hen
you have health, the saying goes, you have
everything. Without it, you have nothing.
What is the state of health in Guyana today?
Guyana’s once-proud health care system, has ruined
by politics and mismanagement, and now lies in
shambles. As the health care system has fallen apart
and medical personnel have been unable to receive
adequate recompense, they have streamed out of the
country to seek living wages elsewhere. In some
areas—chiefly in the hinterlands—medical care is
almost impossible to come by. And even where it is
available, it is usually insufficient, and always
prohibitively expensive.
Good health has become a luxury that only the
wealthy can afford.
With the withering away of health care, disease and
despair have engulfed the country. The scourge of
HIV/AIDS ravages the population, particularly the
youth. Other epidemics, such as malaria, affect
entire communities, and the population as a whole is
suffering an increase in a wide variety of
diseases.
This lack of access to decent health care endangers
the well-being of every Guyanese, degrading the
quality of life at every stage of the life cycle.
In
recent years, it is true, significant emphasis has
been placed on treating HIV/AIDS, with funding
provided by USAID. The attack on HIV/AIDS has been
aggressively and commendably led by the Minister of
Health. And in general, small improvements in
Guyana’s health system are noticeable. Recent
improvements in various aspects of heart surgery are
noteworthy. Nevertheless, Guyana has a long way to
go in order to attain adequate health care. Today,
when compared to neighbouring states, Guyana has:
! The lowest life
expectancy—60 years for men and 64 years for women,
as compared with a life expectancy rate of 73 years
in Suriname, Venezuela, Trinidad and Tobago.
! The highest
infant mortality rate—56 per thousand live births in
1999 (as compared, for example, to 24 per thousand
live births in Costa Rica).
! The highest
maternal mortality rates.
Our
old people are neglected, our youth are devastated
by HIV/AIDS, and the population as a whole suffers
from lack of wellness. No government with a
conscience can allow such suffering to continue. And
no government with the ambition to propel this land
into prosperity and a high quality of life can
countenance a population that is sick and
uncared-for.
In
the name of humaneness, every Guyanese citizen must
have access to vaccines, medicine, competent
diagnosis and treatment. And in the name of
nationalism, if we desire Guyana to be a robust
nation, Guyanese citizens must be robust in health.
he
state of health of the Guyanese people is at a
critically low point. In many areas, the health
situation is spinning downward in a steady spiral of
deterioration. To cite but a few examples:
! Hypertension
has increased tremendously.
! Diabetes is
growing more prevalent.
! Cancer is on
the rise.
How
can Guyana be a vigorous country when its population
grows increasingly fatigued and infirm? And how can
we countenance the suffering that is attendant to
disease if we have the power to stop it? The inner
voice of conscience stirs us—as individuals and as
Guyanese—to help our unfortunate brothers and
sisters.
HIV/AIDS
HIV/AIDS is the fourth leading cause of death in
Guyana. Once confined to a few vulnerable groups,
HIV/AIDS has now spread to the general population,
growing almost exponentially.
Some causes of this pandemic are:
! The
authorities’ belief that AIDS would be confined to
the minority ethnic group.
! A lack of
popular awareness.
! Limited access
to retroviral drugs and other treatment.
As
HIV/AIDS spreads, Guyana’s social stability is put
at risk. A large population of orphans is being
created—orphans who, without family socialization,
threaten to play a destabilizing role in Guyana as
they enter young adulthood.
In
addition, the treatment of HIV/AIDS victims is
placing an overwhelming burden on Guyana’s already
overtaxed medical infrastructure and its economy.
Medical experts predict that, unless this disease is
checked, it may spread and reduce life expectancy in
Guyana to as low as 52 years within the next ten
years. This is a massive crisis that we must do all
we can to prevent.
Nutrition
A
key role in the susceptibility of the population to
disability and disease is the lack of proper
nutrition in people’s diets. We must make the basic
nutritional staples available to all Guyanese at
reasonable prices.
Children in particular are at risk of malnutrition,
for almost all the food that they receive in school
consists of nutritionally insignificant snacks and
commercially prepared foods. No structured programs
exist to ensure that children are provided with the
proper foods. Let us set aside the interests of
these snack manufacturers and focus on the
well-being of our children, the generation that will
lead Guyana tomorrow.
Water
Guyana’s water quality has become unreliable,
chiefly in urban areas, due to a number of factors:
! Vandalism.
! Lack of
maintenance. (In Georgetown, for instance, 70% of
piped water is lost due to broken and damaged mains
and related conditions.)
! Fuel shortages.
In
addition, many areas of Guyana receive little or
even no water. A country cannot do without water.
That clean water should not be available for all in
the “land of many waters” is a sadly ironic
situation that we must rectify.
The Amerindian Population
Those most severely affected by Guyana’s health care
crisis are its native Amerindian populace, which
suffers acutely and disproportionately from:
! Malaria.
! Respiratory
diseases.
! Water-borne
disease.
! Nutritional
deficiency.
Such tragedy amongst the aboriginal population of
our land cannot be tolerated. Let us not stand by
and watch the decimation of those who were first in
this land, but let us give them the care that they
deserve—yet have so rarely received.
A Broad Social Problem
Nowadays, an increasing number of sick people walk
the streets with no place to go and no one to turn
to. In order to attend to the urgent needs of these
people, we must deal not only with their health
problems but with many other related problems as
well, such as:
! Low income.
! Lack of
education.
! Lack of
adequate housing.
A
compassionate and proactive
Guyanese government must address these needs of the
people in order to ease their distress. Faced with
the sombre facts of Guyana’s difficult health
situation, we must resolve to let no Guyanese child
go hungry and no sick person go untreated. The task
is difficult but it is a worthy one, and it is one
that we can achieve.
e
must devote our attention to ameliorating Guyana’s
wide-spread diseases.
This will involve adopting a wide-ranging strategy
to deal with communicable diseases such as AIDS,
malaria and tuberculosis, making use of education
and counselling, as well as appropriate treatment
protocols.
In
order to manage disease, Guyana must adopt a
multiplicity of strategies. Standard treatment
protocols for drug use must be established, and in
addition we must investigate alternative medical
modalities.
Proper funding is of the essence, and Guyana will
seek such funding from overseas sources, such as the
Global Fund.
! AIDS
" Focus efforts
on the population between the ages of 15 and 35.
" Continue
implementation of the HIV/AIDS National Strategic
Plan, including education, counselling, adoption of
treatment guidelines and access to antiretroviral
drug therapy.
! Malaria and
Tuberculosis
" Adopt the
National Strategic Plan to deal with communicable
and vector-borne diseases such as malaria and TB,
including education, counselling, adoption of
treatment guidelines and access to appropriate
medications.
! Funding
" Accelerate
participation in the Global Fund for HIV/AIDS and
tuberculosis.
! Drug Use
Protocols
" Establish
standard treatment protocols for drug use in
treatment of common diseases.
! Disease
Management
" Continue to
intensively build healthier communities through
disease management
! Alternative
Modalities
" Broaden
research into traditional forms of medicine, such as
remedies from plants, herbs and minerals.
Universal Health Care
Universal access to modern health care is crucial if
Guyana’s population is to attain an adequate level
of health and well-being. To this end, community
health centres must be established in every
community at village levels. At these centres and
elsewhere the especially vulnerable members of our
society must be given special attention: seniors,
the physically and mentally disadvantaged, and
mothers with their infants.
In
order to help maintain a modicum of adequate health
provisions, we must upgrade and revamp the
present-day national health insurance.
And
to help provide medical services in Guyana’s
hinterlands, we must launch programs that give
incentives to medical personnel to volunteer their
services.
! Clinics
" Establish a
community health centre in every community at
village levels to provide for the most basic health
needs.
" Equal access to
health and social care services for all Guyanese.
" Provide seniors
and the physically and mentally disadvantaged with
special attention
! Maternal and
Child Care
" Make maternal
and child health interventions a priority (which
will reduce the need for more costly treatments at a
later stage).
! Encourage
Volunteerism
" Give incentive
to medical personnel to volunteer their service in
the interior and rural areas.
! Medical
Insurance
" Upgrade and/or
revamp Health and National Insurance Schemes.
National Strategy
It
is important that our strategy toward health
management be fully integrated. To this end, we must
organize a committee to oversee Guyana’s health
strategies.
One
aspect of our national strategy will be to
rationalize practices and eliminate inefficiencies,
such as closing down underutilised facilities or
using them more effectively.
! Planning
" Appoint a
committee to oversee studies, approaches, and the
overall handling regarding all health issues that
face the nation.
!
Consolidation
" Consolidate
management and service delivery:
" Close
underutilised facilities.
" Convert
underutilised hospitals to outpatient polyclinics.
Facilities
Good health is optimally achieved by having modern
facilities available. Guyana must attain
state-of-the art facilities, and its medical
personnel must have access to the latest research
and practices.
! Modern
Facilities
" Attain
state-of-the-art equipment and procedures.
" Regularize
Medical Evacuation arrangements.
International Aid
In
order to garner as much medical talent as possible,
we will turn to overseas medical professionals in
order to create an international network of medical
professionals—including expatriate Guyanese, who
will be given incentives to return to Guyana.
! Overseas
Doctors
" Create an
international network of medical professionals and
experts for consultation.
" Invite Guyanese
medical professionals who are based overseas to
assist in various areas.
" Implement
medical cooperation with overseas health care
providers as an intermediate measure until local
services are sufficiently improved.
! Expatriates
" Encourage
expatriate medical personnel to return to Guyana.
" Following the
model of the National Teachers Corps, consider a
National Nursing Corps that could be a
public/private partnership to expand the number of
qualified nursing professionals through returning
expatriates and other nationals.
Nutrition
Healthful, nutritious food is the foundation of good
health. In schools, children’s present-day snacks
must be replaced with nutritional meals. And the
general population’s access to good nutrition must
be monitored. In particular, people must be assured
access to untainted food and a safe water supply.
! Monitoring
" Monitor the
nutritional status of the population, especially the
most vulnerable groups.
" Develop a
national, uniform inspection system to ensure a safe
food and water supply.
! Schools
" Structure and
monitor the food served in school cafeterias.
" Ensure that the
foods school children of all ages receive
nutritional meals on a daily basis.
Attending to the Care-Takers
Although we can request dedication, we cannot
demand self-sacrifice. And thus we must offer
medical personnel conditions commensurate with their
services. We must give them adequate salaries and
perks such as tax-free status, provide them with
on-going professional education and give them the
recognition due to them for their significant aid to
our country.
! Adequate
Salaries
" Increase
salaries for doctors, nurses and other medical
professionals.
" Grant medical
professionals tax-free status in order to encourage
them to remain in Guyana after training.
! Continuing
Education
" Provide health
professionals with opportunities for continuing
education.
! Recognition
" Grant
recognition to our country’s medical professionals
for their tremendous dedication in the face of
adverse circumstances.
Education
We
must educate not only our health professionals but
all citizens regarding health, establishing health
care programs to promote healthy lifestyles and
disease management.
! Health Care
Programs
" Establish
health care programs to promote prevention through
healthy lifestyle.
" Implement an
effective strategy to prevent ill health through
education.
" Create a new
social environment to promote greater awareness and
responsibility among our young adults and socially
active class.
" Raise the level
of education about AIDS and other communicable
diseases.
" Build healthier
communities through awareness and disease management
programs.
! NGOs
" Systematically
include NGOs and private sector groups in public
education campaigns.
! A Broader
Context
" Institute an
effective strategy to recognise the links between
health, poverty and income; between health and
education; and between health housing and the
environment.
In Sum
If
there is a positive aspect of Guyana’s health
crisis, it is that when we see the suffering of our
fellow citizens, we instinctively feel compassion,
whatever their ethnicity or politics, and a
quickened sense of responsibility.
Let
us take that empathy and make it the centre of our
nationalistic endeavours. Let us create real change
in the world. Let us do whatever we can to help
those in need.
And
as we help each other, one person at a time, we will
ultimately heal an entire nation.
