Primary health care is a paramount need

Apr 18, 2012 News

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– Transplant Surgeon

Primary health care has always been, and will continue to be, a paramount need in any country,

particularly in a developing country, says Dr. Stephen Guy. The kidney transplant surgeon, who is currently attached to the Drexel University College in the United States, has over the past few years been offering his specialist service to aid kidney transplant operations in Guyana.
Dr. Guy is a kidney, pancreas and liver transplant surgeon specialising in multi-organ transplantation for over 15 years. He, along with a number of other reputable health professionals, has been lending support to Dr. Rahul Jindal, who has been spearheading kidney operations here in Guyana.
It is the view of Dr. Guy that  “while we are augmenting what was already being done with sophisticated forms of treatment” there is need for the local public health sector to channel resources to further bolster primary health care. He pointed out that there is a large group of people who are likely to develop kidney failure, a health challenge which is historically caused by diabetes and high blood pressure.
“Those two illnesses are prevalent here in Guyana and throughout the world and so I would hate to see large portions of the population being written off because of the lack of sophisticated treatment.”
According to Dr. Guy, it was with this awareness in mind that the North American-based kidney transplant team decided to provide surgical expertise with a vision that local physicians would provide most of the follow-up care.
He alluded to the notion, too, that doing transplant operations in Guyana lends to the raising of standards of medical care in other related areas.
“It shows you can do this and anything in a country such as Guyana, given the requisite infrastructure and support for this kind of endeavour…and it doesn’t have to be limited to North America.”
However, he noted that since not every patient diagnosed with kidney failure could undergo a transplant operation, the aim of the visiting team is to find ways to help address their condition.
“For me, helping people and saving their lives is a very satisfying profession, and coming here to Guyana and helping is an extension of that.”
Having visited this country on a number of occasions and seeing the firsthand delivery of health care, Dr. Guy noted that while it may be at a different level than that obtained in North America, it still is very good.
“This is a small country and there hasn’t been people trained to do this kind of surgery and this kind of treatment, so we are providing this service.”
Another member of the kidney transplant team, Dave Oliver, Clinical Manager at the Walter Reed Army Military Medical Center in Washington D.C., recently explained that even fruit juices in too large quantities could negatively affect persons suffering from diabetes. According to Oliver, a specialist in clinical dialysis and a registered nurse infusionist, while there are varying ways that can be used to address kidney failure, prevention should be placed at the top of addressing this health condition. Prevention awareness, he stated, is in fact the least expensive alternative, which includes being knowledgeable about one’s blood pressure, blood sugar and diet.
“Being aware of these factors is very important for folks who may or do have some signs of kidney failure…”
Taking precautionary measures such as pressure screens and the use of necessary medications are regarded as relatively inexpensive means of addressing renal failure.
Oliver pointed to the fact that high blood pressure is known to damage virtually every organ in the body with the most visible effect being kidney failure, heart conditions and vision problems.
Given the impact that a high blood sugar level can have on an individual with diabetes, Oliver said that it is especially important for diabetics to “avoid foods that are high in concentrated sugar which can damage many organs, especially the kidneys, which can help to push the pressure up. You need to control the foods.” And not only foods high in sugar could pose a threat to persons with diabetes, as according to Oliver, too much salt can also be dangerous.
Oliver’s contribution to the kidney transplant programme in Guyana will also include training of local health workers at the Balwant Singh Hospital, as he asserts, “my goal is to make my needed presence obsolete. I would like to begin to train a few staff to take over my duties.”
He nonetheless acknowledged that the hemodialysis capability of the nurses supporting the local transplant programme has been laudable.
“The nurses here have done a marvellous job and are becoming better at what they do…the only thing missing is the peritoneal dialysis expertise aspect. It is not as technically difficult, as it does not require machines, a high level of training, huge resources such as facility space and time, but it does require the expertise of knowing how it works in the theory,” Oliver said.
As such, training of staffers will begin shortly, including the proper use of catheters, and efforts will be made to make them (catheters) an available resource.

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