Dear Editor,
I HAVE heard and written of shocking stories from the GPHC dating back to the PPP’s time in office. I think the PPP should take most of the blame for the problems that are happening in the health service. They had 23 years to address them. They did not. They politicised the GPHC and the medical council. They politicised the entire health care system. The government should take the blame for not correcting and addressing the ills of the health service. Three and a half years are not enough to correct 23 years of mismanagement. Hopefully, if given another term in office, we may see tangible evidence of changes for the better for the long-suffering patients.

I have heard and written of coronary angiograms and stents being undertaken without cardiothoracic back-up by a doctor at the CHI who is not recognised as a specialist by the country where he did his fellowships. Dr. Madhu Singh of the Balwant Singh Hospital, aptly summed it up as playing Russian roulette with patients’ lives.

I have heard and written of renal transplants being undertaken without a recognised renal transplant surgeon, without the basic facilities to monitor and manage the transplant kidney and without the facilities and skills to manage complications, if they arise during or after transplant of the kidney. I have heard and written about an emergency department that will be expanded to a trauma centre without a recognised emergency consultant or trauma consultant, with nurses without a clue of trauma medicine and with limited paramedic service. I have heard and written of the establishment of a Neonatal Intensive Care Unit(NICU) without a neonatal intensivist, where doctors are not just guessing and learning on the job, but are also totally incapable of doing competently, basic invasive medical procedures

Now this. Vincristine, a potentially deadly chemotherapy drug being administered intrathecally. Mr. Editor, not with one patient, not with two patients, but with three patients who are now dead.

The World Health Organisation (WHO) and the Institute for Safe Medication Practices (ISMP) strongly recommend that Vincristine should NOT be delivered to the patient at the same time with any medications intended for CNS administration (intrathecal). The reason is simple. Mix-ups can occur and vincristine, which should only be given intravenously and is deadly if given intrathecally, can be accidentally mixed up with the intrathecal drug and given intrathecally.

I read in the printed media that the vincristine was being administered simultaneously with another chemotherapy, methotrexate. Methotrexate can be given intrathecally. I suspect this is where the mix-up occurred. The vincristine was mistaken for methotrexate and given intrathecally.

I also read that the junior doctor who administered these drugs was being supervised by a senior doctor. Was this senior doctor sleeping when these mistakes were repeated not once, not twice, but three times? I don’t think this senior doctor was sleeping. In my opinion this senior doctor did not know what he/she was about; hence, he/she could not recognise the danger. He/she may be one of those calling him/herself specialist when he/she is not. Something the PPP should have addressed when in power for 23 years. Developing a non-political medical council and a non-political independent body to review credentials of doctors who return as “specialists.”

What is happening is not new. It was happening long before Dr. Walter Ramsahoye was President of the Medical council. When Dr. Ramsahoye was fighting this battle I was in high school. He fought tooth and nail to ensure that those returning to Guyana were actually specialists. A specialists’ register he wanted to establish. That battle he lost because the masqueraders outnumbered him. I have now taken up that battle. I have been writing about this for years. Like Dr. Ramsahoye, I was attacked. Dr. Mahendra Carpen of the Caribbean Heart Institute emailed my boss at Nottingham University Hospital complaining that I have been peddling misinformation, which is affecting his patients. My boss saw the letters and had no concerns since they were medically sound. They were based on facts and international standards and medical evidence established by Randomised Controlled Trials. Evidence Based Medicine, the term. Dr. Carpen could not counter what I had written and continue to write, hence he tried to silence me. Dr. Carpen literally pleaded with my boss not to release his name and his email to me. My boss requested to know why. No answer was provided by Dr. Carpen. He went silent after his cowardly email, hence I was told and saw the email. I remain fearless and continue to write, identifying myself, my workplace of contact, my email address and phone number, not requesting to be anonymous and prepared to defend what I write. A true medical soldier. Dr. Carpen was not the only one. Dr. Kishore Persaud, the so-called transplant surgeon at the GPHC would upload my letters to Facebook and he and like-minded persons would attack me. Why attack me? Just simply use the printed media to counter what I have written and continue to write. The fact is that they can’t and they hope I become scared and stop writing when they attack me. And I can provide many other instances of me being attacked, but I just continue to write. All of them hiding behind the cloak of an incompetent and useless medical council.

The fact, Mr. Editor, is that this battle cannot be won if I am the only one involved in this campaign. I have provided advice on multiple occasions on how the government can review the credentials of doctors who return to Guyana and claim to be “specialists.” It is very simple, completely ignore what they have done. Guyana lacks the skills to assess this. Simply request to see the certificate of completion of specialist training that they should receive if they had completed specialist training. Contact the institution to make sure the certificates are genuine. Without the certificates they are not specialist and will put patients’ lives at risk.

Last week three young angels died and thousands died before them. My mother died at tghe GPHC when I was eight years old leaving five orphans — the youngest eight months — who were not guaranteed a daily meal. That’s why for me it is personal. Today is Oncology. Tomorrow may be Cardiology, Renal transplant,NICU or A&E. I pray it never happen, but it will happen if the problems I’ve highlighted are not addressed. I pray this should be number one priority of the government if re-elected. The PPP can’t, since nothing was done in 23 years, leaving me to conclude that they simply don’t have the know-how or simply wish not to fix the problem for political reasons.
Regards
Dr. Mark Devonish MBBS MSc MRCP(UK) FRCP(Edin)
Consultant Acute Medicine
Nottingham University Hospital
UK’