– 319 trained since

By Rabindra Rooplall

OVER the past four decades, Guyana’s Medex Programme has produced a total of 319 persons who function primarily in the rural, riverine and hinterland areas.
This is according to Chief Medex of the Health Ministry, Lolitta Rebeiro, who noted that for 42 years, the Medex Programme has been contributing significantly to the public healthcare system.

The first batch of 22 medex graduated on October, 18, 1978 and was immediately dispatched to Health Centers and District Hospitals in the remote areas of Guyana. The training programme was, and is still accredited by the University of Guyana.
Since then, the programme was further developed as a direct response to the limited number of qualified medical doctors to staff all facilities countrywide.
According to Rebeiro, the programme is governed by the Legislative Medex Act of Guyana of 1978, which was set up after the founder of an international medex programme, Dick Smith, approach the Government of Guyana.

“He offered to facilitate the training of local mid-level healthcare practitioners to serve the citizens living in the remote areas of our country,” Rebeiro said.
She explained that medex are trained to perform specific duties and is a member of a team, which includes a doctor.
The medex, she said, should be supervised by a doctor as they perform specific and routine tasks, thus relieving the doctor of these relatively simple tasks.
Rebeiro explained that medex were trained to focus on treatment and management of patients in and out of hospitals and were referred to as “Barefoot Doctors.”

Over the years, the curriculum underwent a few changes whereby the first few batches were trained in dentistry but then was eventually made into a separate training programme.
In 2006, a batch of 26 students embarked on a 42-month training under the theme ‘The New Pathway’, which allowed school leavers who did well at their CXC to enter the programme.
This programme, she explained, included training in midwifery; two batches of medex of this nature were trained since then and there is currently one batch in training.
Hailing from Region One, Moruca (Barima-Waini), Rebeiro has been serving in the health sector for 20 years. Starting as a Registered Nurse in 2000, she worked as a medex from 2006; she was appointed Chief Medex in January 2016.

“Medex are mid-level managers. At present, they are responsible for the maternal and child health aspect of healthcare in their respective region or sub-district. In some areas, they are also responsible for chronic Non-Communicable Disease clinics especially where there is no doctor,” she noted.
The Chief Medex said there is a need for at least 73 more medex in the public health system to provide adequate health coverage.
She explained that currently, 34 are already undergoing a four-year-training programme, which will guarantee them each an Associate of Science Degree upon successful completion in 2022.