Category Archives: Health

Govt. changed evaluating criteria for drug supplies after inviting bids

…was done without informing stakeholders – IPA  

Chief Executive Officer of International Pharmaceutical Agency Guyana Inc (IPA), Lloyd Singh, is alleging that the Ministry of Health changed the criteria for drug supplies after it had already invited companies to apply for a pre-qualification status.
This information is documented in a motion filed by Singh in the High Court, to reverse the decision of the National Procurement and Tender Administration Board, which decided that based on the revised criteria, the New Guyana Pharmaceutical Corporation (GPC) will be the sole prequalified supplier until 2016.

Lloyd Singh, IPA’s CEO

Singh in his petition to the court noted that on 26th November last, the Ministry of Health advertised in the Guyana Chronicle, invitation for companies to submit tenders to be prequalified for the supply and delivery of pharmaceuticals and other medical supplies and consumables for the period 2014 to 2016.
According to Singh, the purported revised evaluation criteria appeared for the first time among the bidding documents some time after the advertisement was published.
He said that the renewed criteria introduced for the first time a new system of evaluation criteria with a point system and some mandatory provisions which, “arbitrarily and dramatically altered the previous evaluation criteria without discussions with the stakeholders and without notice to the applicant (IPA) and other suppliers.”
Under the contentious revised criteria, bidders had to demonstrate a gross annual turnover of US$5M and net assets of US$2.5M.
Another criterion was that maximum score was to be awarded to applicants who would have paid $50M in Corporate taxes, annually.
Additionally, the company that has 50 or more employees, and warehousing capacity of 30,000 square feet in the city, will also gain an edge.
Singh also lamented the fact that despite the invitation being published in November 26, it was not until 20 days later in December that the company was informed of the list of required items to be supplied.
At the time of the announcement of the revised criteria, many stakeholders had been critical of the Ministry saying that they were tailored to suit the New GPC.
New GPC is owned by Dr. Ranjisinghi ‘Bobby’ Ramroop who happens to be the best friend of former President, Bharrat Jagdeo.
That company has been supplying the bulk of the drugs to Government for the past 15 years, ever since it was acquired by Ramroop in 1999.
Leader of the Political Opposition, Brigadier (Rtd) David Granger, is on record castigating the decision by the Ministry, saying it created a situation where rivals of New GPC would not be able to meet the criteria.

New GPC’s Dr Ranjisinghi ‘Bobby’ Ramroop

Granger said that what the Ministry has done is to devise tailor-made criteria which are meant to negate other competitors so that New GPC will be used as the sole supplier of drugs.
In July last, Head of the Presidential Secretariat, Dr Roger Luncheon, announced that the Tender Board found New GPC to be the only of the seven companies, which had applied, to have met all of the criteria.
Ansa Mcal was the first of the other companies to publicly lament the decision in favour of New GPC saying evaluators did not even visit its facilities.
With billions of taxpayers’ dollars at stake, independent suppliers and the Opposition have time and again been accusing Government of favouring New GPC, a company whose principal, Bobby Ramroop, shares close ties with former President Jagdeo.
The company has been benefiting from billions of taxpayers’ dollars annually, controlling supplies of up to 80 per cent of the drugs purchased by the Georgetown Public Hospital Corporation (GPHC) and the Ministry of Health.
New GPC has been a feature in the Auditor General’s report over the years with several instances focused on multi-million-dollar deficiencies in the procurement and supply of drugs to Government. The purchase of drugs this year is expected to surpass US$25M.
The purchases have been a major source of contention between Government and the Opposition for years now because of the seeming close relationship between its main principal and the Administration.

New GPH emergency service laying groundwork for expanded response

Just a month after the Georgetown Public Hospital’s Emergency Medical Service began operations, Emergency Medical Technician (EMT) Ron Morris found himself delivering a baby en route to the hospital.

EMT Jermaine Ifill in one of the ambulances used by the Georgetown Public Hospital’s Emergency Medical Service.

Morris, the EMT on duty, said that the service received a call about a pregnant woman experiencing severe abdominal pain. The ambulance picked Wendy Gill up from the road where she stood waiting for it and Morris realised that the baby’s head was already protruding. Left with no other option, Morris delivered the baby in the ambulance, and both mother and her healthy baby boy were transferred to the Maternity Ward upon arrival at the hospital. Morris related that this was just one of the numerous instances whereby the service was able to help individuals.

The service, which aims to ensure safe transport for ailing individuals, with the help of EMTs, started operations in March of this year.

This is according to Zulfikar Bux, Head of Department for Accident & Emergency at hospital, and who is responsible for the pilot programme, which is being undertaken by the hospital in collaboration with the Ministry of Health and Vanderbilt Medical Center in Nashville, Tennessee.

Prior to the programme, Guyana did not have a medical response system, and the city hospital’s ambulances were used primarily to transport hospital patients from one medical facility to another. According to Bux, this was detrimental because patients, especially accident victims, bore the brunt of this inefficiency and they may have been paralysed simply because they were not handled properly, or put in a brace. He said, “Getting a sick patient to an appropriate medical place, in a safe and timely manner is the goal of the emergency response.”

The EMTs, who would have graduated in January, are trained in the basic skills necessary. Bux explained, “There exists three levels of EMTs; basic, intermediary and full-fledged paramedics. What we’re doing, is starting small, with EMT basics. The plan was, to get a group of EMTs, train them so that they could respond.” Even though 20 students were trained, he indicated that some of the EMTs were allocated to different government agencies, such as the army.

The hospital currently has an ambulance working 24 hrs, staffed with two EMTs. Even though there are some technical difficulties with the telephone line, the emergency service can be reached on 913. Bux said, “The trained EMTs responding to this call will rush to the scene, stabilise the individual and ensure safe transport.” He, however, noted that “The EMTs at this time will not be administering medication based on their skill level.” There are, however, advances in this area; the EMTs will now contact the hospital via radio so that the doctors on call are made aware of the condition of the incoming patients, and consequently be prepared for treatment upon arrival. Bux said that the ambulance is immediately sent to locations so long as it is available but noted that the individuals answering the calls are trained professionals who dispatch the ambulance depending on the emergency. He indicated that because the programme is still quite new, there has not been an instance where the dispatchers have had to choose between two locations but he acknowledged that this is a problem that they are anticipating.

According to Bux, “The whole idea is to gradually train new EMT’s and expand in time, to implement phase 1 in Georgetown, then phase 2 hopefully in West Demerara, Berbice, and East Bank as these are the mostly populated areas. Once we cover the land transport, we will actually look at air medivacs.”

“The public needs to understand, that because it is such a small brigade we will be overwhelmed. This is just a start up, we’re not going to be perfect right now,” he said, while adding that with continued progress, these problems will be “ironed out.”

He indicated that there is currently a tentative plan to train an additional batch of EMTs in October to facilitate the additional of two more ambulances to the service. This training will be done under the supervision of Morris, who is the training and development officer. Morris, who was previously a registered nurse, was among the beneficiaries of the initial training programme.

PAHO Representative lauds Guyana’s HIV/AIDS gains

- prepared to support fight against stigma and discrimination

PAHO Resident Rep., Dr. William Adu-Krow

With a one percent Human Immunodeficiency Virus (HIV) prevalence, Guyana has done an admirable job in managing its national HIV/AIDS programme.  This is the assertion of Resident Representative of the Pan American Health Organisation (PAHO), Dr William Adu-Krow.
“I think a lot has been done to bring the prevalence to where it is and therefore it (the programme) has been managed well,” said Dr Adu-Krow during an interview with this publication. And it was because of such an achievement, he noted, that the United States President Emergency Programme for AIDS Relief (PEPFAR) has been winding down.
According to Dr Adu-Krow, who is relatively new to the position of Resident Representative here, Guyana has been able to do a great deal in terms of raising awareness regarding the facts and myths relating to HIV/AIDS.
However, there is yet work to be done, he noted, since there are persons such as Men who have Sex with Men (MSM) and Commercial Sex Workers (CSW) who are still marginalised in the society.
“Once society doesn’t accept them they hide and therefore it is difficult to treat them,” said Dr Adu-Krow, as he alluded to stigma and discrimination as one of the major issues that has long been threatening to hamper the gains made in the HIV/AIDS fight.
Among those mostly discriminated against, he noted, are those who engage in homosexual lifestyles. He disclosed that while there are organisations, some local, that were established specifically to advocate for the rights of such individuals, there are still some who cannot afford to come into the open for fear of discrimination.
“If they can’t come out to the open, they cannot be treated (if they are infected), if they cannot be treated then the viral load (the amount of HIV in the blood) that they have might be so high that they can transmit the virus,” Dr Adu-Krow observed.
He is therefore of the belief that there may be a great deal of persons still living in the shadows because of their sexual orientation and therefore may not be aware of their HIV status.
Moreover, the PAHO Resident Representative has concluded that “we have got a lot more work to do on this issue of stigma and discrimination, especially with the marginalised population.”
Although many are convinced that homosexual tendencies come down to an individual’s personal choice, there are many who are unwilling to openly reveal their status in light of the fact that such lifestyles could be punishable by existing laws, with men who engage in homosexual relations and cross-dressers  being specifically targeted.
But according to Dr Adu-Krow, “if we have incriminating laws whereby if you are a homosexual you can be imprisoned, the people are not going to come out to be tested for you to realise that they are homosexuals who may have HIV too.”
There have been continuous calls for the repeal of the existing legislation, a move the PAHO Representative intends to support.
“The advocacy has started, even before I came, because at the last meeting with Global Fund it was decided we needed to look at those laws and see how best legislation can come and assist us, because the more you incriminate them (homosexuals) the more they go underground and their viral load will increase in their system,” disclosed Dr Adu-Krow.
Global Fund is an international financing organisation that disburses resources globally to prevent and treat HIV/AIDS, tuberculosis and malaria. For a number of years, Guyana has been a beneficiary of the Global Fund disbursements.
According to the PAHO Representative, in light of the fact that stigma and discrimination is a hindrance to progress, efforts must be channelled to ensuring that it is not permitted, as far as possible. He made reference to early fights against tuberculosis and leprosy, both of which were affected by stigma and discrimination, thereby resulting in persons refusing to be tested. “Once you open up to these people they feel free to come and get tested and get medications so that they can prevent themselves and other people from getting the disease. So there is no doubt we still have work to do,” Dr Adu-Krow asserted.
Moreover, he is calling for efforts to be made to reach out to religious bodies to help reduce existing levels of stigma and discrimination. He noted that “normally institutions are the last groups to embrace change; individuals do change, but institutions I think are very dogmatic, so we have got to work through churches and gradually get them on board.”
And although churches may not be willing to accept certain lifestyles, Dr Adu-Krow has warned that efforts must be made to guard against shunning persons.
“From a PAHO/WHO standpoint, we need to work with all individuals without discrimination because we know we all have our own choices to make at the end of the day.”

Health Minister welcomes 11th Chinese Medical Brigade

The outgoing 10th Brigade

honours departing Tenth Brigade

THE 16-member 11th Chinese Medical Brigade, consisting of Orthopaedic specialists, Plastic and Burn Surgeons, General Surgeons, Nephrologists, Ophthalmologists, Gynaecologists and Paediatricians, among other vital medical skills, was warmly welcomed to Guyana by Health Minister Dr. Bheri Ramsaran at a reception held at the Cheddi Jagan Research Centre (Red House) in Kingston, Georgetown on Tuesday evening.

This brigade will perform duties at the Georgetown Public Hospital and at the Linden Hospital Complex, and would be engaged in medical outreaches for two years. Members of the outgoing Tenth Chinese Medical Brigade

Minister Ramsaran presents one of the Chinese doctors with an award

were present at this function, and Health Minister Dr. Bheri Ramsaran gave each an award along with a token and a book detailing the history of Guyana.

It was obviously a bitter-sweet moment for this departing brigade. Dr. Ramsaran hailed their hard working nature, and thanked each member for the sterling service they had given to the Government and People of Guyana. He said it regrettably was time to say goodbye, even as he informed them of the gratitude and appreciation of the Ministry of Health and the Government of Guyana for the work they each had done.

Minister Ramsaran making brief remarks at the function

“I urge this new team to not only work hard in the hospital, but also practise outside of the hospital. This is a hallmark of the Chinese medical team, and every time they keep getting better. Guyana is the only country in the Latin America with a Chinese Medical Team, and I hope the eleventh team continues to make the Chinese flag fly high,” Minister Dr Ramsaran said.

“You represent a strong foundation of what South/South cooperation represents. You have brought the new perspective on China. China is making its mark in the Caribbean, your presence here is significant,” Dr. Ramsaran said.

He told the incoming medical team that the Government had constructed living quarters to better accommodate them, even as Guyana

The newly-arrived 11th Chinese Medical Brigade

hopes to see an increase in their numbers.

Also at the event was Director of Medical and Professional Services, Sheik Amir; Charge d’Affaires of the Chinese Embassy, Yuying Liu; and GPHC CEO, Michael Khan.

(By Asif Hakim)

Business community urged to collaborate with GWI to effectively manage City sanitation system

Members of the head table: Executive Director, Infrastructure Planning and Implementation, Ramchand Jailal; GSIP Programme Manager, Orin Browne; Manager, Sanitation GWI, Rensforde Joseph; and Chief Executive Officer, GWI, Shaik Baksh.

At GoG/IDB seminar on GSIP…

THE Government of Guyana (GoG) and the Inter-American Development Bank (IDB), collaborating on the Georgetown Sanitation Improvement Programme (GSIP) being executed by the Guyana Water Inc.(GWI), yesterday, held a seminar on the care and management of the Georgetown Sanitation System at the Regency Hotel in Hadfield Street, Georgetown.

The aim of the seminar was to foster a long-lasting partnership with the city business community for the effective management of the sanitation system.

A section of the participants at yesterday’s seminar.

The business community was urged to collaborate with the GWI to effectively manage the sanitation system.

Speakers included Permanent Secretary of the Ministry of Housing and Water, Emil Mc Garrell, who called on the business community to utilise its corporate social responsibility programmes to assist in improving sanitation in the city.

Mc Garrell said it is essential that rehabilitation works be done to improve the sanitation system for economic advancement of the country, because sanitation needs to be addressed and recognised for its health implications; and it has long been noted that the sanitation system needs rehabilitation.

Mc Garrell said civil works are currently being done to accelerate the project to a satisfactory state, in order that the programme might deliver on its promises.

He noted that private contractors attached to the project are now in a position to repair roadways, which had been dug up due to rehab of the sanitation infrastructure.

He also spoke of the proper management of waste water, charging many businesses with culpability for discharging untreated waste water into drains and waterways.

Giving an overview of the GSIP, Programme Manager Orin Browne said the seminar was a key component of the GSIP, and was initiated through an agreement between the GoG and the IDB for improvement of the operational performance of the Georgetown Sewerage System.

He said the contract was signed on December 8, 2010, and is a continuation of the first phase of the rehabilitation of the sewer system, wherein, a huge sum of US Dollars had been expended to undertake rehabilitation works.

Browne also highlighted aspects of the system and its components as he spoke of the current road works and pipe-laying.

Sanitation Manager at GWI, Rensforde Joseph, remarking on care and management of the sewerage system, said GWI and the Ministry of Public Works are collaborating to ensure that road repairs are executed in accordance with the requirements of the contract and the high standards of quality expected.

He noted that the utility is executing full measures to ensure that the contractors (S. Jagmohan and Nabi Consortium) execute the works in compliance with the technical and environmental requirements of the contract, to ensure attainment of quality deliverables of the project.

Joseph added that, upon completion of the programme, expected in the third quarter of 2014, Georgetown residents can expect a significant reduction in sewage overflows and an overall improvement of sanitation and hygiene in the city.

(By Michel Outridge)

 

Concerns about counterfeit products and water quality spur crucial workshop

“The fate of good food in terms of labelling now rests with you,” said Resident Representative of the Pan American Health Organisation and World Health Organisation (PAHO/WHO), Dr. William Adu-Krow, as he addressed the participants of a ‘Food nutritional labelling and water testing’ workshop yesterday.

A section of the participants attending the workshop yesterday.

And there is significant progress already being made to ensure that authenticity of food labelling obtains on the market, Dr. Adu-Krow noted, as he presented brief remarks at the start of the forum held at the Institute of Applied Science and Technology building, University of Guyana campus.
“I think that you are making a lot of inroads…Based on the expertise available we are confident that food inspectors and environmental health officers will be equipped to exercise and enhance regulatory oversight on food labelling for compliance to nutritional labelling and claims as stated on the labels on food products.”
With focus on labelling features such as sample content, caloric value, claims and warnings, the workshop, which was co-organised by the Government Analyst Food and Drug Department (GA-FDD) and PAHO, is designed to examine, among others, the labelling of genetically modified foods – whole grain, processed foods, processed fruits and vegetables, and processed meats.
According to Food and Drug Director, Marlan Cole, the workshop is arguably the first of its kind to be spearheaded by his department. Nevertheless, he underscored that it could not have come at a better time, since the local market is currently inundated with counterfeit products. “This situation is not restricted to food only as it includes drugs, cosmetics, and other products as well…,” said Cole, who went on to note that it was in fact a strategic move to collaborate with supporting agencies such as PAHO and the University of the West Indies’ Tropical Medicine Research Institute (TMRI) to address the existing state of affairs.
Tasked with facilitating and sharing key information to help combat counterfeiting challenges, the visiting TMRI group includes Professor Marvin Reid, Sasha Thomas and Sardia Morgan-McDonald.
Speaking at the opening of the workshop, Professor Reid said that “the expectation from our side is that there will be a bi-directional flow of information; we will learn from you because in your own right you are all your own experts and you know what the conditions are on the ground. From our side we will try to share as much as we know to assist you in making your work much easier.”
Cole emphasised that in its earnest attempt to tackle the counterfeiting challenge, the Food and Drug Department has also been working closely with members of the National Food Safety and Control Committee and Environmental Health Officers.
“We must be able to bridge that gap between the manufacturers and the consumers, and in bridging that gap, we must be able to support determinations as it relates to the content of food, drugs or cosmetics…”

PAHO/WHO Dr William Adu-Krow (centre) hands over portable water-testing kits to GA-FDD Director, Marlan Cole, in the presence of TMRI Representative, Professor Marvin Reid (left).

According to Cole, “we must be able to say if it is low-fat, no-fat, 100 per cent free of trans-fat, free of whatever might be claimed. Any health claims an officer must be able to look at a label and make a determination and reliably inform consumers.”
He pointed out that usually products are outfitted with labels that make a number of claims for marketing and selling purposes, and it is therefore the role of entities like the GA-FDD, together with associated agencies, to ensure that these labels are authentic.
And detecting counterfeit labels may not always be a very difficult task, since according to the GA-FDD Director, “we know in many instances when a product is being counterfeited there are many mistakes with the label itself.”
As such, Cole is convinced that the workshop is one that will see crucial information being transferred from the expert TMRI consultants to the participants, who will be the ones engaged in the task of detecting counterfeit products. And according to Cole, too, “the consultants are very experienced in this area and I know the information would be used in the very best interest of our manufacturing and importing industries and our consumers will by extension be informed as well.”
This move comes at a time when consumers are already more alert about the products they seek to purchase, Cole noted, as he observed that “consumers are becoming very health conscious, they are seeking out products that are natural, that are organic, that are low in sugar and low in salt.”
Moreover, GA-FDD’s Tandica Barton in opening remarks yesterday said that the workshop is geared towards safeguarding the health and wellbeing of consumers. She pointed out that “it is with great hope that in the next few days all participants will be well informed about the important aspects of nutritional labelling.”
As such, the workshop will examine principles of nutrition; introduction to food labelling regulations, nutritional labelling and its requirements; nutrient content and health claims and the development of a food label with nutritional content.
The four-day workshop, which targets mainly Food and Drug as well as Environmental and Public Health officers, drawn from various regions, also entailed a segment on how to maintain and use portable DelAgua water-testing kits that were donated by PAHO. Aided by the testing kits, it is expected that concerted efforts will be made countrywide to test the quality of water available to the consuming public.
The testing kits are slated to be utilised mainly by environmental health workers, and at least one will be handed over to the Guyana Water Incorporated in order to facilitate bacteriological analysis of drinking water in remote areas. This process, it is believed, will address the water quality challenges that were found during a gastroenteritis outbreak in Region One last year.

No new Chikungunya cases confirmed

- as Health Ministry prepares to conduct scientific study on vector

Although there have been some reports circulating that the Chikungunya virus has been detected in the capital city, health officials have assured that no such case has thus far been  confirmed.

Vector Control Director, Reyaud Rahman

According to Chief Medical Officer, Dr Shamdeo Persaud, there have been suspected cases reported from a number of locations, but to date none has been confirmed outside of Berbice, Region Six. The number of confirmed cases, he said, remains at 14, all of which were detected in sections of that Region.
This state of affairs has been corroborated by Director of Vector Control Services, Dr Reyaud Rahman, who disclosed that the intensified vector control efforts that have been engaged, appear to be yielding results.
This publication was able to confirm that several samples, amounting to just over 80, taken from patients with flu-like symptoms complemented with fever, have been deemed void of the virus by the Caribbean Public Health Agency (CARPHA).  Also, reports are that in excess of 150 samples have since been sent to CARPHA to ascertain their status.
In the meantime, the Vector Control Unit of the Health Ministry has been directing much effort towards training vector control workers in Regions Five and Six to build capacity in those regions.
As part of its ongoing effort, the Health Ministry has been working in collaboration with a number of organisations including the Civil Defence Commission (CDC). Moreover, Dr Rahman was yesterday tasked with delivering a presentation to CDC officials about the prevention methods, control and treatment of the virus.
Also, Dr Rahman disclosed that efforts have been directed towards a capturing process, whereby mosquito larvae are caught to facilitate entomology or a scientific study. This process, according to the Vector Control Director, is one that is expected to “give us a lot of feedback.” According to him, it will especially aid the technical efforts of the Vector Control Unit, since it would be used to carry out studies to ensure that the insecticide being used to combat the vector is of good quality, among other things.
The Chikungunya virus is spread by the Aedes Aegypti mosquito which is also responsible for transmitting dengue fever.

Chief Medical Officer, Dr Shamdeo Persaud

This mosquito is known to be prevalent along the coast.
Moreover, since the threat of the virus surfaced in the Caribbean during the latter part of last year, the local Health Ministry had embraced a proactive stance whereby vector control activities were considerably increased.
But while most were expecting that the virus would strike in the city, the Health Ministry announced that its two first cases, and all others since, were confirmed in the Berbice area instead.
Soon after, a 10-member team of Vector Control officers, led by Dr Rahman, was dispatched to manage a vector control strategic action plan in Berbice. This tactical undertaking was especially designed to suppress the virus and ensure that it does not spread outside of Region Six.
Minister of Health, Dr Bheri Ramsaran, had however told this publication that it would not be unexpected for the virus to spread to other parts of the country, as people are continually travelling in and out of the affected Region. He however noted that the ideal situation would be to ensure that it is contained.
Moreover, he disclosed that the Ministry is appealing to persons to not venture into the affected areas, for the time being, in order to reduce the spread of the virus. This tactic has been recommended, the Health Minister said, in light of the fact that those infected have been found to be ‘common contacts’ which is in fact a classical way that vector-borne diseases are spread.
Cases of the virus have thus far been confirmed in Canje, Port Mourant and New Amsterdam, all in Region Six.

“Join your national association” CNO urges Region Four nurses

In a fervent quest to ensure that practicing nurses are continually encouraged to help advance the profession, Chief Nursing

Chief Nursing Officer, Tarmattie Barker

Officer, Tarmattie Barker, has voiced an appeal for them to attach themselves to the local nursing association.
Barker was at the time addressing a group of nurses during a belated observance of International Nurses’ Day last week for nurses of public health facilities in Region Four. The simple event was venued at Ramphal House, Shiv Chanderpaul Drive, Georgetown.
“I want to encourage you to join your national nurses’ association…You know it is critical when we have a body to represent us,” the Chief Nurse told the gathering of nurses.
The Guyana Nurses Association (GNA) is a non-governmental, not-for-profit organisation opened for membership from all Registered Nurses, Midwives, Nursing Assistants and Public Health Nurses. Retired nurses and care givers are also known to associate with the body.
The mission of the Association is to advance the status of the nursing profession through capacity building, an improved public image, and the maintenance of quality nursing services and care to clients.
Moreover, Barker amplified the importance for nursing associations to take advantage of fora such as the recent International Council of Nurses (ICN) meeting that was held in Geneva ahead of a World Health Assembly meeting.
While Barker was not able to shed light on Guyana’s attendance to the ICN meeting, she pointed out that among the topics that were discussed were “universal health care and the achievements that have been gained over the years, and looking at our health work force which is a critical area because we don’t have adequately trained health personnel.”
Without adequately trained personnel, Barker asserted that “we will not be able to deliver the kind of quality care and give the kind of services needed.”
This publication has been able to uncover that based on nursing statistics accumulated a few years ago, the local health system has in place in excess of 700 staff nurse/midwives, more than 300 single trained midwives, 484 nursing assistants, and some 65 medexes trained as midwives.
Also addressed at the ICN meeting, held during the period May 14 and 15, was safe quality nursing and midwifery services and care.
It saw the attendance of at least 91 national Nurses Associations.  “That was the same time during Nurses’ Week and they had many (important) discussions and deliberations…I want to say to you that I know you are a group here who should be endeavouring to be a part of the Association,” Barker appealed as she highlighted her expectation that come next year deliberate efforts will be made to benefit from the strategic forum to help build on gains already made.

Nurses gathered at Ramphal House last week for a belated observance of International Nurses’ Day

But even if Guyana were to absent itself, Barker observed, it is expected that some benefits will still “trickle down” to these parts since the local Nurses Association is a registered member of the ICN.  The ICN is a federation of more than 130 national nurses associations and therefore represents associations across the globe.
Barker mentioned too that Guyana is a member of the International Confederation of Midwives (ICM) which supports, represents and works to strengthen professional associations of midwives throughout the world. “We are moving forward by becoming part of those international organisations – International Council of Nurses, International Confederation of Midwives,” said Barker as she acknowledged that it was Guyana’s embracing of such bodies that allowed for its participation at the ICM’s 30th Triennial Congress earlier this month.
The five-day congress venued in Prague, Czech Republic, was attended by Nurse Tracy Gentle. And according to Barker, that meeting was one that addressed issues including bridging the gap between midwifery and women’s rights to increasing health care for women, the family and the community. The forum also saw the launching and discussion pertaining to the State of the World Midwifery Report.

Nevis seeks support from Guyana to set-up Haemodialysis Unit

Guyana’s health care service, particularly as it relates to the delivery of haemodialysis, is a model to be emulated.  At least this is the conviction of Minister of Health of Nevis, Mark Brantley.

The press conference in session yesterday. (From left) The Nevis team – Health Planner, Ms Shelisa Martin-Clarke; Director of Nursing, Ms Aldris Pemberton-Dias; Medical Chief of Staff, Dr John Essien and Minister of Health, Mark Brantley. The GPHC team –Chief Executive Officer, Mr Michael Khan; Director of Medical and Professional Service, Dr Sheik Amir; Director of Nursing Service, Sister Audrey Cory and Assistant Director of Nursing Service, Sister Noshella Lalckecharran

Minister Brantley and a team of technical officers from his Health Ministry are currently here on a three-day visit designed to forge collaborative ties with the Georgetown Public Hospital Corporation (GPHC) with a view of setting up a Haemodialysis Clinic in Nevis.
Haemodialysis is a procedure administered to renal failure patients to remove metabolic waste products or toxic substances from the bloodstream by dialysis.
Currently, at least, one Nevisian patient who suffers from renal failure is being dialysed at the GPHC. In fact, Minister Brantley said that the patient has been forced to relocate to Guyana for the past year in order to readily access the service.
This is in fact the situation that obtains for a number of similar cases, Minister Brantley said, that are known to attract cost factors, both financially and otherwise, whereby patients are required to be away from their families for extended periods.
Although the renal failure cases in Nevis are currently less than five, Minister Brantley said that “as a Government we have an obligation to our population to see as much as it is feasible to do, to have certain services available to them within the country so that they are not away from their families…”
And so it was against this background, he said, that a decision was made at the Nevis end to undertake what he described as a ‘study tour’ in order to “have the necessary conversations to see how we can further cement the relationship between Guyana and the island of Nevis in terms of health care.”
This has thus far translated to the Nevisian Health Minister, accompanied by his Medical Chief of Staff, Dr. John Essien; Director of Nursing, Ms Aldris Pemberton-Dias and Health Planner, Ms Shelisa Martin-Clarke touring the public hospital.
“We admire in particular the level of training you have here; the training possibilities that exist, and frankly what you have done here with limited resources is nothing short of remarkable based on what we have observed,” said Minister Brantley.
Moreover, he noted that “we feel that our people can benefit from some training and some technical assistance from Guyana and we feel that it is part and parcel of the closer collaboration that we see emerging throughout the Caribbean.”
“I would like to go on record thanking the Honourable Minister of Health here, .Dr. (Bheri) Ramsaran who met us yesterday (Wednesday) and gave us some of his time,” said Minister Brantley as he lauded the support that has been thus far forthcoming. He is optimistic that “this trip is the start of something very good and we can certainly find ways and means to cooperate.”
In fact Minister Brantley, who also has responsibility for a number of other Ministries, and functions in the capacity of Deputy Premier in his country, described the trip here as symbolic in many respects pointing out that the move can be classified as a good one not only for Nevis but also for Guyanese who have relatives there or may be residing there themselves.
Nevis, which is a part of the Federation of Saint Kitts and Nevis located in the Leewards Islands, is a federal two-island territory in the West Indies that is home to a large number of Guyanese in a population of about 13,500.
“Even though it is the first time for all of us being here, we feel that we know Guyana already…We see street names and places that we recognise from our conversations over the years,” said Brantley as he disclosed that there are some Guyanese who have been residing in Nevis for well over two decades. This, according to him, has over the years allowed for Guyana to benefit economically.
The press conference was moderated by Chief Executive Officer of the GPHC, Mr Michael Khan, who was accompanied by the hospital’s Director of Medical and Professional Service, Dr. Sheik Amir; Director of Nursing Service, Sister Audrey Cory, and Assistant Director of Nursing Service, Sister Noshella Lalckecharran.
According to Khan, “we feel very positive that we can contribute towards helping them set-up their (Haemodialysis) Unit…If I am not mistaken they already have one unit but they need to get their infrastructure in place… to get going.”  But ahead of infrastructural support, Khan alluded to need for the facilitation of training, in the near future, for Nevisian nurses.
With the promised support, Dr. John Essien said that the Nevis Health Ministry will undoubtedly be poised to have its own Haemodialysis Unit in place to even cater to the portion of the population that suffers from chronic illnesses such as diabetes and hypertension, both of which can lead to renal failure.
He disclosed that while renal failure can currently be treated through peritoneal dialysis, the need is there for haemodialysis for some of the more ill patients.
“We are hoping that this visit to Guyana will be the beginning of something very concrete on our side in terms of guaranteeing that this service will be maintained in the long run…” said Dr. Essien.

Medical knowledge at Doobay Renal Centre “tremendous” – Canadian Consultant

Dr. Christian Rabbat (at left) attends to a patient undergoing dialysis at the Doobay Renal Centre yesterday in the presence of Nurse Jennifer Fisher.

Since opening its doors in 2011, the wealth of medical knowledge at the Doobay Renal Centre has grown tremendously.  At least this was the deduction of Kidney Doctor at the McMaster University in Ontario, Canada, Dr. Christian Rabbat.
Over the past few days, Dr. Rabbat has been offering consultancy services at the Annandale, East Coast Demerara, Renal Care facility, and is among a number of other specialists from the McMaster University who have been taking turns to offer regular consultancy there.  His first visit to the Renal Centre was six months ago.

Speaking to this publication during an interview yesterday, Dr. Rabbat explained that whenever an initiative such as the Doobay Centre is implemented it is expected that a lot of learning has to happen.  “The staff needs to learn the technology, the patients need to get used to the surroundings and some of the early difficulties with getting machines up and running properly (at the Doobay Centre) were rapidly dealt with and overcome,” said Dr. Rabbat.  In fact he has attributed the tremendous success realised there to founder of the Renal Centre, Dr. Budhendra Doobay, a Guyanese by birth residing in Canada.
According to Dr. Rabbat, instead of merely being able to dialyse patients by inserting catheters into veins, medical officials at the Doobay Renal Centre have for some time now been able to undertake this task through fistulas. This is in fact a surgically created communication between veins connected to an artery into which needles are placed to aid the process of dialysis. And this method has been recognised as the gold standard for dialysing since it is known to “drastically reduce the blood stream infection rate. The blood stream infection can be a life threatening complication so we are seeing fewer of those,” at the Doobay Centre, said Dr Rabbat.
Moreover, he assured that the dialysis service offered at the Annandale, East Coast Demerara Renal Centre is on par with that obtained in North America.  “One of the things that I sometimes tell myself is that I can’t always apply the same standard that I am used to, here, but I have realised that, that statement is wrong. There is every reason why I should apply the same standards that we do at home to here to ensure that optimal safe patient care is delivered…I continue to be impressed at what the staff is doing here,” Dr. Rabbat confided.
The Doobay Centre currently has in place about eight qualified nurses who attend to patients on a daily basis and according to the Kidney Doctor, “the nursing talent that I have seen in this Unit is not to be questioned.”
“I think they provide superb nursing skills in bringing people on dialysis and taking them off, and they also provide ongoing education and supportive care that is required for this type of process,” said a confident Dr. Rabbat.
His remarks were corroborated by Dialysis Nurse of the McMaster University, Jennifer Fisher, who is working along with Dr. Rabbat.
Fisher who has been practising dialysis nursing for 15 years, disclosed that “these are very qualified, knowledgeable nurses here…essentially the dialysis unit is the same here as it is at home and I find the nurses are providing excellent care.”
“They are safe (and operate) with kindness and they take great interest in their patients,” Fisher added.
The role of a dialysis nurse includes: first weighing patients in order to determine how much fluid they must be relieved of, after which their dialysis fistula, or very rarely their catheter, is accessed so that they can be “hooked up to a dialysis machine.” Throughout the dialysis treatment, a nurse is expected to monitor patients so as to ensure that they do not develop side-effects or complications.
The nurse is tasked with removing the dialysed patient from the dialysis machine and, if necessary, provides medications.
Although the function of a dialysis nurse is “pretty straightforward,” Fisher disclosed that only an aptly qualified nurse can efficiently fill this capacity.  “This is a different kind of nursing; it is more technical than being on a ward of a hospital…not only to understand patient care but how to take care of the machine as well,” Fisher explained.