…in wake of another childbirth death at New Amsterdam Hospital
Cabinet calls for Inquiry into maternal deaths at New Amsterdam Hospital
THE recent occurrence of yet another death of a mother in childbirth at a hospital in Berbice has resulted in Cabinet expressing its dismay during its last Statutory meeting on Tuesday at the Presidential Complex in Georgetown.

Cabinet also called on Minister of Health Dr Leslie Ramsammy and the Ministry of Health to do all that is necessary to protect the lives of women at childbirth. This follows the specific case of Esther Dwarka-Bowlin,  acting Headmistress of the Princetown Nursery School in Corriverton, who died sometime between Friday night and Saturday morning at the New Amsterdam Hospital.

Another young mother died yesterday at New Amsterdam Hospital in Berbice, the fourth within the last five weeks.

Twenty-one-year- old Yogetta Bisham has left her newborn daughter whom she delivered yesterday morning.

The others who died recently in childbirth were Rebekha Chinamootoo, 26, of No. 36 Village, Corentyne, who died after giving birth to a healthy baby boy by ‘c-section’; and Nadira Sammy, a pregnant teenager of No. 69 Village who was diagnosed with high blood pressure and died two days before she was due to have her baby via ‘c-section’ as well.

“Cabinet has called on the Health Minister to ensure that investigations into the matter be concluded soonest and within the set time-frame,” Secretary of the Cabinet, Dr Roger Luncheon announced at a post-Cabinet briefing yesterday.

Additionally, Cabinet mandated that officials in the Ministry of Health, Regional Health Services and other personnel in whatever way related to the investigation and the delivery of care at the institution, be present at a specially summoned Cabinet sub-committee to deal with information and clarity regarding the incident, and to focus on steps towards improvement.

According to Dr Luncheon, Cabinet insisted that the Ministry of Health was the recipient of significant resources dedicated to maternal Health Care. And so it is reasonable to expect achievements based on successes in other areas of health and political will.

Two months ago, the Ministry of Health said it is intensifying its fight against childhood illnesses, and maternal deaths – the fourth and fifth Millennium Development Goals (MDGs), as it continues to pursue a life expectancy of 75 years by 2015.
Minister Ramsammy, in a statement to the media in mid-August, said these areas are the most important public health goals of the sector in the next five years to 2015.
The Ministry of Health, according to him, is not contented in meeting the MDGs four and five; rather it is determined to reach targets for child and maternal mortalities that bring Guyana on par with more developed CARICOM countries.
In this context, the Health Minister noted that the Ministry has intensified its efforts to reduce childhood-related morbidity and mortality in Guyana.
Ramsammy even outlined an aggressive programme to combat the two main causes of deaths and illnesses among children in Guyana, and noted that the programme to reduce child mortality is intended to ensure Guyana has no problem in attaining MDGs four and five by 2015.

SIGNIFICANT REDUCTION
Ramsammy said Guyana has achieved significant reduction in childhood illnesses and has made progress in the fight against childhood-related morbidity and mortality.

“Indeed, Guyana is on pace to achieve the childhood-mortality related MDG four. For the latest verified year, 2008, the under-5 mortality rate was 19 for every 1,000 children, with a total of 286 recorded deaths of children under 5 years. For comparison sake, the under-5 mortality rate was estimated to be 120 in 1990.  Since 1990, Guyana has achieved a greater than 80per cent reduction in childhood mortality,” he said.

He noted that, in terms of childhood mortality, the two major causes of deaths are acute diarrheal diseases (ADD) and acute respiratory infections (ARI).

ADD and ARI together reportedly account for 8.7 deaths per 1,000 children and together accounted for 46 per cent of all deaths of children under 5 years in 2008.

ADD caused an average of 5.2 deaths per 1,000 children under 5 years, accounting for 27per cent of all deaths of children under-5 years in 2008. This makes diarrhea the leading cause of death among our children.

ARI caused an average of 3.5 deaths per 1,000 children, accounting for 19 per cent of all deaths of children under-5 years in 2008.

ARI was the second leading cause of deaths in Guyana.

Globally, ADD and ARI are the two leading causes of deaths among children. Together these two causes of children deaths account for more than 40 per cent of all children deaths in the world.
This is similar to the situation in Guyana where these two causes are responsible for 46 per cent of all children deaths.

ADD accounts for 17 per cent and ARI accounts for 19 per cent of all under-5 children deaths in the world. While the ARI global contribution to children under-5 deaths (19 per cent) is similar to the contribution of ARI to children deaths in Guyana (19 per cent), the contribution of diarrhea to children deaths in Guyana (27 per cent) is much higher than the average contribution of diarrhea to children deaths globally (17 per cent).

In terms of morbidity (illness) among children, ARI and ADD are also major causes of illnesses. ADD resulted in almost 12,000 recorded childhood illnesses in 2008.

“This merely reports those cases of gastroenteritis which were serious enough for the family to take ill children to the health care providers. Of the total number of diarrheal cases recorded that year, almost 46 per cent of them were among children under-5 years. There were about 26,000 cases of diarrhea recorded that year for the whole population,” Ramsammy said.

He pointed out that acute respiratory infection still ranks as the number one cause of illnesses (morbidity) among children, with about 40 per cent of all illnesses among children under 5 years.

The Health Minister said, “Most of the deaths due to ADD and ARI are preventable. The Ministry of Health is further intensifying our efforts to prevent ADD and ARI-related morbidity and mortality.”

Partners
The Health Minister, in his statement, noted that the Ministry has been working with the Pan American Health Organisation / World Health Organisation (PAHO/WHO) and the United National Children’s Education Fund (UNICEF).

These collaborations, according to him, are important in strengthening and expanding these responses.
In addition, the Ministry of Health is working in collaboration with various sister Ministries, such as Water and Housing, Education, Local Government and Amerindian Affairs, and with local government organs such as Regional Democratic Councils (RDCs), Neighbourhood Democratic Councils (NDCs) and the Amerindian Councils, to ensure optimal implementation of several other programmes.

Ramsammy stated that these initiatives, if effectively implemented, could mean a further 50 per cent reduction in illnesses and deaths among Guyana’s children by 2015.

Minister Ramsammy said, “Our children are more than our most important assets. The determination to have our children grow up to be productive adults is a moral imperative and establishes a chart for a development path that guarantees our country a future of no poverty and a future that is in keeping with our destiny – El Dorado, a land of plenty, a nation in which dreams are a part of every child’s future and every child is guaranteed a long, productive life”.