Making GPHC a better, safer and more welcoming hospital

Nov 29, 2018 Letters

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DEAR EDITOR,

Permit me in the capacity of a health professional to pen a few lines on an issue that desperately needs to be caught up or at minimum swept up in the present government’s tsunami of change.
A recent newspaper article, brought to the fore the undercurrents of a likely financial scandal involving changes/ renovations that were due to be carried out over 32 months at Cheddi Jagan International Airport located at Timehri.
(https://www.kaieteurnewsonline.com/2018/11/20/us150m-and-countingis-guyana-getting-a-new-or-renovated-airport/)
It is a well–known and well-shown fact, that anything of a fiscal nature involving the Guyana Government has always been shrouded in mystery and deception, and this case was no exception, even down to the surreptitious recipient of the tender – China Harbour Engineering Company.
To coin a well-known Guyanese adage, “Whah gone wrong ah morning, can’t come good ah night”. For what was originally decided on during the previous administration regarding the contractual terms have not materialized.
While I am a great believer in change, I nevertheless felt that somehow or other the change agents were way off the mark, or perhaps in more direct terms – off location. However, this is not the crux of my discussion, as I endeavour to once again bring attention to places where changes are really needed. Changes that would considerably change the health and lifespan of the citizens— such as investing money in building or making GPHC a better, safer more welcoming hospital – one which would significantly lower the mortality and morbidity rate .
Currently the maternal, neonatal and general mortality rate in itself speaks volumes and stand as silent reminders of needed change, as attested by Dr. Lucio Pedro, Head of the Obstetrics and Gynecology Department of the Georgetown Public Hospital Corporation.
Despite the opening of a new maternity wing, the hospital still faces its greatest and perhaps insurmountable challenge – that of decreasing both the maternal and the neonatal mortality rate towards attainment of Goals Four and Five of the United Nations Millennium Goals, which speak to the reduction of both maternal and infant mortality rates.
(www.kaieteurnewsonline.com/2017/11/25/gphc-maternity-unit-still-hard-pressed-to-reduce-maternal-and-neonatal-rates-obgyn-head/)
The former British Prime Minister Sir Winston Churchill, as far back as 1943 during the discussion in the House of Commons on the restoration of the Commons Chamber destroyed by bombs, stated thus, “ we shape our buildings and afterwards our buildings shape us”.
(https://www.parliament.uk/about/livingheritage/building/palace/architecture/palacestructure/churchill/)
Additionally, as humans we spend a great part of any given day in buildings, which can exert a deep-seated effect on our general well-being, be it for better or worse. Doctors and medical personnel the mainstay of any hospital, were also victims to unsafe and uninhabitable buildings, complaints about which fell on deaf ears for several years.
In fact, in a newspaper report in 2013, one doctor who refused to disclose his identity said that 15 years prior, the doctors had written a letter to the hospital making them aware of the said situation. (https://www.stabroeknews.com/2013/news/guyana/10/19/doctors-refuse-to-give-up-crumbling-quarters/)
Conclusively, another complaint in 2017 brought about the renovation in 2018 of the North and South Block of the Doctors’ Housing Facilities. Research conducted in the U.S.A has shown that effective building design is of remarkable importance especially in hospitals, the potential of which is oftentimes omitted or forgotten.
Operating Rooms or Theatres, (a seemingly fitting nomenclature) considered one of the most critical areas in any hospital, most of which although operational still do so on vestiges of the past, inadequately built to handle people, equipment and processes that a current operating room needs to house. Researched informed design of an Operating room can go a long way towards improving performance and safety.
A fact to be borne in mind is that hospitalization is a need service and not a want service, and as such brings about considerable stress due to fear, diminished physical limitations, absence of needed medications , fear of medical interventions and uncertainty about future well-being. Hospitals that are noisy, drab, dark, possess outdated or absent equipment, unwelcoming to families, only serve as further stress inducers. There have been circulating rumors about the construction of a specialized hospital, and expressed concerns about the existing one.
(https://www.kaieteurnewsonline.com/2011/02/02/does-building-a-specialty-hospital-mean-gphc-will-be-another-white-elephant/).
Here and now let it be said, such an idea was conjured up in a thoughtless head. The latter mentioned judgment proved to be right when Surendra Engineering Corporation Limited the company which won the bid for the construction of a Specialty Hospital in 2012., fled the coop with U.S. $4.2M belonging to the Guyana Gvernment.
(https://www.kaieteurnewsonline.com/2017/05/15/billions-squandered/).
I am calling on the government to use whatever remaining that they have got, using it to give GPHC their best financial shot– one that would benefit hospital staff, patients, patients’ families and all stakeholders. It is crucial that prior to any renovation undertaking that the government carefully research and use all available empirical evidence to guide any likely design, especially the use of well-qualified architects.
Evidence-based design has recorded how to make hospitals safer and less stressful, and operates in tandem with architect and designer imagination, creativity and judgment by providing empirical data on design elements that actually work.
Some facets to be considered are: staff visual access to patients, easy-to-clean surfaces, sound-absorbing flooring, ceiling and walls, way finding, including the building entrance, floor plans and information desk, patient control of light, family support spaces, such as comfortable waiting areas, an overnight bed in the patient room in cases of very sick patients, acuity adaptable rooms to avoid moving patients as their condition changes.
Staff support spaces, such as decentralized nurse workstations, immediacy of supplies and medications, and comfortable break areas, medical staff support spaces, such as the quality of meeting rooms, sound quality of operating rooms, and quality and location of workstations. Georgetown Public Hospital Corporation is the country’s largest hospital, and though built 180 years ago, still has a rich history to show. Let us now respectfully lay to rest the dead, as we strive towards the mark ahead. The government should now invest money for the nation to see that healthcare remains a top priority.
Hospitals will never be places that patients enjoy. However, when ill, the building design can assist in maintaining their morale still. Create and/or renovate the GPHC, making the building in general, safer and less stressful for patients, more welcoming to families, improving the quality of work and work life of the staff, and improving environmental sustainability.

Y. Sam

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