A GINA Feature
THE Health Ministry embarked on a mission in 2011 to ensure that all Guyanese, irrespective of age, location, gender and ethnicity, access health care that caters to their needs. And by the end of the year, it was evident that the sector’s progress in 2011 was unmistakable, with the opening of a new in-patient wing at its main hospital, the formalising of the pact with the Indian government for a 250 – bed specialty hospital, increased training of professionals, the dispatch of overseas trained doctors, introduction of new vaccines and significant investments in the up-grade of the numerous health facilities across the country, while new services were offered.
This success was realised as a result of the $14B allocated in the national budget for improving the quality of services provided, through continued efforts of enhancing infrastructure and human resources, and the delivery of the publicly guaranteed health services.

GPHC
The Georgetown Public Hospital Corporation (GPHC) continues to be the premier health institution in Guyana; and to ensure it sustained a high level of service, a new 300 bed in-patient facility outfitted, with modern amenities, was opened in the latter part of the year.
With regard to the services provided, apart from the delivery of out-patient services, the institution conducted over 6,000 scheduled and emergency surgeries, including general surgery, orthopaedic, paediatric, urology, maxilla-facial, plastic surgery, OBS/Gynae, ophthalmology, ear, nose and throat, and neuro- surgery.  

Decentralised services
Over the past years, government has also invested in decentralising health services, ensuring all Guyanese have access to health care closer to their homes. This effort has seen the construction of a number of health centres, huts and hospitals around the country. In 2011, several new health centres became functional, including the Tuschen and Zeelugt centres in Region 3.
Meanwhile, renovations were also done at the GPHC, Diamond, West Demerara, Fort Wellington, and Bartica hospitals, and at numerous health centres, including Buxton and Campbellville, and the Enmore polyclinic. In cases where the facilities do not have surgeons to conduct surgeries, roving teams of doctors visited hospitals in the hinterland, while serious cases were medivaced to the city.

Specialty Hospital
Government has long displayed its interest in ensuring advanced health care is accessible in Guyana, since many people needing complex care have to travel overseas. As a result of this interest in the well-being of the citizenry, in February former President Bharrat Jagdeo and newly appointed Minister of Health, Dr. Bheri Ramsaran, visited India, returning with the good news that the envisioned specialty hospital would be funded by an Indian line of credit. Government has since injected $97M for the site preparation at Liliendaal.
The 250-bed hospital, when completed, will provide services including cardio-related and cosmetic surgeries and organ transplant. Construction is expected to begin by the first quarter of this year.

Enhancing capacity
From the start of the year, the health sector prioritised training for its personnel, thereby continuously building capacity to ensure services are effectively delivered, while providing added manpower for the delivery of additional services. To further advance training initiatives in 2011, $345M was injected into the sector.  
In March, 105 youths commenced training in the pharmacy assistant, environmental health assistant, medical laboratory technicians and x-ray technician programmes. In October, a second batch of trainees was inducted, including 117 professional nurses, 63 nursing assistants, 31 medical laboratory technicians, 24 pharmacy assistants and 27 environmental health assistants.
Twenty eight persons from the 10 Administrative Regions, except Regions 4 and 5 also started training in the Community Health Worker (CHW) programme. They received specific skills and knowledge that enable them to drive the delivery of care in the primary health care system, much like the medex. Upon completion of training, they are expected to provide basic care in their respective communities. 
These programmes ensure doctors and nurses have sufficient and effective support in the delivery of health care services. Additionally, an information technology component will also be added to programmes, to further enhance the trainees’ abilities.
Post-graduate psychiatric and anesthesiology programmes are also available for nurses, while doctors can also access post-graduate training at the GPHC. Additionally, three Guyanese doctors began training in ophthalmology in Guatemala and Paraguay.
Importantly, 34 trained doctors were dispatched to function at various health facilities around the country to provide a higher level of service.

Continued Eye care services
The Regional Health Services (RHS) Unit, having recognised the need for eye care at the grass-root level, conducted medical outreaches in several communities, including Agricola, Buxton, Cane Grove, Ann’s Grove, Enmore, Ithaca, Number 9 Village, Bath Settlement, Leguan, Wakenaam and Suddie, and at the National Toshaos Conference.
This year, over 1900 people were screened for eye-related defects, and were diagnosed with cataract, pterygium and refraction errors. While some received surgeries, others were prescribed reading and prescription glasses.
The RHS also added VIA screening to the package of care delivered during the outreaches. Hundreds of Guyanese have taken part in the outreaches which have proven to be convenient and cost-effective, particularly for the elderly. 

Addressing NCDs
The year saw the Health Ministry playing a significant role in advancing the non-communicable diseases (NCDs) agenda on the international stage, at the United Nations General Assembly’s 66th session in September. This has resulted in the world now appropriately acknowledging NCDs as a new front in the fight to promote global public health and poverty. 
Not only did Guyana contribute to the planning of the session, attended by a number of world leaders, but the former Minister of Health, Dr. Leslie Ramsammy, presented a declaration on NCDs, which is separate from the MDGs document, since it has been recognised that the NCDs contribute to a large number of deaths worldwide.
Guyana’s involvement in the preparation of the declaration reflects that, in terms of size, small countries can make a difference; in this case Guyana stands out.
Another step was taken by the Ministry of Health to address the impact of NCDs, this time with emphasis on gender, which is a structural determinant of health, meaning that it is part of the fabric of people’s lives with its norms, roles and relations affecting exposure to risk factors and health outcomes of the four major NCDs – cancer, cardiovascular, chronic respiratory, and diabetes.

Strengthening HIV/AIDS fight
In advancing the fight against HIV/AIDS, efforts were taken a step further with the institutionalisation of the HIV Drug Resistance Monitoring programme. Guyana is the first in region to introduce such an initiative, and this has resulted in more than 80 percent of the persons who should be on ARVs receiving treatment.
Additionally, over 40,000 people were tested for HIV during the National Week of testing, as compared to 35,000 during the same exercise in 2010.
Guyana’s 2011 MDG impact report highlighted that there has been steady progress towards meeting the sixth goal of combating HIV/AIDS, malaria and other diseases. Government has been successful in its use of a multi-pronged approach to combating HIV/AIDS, with increased awareness of the disease, promotion and provision of testing, the use of preventative measures, and the expansion of available treatment. These actions have resulted in the decrease of HIV prevalence and increased survival of those infected. 

Enhancing maternal health/ reducing child mortality
The Health Ministry took a stand to address maternal/infant deaths by emphasising early identification of high risk pregnancies, exercising good practices, and the effective provision of services at health centres.
The 2011 MDG report, with regard to maternal health, points out that there has been a reduction in maternal mortality and access to reproductive health has increased. Improvements in maternal health have been bolstered by almost universal antenatal care coverage, increased access to improved facilities, and the fact that over 96 percent of births are now attended by skilled health personnel.
The year 2011 also saw the world reaching its seven billion population mark. Several new mothers were honoured by the Health Ministry which committed to work towards ensuring every child lives a long and healthy life.
As for the decline in child mortality, this is attributed to the successful implementation of the nutrition, maternal and child care programmes, expanded immunisation coverage and the Prevention of Mother-to-Child Transmission (PMTCT) programme.
The ministry added another antigen to its stock of 15 — the pneumococcal conjugate vaccine (PCV13), which protects against 13 strains of the pneumococcal infections which severely affect young children. Additionally, the HPV vaccine was also made available in Guyana as a counter agent for cervical cancer.

Observances
The ministry observed several critical health days, including World Sight Day, Caribbean Wellness Day, World TB Day, and World Cancer Day, among others.
Guyana observed World TB day 2011 under the theme, “On the Move against Tuberculosis, On the Road to Elimination.” This event saw the launch of the ‘TB free’ campaign and the commissioning of the refurbished TB Unit and digital x-ray machine at the Georgetown chest clinic.
Health professionals in Guyana observed World Blood Donor day under the theme “More Blood Donors more Healthy Lives”.
This was in tandem with a mandate given to the National Blood Transfusion Service to recruit more voluntary unpaid blood donors to bring in at least 90 % of voluntary blood donation in 2011.
The Health Ministry also continued to build its relationship with its local and international partners.