A Partnership for National Unity accuses the People’s Progressive Party/Civic (PPP/C) administration of mismanaging the national primary health care system. The result is that the system is failing women, children and the aged, especially in hinterland and rural areas.
The primary health care system is meant to provide access to good health care for all – whether they live on the coastland or in the hinterland, in town or village. The PPP/C administration, however, seems to be incapable of solving the problems of health administration. It is now freely admitted that Guyana’s targets to achieve the United Nation’s Millennium Development Goals – MDGs – Four and Five which concern the reduction of both maternal and infant mortality rates are unlikely to be met by 2015. Several severe problems hinder the national primary health care system.
- Administrative incapacity is the severest systemic impediment to the delivery of health care. The Minister of Health is on record as having lamented, “We are somewhat alarmed at the level of Cabinet about the maternal mortality deaths…”
- The administration’s clumsy treatment of its nurses and its attitude to their training is the second source of serious problems. Officials of the Guyana Nurses’ Association and Georgetown Hospital expressed alarm at the highfailure rate – about 85 per cent – of a recent batch of nurses from the Georgetown School of Nursing, Charles Roza Nursing School and the New Amsterdam Nursing School.
- The functioning of regional hospitals and community health centres has also contributed to the weakness of the national primary health care system. The Ministry of Health has had to react to problems affecting nurses at the Linden Hospital Complex and at the West Demerara Regional Hospital (Region No.3) where nurses and other staff members threatened to strike in order to call attention to the non-payment of allowances and to the security lapses at the hospital. The Parika Health Centre has to be closed every time the rain falls because the building floods. The Skeldon Health Centre was abandoned a few months after it was commissioned.
- Health care delivery is erratic. The Minister of Health publicly lamented the “general dissatisfaction among Berbicians (in Region No.6) about health services being provided.” He threatened that health care officials would be made to ‘face the music’ more often and to account to the public for their actions.
- Ministry of Health bureaucrats seem to have no idea of cost, distance and difficulty of transportation and communication in the hinterland. Staff at Imbaimadai Health Centre (in Region No.7), for example, was simply instructed to send seriously ill patients to Kamarang – a long journey usually by costly, privately-owned boats. There have been unnecessary deaths from snake bites and malaria owing to a lack of medication. St. Cuthbert’s Mission Health Centre (in Region No.4) often turned away older patients owing to the lack of drugs. A child died last month as a result of a diarrhoea outbreak at Masakenari Village in the Rupununi (in Region No.9).
- The Ministry seems to be incapable of preventing, or responding promptly, to the prevalence of preventable diseases. Data indicate that there were 144 deaths over a 12 year-period from 2001 to 2012 owing to Acute Gastroenteritis-Acute Diarrhoeal Diseases. 61 per cent of all deaths were children – five years or younger. Every year brings more deaths, most recently in Region No.1.
- The high cost of medical evacuation has been a consequence of dysfunctional community health centres. The Ministry of Health spent more than $25M to facilitate the medical evacuation of emergency cases from hinterland areas in 2011 because patients could not receive care at the regional hospitals.
- The absence of a national ambulance service and a corps of emergency medical technicians is the source of yet another problem. The entire country has only about 25 ambulances.
- The Ministry of Health has been confounded continuously by the costly challenge of wanton waste and disposal of expired drugs. The Auditor General’s report revealed that $49.498M worth of expired drugs was dumped by the Georgetown Public Hospital Corporation alone last year.
The PPP/C administration’s thrust to achieve universal health coverage through the primary health care system has not been a success. Its failure to prevent maternal deaths, to protect vulnerable children from deadly gastro-intestinal diseases and to provide adequate care for the aged has lowered the quality of life for many Guyanese who depend on the flawed system.