– Ramsammy said hospital report was due yesterday, CMO’s report by tomorrow
HEALTH Minister Dr. Leslie Ramsammy said his ministry will adhere to the process, as it relates to the investigation into the latest maternal death of 38-year-old Marion Bristol, who delivered a healthy baby girl. According to him, the report from the Georgetown Public Hospital Corporation (GPHC), where the woman succumbed, was due yesterday (Wednesday) and the Chief Medical Officer’s report is due by the end of the week.
The 38-year-old, of 47 Miles Mabura Road, was transferred from the Linden Hospital Complex on Saturday last.
According to a statement from the GPHC, the woman, who has a history of having previously delivered via Caesarian Section – a case which poses an increased risk of bleeding during subsequent pregnancies, was transferred as a result of the baby having a ‘heart beat that was considered too fast and the position of the baby showed cause for concern’.
The statement added that upon the patient’s arrival at GPHC, she was assessed and it was found the baby’s heart rate had returned to normalcy.
Reports are that the patient was subsequently admitted to the Pre-natal Ward where constant monitoring was done.
“She showed no signs of pain or discomfort so there was no need for immediate surgical intervention. An ultrasound was subsequently ordered to determine whether or not a normal delivery would have had to be performed, as against a Caesarian Section (due to the position of the baby); however, due to the place of the delivery, the ultrasound was not able to be done,” the GPHC statement said.
At approximately 21:50h on Monday, the patient started complaining of pains and she was bleeding profusely.
Bristol was reportedly not in labour at the time and the bleeding continued, and she was subsequently prepared for a CS.
However, according to the GPHC statement, the 38-year-old woman went into labour and had to be delivered in the labour room.
Bristol continued to bleed and on her way to the theatre succumbed.
The GPHC statement made it clear that from the time Bristol began to experience pains to the time of her demise, no more than one and a half hours had elapsed.
The GPHC acknowledged the allegations of negligence in the recent spate of maternal deaths, but, in their statement yesterday, said, “Although medical staff battled tirelessly to preserve the lives of these mothers and their newborns, it must be stated that some deaths are unfortunately unavoidable. In these instances, complications develop wherein there is nothing the best physician or state-of-the-art facility can do to reverse the situation.”

RESPONSE
Ramsammy told the Guyana Chronicle that the Cabinet sub-committee overseeing the probe into the recent hike in maternal deaths is currently in possession of the report on the incidents.
In response to calls for an inquiry, the government mandated the Cabinet sub-committee on health to play a meaningful role in the investigations into such deaths. Cabinet Secretary, Dr Roger Luncheon revealed that instead of the ‘buck’ stopping with the Ministry of Health, the sub-committee will now have a major role in the ministry’s accountability as it relates to maternal deaths.
The Health Minister said the ministry is looking to see where systems have broken down, “if systems have broken down.”
However, Ramsammy called for some perspective by the general public, noting that while these deaths have occurred, it is the same health workers who have successfully prevented similar deaths in previous years.
“It is the same health workers who succeeded in reducing the maternal death level…I think people lose that perspective because it looks like things are worse than they ever were. That is not true,” he said.
The Health Minister added that while a “fuss” is made over such incidents, he will not “demonize” any health worker.
“I will wait for the results,” he said.
Relative to length of time taken in getting the reports to the Cabinet sub-committee, Ramsammy made it clear that this process is not a 24 hour one.
“We have to have all the facts clear. There is the post mortem report and we only have one pathologist in Guyana, Dr. Nehaul Singh. While he finishes the post mortems because of the work load, the reports take some time,” he said.
The Health Minister added that while a speedy resolution is ideal, there are many elements to be considered for a complete report.
He said, “We need to talk to the doctors and the nurses to get a good sense of what happen, besides looking at the charts.”
Ramsammy also assured that, from his level, all efforts continue to be made that the rules are in place, but acknowledged that there are cases when the operations on the ground stray from what is stipulated.
However, he reiterated the fact that there have been successes in maternal health care, something that should be acknowledged.
“The maternal deaths have reduced by half over a period of five years,” Ramsammy said.
There were four maternal deaths in five weeks in Region Six (East Berbice/Corentyne) that have raised concerns, followed by other deaths at GPHC.
According to the Health Ministry, there have been approximately 17 maternal deaths for the year.
Recently a report, ‘Trends in Maternal Mortality’, was released by the World Health Organisation, UNICEF, the United Nations Population Fund and the World Bank.
It indicated that the number of women dying annually from pregnancy-related complications had dropped by 34 per cent; from 546,000 in 1990 to 358,000 in 2008.
The report listed the major causes of their deaths as severe bleeding after childbirth, infections, hypertensive disorders, and unsafe abortions.
Goal Five, of the eight Millennium Development Goals (MDGS), targets the improvement of maternal health, which is expected to be reduced by three quarters, between 1990 and 2015.