-Cuban doctor to be assigned
There has not been a deterioration of service at the Aishalton District Hospital, Minister in the Ministry of Health, Dr Bheri Ramsaran says while acknowledging the need to improve capacity, not only there but at other locations also.
“We are not looking at Aishalton in isolation”, said Ramsaran in an interview yesterday with Stabroek News. While acknowledging some of the deficiencies identified, the Minister defended the Ministry and the work it has been doing. “Those things have to be addressed against the bigger background”, he said.
On a visit to the remote community by Stabroek News earlier this month, staff at the hospital had related problems of staffing, water, electricity and transportation among others. This newspaper had been told that despite the issues being raised in quarterly reports to the authorities, nothing was done. During this newspaper’s visit, residents and staff had said that only three hours of electricity were received per day from 6 pm to 9 pm and following this, flashlights and candles were used to provide light, even in emergencies. Pieces of equipment that required electricity to be operated were not used because of the limited supply and a generator which had been donated by a non-governmental organization was not in working order due to a missing part.
They had noted too that the hospital, which serves over ten communities, located dozens of miles apart, had not had a resident doctor for over two decades and transportation to transfer patients to the better-equipped hospital at Lethem was difficult since the hospital did not have its own vehicle. There was also a limited water supply as the solar pump was too small to pump water to all parts of the hospital and only piped water to one tank. Additionally, a nurses’ hostel and a doctor’s quarters were unfurnished and never commissioned.
Ramsaran said yesterday that contrary to staff reports of the Regional Health Officer (RHO) and the Regional Executive Officer (REO) not visiting the hospital; at least two visits had been made by the RHO last year. He said that there is continuous interaction and there were several visits last year by the relevant authorities. He said that apart from these visits, there are other avenues through which complaints can be aired, including when health workers attend workshops at Lethem.
He acknowledged that the problems were raised with the RHO and included in reports sent out. “Those things have to be addressed against the bigger background”, he said adding that “We need to act on these reports quickly”.
Regarding electricity supply, he noted that this is limited but stated that there is some stand-by capacity. In this light, he pointed to the non-governmental organization, Remote Area Medical (RAM) making its generator in the South Rupununi community available. “As I understand it, they would allow us to kick in their power plant at an emergency in the night”, he stated. Told that the generator had not been functioning since 2008, Ramsaran said that such things might happen and need to be looked at. He commented that even the NGOs are having problems and “so we were probably relying on that, you have to have certain other things done”.
The minister stated that his understanding is that power is supplied for a particular period of the day. “The central authority is supposed to give power for a certain period in the hospital and it happens in other areas too. As I understand it, the hospital is supposed to deliver certain services using the power provided by the administration”, he said. He declared that the situation is not a deterioration of service and there is gradual improvement. “This has been the norm and you keep up-scaling”. He added that one of the mandates of last week’s visit by a regional team was to check on putting more solar capacity at Aishalton. “Rome was not built in a day”, he said.
The minister took issue with the article stating that the toilets and baths at the nurses’ hostel and doctor’s quarters were not functioning because there was no running water to them. “If you are not utilizing them, you would not put your resources there”, he said. “If we were to put for example, a doctor at Aishalton, you would see that the pump would be there”, he asserted stating that this is “scratching the surface. These are hair-splitting, things we can get done”. Staff had reported that the pump was too small to service to entire hospital and is only able to pipe water to one tank and then it has to be fetched to wherever it is needed and this is not the situation that obtained before. Additionally, with a nurse stationed there having to provide her own furniture, Ramsaran stated that there is a requisition process but it could have been a problem of communication also.
Meanwhile, he said that this newspaper’s article had presented the situation there as though it was “a drastic deterioration of services” and declared that this is not so. Regarding the fact that the hospital has not a resident doctor stationed there for over two decades, he said that the Medex training programme was created to address such conditions. “These facilities are geared to be manned by such level of practitioners”, he said. “Aishalton and the other areas have not had their own doctors because the medex programme…is geared to create capacity to fill those hospitals”, he added.
However, he assured that a doctor would be placed there. “We are going to be putting a Cuban doctor at Aishalton”, and this would be done within a “reasonable time”. He had also pointed out the government has never promised to have a doctor at every location though he pointed to Guyanese being trained at Cuba. In the meantime, however, the medex will be there. “We will enhance the referral system and maintain what has been there. There will be no slippages”, stated Ramsaran.
Ambulances
On the transportation woes being faced, he noted that there are now two ambulances at Lethem and “we need to probably use those more effectively around the region”. He noted too that the Ministry has been working with RAM to secure a vehicle for use by the NGO in the region.
Generally, Ramsaran said that maintenance will be a big factor and assured that the issues will be looked at. Any difficulty that the hospital might have, the REO is visiting and within limitations, they will be addressed, he said. Others that might continue, the Ministry will try to address them as quickly as possible within limitations, he assured while emphasizing the need to care resources.
On food, the provision of which was outsourced, the minister noted that this is not only happening there but also in other parts of the country. This newspaper had been told that sometimes this was not prepared to the patient’s specific dietary needs. “The food…is ordered by the person in charge of the hospital and he is supposed to have the requisite technical, medical knowledge. The contractor is supposed to supply food that he- the boss in the hospital would have ordered and if that boss orders the wrong food, the contractor is not to blame. And if the contractor supplies the wrong food and the boss accepts it, something is wrong. We need to look at that”, said the Minister. He said that if it is not being adequately done, steps are being taken to have it reverted to the hospital. However, the contracting out of the feeding programme for patients will continue if it is found feasible.
He assured that no services will be withdrawn and this will be increased as capacity is increased, particularly at the regional hospital at Lethem. Ramsaran acknowledged that there is a need to “improve services all the time at all facilities and especially since we are so caring to our indigenous people we need to do that too in those areas”. Aishalton is not being looked at in isolation, he said, and the hospital is being strengthened “because at the regional level, we have more doctors more capacity and we want them to work better”.
Meantime, earlier this week, Chairman of Region Nine, Clarindo Lucas had told this newspaper that the rehabilitation of the Aishalton Hospital will be given priority this year.
He said that the regional administration was made aware of the problems facing the medical institution following a visit to the South Rupununi community last week. He disclosed that the trip was for the purpose of garnering input as to the needs so that these could be included in this year’s budget. He said that the problems faced by the hospital were among those raised. Lucas said that the work which needs to be done will be dictated by how much money is allocated in the budget and this is dependent on Parliamentary approval. “If they give me money, then we will do it”, he stated.
