Dear Editor,
The Region 6 Health Department is grateful that a letter dated 24th of July,2022 captioned “Gov’t’s healthcare programme lacks equity in rural areas” provides an opportunity to highlight many significant improvements within the health sector of Region 6 over the last two years. After many years of improvement, the Region 6 health sector experienced some serious setbacks after 2015. For example, X-Ray services at the New Amsterdam Hospital virtually disappeared. Medicine and medical supplies were scarce. On several occasions, the operating theatre at the New Amsterdam Hospital was inoperable because of supplies unavailability and poor equipment maintenance. Laboratory services throughout the sector in Region 6 was sporadic. The New Amsterdam Hospital’s mortuary was down most of the time until 2020. Mibikuri Hospital functioned more like a health center. The Port Mourant Ophthalmology Hospital almost closed and the National Psychiatric Hospital was a national scandal. Community outreach programs, especially to riverain areas, came to a halt.
From late 2020, the Region 6 Health Department resumed its community outreach programs, which are critical as the sector pursue health equity. The operation of Level 1 (Health Posts) and Level 2 (Health Centers) are very important to ensure equity in health care. These are the facilities where women seek antenatal and postnatal care and where children vaccination programs ensure all children are protected from the eighteen deadly vaccine-preventable diseases. In 2021, infrastructural upgrades were completed at all the Health Centers in Region 6 at a cost of about $100M. Orealla and Siparuta Health Centers, deep in the Corentyne River, were provided with ATVs in early 2022 to allow for open access to healthcare. We also developed vaccine storage capacity at the Siparuta Health Center. These health centers have permanent doctor-led services. Thus far for 2022, 4 Specialist outreaches were done in Orealla and Siparuta. Bara-Cara equally benefitted, with 6 medical outreaches already for 2022, including Ultrasounds and VIAs being made available for the first time on these Outreaches.
VIAs are critical for cervical cancer diagnosis and treatment.
Our reports indicate for 2022, a total of 63 outreaches ‘were’ accomplished thus far, with 12 alone in the month of July. This is the highest number of outreaches recorded for Region 6 to date. These outreaches catered for the Homes and Orphanages in the Region. All health centers now have a visiting doctor and scheduled chronic disease clinics. In some Health Centres,
we have added specialized services, such as Dental Services and VIA services. The Region, in collaboration with the MOH, have expanded the Emergency and Outpatient Units with additional services. Thus far, for 2022, more than 100 Ultrasounds have been done at Mibikuri Hospital. Before now, these persons would have had to travel to New Amsterdam or to Port Mourant or be referred to a private facility. ECG is now also a routine service at Mibikuri. Specialist clinics for the NCDs, such as diabetes, high blood pressure and heart diseases, have now resumed at Mibikuri Hospital. In addition, a digital X-Ray was procured and currently awaiting installation. Equipment was also procured for its laboratory services. Once installed, fewer persons would need to be referred to New Amsterdam Hospital.
The Health Sector is also working towards commissioning a mortuary at the Mibikuri Hospital. This hospital is one of the hospitals where telemedicine will be added in 2023/2024 to permit radiologist-led imaging diagnostics and ophthalmologist-led diabetic eye-screening. The Port Mourant Hospital is, indeed, an old hospital. This hospital has been added to the Region’s re-development program. In the meanwhile, outside of adding doctors to the roster to raise the level of care, other significant improvements are visible. There are now routine ECGs, ultrasounds, and X-Rays. A modern digital X-Ray was installed this year and will be linked to the GPHC via a PAC system to permit the GPHC radiologist to help in diagnosis. The laboratory was improved with new equipment that allows more laboratory testing. A new TB clinic has started. There is also now a mortuary.
In a matter of weeks, construction of a new hospital begins at #75 Village. The new hospital will replace the old Skeldon Hospital (Level 3). The new Skeldon Hospital will function as a Level 4 hospital, like New Amsterdam Hospital. But that does not mean that efforts to improve the old hospital will not continue. A range of new medical equipment, such as ventilators for critically-ill patients, ultrasound and ECG, have been added. A new refurbished Male Ward was commissioned. A new ambulance was also handed over to the hospital recently. The New Amsterdam Hospital now has 3 fully-functional Operating Theaters and an Infectious Unit was added. This hospital is now capable of an expanded range of surgeries, including laparoscopy surgeries. On the 13th of July the first Arthroscopic surgery was done at the said hospital and the patient is in the recovery process. CT imaging is now done at the New Amsterdam Hospital, with more than 1600 done free of charge, including CT with contrast, since last year.
The CT is linked to the GPHC through a PAC system, permitting teleradiology service with specialists from GPHC. With this technology, referrals to GPHC are reduced. Two new ultrasound machines will allow for service upgrades in the emergency room. The National Ophthalmology Center, which for most of 2015 to 2020 was closed, resumed full operations this year. Since February 2022 surgeries, including cataract surgery, resumed. For this year, more than 1,047 surgeries were done, with more than 1,000 scheduled for the next two months. Presently cataract patients from Regions 1 to 10 are receiving cataract surgery at Port Mourant. This is just a cursory glimpse of the upgrades done in the Region 6 Health Sector. Only recently the Parliamentary committee on Social Services, headed by Dr. Karen Cummings, an Opposition MP, visited the health institutions in Region 6 and was particularly pleased to see the significant improvement in the health sector in just two years.
One of the sore challenge in the period after 2015 was the frequent massive medicine shortage. This year shortages have almost been eliminated, with availability between 85 and 95%. This improvement shows a 46% reduction in transfers to GPHC, from 407 in 2017 to 220 in 2021. In 2021, 19,206 X-rays were performed, the highest recorded to date. Similar increases have been recorded for ultrasounds, ECGs, CTs and laboratory tests. All the diagnostic departments in our level 3 and 4 facilities (hospitals) are fully functional, and our aim is to reduce downtime, and this is reflected in our indicators. For 2022, Region 6 has recorded zero maternal deaths while registering improvements in stillbirths and neonatal mortality rates. The dialysis unit at New Amsterdam Hospital is fully operational with an increase in patient load from 18 to 25 to date. We are also in the process of setting up a Regional Oncology Unit which is expected to bring further relief to the residents of Region 5 and 6. The Regional Blood Bank has exceeded its 2021 target, collecting 2,007 units of blood, which is also the highest to date. This is another area where we have begun to exceed our targets significantly.
While there remain major challenges, the health sector in Region 6 has seen significant improvement in every facility and the improvements have translated into better outcomes. While emphasis are placed on quality of service, patient experiences have been particularly prioritized. This is the reason much attention has been paid to waiting areas, rest room facilities etc. It is no accident that the Parliamentary Committee, in its recent visit, commended the Region for the visible improvement in health. This improvement is seen in both the environment and the quality of care at the National Psychiatric Hospital. As one enters the National Psychiatric Hospital, the improvement becomes immediately visible. Rebuilding and re-establishing health services for Region 6 has been a challenging task. This was compounded by the COVID 19 Pandemic. While we acknowledge that there remains vast room for improvement, the letter writer appears to either being unaware of what is taking place in the sector or that he relied much on hearsay. The doctors, nurses and the allied health workers have been working hard to regain the confidence of people in Region 6.
Sincerely,
Dr. Vishalya Sharma
Region Six Health Officer
