Response to Reports on the Health Sector

Aug 26, 2022 Letters

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Dear Editor,

By 2020, there was no X-Ray services at New Amsterdam Hospital. The laboratory was unable to provide basic testing because either equipment was down or reagents were unavailable. Common medicines critical for patient care were mostly unavailable almost all the time. Beds, bathrooms/restrooms and the building in general were in need of urgent maintenance, the total environment was in deplorable state. The operating theatre had leaks, fungus/mold had taken over the walls, basic equipment was in need of repairs, the wards were in shameful conditions, even sheets and pillows were missing, urgent painting was needed across the board. Operating room tables and delivery beds were in poor condition. The CTG fetal monitoring equipment no longer existed in the delivery rooms. The dental suite, including the broken dental chair, was in shameful condition. The oxygen therapy system was unreliable. The hospital back-up generator’s ATS for automatic switching on was not functioning. Washing machines, dryers were no longer functioning. Basic medical supplies were in severe shortage. The solar panels needed rehabilitation. The hospital roofs were leaking. There was a general clutter in the hospital compound and the sewer system was overflowing. Adding to the unseemly sight in the hospital environment, the incinerator required major overhaul and rehabilitation. The mortuary was out of service. The hospital’s ambulances were barely serviceable.

This was the sad state at New Amsterdam Hospital in August 2020. It was disappointing that the media paid no attention. This was not a unique situation at the New Amsterdam Hospital. The whole health sector was totally neglected. While the media was preoccupied with other matters, they paid little to no attention to the dire situation at New Amsterdam Hospital and across the health sector.

Since that time, beginning in August 2020, when a new Minister of Health was appointed and a new PPP government came into office, major initiatives have been taken to remedy the situation at New Amsterdam Hospital and throughout the health sector. The description that Kaieteur News used in an editorial on Wednesday, August 24 and in earlier articles that they claimed the IDB now has found in a study refers to the conditions the MOH was addressing from August 2020 and used as the basis for rehabilitation and upgrading plans that were put together since that time.

At New Amsterdam Hospital, a new X-Ray has been functioning since early 2021; earlier in 2022, a new mobile digital X-ray was procured and functioning, presently a new fixed-site digital X-Ray is being installed. A CT machine has been provided and has been operationalized, laboratory equipment has been procured, ECG equipment, ultrasound machines, CTG for fetal monitoring in the delivery rooms, better systems for supplies have been put in place, basic maintenance work on the existing operating theatres have been done, new maternity building, with three new operating theatres is about to be commissioned, operating room tables, new delivery beds, new ICU beds have been procured, new ventilators and anesthetic machines have been installed. A new oxygen therapy system is in place. The ATS for the back-up generator has been installed. The solar system now contributes 20% of the energy needs of the hospital. There are now new ambulances for the hospital. A new chemotherapy building will be operationalized in a few weeks. The dialysis center has been reactivated. A new, fully-equipped Infectious Disease Building has been constructed and operationalized. General environmental clean-up has been put in place. Upgrading of the laundry services have been embarked on.

In addition, a major upgrade of the hospital is planned under the IDB project that the government has negotiated. The plans developed by the MOH includes a new emergency and trauma building, expansion of the operating theatre suites, a new ICU and HDU area, new neonatal unit, etc. Already a chemotherapy area is ready to be commissioned. The work identified at the New Amsterdam Hospital is what the government has planned. The IDB project will be a part of the planned work.

While it is encouraging that news entities like KN are again interested in what occurs in the health sector, we completely reject the attempt by the KN to transfer the neglect that was evident at the New Amsterdam Hospital before August 2020 to the PPP government. KN must have reasons why when those deplorable situations existed; it paid no attention as it stood by before 2020 without ever highlighting the scandalous situation at the New Amsterdam Hospital. We would like to assure everyone that what is described in KN for New Amsterdam Hospital is far from what really exists at the hospital presently. While we have made significant progress, the MOH and the Region 6 administration are well aware that conditions are not yet what the MOH would want the New Amsterdam Hospital to be.

The IDB project being formulated for the New Amsterdam Hospital is using the state of the hospital at the time the MOH began putting together the plan in 2020 to correct the situation and to upgrade the hospital. While the situation is very different today, this is still a work in progress right now.  Thus, the urgency to implement the major upgrading plan which the MOH has put together and which the IDB will fund.

Two years ago, when a new Minister of Health took office and a new government was in place, the health sector was in a desperate place. It was clear that those in charge of the health sector in the years preceding 2020 had thoroughly neglected the sector. Significant investments have been made to address the many areas of neglect that were evident in August 2020. Much progress has been made, even as the health sector was occupied with a COVID-19 response.

The reports in the media, particularly in KN, are referring to the state of affairs the PPP government inherited, identified and have been correcting. The media essentially remain two years late. The work identified, some of which have been on-going over the last two years, are works which the PPP government have put in place to upgrade services in our hospitals. The IDB has agreed to work with us to finance some of the various works we have undertaken.

Outside of New Amsterdam Hospital, the situation at other hospitals was not different. Similarly, the neglect of the health centres and health posts was shameful. The IDB conducted an assessment of more than 330 health centres and health posts in all ten regions in 2018/2019. The assessment was a Service Availability and Readiness Assessment (SARA). The report showed that the primary health care system was, like the hospitals, totally neglected. Many of the health centres and health posts had broken beds and furniture, leaking roofs, broken windows and doors. Many had problems with utilities, such as electricity and water and many other problems.

Since August 2020, a massive effort to remedy this situation in health centres and health posts has been undertaken, with an investment over the two years that amount to more than $1.5B. From RHO’s reports over this past year, greater than 90% of health posts/health centres today have electricity and water. Most of the health centres/posts today benefit from improvement. Many have been repainted, most of them had waiting areas constructed, washrooms have been upgraded, most have running water, most have access to electricity, etc. In the coming years, everyone of these facilities will benefit from further upgrading in infrastructure, technology, medicine and supplies and human resources.

As far as the hospitals are concerned, including the New Amsterdam Hospital, the government has made significant progress in improving the conditions. While efforts at rehabilitation and improved maintenance are continuing, the government recognizes the need for massive investment to upgrade many of the facilities.

The sector has developed an ambitious plan for upgrading all existing hospitals in the country. The IDB has been a major partner in the health sector for a long time. The IDB is partnering with the Government of Guyana in the upgrading of three facilities, the GPHC, New Amsterdam Hospital and Linden Hospital. The Government of Guyana has identified areas for upgrades in these hospitals, including in more comfortable, more modern facilities for emergency medicine, better operating theatres, better diagnostic facilities and improved in-patient areas. For these three hospitals, the government has allocated US$160M from the IDB portfolio to support major upgrade of these facilities. In the first phase, US$60M is being earmarked from this loan. Just over US$48M will flow towards improvement of three hospitals. More than US$7M will flow towards introduction and rolling out of a telemedicine programme.  Just over US$3M will be directed to overall service delivery across the health sector.

Outside of the three hospitals, which are the target hospitals for the IDB loan, other investments are being made to upgrade existing hospitals. Among major inputs, Suddie, West Demerara and Bartica Hospitals are presently on the books, with designs for new hospitals completed and new construction for these hospitals planned. Presently, financing is being arranged by the government for these hospitals. Skeldon and Fort Wellington Hospitals are being replaced by new construction at new sites. Land preparations for these two hospitals have already begun. In addition, new hospitals are being constructed starting now at Enmore, Little Diamond, De Kendren and Anna Regina. A new Maternal and Children Hospital will start construction in weeks at Ogle.

Since August 2020, given the deplorable conditions in the health sector, these plans were being put together by the new government. The urgency of mobilizing resources for the plans the Ministry put together for correcting the neglect and upgrading the sector was immediately recognized. The IDB reports reflect the need that existed then and the reason why resources were being mobilized. We urge newspapers and others to be more conversant with the reasons why the rehabilitation and upgrading are being done. The works being done are works that have been put together, not by the IDB, but by the Ministry of Health. The IDB will help fund some of the work still to be done.

Dr. Leslie Ramsammy

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