By Cathy Richards
After being launched as a facility designed to meet the comprehensive health care needs of residents of Linden and surrounding areas, the Linden Hospital Complex (LHC) remains plagued by a shortage of trained staff and a lack of equipment that see many cases referred to the Georgetown Hospital.
Since last December’s commissioning of the hospital, management still has not been able to effectively operate all sections of the LHC, and according to Chief Medical Officer (CMO) at the hospital Dr. M.F.K Riyasat, the lack of key elements at the complex continues to hinder its effective functioning. Patients are still being transferred from the multi-million-dollar facility to the Georgetown Public Hospital Cooperation (GPHC) for simple procedures.
In a recent interview with Stabroek News, Dr Riyasat said there has been at least a 50% reduction in the cases transferred to the GPHC. However, once the hospital is adequately equipped and the nurses trained to operate the equipment this practice would stop. He said cases are now only transferred to the Georgetown hospital when a particular drug is not available or when the LHC does not have the required equipment. He also alluded to the lack of vital equipment such as CT scans, ultra sound machines and Intensive Care Monitors.
A tour of the facility revealed the concerns of residents and the CMO alike. Dr Riyasat and his secretary currently occupy the area that had been earmarked to house the ultrasound unit. Though some equipment has been installed in the ICU, it remains non-functional due to a shortage of monitors and trained ICU nurses. Dr Riyasat said he had written to GPHC CEO Dr Michael Khan on the issue but to date there has been no response.
The laboratory still cannot do a number of tests such as those for electrolytes, acid base and cultures. “Here again, we have some of the necessary equipment but again nurses are not trained in specific areas as is required,” Dr Riyasat said. He noted that for more than ten years cultures have not been done in Linden. “The Bureau of Standards came in some years ago and closed the department because at that time they found that the room was not applicable, there was not enough microscopes, [and] there was a shortage of technicians, among several other shortfalls. So for more than ten years now we have been taking off samples and sending to Georgetown,” he said.
On the count of referrals for surgical procedures, it was highlighted that there is need for anaesthesiologists.
Currently three Chinese anaesthesiologists are attached to the LHC but due to their schedules, they are often away on a regular basis. He said too whenever there is a Chinese holiday, the team would also leave. “What happens in the instance when they leave [is] we have sufficient local surgeons but no anaesthetist so it is impossible for us to perform surgeries. We now have two well-equipped theatres but very often we cannot use them, it is almost several days in every month that the Chinese are out on some holiday,” he said. A run through a schedule of the Chinese holidays for 2010 listed about 25. But it was noted that the Chinese team also observe Guyana national holidays and the current schedule did not include special leave days or the attendance of special events.
The LHC also needs a resident bone specialist and an Orthopaedic surgeon.
Currently a visiting bone specialist holds clinics twice monthly at Linden and in keeping with his contract, conducts surgeries at least one Saturday in every month. “The Linden hospital is strategically located in the centre of 80% of the mining locations in Guyana and also is in a mining town where accidents will and do occur on a regular basis. Almost every time there is an accident in one of the interior locations and the patients are brought out here effective corrective care is delayed because we have to further transfer to Georgetown in some cases those patients die,” Dr Riyasat said.
Simple cases of deliveries are also regularly being transferred to Georgetown. This newspaper also understands that there is no neonatologist to attend to at-risk babies, such as those born premature, twins or triplets. The maternity ward is also not outfitted with an adequate number of incubators. “Right now those incubators that we have can barely give lil oxygen. For a number of years we have been budgeting for these thing but we have not been getting funds for capital items. That is why you see all those hospital buses breaking down all over the place all the time it’s because we are not getting monies for capital items,” Riyasat said.
The CMO said too that due to the shortage of proper incubator facilities and a neonatologist, they were recently forced to transfer a mother who was carrying triplets to Georgetown. “We cared and monitored that mother for over three months and then at last when we should have been getting some recognition here in Linden for having a triplet born here, we had to transfer her to Georgetown,” he said. Simple procedures of ultrasounds are also regularly transferred to Georgetown, the CMO lamented. “We send lots of patients everyday to Georgetown for ultrasound because that is the only way we can get the diagnosis of a patient. For those who are able-bodied and can walk, we send them on their own and for those who cannot we send them with the ambulance,” he said.
The new LHC which is classified as a class four hospital also needs specialists in internal medicines since none has been there in over 15 years. Additionally, with the reopening of the maternity ward at the Upper Demerara Hospital (Wismar hospital) there is also urgent need for a second ophthalmologist. The CMO said the hospital is staffed with a Chinese ophthalmologist who is off every other weekend and most times the hospital is not sure of her schedule. “We as doctors here have so many challenges but the public do not know these things, so we get all the blame all the time. Even for the theatre we don’t have sufficient scrub nurses.
“Whenever there is an emergency we have to send for the few we have at extreme locations and if you understand that geographic of Linden you would understand what I am talking about and now with the closure of the bridge, it is ten times worse,” Dr Riyasat said.
A good account was given of the accident and emergency unit, which has a team of doctors working on a twenty-four hours basis. This newspaper understands that $400million was to have been used to buy equipment for the new facility but this has never materialised since the money was put into building the new complex which took twice the estimated time for construction. “What happened there was that because of the length of time that they used to do the building the price of materials went up and they had to use that money to satisfy that shortfall,” the CMO said.
