Dear Editor,
THE Region Six Health Department is grateful that a letter dated 24th of July, 2022, captioned “Gov’t’s healthcare programme lacks equity in rural areas” provides an opportunity to highlight the significant improvement in the health sector of Region Six over the last two years.

After many years of improvement, the Region Six health sector experienced some serious setbacks after 2015. For example, X-Ray services at the New Amsterdam Hospital virtually disappeared. The National Ophthalmology Hospital virtually closed. Medicine and medical supplies were scarce. On several occasions, the operating theatre at the New Amsterdam Hospital was closed because of unavailability of supplies and poor equipment maintenance. Laboratory service throughout the sector in Region Six was sporadic. The New Amsterdam Hospital’s mortuary was down most of the time until 2020. Mibikuri Hospital functioned more like a health centre. The Port Mourant Ophthalmology Hospital almost closed and the National Psychiatric Hospital was a national scandal. Community outreach programmes, especially to riverain areas, came to a halt.

Since late 2020, the Region Six Health Department resumed the community outreach programmes. These outreach programmes are critical, as the sector pursues health equity. The operation of Level 1 (Health Posts) and Level 2 (Health Centres) is very important to ensure equity in health care. These facilities are where women seek antenatal and postnatal care and where children’s vaccination programmes ensure that all children are protected from 18 deadly vaccine-preventable diseases. In 2021, infrastructural upgrades were done to all the Health Centres in Region Six at a cost of about $100M. In the case of Orealla and Siparuta Health Centres, deep in the Corentyne River, both were provided with ATVs in early 2022 to allow the health workers to conduct outreaches to persons who had difficulties in accessing healthcare. We have also developed vaccine-storage capacity at the Siparuta Health Centre. These health centres have permanent doctor-led services. Thus far for 2022, four specialist outreaches have been done in Orealla and Siparuta. Bara-Cara equally benefitted, with six medical outreaches already for 2022, including ultrasounds and VIAs being made available for the first time on these outreaches. VIAs are critical for cervical cancer diagnosis and treatment. Our reports indicate a total of 63 outreaches being done for the year thus far with 12 alone being conducted in the month of July. This is also the highest number of outreaches recorded for Region Six to date. These outreaches also catered for the homes and orphanages in the region.

All health centres now have visiting doctors and scheduled chronic disease clinics. In some health centres we have added specialised services such as dental services and VIA services.

The region, working in collaboration with the MoH, has ensured the expansion of the Emergency and Outpatient Units with additional services added. Thus far for 2022, more than 100 ultrasounds have already been done at Mibikuri Hospital. Before now, these persons would have had to travel to New Amsterdam or to Port Mourant for ultrasound or be referred to a private facility. ECG is now also a routine service at Mibikuri. Specialist clinics for the NCDs, such as diabetes, high blood pressure and heart diseases, have now been resumed at Mibikuri Hospital. In addition, digital X-Ray equipment has been procured and is awaiting installation.

Equipment has also been procured for the laboratory services. Once installed, fewer persons would be referred to the New Amsterdam Hospital from Mibikuri Hospital. The health sector is also working on commissioning a mortuary at the Mibikuri Hospital. This hospital is one of the hospitals where telemedicine will be added in 2023/2024 to permit radiologist-led imaging diagnostics and ophthalmologist-led diabetic eye-screening.

The Port Mourant Hospital is, indeed, an old hospital. This hospital is on the re-development programme in the next few years. In the meantime, outside of adding doctors to the roster to raise the level of care, some significant improvements are visible. There are now routine ECGs, ultrasounds, and X-Rays. The X-Ray has been installed this year and because it is a modern digital X-Ray, it will be linked to the GPHC via a PAC system to permit the GPHC radiologist to help in diagnosis. The laboratory has been improved with new equipment that allows more laboratory testing to be done. A new TB clinic has started. There is also now a mortuary.

Beginning in a matter of weeks, the construction of a new hospital at #75 Village will begin. This new hospital will replace the old Skeldon Hospital (Level 3). The new Skeldon Hospital will function as a Level Four hospital, like the New Amsterdam Hospital. But that does not mean that efforts to improve the old hospital will not continue. A range of new medical equipment, such as ventilators for critically ill patients, ultrasound and ECG, have been added. A new, refurbished Male Ward has been commissioned. A new ambulance was also handed over to the hospital recently.

The New Amsterdam Hospital now has three fully functional operating theatres and an Infectious unit has been added. The hospital is now capable of an expanded range of surgeries, including laparoscopy surgeries. On the 13th of July the first Arthroscopic surgery was done at the said hospital and the patient is in the recovery process. CT imaging is now done at the New Amsterdam Hospital, with more than 1600 done free of charge, including CT with contrast, since last year. The CT is linked to the GPHC through a PAC system, permitting teleradiology service with specialists from GPHC. With this technology, referrals to GPHC have been severely reduced. Two new ultrasound machines allow upgrades in the service available in the emergency room.

The National Ophthalmology Centre which for most of the period 2015 to 2020 was literally closed resumed full operations this year. Since February 2022, surgeries, including cataract surgery have resumed. So far this year more than 1,047 surgeries have been done, with another more than 1,000 scheduled for the next two months. Presently, cataract patients from Regions 1 to 10 are receiving cataract surgery at Port Mourant.

This is just a cursory glimpse of the upgrades that were done in the Region Six health sector. Only recently the Parliamentary Committee on social services headed by Dr Karen Cummings, an Opposition MP, visited the health institutions in Region Six and was particularly pleased to see the significant improvements in the health sector in just the last two years. One of the sore challenges in the period after 2015 was the frequent massive medicine shortage. This year so far, shortages have been almost eliminated, with availability between 85 and 95 per cent.

The improvement has translated in the significant improvement in regional indicators showing a 46 per cent reduction in transfers to GPHC, from 407 in 2017 to 220 in 2021. In 2021, 19,206 X-rays were performed, the highest recorded to date. Similar increases have been recorded for ultrasounds, ECGs, CTs and laboratory tests. All the diagnostic departments in our level three and four facilities (hospitals) have been fully functional with the aim to reduce downtime, and this is reflective in our indicators. In 2022, so far, Region Six has recorded no maternal death and has recorded improvement in stillbirths and neonatal mortality rate.

The dialysis unit at New Amsterdam Hospital is fully operational and we have even had an increase in patient load from 18 to 25, to date. We are also in the process of setting up a Regional Oncology Unit which is expected to bring further relief to the residents of Regions Five and Six.

The Regional Blood Bank for 2021 has exceeded its target and collected 2007 units blood for 2021, which is also the highest to date. This is another area where we have begun to exceed our targets significantly.

While there remain major challenges, the health sector in Region Six has seen significant improvement in every facility and the improvements have translated into better outcomes. While emphasis has been placed on quality of service, patient-experiences have been particularly prioritised. This is the reason much attention has been paid to waiting areas, rest room facilities etc. It is no accident that the Parliamentary Committee in its recent visit commended the region for the visible improvement in health. This improvement is seen in both the environment and the quality of care at the National Psychiatric Hospital. As one enters the National Psychiatric Hospital, the improvement becomes immediately visible.

Rebuilding and re-establishing health services for Region Six have been challenging tasks. These were compounded by the COVID-19 pandemic. While we acknowledge that there remains vast room for improvement, the letter writer appears to either be unaware of what is taking place in the sector, or that he relied much on hearsay.

The doctors, nurses and the allied health workers have been working hard to regain the confidence of people in Region Six.

Yours sincerely,
Dr Vishalya Sharma