidents, mining and river accidents, and the full gamut of physical violence including banditry, domestic violence and suicide. It is against this backdrop of constant threat to life and limb and water borne diseases that can be spread through floods that we once again initiate the call for the establishment of a fully functional and functioning Emergency Medical Service with a highly mobile team of paramedics across all ten regions of Guyana.

Guyana has been churning out new batches of Cuban and Chinese trained medical personnel over the years with 80 doctors graduating in October 2016 according to a GINA report which also noted that in the 10 years prior, about 700 doctors had been trained in Cuba and returned to serve this country for the mandatory 5 years. Guyana also has locally trained doctors graduating from the University of Guyana and other universities operating here.

With a relatively small population, albeit spread over a wide coastland and also hinterland regions, Guyana’s burgeoning population of medical professionals should signal a dramatic improvement in the quality of medical services in Guyana, including emergency medical services. But since emergency medical services do not lend themselves readily to entrepreneurial effort, it behoves the state to drive their formulation and establishment.

In March of this year, the state information agency, GINA reported that Emergency Medical Services (EMS) in Guyana were being “expanded” with the training of no less than 32 Emergency Medical Technicians (EMTs). This training was to be done over a period of only 6 weeks and the National Medical Director of EMS, Dr Zulfikar Bux stated that the training, “encapsulates them understanding basic and a little advanced types of CRP, CPR, meaning how to resuscitate patients when they are on the scene. Other aspects of the training include them being able to transport patients in accidents in a safe manner.” According to Chief Emergency Medical Technician (CEMT), Ron Morris, the trainees were, “doing some observational rotation inside the emergency department and they are also doing some clinical rotations on the ambulances with actual EMTs, getting a feel of how runs are done.”

Despite the positive outlook expressed by these two professionals, several months onwards from March 2017, we are still to hear of the EMTs being deployed and functioning fully in our regions with clearly marked vehicles, which should have markings that differ from standard ambulances and other vehicles of the Ministry of Public Health’s hospitals across the country. A countrywide public information drive should be launched informing, educating and encouraging the Guyanese public with respect to the EMS: its existence, its purpose and functions, and its contact information. The much maligned and highly dysfunctional 911 service should also be working in tandem with the EMS such that they have a 24- hour direct line of communication with each other, and with their communications departments staffed by well trained and highly motivated individuals only.

The Guyana Fire Service (GFS) too, announced in October 2016 that it would be providing an Emergency Medical Service in conjunction with its fire-fighting services. Fire Chief Marlon Gentle said that the EMS would initially cover from Timehri, East Bank Demerara to Enmore on the East Coast of Demerara, and as many as 5 ambulances were to be utilized with 14 persons being trained as EMTs.

Needless to say, the general public has not seen any evidence of these EMTs in action so as to become aware of their existence within the Guyana Fire Service. The truth is that despite several pieces in the media, the system of Emergency Medical Services in Guyana does not have a public persona, and as such, to the ordinary citizen it is a non-existent service.

This leads us to ponder the difficulty in moving from conceptualization to actualization in Guyana for many such laudable projects. If it is a case of insufficient budgetary allocations, then the Guyana government and the Minister of Finance must address this in the 2018 Budget for which planning is already well underway.

However, if this is due to professionals not being allowed to take ownership of and to run the programme independently with a sufficient budgetary allocation and without unnecessary political direction, then this is a recipe for a non-starter and an ineffective project.

Guyana’s EMS systems must be placed entirely in the hands of professionals who must then deliver a functioning, integrated and effective system to the general public. We must not stand idly by waiting for the next disaster to happen.