On September 21st we referred in these columns to the case of a young woman who had recently faced disrespect and mistreatment at the Georgetown Public Hospital (GPH) – the country’s main public health facility. In her own words, published in the weekly “Women’s Chronicles” column in the Sunday Stabroek, the young woman related the harrowing circumstances she endured in late August when she was admitted for what should have been a routine laparoscopic procedure to remove ovarian cysts.
Among the questionable care decisions was the hospital switching at the last moment from a minimally invasive to an open procedure. In the main, the behaviour of the nurses in the maternity surgical ward ranged from dismissive to callous.
The young woman opined: “… I believe that a lot of patients’ deaths are not caused by the procedures they undergo but rather by the lack of proper aftercare from the nurses in charge. While I understand that wages may not be attractive, nurses have taken an oath to care for patients…”
This is but one of the testimonies of the heartless and unprofessional treatment meted out to patients. Also to be navigated by patients are the unsanitary and understaffed facilities, misdiagnosis and incorrect application of potent medicines.
On September 7th, APNU councillor Shurla Scott at the statutory meeting of the Region Six Council, stated that her first-hand experience at the Skeldon Hospital was not a pleasant one after she visited a patient at the hospital.
“The first thing I noticed is that there was no medical supervision there in the night at Skeldon Hospital… I remember standing here enquiring about Skeldon Hospital as it relates to staffing and this council was informed that there was enough staffing at Skeldon Hospital especially with the doctors”, she related.
Scott said, that she was present at the hospital for four days for visiting hours, “And I saw two Guyanese doctors for those four days consecutively and two Cuban doctors… The very patient was prepped to be transferred because there was no supervision.”
According to Ms Scott, there was also a recommendation in the patient’s chart to have an ultrasound done but it was day four and this had still not been carried out.
She said that on enquiring with the sister in charge at the hospital she was told that she was “frustrated because nothing is being done, all of the reports that is coming from Skeldon to the region is falling on deaf ears…Shortages of staff, nurses, shortages of doctors, medication… And …that very patient was expected to have medication at 6 am, I was there, and the patient received her medication until 9 am… because I intervened that patient was transferred.”
Ms Scott said although the patient was prepped and awaiting transfer this was done only four hours later despite the ambulance being present at the institution.
“When I enquired why, I was told the doctor was on lunch, I was told the doctor has to eat, of course I agree with that but this is one doctor that has been working since the morning… I was told that the Cuban doctors have limited medical functioning because there are certain things they can’t do… They can’t send charts, they can’t write up X, they can’t do Y”, she said.
Ms Scott said that she was finally able to meet with the doctor responsible for the patient around 2:30 pm. He “was literally walking around with a resignation so I proceeded to speak to the doctor as well, it was the very thing I received from the sister in charge… Nurses are not around, no nurses in the night, ten-day (part-time) workers are supervising wards, there is one nurse running the emergency female and the male wards, that is the reality on the ground”, she told the chair of the council.
There was no public response by anyone in authority to Ms Scott’s concerns.
On September 22nd there were even more damning revelations about the Skeldon hospital from letter writer Jam Khan. Ten issues were listed by the writer. We shall list three here.
1. Shortage of Doctors, Nurses: One of the most pressing issues at Skeldon Hospital is the severe shortage of medical professionals, including doctors and nurses. Patients often have to wait for extended periods to receive medical attention, leading to worsening conditions and increased suffering. On many occasions there was one nurse servicing the emergency unit and the wards, and also in the evenings a single nurse ran the entire hospital.
2. Poor Doctor Communication/Attitude: The doctors at Skeldon hospital need to be properly trained in communicating with patients’ relatives. I saw the doctor in charge behave as though he was Lord of the domain, and failed to provide proper answers on being asked about various issues with my sister. When asked questions he complained about being harassed. Additionally, one of the doctors was literally hiding from my relatives.
3. Atrocious Patient Care: The responsibility for the day-to-day personal care of my sister fell on my relatives. The nurses refused to undertake this task and the doctor said it’s not their responsibility. Each morning while I was there, we found my sister lying in her urine and excrement. She had to be cleaned and changed by female relatives. My sister’s feeding tube had to flushed/cleaned by relatives.
Again there was no public response from the authorities to this sickening state of affairs.
In this same month, a 22-year-old paralyzed girl, Farzana Khan died after suffering a heart attack.
According to her aunt Shameeza Khan, “She take in Saturday and I took her to the New Amsterdam Hospital and when we went there, there was no doctors at the outpatient and we had to wait for over two hours.”
According to the woman, although it was an “emergency” they had to wait their turn to meet with a doctor. “There was no doctor working at the outpatient, a doctor from emergency come out and end up see us”, she related.
However, after they were able to meet with a doctor several tests were ordered for Farzana who at that time had a heartbeat of 151. “When we walk go the lab it was open but the guy there turn us back and said come back Monday.”
She continued, “He come out and I show him the paper and he ask me if she was getting pain and I said yes and he say he can’t do the test now let I come back Monday morning.”
Shameeza said that on Sunday evening Farzana fell into a coma-like state after which she was rushed to the New Amsterdam Public Hospital where she succumbed.
There has been no known public response to this case.
The horror stories continued on Friday. This time at the West Demerara Regional Hospital (WDRH). Five-year-old Jai-Devi Gurdyal passed away after allegedly being administered an overdose of asthma medication. Her mother spoke of the crude and humiliating manner in which she was treated even as her child lay mortally ill. This case requires an immediate investigation to determine whether there was malpractice here and the matter should be taken up by the Medical Council of Guyana.
At various fora here and overseas, President Ali speaks volubly about the amount of money being poured into the health sector. New hospitals are being built in all parts of the country. Advanced equipment is to be acquired for diagnosis and interventional medicine. With funding from Hess, Mount Sinai of New York is meant to be investing time and energy in modernising the health care system.
None of it means a whit if primary health care in this country is so backward, dehumanising and produces results as those referenced herein. Indeed, money would be wasted if primary health care isn’t comprehensively addressed before aiming for more sophisticated care and gleaming edifices. As we have pointed out before, the PPP/C has been in office for 26 of the last 31 years. If the current state of the health system is a reflection of their abilities to manage and improve then no amount of oil money will make a difference.
We would respectfully suggest that President Ali summons his Minister of Health for answers on the cases listed here and swift determinations made on what needs to be done to improve staffing and conditions at facilities like Skeldon.
The authorities are also quite good at convening investigations and trying to wait the public out in the hope that the affected families settle or simply give up. The death of five-year-old Jai-Devi Gurdyal must become a test case of the responsiveness of the respective health authorities. The public expects to hear from the health minister, the regional chairmen, the regional health officers, the director of regional health services and the chief medical officer among others in these recent dreadful cases.
