The Story Within The Story… Questionable medical schools; too many C-Sections for moms

Oct 14, 2018 News

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By Leonard Gildarie

What I am about to write will raise the hackles in especially hospitals, but then again that is the idea.

I am hoping that we can spark some debate and a look at the operations of especially our local, privately-owned hospitals. Many of them are getting away with murder.

I was browsing the online news of CNN on Friday and stumbled on a piece headlined “C-section deliveries nearly doubled worldwide since 2000, study finds”.

I was intrigued and then angered. And I will explain why.

CS use in 2015 was up to ten times more frequent in the Latin America and Caribbean region, where it was used in 44·3% of births, than in the west and central Africa region, where it was used in 4·1% of births. It is the highest in the world.

Caesarean section—the most common surgery in many countries around the world—is a procedure that can save women’s and babies’ lives when complications occur during pregnancy or birth. However, the report explained, caesarean section use for non-medically indicated reasons is a cause for concern because the procedure is associated with considerable short-term and long-term effects and health-care costs.

Caesarean section use has increased over the past 30 years in excess of the 10–15% of births considered optimal, and without significant maternal or perinatal benefits.

On the basis of data from 169 countries that include 98·4% of the world’s births, it is estimated that 29·7 million births occurred through CS in 2015, which was almost double the number of births by this method in 2000.

Here is where it gets worrying.

Based on the most recent data available for each country, 15% of births in 106 (63%) of 169 countries were by CS, whereas 47 (28%) countries showed CS use in less than 10% of births.

CS use was 1·6 times more frequent in private facilities than in public facilities.

I know it is a lot of figures. But it is important.

In recent years, we have been receiving complaints about what appears to be predatory practices at the local, privately owned hospitals.

Let me make it clear that I love a strong private sector. It will be the way to go to build this country.

In recent years, too, there has been a growth in the medical services offered, from ISO-standard labs, to more modern hospitals.

However, when the hospitals forget their core mandate of saving lives in favour of profits, we have a problem on our hands.

The cost of a natural birth at a private hospital averages $75,000 while a C-section about $250,000-$300,000 barring any complications.

We have been receiving complaints that at least one city hospital has been pushing C-sections aggressively. And the reasons or conclusions are very simple – profits.

I have been thinking for a while to expose this. It is a very inhumane thing to subject a woman to, unless it is one of choice or a life-saving necessity.

While C-sections are relatively safe, reducing risks at birth, it indeed has long-term effects on women. I know because close relatives have given birth via C-sections and I have watched them struggle over the years to adjust to their post-operation, post-pregnancy body.

We need a stronger regulatory system to monitor our hospitals.

It is rare that we find doctors being sanctioned, at least publicly. I can’t recall hospitals being criticized publicly about operations. Should we do so?

We have heard of the millions of dollars in taxes being evaded because of the loose, cash-based system of the hospitals.

This is an area that needs addressing. We need to hold them accountable with our regulators more vocal in protecting our citizens who utilize the services offered.

For the Caribbean to boast the highest incidences of C-sections could be construed in a number of ways and the complaints that we have been receiving paint a picture that is not flattering.

We don’t want to accuse our hospitals of predatory practices.
The figures of private hospitals versus the public ones would tell a tale.

But enough of that.

In another unrelated matter, the news this past week spoke of the operations of off-shore medical schools in Guyana.

In Barbados, an Indian national is in trouble for fraudulently pretending that his school offers accredited medical courses for students who want to work in the US and other attractive markets.

The problem was that the students were left high and dry as the school was not only unaccredited but the operations was loosely run with staffers not paid for months, among other breaches.

In Guyana, we have had one woman who had been nabbed and placed before the courts several times for her nursing school scams.

She has connections and friends, one can only surmise, that very soon she may surface again, in another location.

The cases only came to light after students raised complaints.

Then there are several medical schools, according to the National Accreditation Council (NAC) website. I counted at least eight operating in Guyana.

Are these courses accredited with the US and other North American authorities?

Here is the problem.
In the case of the Barbados operator of the medical school, he had an active network in India marketing his school, promising the moon and the stars of the medical field at a fraction of costs in India.

Many parents would have borrowed and doled out their hard-earned savings to only learn that the school is “canta”, as Guyanese would say.

So we have a situation in Guyana where off-shore medical schools are likely not accredited, thus the promises they made that students, once they graduated, will secure overseas postings in the US and other places- that is totally unacceptable.

At least one medical school, run by Indian nationals, has built an imposing structure in Providence, signaling intentions for the long haul. We would want to ensure that they are above board and the NAC and other such regulators are carrying out their mandate.

A country without regulations would be a headless chicken.

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