Dear Editor,
Individuals and organizations, including the Opposition People’s Progressive Party (PPP), are demanding there be an independent investigation in the deaths of three children at the Georgetown Public Hospital Corporation (GPHC). This demand is for the right thing and an independent investigation should have been convened automatically, in accordance with standard protocols for the death of any child, under any circumstance. It is egregious that the GPHC is investigating itself. It is so worrisome that the public and political parties must intervene and demand an independent investigation.
The call for an independent investigation reflects the public outrage surrounding the death of three children at the GPHC. The GPHC continues to hide behind the refrain they are investigating the deaths. The Minister and the Ministry of Public Health, after more than a week of deafening silence, finally held a private media conference with hand-picked reporters. She finally expressed condolences to the affected families and expressed satisfaction that GPHC is investigating the deaths. I am flabbergasted that the GPHC, the Ministry of Public Health or the Minister of Public Health seem oblivious that they are violating standard protocols.
The present management of the GPHC clearly does not seem to be aware of the standard protocols for how the death of a child must be handled. These protocols were established as part of the Ministry of Health Act. The Ministry of Public Health similarly appears to have forgotten what these protocols are. The Senior Minister of Public Health, Ms. Volda Lawrence, is guilty of not being aware of the protocols and oblivious of her responsibility to ensure these protocols are rigidly applied. Now that PAHO has become engaged, I am hopeful that PAHO will remind them of the protocols. Guyana introduced a standard protocol more than a decade ago to ensure that the death of every child is investigated, not as an option, but an obligation.
I was the Minister when the protocols were implemented. The protocols require an immediate reporting of the death of any child, no matter what the circumstances might have been, whether it was a preventable death or a non-preventable death. Every child death must be reported by the institution or the healthcare provider involved within 24 hours to the Chief Medical Officer (CMO) whose responsibility it is to inform the Minister. The institution where the death occurred or where the child is taken must investigate the death without any delay and submit a report to the CMO within forty-eight hours. The Ministry has seven days to examine the institutional report and make further queries and then initiate an independent investigation, if the Ministry deems it necessary. This protocol, therefore, avoids the hospital or doctors investigating themselves, thus avoiding any conflict of interest.
Three children are dead and at the centre of the outrage are questions about the medicines used and how these medicines might have been administered. The GPHC only agreed to start an investigation after the parents expressed their fears that their children might have died, not from their illnesses, but from matters relating to the care they were receiving at the GPHC. Let me reiterate – I have always believed that healthcare providers always want to do the very best they can to provide quality care to the persons they care for. Still, something went wrong that led to the death of three children and there is suspicion relating to the safety of the medicines and how they were used.
An independent investigation should have been immediately initiated, in accordance with the standard protocols. There was no need for anyone to demand an investigation. The fact that almost two weeks later, the GPHC insists it is still investigating and that the Minister has the temerity to tell the nation after almost two weeks of silence that the GPHC should be allowed to complete its investigation is a violation of the protocols and adds to the outrage surrounding the deaths of these children. What is more appalling is that the Minister and the GPHC seek praise for the inappropriate investigation being conducted. An independent investigation is what is required and the GPHC, the Ministry of Public Health and the Minister have no say in this matter – it is required in accordance with standard protocol.
At the time those protocols were introduced, the intention was clear – the death of every child requires an investigation so that we could learn lessons and work towards no repetition of whatever might be the weaknesses in the health care system. The GPHC was required to submit a report of its findings for each death within 48 hours and the Ministry of Public Health was required to start an independent investigation which should have been completed already.
When the institutions are investigating themselves, usually it is a dead-end. Two examples will suffice. Around July 2017 a three-year old died, after a yo-yo management between GPHC and a private institution. The GPHC insisted they were investigating. The Ministry of Public Health said they were awaiting the GPHC report. On September 3, 2017, a one-month old child died at the GPHC. The parents insisted the child died because of an overdose of antibiotics. Again the GPHC and the Ministry insisted that the GPHC was conducting a thorough investigation. The nation is still awaiting those reports. Those investigations actually died a natural death.
The fact that the standard protocol is not being used either means that there is a frightening ignorance of these protocols or that there is an ulterior motive.
Yours faithfully,
Dr Leslie Ramsammy
Former Minister of Health
