GPHC needs to come clean and let Guyanese know exactly what happened to these children

Feb 16, 2019 Letters

---

 

DEAR EDITOR,

Sadly, in January, three paediatric cancer patients died at the Georgetown Public Hospital Corporation (GPHC) when they were treated with two widely used and safe anti-cancer drugs – vincristine and methotrexate. These medicines are not novel and they are well characterized. They induce their effects by mechanistically arresting cell division and thereby causing a reduction in the number of cancer cells. As such, the World Health Organization (WHO) has endorsed their use by including them in its list of essential medicines. However, the reasons behind why such safe medicines have caused three children to die at the GPHC need to be shared for the benefit of all. Of course, such a catastrophe prompts serious concerns about whether these drugs were administered through the recommended mode and whether they were stored under the required conditions, among others.
Moreover, allegations swirled that the GPHC erroneously delivered these anticancer agents through the spine i.e., by an intrathecal means in spite of clear warnings that vincristine is deadly when given to patients via such a route. This information has been around for more than 60 years. Pharmaceutical companies clearly recommend that this medicine should only be administered through the veins i.e., by an intravenous route. Therefore, intrathecal administration is medical malpractice. Moreover, it is also manslaughter.
Further, an inspection into the second anti-cancer drug, methotrexate reveals that this drug has also been around for more than 70 years. Its recommended mode of administration is via the spine only if it does not contain the preservative, benzyl alcohol. Benzyl alcohol can be fatal, especially for certain pediatric patient populations. The GPHC needs to come clean and let Guyanese know exactly what happened to these children. Moreover, such level of openness is necessary in preventing unnecessary deaths.
During this historic era of the digital age, the GPHC operates in a medium where information is at its disposal; thus, there is no reason for such medical errors. Information about these drugs saturates the clinical literature. Even a quick Google search concerning these drugs will instantly produce volumes of information. Further, every drug has an accompanying pharmacological literature.
Given this, it is quite disturbing that the GPHC erroneously administered these drugs through the wrong route on three separate occasions in one single month. The GPHC clearly lacks skilled professionals. These are the very reasons why Guyanese cannot trust the GPHC and the entire health care system. No wonder politicians seek medical treatment from abroad and reject the deadly health care offered here.
Additionally, mismanagement at the GPHC because of political influence is also a major reason why patients die from causes, which are 100% preventable. Just look at the way our drugs are dumped – under bottom houses on flood-prone Sussex Street, and in the Ocean View Hotel. Government has got money to burn on storage. Government even paid over three times the current market value for the Sussex Street bottom house.
The importance of appropriate storage cannot be underestimated and it is necessary in preserving the chemical integrity of our drugs and thus their pharmacological effects and safety. Medicines are required to be stored as per specific manufacturer recommendations. For example, vincristine should be stored only in a cool dry place and in the dark while, methotrexate needs a different set of conditions for storage. Improper storage can cause our drug supply to contaminate with bacteria, parasites, and fungus in altering the chemical structure and the chemical stability of drugs, thereby rendering them expired, ineffective, poisonous and deadly.
Editor, here is another dimension demonstrating how politics have turned our health care system into one that is deadly and these three children are the victims of such a system. Guyanese will never forget how Ms. Volda Lawrence, the Minister of Public Health, bragged that she will hire only members of the PNC to serve in the government-run health care system. This is shortsighted and inhumane.
Today, many individuals without an ounce of health care training hold key positions at the Ministry of Public Health (MOPH) and at the GPHC, instead of skilled professionals. Sadly, the poor pay the price while members of government travel abroad for medical care on tax dollars they suck from the poor. Such abuse must end if we are to respect human lives and develop our country.
Unfortunately, given the level of corruption, most Guyanese fear that the MOPH and the GPHC will bury the truth about what happened to these three children through sham investigations to avoid accountability. This kind of corrupt investigation is rampant at every agency in Guyana. Most of us have been robbed of our rights by such kinds of corruption.
The MOPH and the GPHC have already heightened our fear by informing the public that the autopsies of these children are inconclusive. How can this be? This is hard to swallow. An independent investigation will extract the truth and it is needed. Guyanese cannot trust the MOPH and the GPHC. Of course, health care professionals know exactly how these children die, because vincristine given through the intrathecal route is known to induce a unique repertoire of symptoms, which is characteristic of such a problem. This is science. Science is reliable.
The MOPH and the GPHC need to respect the families of these children and provide them with the facts surrounding the deaths of their loved ones. These families need closure. However, given the level of corruption, we may never know the truth and so do not hold your breath for it.

Sincerely,
Annie Baliram

---

---