On Monday, a 52-year-old Corentyne man succumbed to poisoning at the New Amsterdam Hospital in Berbice. He had drunk an unknown quantity of some deadly substance minutes after inexplicably unleashing a series of chops on his ex-wife and her current partner at his home the day before.
The ex-wife Nesha Permauloo related to this newspaper that the attack was unexpected as the visit by her and her partner to her former home had become somewhat of a routine. Additionally, the three of them had been sitting around drinking and talking, again as per normal, and there had been no sign that Narine Permauloo was angry or upset before he snapped. Ms Permauloo and her partner are expected to recover, but there could have easily been three fatalities as a result of this incident instead of one. Quite possibly, this was the thought driving Mr Permauloo when he committed the act.
And while the attack would have been surprising to Ms Permauloo, what has been learnt about her former husband after the fact indicates that something was terribly wrong. Perhaps the entire episode could have been avoided if there had been an intervention earlier. By simply asking questions, our reporter was able to learn that Mr Permauloo had attempted suicide just last week, by swallowing a number of pills. He was taken to the hospital, where he possibly had his stomach pumped and was later discharged. There was no indication from his family that he had been referred for counselling or any sort of psychiatric help. If, as it seems, this was not done then it is an indictment of the medical professionals who attended to him.
Additionally, the fact that referrals are not automatic when such cases are presented is an indictment of the Ministry of Public Health and by extension the government. It is no secret that the mental health system, like its major facility at Berbice, is in tatters. Despite Guyana’s label as ‘the suicide capital of the world,’ mental health is still not being as aggressively addressed as it should be.
Attempts at fixes have been made, including the Guyana Police Force’s 24-hour inter-agency suicide prevention helpline, which was launched in August 2015, and the Ministry of Public Health’s national suicide prevention strategy the following month. However, from what is still being seen, there has not been much of an impact. Or rather it is not known whether either intervention has helped.
The Guyana Police Force, which is fond of trotting out statistics on its performance, has not to date revealed to the public the status of the helpline: how many calls are received per month and how many referrals/interventions/ responses it has made. The situation with the Ministry of Public Health is similar. Aside from announcing the setting up of a Mental Health Unit, and hosting a Mental Health Conference for teenagers from seven schools in the city, it seems the ministry has done diddly-squat as regards mental health since 2015.
To be very clear, the measures as laid out above are far from adequate given the problem at hand, and can be likened to using plywood to patch one’s roof after a series of storms have ripped away the zinc sheets.
There must be a record somewhere of then minister of health Dr Leslie Ramsammy’s impassioned lament in 2009 on the degeneration of the mental health system. He had admitted that for years, in the face of growing deterioration, there had been minimal expenditure on mental health and a general neglect of the sector. He had called for urgent action on suicide prevention, noting that the statistics were revealing a burgeoning problem, and he appeared to be making an effort to begin to address the anomaly. However, it is also common knowledge that once he was replaced by Dr Bheri Ramsaran in 2011, everything came to a screeching halt.
Fast forward to June 2015 and there was then minister of health Dr George Norton describing the state of the National Psychiatric Hospital (NPH) as disgraceful, pitiful and totally unacceptable during a familarisation tour. He had promised then to upgrade the facility and furthermore ensure the availability of clinical psychologists and psychiatrists so that all Guyanese would have access to psychiatric care and evaluation. Mr Permauloo’s case is evidence that more than a year has gone by without any of this being done. And it is not the only case, suicides are continuing unabated.
Guyana now has a new Minister of Public Health, Ms Volda Lawrence, who, in a show of proactivity, moved her office to the government drug bond at Diamond, East Bank Demerara in a bid to ensure a smooth flow in drug procurement and distribution. Laudable indeed, since this sector has been plagued with shortages on the one hand and the dumping of millions of dollars worth of expired medicines on the other. But a bit of a pity also, as it should not require the presence of the Minister to sort out drug distribution.
One hopes that the same attention will be paid to Guyana’s human resources who are dying for want of mental health intervention. And no, this should not require the Minister moving her office to the NPH. But the attitude of placing a plaster on the festering sore that is mental health needs to end.