It is apparent that Guyana has been left way behind

May 22, 2014 Letters

DEAR EDITOR,
Strangely, the picture of the GPHC Nurses currently undergoing the Critical Care Training Course was juxtaposed alongside the report and picture of another maternal mortality victim. As a British-trained Certified Midwife, Registered Nurse, Registered Psychiatric Nurse and holder of a Masters Degree in Education, I am nevertheless experiencing severe difficulty fathoming why such an occurrence still exists. In this 21st century.
The world in general has moved on a long, long way, has turned the corner and is on a new page in a new era. It is apparent that they have left Guyana behind, and the country has not even realized this. It is time for Guyana to wake up! Shake Up! Take up its rightful place and get rid of the nurses acting as curses.
Pray tell me, what are the factors for such an obstetrical debacle? Certainly there is a crying need for a complete overhaul of the nurse-training system, syllabus revision, not to mention immediate staff removal? How many more deaths must take place before the respective department in Guyana realizes that there is a crisis and a serious one too.
The nurses and midwifes are certainly practicing age-old obstetrics, or are they too old to learn new tricks and techniques. Incidentally, my profound condolences go out to the entire family, especially the children who are now without a mother.
This unfortunate woman had all the trappings of what we term in obstetrics “high risk patient”, and even an obstetrical novice would know that such a condition requires special care. The hypertension (high blood pressure) with accompanying swollen feet, should have served as further warning signals. Then compound that with the fact that she had not only recently delivered, but was also transfused shortly after.
In trying to control both my anger and accompanying amazement, I dare ask who gave the discharge orders. If even the doctor had given the discharge orders, was he/she made aware of the patient’s pre-and post-partum state or the fact that she had delivered a pre-term baby, and had also been transfused two units of blood?
She was also at risk for eclampsia. and possibly her shortness of breath was attributable to fluid overload, where too much blood was transfused into the body in too short a time for the body to cope with it. The breathlessness could also have been a reaction of the transfusion and this can occur up to weeks after the transfusion.
On another point of note: was she given an accompanying diuretic during each unit administration or post-transfusion? Was her haemoglobin level checked after the transfusion to ensure that it was at a satisfactory level? Again, she could have suffered from TRALI (Transfusion-related acute lung injury).
I do hope that my nursing colleagues in Guyana, those of an obstetric bent would read this article, become knowledge-enriched, and be aware of the possibilities and eventualities that accompany parturition.
Taking into full consideration the plethora of maternal deaths thus far, for causes that completely unnerve us who practice this side of the continent, I wonder if due to the absence of severe disciplinary action against the responsible parties the nurses have adopted a laissez-faire attitude.
Let them be warned that on this side of the continent they would have action from their place of employment, their licensing body with possible suspension or complete loss of licence, not to mention a lawsuit from the family involved.
Enough is enough. This is the ultimate definition and I call on the Government and the respective Health Body to take this situation in hand and put an immediate halt to the senseless loss of maternal lives, which only serves to highlight nurses as curses, and Guyana as a veritable Third World country.
The rights of pregnant women to receive respectful and skilled care from well-trained health professionals have become more prominent. The maternity health care staff should be held accountable and to a high standard as in their hands lie two lives. Let every maternal death serve as a lesson to be learnt, retained and never repeated. Improvement and eradication of this seeming epidemic would be achieved through implementations arising from investigation and identification of the causal factors
After all, motherhood should be a joyful and positive experience, but for far too many women in Guyana, pregnancy and childbirth have become a dangerous and frightening time in their lives. This must stop.
Aluta continua—The struggle continues.
Yvonne Sam

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