Skeldon’s own Dr Amarnauth Dukhi

By Ravena Gildharie
LESS than five years ago, neurosurgery was a vital health care service beyond the reach of most Guyanese. Patients had to look outside Guyana for even the simplest brain and spinal procedures which fetched exorbitant costs and meant that many locals faced grim realities and were often left to embrace the unfortunate hand they had been dealt. That situation is

now reversed as Caribbean patients are now seeking this speciality service in Guyana.

Guyana is now one of four Caribbean states with practising in-country neurosurgeons. The others are Jamaica, Trinidad and Tobago and Barbados. The cost of brain and spinal surgeries in the United States can reach as much as US$250, 000 (GY$50 million) based on the complexity of the procedure.

Locally, brain and spinal surgeries are offered free to residents at the Georgetown Public Hospital Corporation (GHPC) where there is an equipped Neurological Department as well as weekly clinics to consult, assess, treat and follow-up with patients requiring such. The facility is staffed by a neurosurgeon, four medical officers-in-training and a professional counsellor. Similar services are offered at almost all of the private hospitals, where advanced life-saving brain surgeries have been done at a cost of about US$20, 000 (GY$4 million).

This added feature in Guyana’s healthcare, both in the public and private sector, is linked to the gifted hands of one consulting neurosurgeon, Dr Amarnauth Dukhi, the country’s lone specialist in this field at the moment.
“I work seven days a week, but I’m on-call 24 hours…There are some weeks I have as many as 10 surgeries; other weeks I have three to four, so it varies. But so far I’ve done over 400 neurological procedures since 2015 when I returned to Guyana and started working,” Dr Dukhi told the Pepperpot Magazine in an exclusive interview.

Proud of his efforts in building a new frontier for health care in his homeland, Dr Dukhi remains humbled by the fact that there is still a long way to go, cognizant of the lack of updated technology, equipment and facilities to match neurosurgery care offered in the developed world.

For now, he remains committed to changing as many lives as possible.
Born and raised in Skeldon, Berbice, a young Dukhi at age seven, felt a calling to the medical field after his grandparents passed away at a young age. He observed a vacuum in health care especially in his rural county and was adamant to make a change. The eldest of two children, Dr Dukhi remains in Guyana while the rest of his family have long migrated.

As a student of the Skeldon Secondary, he performed outstandingly at his sitting of the Caribbean Secondary Examination Council (CSESC), but at age 15 was too young to begin medical school. He pursued a Bachelor’s Degree in Biology and biochemistry at the University of Guyana, and subsequently worked for a short period before he secured a scholarship to study medicine in Havana, Cuba. He emerged at the top of his class, shining above students from 36 different countries. The performance earned him another scholarship to pursue a double Master’s programme specialising in family medicine and neurosurgery.

CHALLENGES AND OPPORTUNITIES
Prior to the speciality programme, Dr Dukhi practised at GPHC and later at the New Amsterdam Hospital. After his double Master’s, he returned to GPHC. In some of the main procedures, he attends to brain and spinal cord tumours, repairs to spinal cord defects especially in infants and young children, fractured skull and other head trauma and bleeding in the brain. Majority of head trauma cases stem from vehicular accidents, the neurosurgeon said.

He pointed out too that a significant percentage of infants and small children with birth defects originate from remote hinterland and rural areas. Dr Dukhi believes this is due to limited obstetrics care for pregnant mothers in those communities, where simple practices such as use of pre-natal and folic acid are not popular.

The result is malformations such as babies being born with their brain outside of the skull, extending spinal cords and conditions as hydrocephalus, called water in the brain, and where there is an abnormal buildup of cerebrospinal fluid in the cavities of the brain. Children suffering this conditions may visually present with a severely enlarged head.

Last year, Dr Dukhi conducted a critical surgery on a four-year-old who suffered with what appeared as a growing bulge in his lower back. It was, in fact, a neural tube defect that the child was born with. Repair operations are recommended during the first six months of the infant’s life. Nevertheless, Dr Dukhi conducted a successful surgery, the first of its kind believed done at GPHC.

“That child is doing quite well. He is attending school now and going about his daily activities as normal. That is what gives me satisfaction to see patients recovering well and going on with their lives,” Dr Dukhi stated.
Though successful, it is cases like those that challenge the minds and hearts of not only Dr Dukhi but perhaps all in and out of the medical profession.

“Sometimes we get cases referred from the outlying hospitals which are inoperable because of the advanced condition of the tumour or the location of it and this is most prevalent in children. As a doctor, it is often hard to deal with these cases, how to tell parents and make them understand that their child is going to die because there is nothing we can do,” said Dr Dukhi.
However, he stressed that the work has to go on, and doctors have no choice but “to be strong.”

SUCCESS STORIES
This strength is fortified in cases such as that of Police Constable Victor Fausette who was shot in the head two years ago by a mentally ill man. The policeman was then age 24 and his life was placed in the hands of Dr Dukhi. The patient suffered severe lesions to the skull and brain and required immediate operation. The survival rate internationally is very low, and success in these cases can be mere “oily” or “slippery” responses. But the surgery was highly successful. Fausette is back on the job, healthy and maintains ties with the neurosurgeon who saved his life.

Then there is Clive Atwell, Guyanese boxing champ who suffered subdural hematomas haemorrhaging during a 2015 match and required emergency surgery.
Dr Dukhi did a splendid job. “Out of 10, I would rate him a nine because based on what overseas specialist said when they looked back at my scans and so, they said he did good,” Atwell told this publication. Though he subsequently underwent a second surgery in the United States, the boxer said it was Dr Dukhi who saved his life.

Omega Van Rossum is another of Dr Dukhi’s patients who calls him her ‘hero’ and feels the doctor deserves an award for his work. Rossum, 31, a military personnel, is recovering well, two years after undergoing a brain tumour surgery. Back in 2015, she saw a visiting specialist for eight months but couldn’t afford surgery that she was advised to do in Jamaica to the tune of about $16 million.

“If it wasn’t for Dr Dukhi, I might have been a vegetable by now,” Rossum outlined, adding that Dr Dukhi did her surgery at a local private hospital at an affordable cost, not even 20 percent of sum she was once quoted by the visiting specialist.
Perhaps, it is this reason why Dr Dukhi is increasingly seeing more patients from the small Eastern Caribbean and Windward Islands. These patients often travel to Guyana based on referrals from their local hospitals and practitioners.