Focus should be on prevention and primary healthcare, not specialty hospital

Jun 10, 2014 Letters

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DEAR EDITOR,
I recently read a news article in which President Ramotar was quoted as saying that “Only someone who is mad or has another agenda will oppose a specialty hospital when you [have] cancer killing so many people in our society, heart disease and so forth killing…people.”(http://www.stabroeknews.com/2014/news/stories/06/08/president-floats-possibility-early-general-elections-anti-laundering-sanctions-hit-hard/).
Obviously Mr. Ramotar is speaking from a particular partisan political perspective, but I have heard similar sentiments expressed by the average Guyanese on the street and feel compelled, as a public health professional, to share a different point of view for the public’s consideration. [Note – for the record – I have not (yet) been diagnosed with any mental illness, and my only agenda is awareness raising; I am not affiliated with, nor do I represent any partisan political entity.]
First – more hospitals – even ‘specialty’ ones – will do absolutely nothing to halt the spread of diseases, especially ones like cancer and heart disease. Cancer is a complex illness with numerous causal factors, many of which are still not fully understood and which researchers worldwide are still studying. One fact that is becoming increasingly clear, however, is that environmental factors – such as the increasing amounts of chemicals in our food, water, and air – are playing a greater role in cancer processes.
If one is serious about halting the spread of cancer, therefore, reducing the amount of chemicals in the environment – via promoting natural/organic agricultural techniques and addressing air/water pollution are the areas where more action needs to be taken. In addition, Guyana already has a Cancer Institute which provides a wide range of services such as mammography, pap smears, chest x-rays, chemotherapy, external beam radiation therapy, intra-cavitary radiation therapy, CT scans and bone density scans.
I am personally familiar with the services of the Cancer Institute, as a close relative of mine had cause to utilize the facility several years ago. Finally, the key to cancer survival, as in most diseases, is early detection. As such, increasing individual and community awareness, and encouraging and providing access to early testing are essential in the fight against cancer. These are services that are provided on a primary level – via community health workers, health centres, etc – not via a specialty hospital.
Second – as regards heart disease – again – prevention is key. When one requires the services of a specialty hospital – meaning either after or immediately before suffering a heart attack (leaving aside cases of congenital defects which children are born with) – one is already a point at which they are sick. My point again is that a specialty hospital will do nothing to reduce the epidemic of heart disease in Guyana. What is needed is for individuals to really seriously examine their diets and activity patterns and make healthier life choices. The old people – like my grandmother who never wanted to go hospital because “dat is where people does die”- understood that hospitals are not places that promote wellness.
What hospitals and the people who work there do is treat illness. They can provide information and some medicines, but wellness is cultivated outside of hospitals – how one lives on a daily basis – the food eaten, the behaviours and activities engaged in, etc. This is a point that I would have thought Mr. Ramotar- himself the adherent of a new, healthier diet (kudos to the First Lady for this) – would have clearly understood. It is sad that politicians and other public figures do not use their considerable influence to promote healthier living among Guyanese, instead of spreading misinformation and continuing to espouse negativity.
Lastly, I must repeat the point that I made exactly one year ago when I penned a letter on the appalling lack of basic drugs at Linden Hospital. At that time, I had gone to the hospital with a friend and her two-year-old grandson who had been suffering from diarrhea and needed rehydrating. At that time, Linden hospital was out of stock of Panadol and Oral Rehydration Solution (ORS)- a basic but essential item necessary for preventing infant mortality.
I am sickened to report that one year later, the Linden Mackenzie hospital – in the second largest town in Guyana, in the year 2014, is still lacking ORS along with other items like liquid Gravol – also key in the fight against infant mortality.
Just a few weeks ago, another friend called to tell me that she and her 11-month-old granddaughter who had been vomiting were sent away from the same hospital and told they needed to go to a private pharmacy to purchase these items. I also recently visited the Charity and Suddie Hospitals in Region 2, where numerous complaints were raised about the lack of supplies and medication – from items such as antibiotics (amoxicillin in particular), to 5% saline, Rh Factor, iron supplements, and Panadol.
Also lacking were adequate supplies of latex gloves and bin liners for biohazard waste – key items for maintaining proper hygiene and sanitary standards. In addition, there is no running water at the Charity health centre- the first stop for all the people living in the riverain areas who might need health care.
My point is this – when the Ministry of Health and other authorities in charge cannot ensure that the hospitals we already have are provided with basic, essential supplies and that the people of Guyana are provided with quality primary and preventative healthcare- we have far bigger problems that a specialty hospital can address.
The neglect of primary health care facilities in Guyana, as well as the lack of commitment to providing quality care – especially to Guyanese from the lower economic strata of society who are not able to pay out of pocket for private medical care – reveals a distressing disregard for the nation’s wellbeing.
Let us not be fooled by the attempts to use construction of a specialty hospital for partisan political purposes. Instead, we must call on those in charge, when they purport to care about our wellbeing, to ensure that when we take our babies to the existing hospitals and health centres in our communities, that they are provided with the medicine necessary for their survival without having to go to private pharmacies.
Let us not see more pregnant women die needlessly in childbirth for lack of quality care. Let people who want contraceptives not be turned away from heath centres because they don’t have any in stock for months at a time. Let us specialize in quality and preventative care first and foremost. And finally, Mr President, instead of slinging insults like ‘mad’ at people who disagree or share a different opinion, it would be so much more helpful and positive if you did something to improve the mental health sector of Guyana – another area that has been woefully underdeveloped for far too many years.
Sherlina Nageer, MPH

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