Last month when the man/woman in the street at Linden addressed issues relating to the medical facilities there, a recurring complaint was the dearth of human resources; seven out of ten people bemoaned the fact that there is a shortage of doctors and nurses. Some Lindeners felt that the new hospital which is due for commissioning shortly would not provide the level of service needed, even with its state-of-the-art facilities, if the people problem remained unsolved.
One resident raised concerns about Cuban doctors, who spoke no English and had difficulty understanding patients and being understood. Yvonne Drakes, a seamstress, said, “I have a problem with the non English-speaking doctors. They have tremendous problems understanding patients and patients understanding them and that is of major concern to me. A patient does not only depend on the prescribed medication to get well. They also depend on the advice of the doctor and if there is a situation where even the nurses cannot interpret what those doctors are saying, it is very bad.” This particular issue has been highlighted before in other communities.
Guyana is not alone in its paucity of health professionals. According to a recent Organisation for Economic Cooperation and Development (OECD) report, the demand for doctors has been rising in developed countries and this is because the numbers of medical graduates are decreasing. Between 1990 and 2007, the report said, the number of doctors per capita in OECD (developed) countries increased by 2% per annum – a very small increase given rising population levels. Now, that this trend has since gone into reverse in some countries, in order to counter it, the report said, these countries have been using international recruitment to hire foreign-trained doctors, including from the African and Asian continents and likely too from this part of the world. It is well known that medical personnel from Guyana and the Caribbean have been recruited to work in developed countries.
Since Guyana can hardly compete with the remuneration that would be offered to its health professionals by these developed countries, its response has been training, and this for the most part sees government offering Cuban scholarships to students who might otherwise have been unable to afford to study medicine – as well as embracing the general practitioners (GPs) and specialists afforded through signed agreements with the Chinese and Cuban governments. Complaints of being lost in translation have never really surfaced with regard to the Chinese medical brigade. One assumes therefore that the doctors who come here under this programme are those who would have taken the time to learn enough English to communicate with their patients and peers. However, although so far their provision of health care services has not been faulted, the limited or lack of English issue has been raised in practically every region where the Cuban doctors have operated. And this is a problem that is likely to continue in the short to medium term.
Cuba generously trains large numbers of medical students from the developing world, and 30 Guyanese graduates in medicine returned last month having spent six years at university in Cuba. However, one of those years was spent learning Spanish so that they could understand their lecturers, which although absolutely necessary, adds a year to their studies; they still must complete their internships before they can actually practise as GPs. On return here they will have to serve out their contracts with the government, but after that, they potentially could mosey up to international recruiters, provided, of course, they can pass the relevant medical licensing exam of whichever country they are migrating to, and in most cases that exam will be in English, not Spanish. In the case of the United States this exam is notoriously tough, although whether that will deter the most ambitious is doubtful.
Unfortunately, the loss of health personnel is likely to continue until and unless Guyana’s economic fortunes change drastically enough to tempt professionals like doctors to stay. If either agreement – Chinese or Cuban – changes Guyana would undoubtedly be in far more dire straits than it is now, since our public health service is so dependent on the services of their doctors.
And as for the linguistic barrier, it must be presumed that the greatest problem will occur with those Cubans who have only recently arrived. Given time, most of them no doubt will improve their English. However, there is no reason why the Government of Guyana, for its part, could not lay on English courses for those among the complement of Cuban (or Chinese) doctors who lack a basic fluency when they arrive.
