Last month, when the World Health Organisation (WHO) and the International Labour Organisation (ILO) published guidelines on mental health at work and a joint policy brief explaining practical strategies for governments, employers and workers regarding the guidelines, they could very well have been speaking directly to conditions here in Guyana. Quite apart from the fact that one would be hard-pressed to find a local employer that has a workplace programme on mental health, in the one area where it should be prioritised, it is totally ignored. Reference is being made here, of course, to the public health system. As a provider of mental health care, it is shamefully inept with regard to its own workers.
As a case in point, in July this year, the Parliamentary Sectoral Committee on Social Services conducted a walk through of several public health facilities in Region Six. Its members, who include at least three medical doctors – a former health minister, a former junior minister of public health and the current minister of human services and social security – appeared to be mostly satisfied with the operations at the establishments they visited. The notable exception was the National Psychiatric Hospital at Fort Canje, East Berbice.
Chair of the committee Dr Karen Cummings was quoted as saying that there was a human resources gap, since the hospital had 206 patients at the time and only four nurses; an egregious understatement. Her solution was that more nurses needed to be trained, which was obvious, but did not address the intolerable dilemma in the short-term. Of course, this was not a problem that the Parliamentary Sectoral Committee could or should address. Those in authority at the Ministry of Health were clearly very aware. Moreover, Regional Health Officer of Region Six Dr Vishalya Sharma accompanied the committee on its perambulations. The question is whether they were doing anything to fix it. Even if they were, there was no sign that they were acting with any alacrity then, nor that the situation has changed for the better today, three months later.
Despite spouting platitudes about the importance of mental health and raising awareness, the Health Ministry seemed not to have made the link that it also involves proper care and treatment for those who have already been diagnosed. By no stretch of the imagination could four nurses adequately care for 206 patients, yet there they were. Seemingly also, no attention was being paid to the strain those four staff members were enduring and the effect it could have on their mental and physical health.
According to the WHO guidelines, heavy workloads, unsafe or unhealthy working environments, and lack of support from managers/superiors are among the issues that create distress on the job and can negatively impact mental health. The conditions at the National Psychiatric Hospital, which also included overflowing septic tanks and issues with drainage, easily matched those descriptions yet it appeared that there was no thought exercised with regard to how they affected the staff.
Abominably, Dr Cummings was quoted as saying that the atrocious physical conditions were “low hanging fruit”, meaning they could easily be dealt with. If that were indeed the case, why were they not addressed in December 2017 when millions of dollars were reportedly spent on upgrading the hospital and its grounds that were prone to flooding?
Further, in August 2021, it was reported that another $26 million was being spent on restoring the hospital following the second fire there that year. Surely, it would have made sense then to also fix the sewerage system and raise the grounds to prevent flooding. It bears noting here that in both instances when the infrastructural improvements to the hospital were announced, the ministry – under the APNU+AFC administration in 2017 and the PPP/C last year – referred to them as being done to provide better conditions for the patients. While there is nothing wrong with that per se, their failure to include that the repairs would also contribute to an enhanced working environment for staff speaks volumes. The politicians would want to say the improved staff conditions were implied. Perhaps they were, but leaving the staff entirely out of the equation points to them being taken for granted, which they are.
Given the woeful actions of the Ministry of Health, the government, which is no doubt aware of the WHO guidelines and the WHO/ILO policy, is in no position to even mention them to any employer in the country. It would have to attend to the huge beam in its own eye, before attempting to cast the mote out of others.
Therefore, although depression and anxiety are known to exist among our population – and in higher numbers than imagined as most workers choose not to mention it for fear of stigma and discrimination – not much will be done to address these issues at that level. This is unfortunate when one considers that COVID-19 has exacerbated those conditions and the current state of the local and global economy will only pile on to stress many workers already face.
Quite often, unlike physical health issues, there are no tangible manifestations of mental illness until sick people break down, explode with out-of-character, sometimes dangerous behaviour, and become a danger to themselves and others. Preventing the risks not only protects against these factors, but supports workers in much the same way as occupational health and safety regulations. It is a very necessary investment in human resources, especially today.
