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Nov 20, 2016 Features / Columnists, My Column
Another died during the process of childbirth at the Georgetown Public Hospital and I fear that she would not be the last. Again the cause would be the application of a drug that has been banned by the developed world. This drug is Cytotec.
Some years ago during the tenure of Dr Leslie Ramsammy as Minister of Health, I raised this issue with him. When I said that the drug is banned in many countries, he told me that it is not really dangerous and that it is applicable in many cases.
His comments came even as there were numerous women suffering from ruptured uteruses after the drug is applied. I searched the internet then and I returned to it yesterday. I found this interesting remark.
“CYTOTEC (MISOPROSTOL) administration to women who are pregnant can cause birth defects, abortion, or premature birth. Uterine rupture has been reported when Cytotec was administered in pregnant women to induce labor or to induce abortion beyond the eighth week of pregnancy (see also precautions and labor and delivery).
Cytotec should not be taken by pregnant women to reduce the risk of ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs).”
The authorities say that there are benefits, but the risks are high. The authorities also say that the use of this drug to induce abortions is rapidly gaining traction in places like Brazil and Texas. Many women use it because it is cheaper than going for clinical abortions.
To my mind, there have been too many maternal deaths associated with this drug. To argue that it has been successfully used is to listen to the argument of a smoker who lives to a ripe old age. He would knock the findings that smoking causes lung cancer.
I am opposed to this drug because every maternal death hurts me badly. Childbirth is natural. I fathered five children, four of whom were born at home. My own mother who made eight of us never went to a hospital, so natural is this process. Indeed there have been the cases of some deaths, but surely not as many as when Cytotec is applied.
I am not a physician by any stretch of imagination and the gynaecologists may come out against me, using all the facts at their disposal, but I hold the view that before Cytotec, women were giving birth with minimum complications.
Such has been the impact on me that whenever I see a pregnant woman, I wonder whether she would be successful. I remember when two of my daughters became pregnant. I was happy. I was not nervous, because I was not aware of this drug to induce labour and my daughters went through their labour like millions of women before them. Today my grandchildren are teenagers. There are three from my sons who are in their twenties.
What saddens me is that the local medical practitioners seem incapable of repairing a ruptured uterus, so the women simply bleed to death. That no one is sued is testimony to the fact it is difficult to gain judgement against doctors. Their colleagues simply will not testify.
This past week, a columnist, Freddie Kissoon, was harsh on the Cuban-trained doctors now employed at the Georgetown Public Hospital. He stopped short of calling them killers. Sadly, he painted with a large brush and smeared every Cuban-trained doctor, except those who graduated during the era when Forbes Burnham was Prime Minister and later President.
Indeed, some of those licensed are of questionable ability. I remember on one occasion having to speak with Dr Vivienne Mitchell when she headed the Guyana Medical Council. She had a problem licensing some of these doctors because she could not access their grades.
The authorities came down on her to grant the licences but she stood her ground until the weight became too much for her. The authorities, then, argued that these doctors would undergo training on the job to develop their competence.
I now hear that a similar situation has developed. Anil Nandlall, a former Attorney General, is fighting for these unlicensed doctors. I hasten to say that I do not know what qualifications these doctors have or whether the situation is one big administrative glitch.
There is a report that on one occasion a senior Minister of Government travelled to Cuba to inveigle the authorities to do something about the pass rate. Guyana did not want to report a large number of failures from Cuba.
When we selected people to be trained in medicine there were some cases who qualified for the training because of their political connection. It stands to reason that if one is poorly qualified at the start, it is unlikely that the individual would perform creditably at the higher level. The product would be substandard, similar to what passes in our education system today.
We sent many to write the external examinations and the results are so disheartening that the Education Ministry is now seeking measures to improve the teaching of Mathematics. I would suggest that measures be put in place to improve the general system. Many still cannot come to grips with basic English.
But it is the medical field that has me worried. I fear that too many substandard doctors are in the system and our people die sometimes after entering the hospital with minor complications. Nigel McKenzie told me that his father-in-law went to the Georgetown Public Hospital following a vehicular accident. He sustained a broken arm and died.
I know that we need doctors in a bad way, but my simple suggestion is for those who graduated poorly from Cuba to be subjected to an intense period of training under the best practitioners we have, before they are allowed to lay hand on any patient. I would also suggest that we shun any medication that can cause death, regardless of the benefits.
After all, the adage that a doctor buries his mistakes still holds true.
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