Tony Vieira's Comments
22 October 2017

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Health
(Aired 5 July 2005)

   Compared to our neighbours Guyana ranks poorly in regard to delivery of basic health care. Years of neglect and incompetence in this sector has left us with a health care infrastructure incapable of serving our people. And it is killing us.

    A 1999 survey tells us that the life expectancy in this country is 66.5 years. This compares unfavourably with Suriname 72 years, Venezuela [where 78% of the people live below the poverty line] 73 years, Trinidad and Tobago 74 years, Jamaica 75 years and Barbados 76.5 years. Maternal mortality rates are also unacceptably high 125 /1000 births compared to 50/1000 in Barbados and 75/1000 in Trinidad, in other words twice as many mothers die in childbirth here than in Trinidad and nearly three times more than in Barbados.    

   Despite increases in budgetary allocations to the public Hospital Georgetown, and the Ministry of Health from 2.7 Billion in 2001 to 6 billion this year [2005] there has been no tangible improvement in the delivery of health care.

   This is a poor country but these amounts of money in real terms are twice as high as what the recognised threshold for delivery of proper health care is. The international norm determined by International Health Care Organisations in 1997 is that the expenditure of $12 US dollars per citizen per year in 1997 would deliver acceptable health care to its people.

   Our expenditure in the 1997 budget averaged $26 US, twice the accepted amount per citizen! But the health care in this country was ineffective to serve us, biases, corruption, incompetence, wrongful allocation of funds by sector are the main causes of this situation according to the National Development Strategy, expenditures do not follow international criteria, they are wasteful, allocated with the wrong priorities and are riddled with theft, corruption and incompetence.

  Our poor environmental health is caused mainly by the high incidence of vector borne diseases such as malaria, Filaria and Dengue fever especially in regions 1, 7 & 8. Whilst the Regions with the lowest morbidity rates were regions 3, 4, 5, 6 and 10. the conclusion is inescapable we are failing to deliver proper health care to our citizens, especially our hinterland brothers and sisters, despite massive investment in the health sector.

  There is no evidence that Doctors are flown into the interior on a regular basis to conduct basic clinics in any of the interior regions and it is a serious indictment to this country that our Medical Council contains no doctors registered as specialists in Haematology, Cardiovascular matters, Oncology [cancer specialists] etc. 

   The morbidity profile indicates that substantial improvement can be achieved through better preventative health care, better education on health issues, more widespread access to proper potable water and sanitation services, and basic access to quality health care. We are allowing our dirty environment to cause illnesses then we try to cope with the consequences, in other words our health care is reactive and not proactive, I wonder if Ramsammy understands what this means.

    If an average person living in Barbados can live 10 years longer than a Guyanese then we have failed our people medically and environmentally and we are killing them prematurely.

      HIV aids here is the highest in the English speaking Caribbean, the estimate is that if the present trend is not reversed, life expectancy in Guyana can be reduced to 52 years as early as 2010 since 50% of the aids cases would be concentrated in the 10-24 year age group.

   Amerindians represent one of the most vulnerable groups to health issues; their conditions are particularly difficult in respect of malaria, acute respiratory diseases, water borne diseases, nutritional deficiencies and almost no access to any proper health care whatsoever. After receiving billions in HIPC relief, our Minister of Health recently had the unmitigated gall to stand up in the interior and tell the Amerindians that the government will be giving them mosquito nets at total a cost of 4 million US dollars, he did this as if he were doing them favour, he should have done this five years ago ever since we received the first cent of the HIPC funds since that was what it is for. Now that it is time to get votes he is doing now, what he should have done then.

       Bacterial contamination of potable water continues to be a problem throughout the country, I want to pause here and remind you that these are not my opinions; it is all recorded in the National Development Strategy which this government tells us that they are implementing through the Poverty Eradication Strategy Paper. I say that we have not taken one step, to even begin to eradicate poverty in this country; the incompetent people doing these jobs guarantee failure.

   Basic sanitation is very poor especially in the squatter's areas many of which have no means of hygienic waste disposal, if the national estimate that 20% of the population live in squatters' areas is true, then the picture takes on an even more sinister dimension.

   The National Development Strategy tells us that new housing schemes, factories, commercial institutions and industries have been developed around housing areas without complying with land development laws. Right now they are building a cement packing plant in the middle of Lombard Street and the EPA and the Government are doing everything in their power to bend the laws of the land to allow it, with total disregard to the possible ill effects that it can cause the people and their children living in Lombard Street near to GNIC.

   The EPA has, as with everything else in the country, become a political football riddled with corruption, incompetence and shenanigans of every sort by the ruling party; high functionaries within the Presidential secretariat have been implicated in these shenanigans.     

   Rather than investing in competent people strategically placed in critical positions which would improve health care immediately by directing the funds into productive areas, the PPP have embarked on a system of renovating structures through corrupt bidding processes, and what they have built over the past 13 years have already begun to crumble.

   90 percent of the specialist medical staff in the public sector are non Guyanese, many practitioners in the public sector also work in the private sector and some observers have noted that they neglect their duties in the public sector in favour of their private practice. A situation which is inevitable, due to the low salaries of the public sector doctors.

    Whilst 70% of the doctors in the country are located in Georgetown, there is no evidence that incentives are in place to encourage doctors to migrate or visit interior locations. The entire Health Sector seems to be uncontrolled, riddled with inequity, is unmanageable in its present form, lacks accountability, and contains technical inefficiencies too numerous to address individually.

      The Ministry of Health is responsible for establishing and implementing health policy standards, accrediting facilities and identifying human resource requirements of the sector throughout the country, it has responsibility for the procurement and distribution of pharmaceuticals and medical supplies in all regions. It funds and manages vertical health programmes, including vector control, rehabilitation services, dental care, mental health programmes, Hansen's disease, AIDS, alcohol and drug abuse.

   The Ministry of Health is just not competent to carry out these massive functions efficiently. Even though decisions have been taken to distribute these functions to the regions it has, as usual, only been talk nothing substantial has been done.