Letter: Sustained shortages of medicines in health sector terrifying

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Dear Editor,

In spite of the billions allocated for medicines and medical supplies in the 2017 budget, there is little hope that shortages of medicines and medical supplies will be reduced in the public health sector.

Under APNU+AFC, availability of medicines and medical supplies has worsened with each passing day. Even as the budget presentation was being made, reports out of Georgetown Public Hospital reveal a worsening situation with serious shortages of medicines and medical supplies at the nation’s top health institution.

In the meantime, the House rented as a medical warehouse for a cost reaching about $15M per month, and for which $75M was paid up front, remains unused. The medical supplies that Minister Norton claimed needed an urgent place for storage, hence the single sourcing of the warehouse, somehow have not reached the warehouse yet.

That the main referral hospital in Guyana is plagued with serious shortages of medicines and medical supplies is scandalous, but that the whole public health sector experiences such shortages on a daily basis is terrifying.

Every public hospital and public health center is forced to cope with daily shortages of medicines, vaccines and medical supplies. After 20 months of empty promises by APNU+AFC, the medical supplies status of the public sector has gotten worse, bringing us back to those terrible days of the 1980s. In the meantime, instead of efforts to remedy the situation, time, energy and money are spent to ensure friends and donors to APNU+AFC are rewarded with contracts to supply medicines at a cost of billions.

As the Minister of Finance was presenting APNU+AFC’s 2017 budget, I got a call from a friend in Region 6. He explained the dire consequences that patients and their doctors and caregivers increasingly face because of the worsening incidences of medicine and medical supplies shortages.

Surely, the situation he describes cannot be unknown to the Ministers of Health. My friend called in the presence of a traumatized family who was forced to take one of their relatives from the New Amsterdam Public Hospital to the Georgetown Public Hospital. The relative was a surgical patient who was referred to GPHC because the New Amsterdam Hospital operating theatre was inoperable because certain supplies were unavailable. All surgical patients were being referred to GPHC. One main medicine that was required for safe surgery, but was not available was suxamethonium. As I write this note, the biochemistry lab at the hospital is non-functional.

Several weeks ago, pregnancy induced hypertensive (PIH) women were told that they could not be safely managed at the New Amsterdam Public Hospital because the institution did not have the relevant medicines available to manage their condition. Common hypertensive medicines were among the long list of medicines that the hospital has been experiencing for some time now.

The women were referred to the GPHC. The relevant medicines in this case is hydralazine, a common medicine costing pennies. Instead, patients are forced to seek distance care at exorbitant expenses because the Ministry of Public Health simply cannot assure the public health institutions reliable supplies of medicines and supplies.

Adding salt to the injury, the women’s families were told that ambulance service was unavailable to transport them. Turns out the ambulances are more down than functional most days. This is a situation that has become too frequent at the Region 6 hospitals and are applicable to public hospitals across the country. Medical professionals are embarrassed every day as they try to provide the best care they can to their patients. Fact is, this is not an isolated case. It is common everywhere in the country.

Hydralazine is a common medicine and is included in the National Essential Medicine List. I had included this medicine in a list of medicines that must be available 100% of the time. In my time as Minister we had a list of medicines that was monitored on a daily basis across the sector to ensure that we would never experience shortages of these medicines.

We recognized that the first step in achieving a reliable supply chain was to first ensure 100% availability of a list of critical medicines and medical supplies. Long before December 2011 when I departed the Ministry of Health we had achieved this target. By 2011, shortages of medicines like hydralazine, was unthinkable. Today, these critical medicines appear to be in short supplies across the country more often than they appear to be available.

In 2016, it is a shame that hospitals like New Amsterdam, Suddie, Linden, West Demerara and others must refer PIH women to GPHC for management. I know that these institutions have the professional capacity to safely manage the health care needs of these women.

But doctors and other care providers need medicines and medical supplies to be able to meet the health care needs of those who depend on them. Without the relevant medicines and medical supplies, doctors are made ineffective.

They are asked to “fetch water in a basket.” As more than $30B are likely to be allocated to the health sector in the 2017 budget, it should not be too much for us to ask that medicines like hydralazine and suxamethonium should never be in short supply.

Yours truly,

Dr Leslie Ramsammy

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