GPHC’s cardiac resuscitation mirrors international standard

Apr 04, 2017 News

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“Do it well or don’t do it at all,” said Dr. Debra Isaac of the cardiac services being delivered at the Georgetown Public Hospital Corporation (GPHC).

Dr. Isaacs, of the University of Calgary of Alberta, Canada, has been giving strategic cardiac support to the public health facility through an initiative called the Guyana Programme to Advance Cardiac Care (GPACC).
But according to Dr. Isaac, despite the fact that Guyana is a developing country, the need for quality service was long recognised. This, she noted, meant that the GPHC was the recipient of equipment that is on par with that which obtains at any North American health facility.
For instance, the GPHC currently has a variety of equipment for cardiac care, including an Echocardiogram Machine and stress test machine or treadmill. As a patient utilises a treadmill machine it becomes steeper and understandably harder. As the process becomes tougher the heart works harder and, according to Dr. Isaac, “we can see what happens to it [the heart]…we can see if you develop evidence that there is some blockage.”
But in so doing health personnel must take care that patients utilising such facilities are not overly exhausted and thus become emergency cases. It is for this reason, Dr. Isaac said, that emergency equipment was procured for the GPHC through GPACC.
“We have emergency equipment here in case something bad happens…we can shock the heart back. It is very rarely used…we hope to never use it. But in our institution in North America you will never have a machine like a treadmill without emergency equipment. So we decided here [in Guyana] it was going to be the same,” related Dr. Isaac. As such, she noted that moves were not made to utilise the treadmill until the emergency equipment was procured.
In order to get things done right, even when the support from the University of Calgary comes to an end, Dr. Isaac said that “we have identified some amazing local health care workers,” who will be capable of taking up the slack.
“The reasons we keep coming back isn’t because of the patients…I love them [the patients] but I can find patients anywhere. There are patients all over…the reasons we keep persevering, even when there is frustrations, the local people like Denise [Adams], like Dr. [Terrence] Haynes and several of our General Medical Officers [and] some of our nurses – they are the people who are going to make this health care system more up-to-date and much better so they are the ones we are here for,” Dr. Isaac asserted.
She added, “They have made huge leaps and bounds over the last year. I am very proud of them…They can manage things at very high levels and they are providing an astounding level of care when you think about what was happening a year ago, and so they are doing a great job. Our nurses are doing an amazing job too,” said Dr. Isaac.
She, however, pointed out that while the level of care is high “if the level of care stays the way it is right now, it will still be amazing, but we still think it can be better. Our goal is not to provide something that is good enough; we want to have something that is of high international standard that is really what the people of Guyana deserve… that is, both adults and children.”
Currently, Head of Cardiology of the Caribbean Heart Institute, Dr. Mahendra Carpen, functions as the head of GPACC in the absence of Dr. Isaac and Professor Wayne Warnica, also of the Calgary University. Also holding a senior position is Dr. Haynes, the Cardiology Registrar.
“They run the programme when we are not here, but then again we can read all the echocardiograms remotely…we can FaceTime with them all the time, and we can guide them,” said Dr. Isaac.
Added to this, she disclosed that another GPHC doctor is currently undergoing a three-year cardiology fellowship programme at the Calgary University.
“He is just completing his first year, so two years from now he will be back here full-time to help Dr. Carpen to continue to train some of the Registrars, the General Medical Officers and our Internal Medicine Residence,” Dr. Isaac related.
According to the visiting specialist, in order to sustain a successful cardiac programme, “we can’t afford for people to wait. Children with heart conditions who are blue, children who are short of breath, children who have heart murmurs …starting right from the stage of baby we need to see them here [GPHC] so that we can do an ultrasound of their heart to see if there is any abnormality.”
Dr. Isaac further disclosed, “I see far too many children here [for whom] it is way too late. I have seen children recently aged 7 – 16 that it is too late to operate on and they will die within the next couple of years…and that breaks my heart and I never want to see that. So we need to work on getting the public aware that they need to go to their physician.”
She however noted that although, “ We can’t have all the mothers bringing their children in directly [to the GPHC]; we couldn’t handle that, but if the child has a problem and you need to bring the child to the health care provider, then if there are issues they can be sent here for an ultrasound. We can make the diagnosis and we can do the treatment and that can include surgery.”
All of the cardiac services offered through the GPACC programme at the GPHC are free of cost and, according to Dr. Isaac, these include ECGs, treadmill tests, all the clinic visits and management.
“You come here and we will treat you for free…we don’t want people to waste time because they think they can’t afford it,” said Dr. Isaac, who revealed that thus far more than 7,000 echocardiograms in addition to a number of other services have been completed at the GPHC through the GPACC programme.

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