Dear Mr. President

‘Dear Mr. President’ is a salutation that demands attention. ‘Dear Mr. President’ is often prompted by frustration with the system. The system that might work mostly for a minority while casting the majority in prisons of fears, wants and dissatisfaction. Whether it is the youth appealing for more opportunities to evolve and self actualise, elders who have dedicated their lives in service to this country who do not want the fight to last until the grave or someone in need of medical assistance, the people want the president to hear them. But do their pleas reach his ears? Does the president see the poetry, the letters to the newspapers or the televised news where weary citizens utter ‘Mr. President’?

On April 26th, a letter appeared in the Kaieteur News, where a 37-year-old mother and teacher appealed to the president. Romayne Atkinson, who was diagnosed with lupus nine years ago penned, her struggles in accessing care in Guyana.

Many Guyanese may not be familiar with lupus. The chronic autoimmune disease can cause damage to a person’s organs, skin and joints. Our immune system fights bacteria, viruses and germs by producing antibodies. However, there is an immune system dysfunction for the person who develops lupus, which then results in autoimmunity where the immune system cannot tell the difference between the body’s healthy tissues and invaders. Autoantibodies are therefore created and attack and destroy the person’s healthy tissue.

Two years after her diagnosis, Ms. Atkinson’s kidneys collapsed. As a result, she lost her supervisory job at a ministry and now works as a teacher in a public secondary school for just over $70,000, which is not enough to cover her living expenses. She is a single parent of two boys; the older is overseas and the younger, who is 11-years-old, lives with her. She relies on him to help her from day to day. The child has fears of losing his mother; one can only imagine the angst he often experiences as he witnesses her struggles. Many adults experience loneliness and depression when they cannot cope with harsh realities and it sometimes it is children who exercise the greatness strength.

Because both of her kidneys failed two years after her diagnosis, Ms. Atkinson needs dialysis to live. Currently her treatments are done at Doobay Medical and Research Centre Inc. on the East Coast of Demerara. The Centre has made treatment available at low cost.

In 2012, Ms. Atkinson had made a brave move to Brazil where all her medical treatment was free. However, because of the high cost of living in Brazil, she had to return to Guyana just eight months later. Besides the cost of the dialysis, she has transportation expenses and regular living expenses. But what about health insurance?

Yes Ms. Atkinson benefits from the National Insurance Scheme, which pays 80% of the cost, but the payments are made after she completes 36 sessions and then she has to wait three to four weeks for processing. During the waiting period she must find the cash to pay.

But what about the free dialysis that is provided at Georgetown Public Hospital? Unfortunately, it is only provided for inpatients and sometimes people who are desperate, must check themselves into the hospital just to receive the treatment, according to Ms. Atkinson. But is one expected to check into the hospital every time they need dialysis? Especially when in many cases it is required multiple times a week. What is preventing the government from making the service available to not only inpatients, but outpatients as well? Not only would it be tiring to be checking into the hospital ever so often for dialysis, but the stress and the risk of infection is also a reality.

Ms. Atkinson’s ‘Dear Mr. President’ was not just a plea for her, but every person in this country who must rely on dialysis to live. How many deaths could have been avoided we may never know, but certainly many Guyanese are now with their ancestors because they could not afford to access care and treatment, or the systems were not in place.

There were a few recommendations in Ms. Atkinson’s letter, which are in no way unattainable or unreasonable. Dialysis treatment should be free, not only for inpatients of the Georgetown Public Hospital but all persons who need it. Dialysis machines should be installed at all regional hospitals, which will make it easier for patients who travel from places, such as Lethem, Bartica, Essequibo, Linden and Berbice, to access this service. Nurses and technicians must be trained. There should also be tax exemptions on the importation of materials and products necessary for dialysis treatment, which will allow centres such as the Doobay Medical and Research Centre Inc. to maintain a reasonable cost per session so that more lives can be saved and prolonged. Until recently, dialysis was $9,000 per session at Doobay, but from May 1st the price was raised to $12,000 because of the high costs of importing supplies. Ms. Atkinson also suggested that there should be subsidised payments for patients on dialysis.

Some of us cannot understand the struggles of dialysis patients, but because of the unpredictability of life, the fact that at any point it can be us or a family member, we must demand that systems are put in place to lessen our burdens and worries.

The ‘Dear Mr. Presidents’ are not single voices echoing on the newspaper pages. They reflect the collective needs of citizens who want to enjoy “the good life.” While there are ministers who the president has appointed to the various ministries, most of whom are competent and can deal with the issues before it reaches a ‘Dear Mr. President,’ the fact that people are still appealing directly to the president tells us that many of their desperate needs are often not being met.

Ms. Atkinson is one person. She has the will to live and wishes to see her sons become men. Her situation reminds us that many Guyanese are forced to turn stones into bread because they are paid poor wages and salaries. Poor people continue to die because of a lack of resources, negligence and because sometimes the treatment that would save their lives are not available here. Unfortunately, most Guyanese cannot afford to travel overseas to be treated when there are little or no options here.

The ‘Dear Mr. Presidents’ are not always written in the newspapers but often the struggles of our people can be seen in their eyes as they stare, question their suffering, question their Gods, question the meaning of life, become comatose and wait to die. But not all choose to give up the fight. There are those like Ms. Atkinson, who continues to battle through her struggles and was brave enough to sound her voice. I hope her ‘Dear Mr. President’ has been heard.