Guyana’s infant mortality rate still too high

Nov 24, 2014 News

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– veteran Obstetrician/Gynaecologist

“There are certain decisions probably made too late or made incorrectly…” – Dr. Sooknanan
 

Veteran Obstetrician/Gynecologist, Dr. Narine Datt Sooknanan has said that Guyana has an exceptionally high infant mortality rate.
Speaking exclusively with this newspaper recently, the medical practitioner, who was in charge of the New Amsterdam Hospital’s Maternity section for over 30 years, opined that while maternal deaths occur at any part of the world, and Guyana is not excluded, that nation’s maternal mortality rate is high.
He feels that the “big problem” is not enough trained specialists in the field of Obstetrics/Gynecology, “and there are certain decisions probably made too late or made incorrectly.”
The medical practitioner underscored the need for medical doctors who are specialized in the field of Obstetrics and Gynecology and who can train junior doctors.

“Unfortunately, Berbice hasn’t many specialists anymore, and that is why we perhaps have maternal deaths.”
He also blamed the unavailability of proper scanning equipment for the high infant mortality rate.
Availability, too, of blood is a major factor. “And sometimes, some mothers come to the hospital late—we don’t have a system that we would have in the developed world where there is a family doctor or district nurse or district midwife, who would check them throughout their pregnancies, but we do have good ante- natal clinics, but a lot of people don’t go.”
Dr. Sooknanan said facilities, too, need to be improved, in the areas of fetal monitoring and a functioning blood bank has to be in place. When asked whether staff can be negligent in the area of maternal deaths, the veteran medical practitioner stated that it is always easy to lay blame on the doctor and nurses, “and there might be a few cases, where obviously things are overlooked.”
“But with the conditions of work and work-load, things can go wrong, and this is probably one of the causes why we have more maternal and fetal deaths…a third world scenario is a little different than in a developed world.”
He also recommended a “multi- disciplinary approach” where many persons are involved in the care of a patient. “Have a physician, midwife, and nutritionist, social worker involved, so you don’t miss things—but we don’t have that sort of system.”
Dr. Sooknanan also stated that many women are apprehensive of child-birth. He advised these women to ensure that they have adequate ante-natal care, and also ensure that any medical conditions they have are treated.”
In addition, the physician stressed that the child’s father plays an integral role in the pregnancy process.
“In Guyana, it is not so common, but overseas, husbands play a major role and we usually allow them in England to sit with their partner and reassure them. It helps tremendously, especially if you have a family member near to you, you feel more reassured.”
Abortion, being legal in the lawbooks in Guyana, is always an option when and only if necessary. He noted that patients have to be counseled.
“You tell them about the complications that can occur; you try to see if you can change their minds and get them to think differently.” He said that there might be religious opposition, but he feels that there are instances in which abortion is justified, such as rape and where the mother’s life is at risk. “You would be helping those mothers, because they are already in poor health,” he added. “People who condemn it (abortion), they probably don’t understand.”
During his early days of practice, Dr. Sooknanan often saw the effects of ‘back street’ abortions, “where people used bicycle spokes and brooms and all these things and the women get so infected and septic that they die from these so- called ‘criminal abortions’; but nowadays you don’t seem to have that, since abortion is now legalized and patients have easy access. They can go to a doctor and have it done under sterile conditions.”
Last August, Chief Medical Officer Dr. Shamdeo Persaud had acknowledged that a shortage of skilled Obstetricians was one of the biggest challenges Guyana faces in its efforts to reduce its maternal mortality rate.
But he had expressed optimism that an ongoing Multiple Indicator Cluster Survey (MICS) will reveal the gains Guyana has been made in its quest to reduce maternal mortality.
Reducing the infant and maternal mortality rates, are listed among the Millennium Development Goals (MDGS) that Guyana, along with other countries of the world, are aiming to realise by next year.
He however, acknowledged that “it has been a little bit difficult to get to our target but I know with the resolve of everyone, including Government and all of our partners, we are moving swiftly to achieve less than 80 (deaths) per 100,000 births.”

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