Letter: Mount Sinai partnership in health is a positive development

NEW YORK - AUGUST 4: Signage hangs outside Mount Sinai Hospital on August 4, 2014 in New York City. Doctors at the Manhattan-located hospital were reportedly testing a man who had recently returned from West Africa for the Ebola virus. (Photo by Eric Thayer/Getty Images)

Dear Editor,

Most Guyanese are grateful that the Hess family used its relationship with Mount Sinai to encourage their Global Health team to include Guyana in their global work. We are grateful that Hess as a Mount Sinai donor has identified a significant sum (US$32M) of their donation to Mount Sinai to be assigned for work in Guyana.

The Ministry of Health, the GPHC and other parts of the health sector, including the private sector, have already started to work with Mount Sinai in an agreement for robust development of health in Guyana, as the GoG pursues a development trajectory to bring world-class health to Guyana and to make Guyana a destination of high-quality health care. While Mount Sinai succeeded in securing funding through the Hess organisation, there are multiple other partners working with the GoG to lift health standards and the scope of healthcare in Guyana. President Irfaan Ali, the Minister of Health and the GoG have no reason to be apologetic for aggressively pursuing world-class partners to help Guyana accelerate development in health. President Ali and his Government have made clear that the goal is, sooner than later, every Guyanese must have access to services that meet all their healthcare needs.

As the MoH has done in the past, all potential partners are welcome to contribute to the lofty goals the GoG has established for healthcare and to meet the overall objective of increasing life expectancy to a minimum of 75 by 2030. The GoG wants to eliminate preventable maternal and infant deaths, to eliminate premature deaths from the non-communicable chronic diseases, such as diabetes, heart diseases, cancer, renal failure and to stop pandemics such as COVID-19. The Ministry of Health recognises we need more, not less partners. In pursuing partners, all of them have invested resources into the partnerships for health.

In signing an agreement with Mount Sinai, the MoH was not looking for a single candidate to help “revolutionise the healthcare system”. The MOH is cognisant of our need for help and has embraced partnership as a way forward to accelerate the health development trajectory. Mount Sinai is only one of the many partners working with the MOH at this time; it was not chosen as a “best candidate”. The reason Mount Sinai has come to most people’s attention recently is because one of their donors earmarked Guyana for Mount Sinai’s global health work. The GoG is highly appreciative that this opportunity has come to Guyana. The Guyanese people will benefit enormously from this and other partnerships.
The GoG has been able to conclude an agreement with Mount Sinai for that global health leader to be in partnership with Guyana to accelerate development in the health sector so that all Guyanese and visitors to Guyana can access world-class high quality health care, no matter what services are needed. Mount Sinai brings to the health sector of Guyana its 170 years’ history of innovation, research and discovery, a history of exceptional care for patients, a tradition of caring patient experience and excellence in health management. The GoG and the Ministry of Health are privileged to be partnering with Mount Sinai as President Ali and his Cabinet pursue health for all.

One section of the media is the latest in a long list of entities and individuals that have acknowledged that the partnership with Mount Sinai is a positive development in Guyana. It did bring in the usual “but”. The “but” in this case is that the GoG is investing resources in an unaccountable and non-transparent way that negates the positive from this partnership. No matter what perception one might have about the financing arrangements, the importance of the partnership is not diminished and we are happy that this section of the media has acknowledged this. Mount Sinai will help the health sector of Guyana to accelerate development, including expanding the scope of services provided, improving the quality of care and patient experience, building human resources, both in management and in technical capacity, in Guyana, no matter what the financing arrangements are.

With major investments in infrastructure and procurement of new technology, Mount Sinai will provide technical expertise to ensure optimisation in these investments. The need to digitalise data and to integrate electronic medical record is now long overdue. The major deficit in service provision for heart diseases (cardiac) and cancer which the G0G is determined to eliminate is a priority area for inputs from Mount Sinai. With partners like Mount Sinai, the integration of modern health practices is assured.

The opportunity to foster a robust partnership arose out of the interest of the President of Hess Corporation and the corporation itself. The Hess family has a close long-time relationship with Mount Sinai, long before Hess was in Guyana and encouraged Mount Sinai to enter the partnership with Guyana. President Ali and Vice President Bharat Jagdeo were key players in catalysing the rapid movement towards concretising an agreement for Mount Sinai to commit resources to Guyana. Every Guyanese will benefit.

The partnership requires many members of Mount Sinai’s leadership team to work alongside teams in Guyana on an ongoing basis for the next three years. For example, the whole administrative and clinical management team for Mount Sinai’s Morningside Hospital will work alongside the management team of GPHC in counterpart arrangements. Some of the interaction will be by virtual methods, but some of the interactions will be in-person with the Mount Sinai team members in Guyana or the Guyana team members at Morningside.

For the next three years, the two teams will work daily alongside to ensure better services, including patient experience and quality of care, at GPHC.

While this missive is not intended to provide a listing of all the activities, several activities merit mentioning. One area that Mount Sinai will work alongside the Ministry of Health to improve is the provision of a comprehensive set of interventions for cardiology (heart diseases) and oncology (cancer). Mount Sinai is globally recognised for its cardiology and oncology services. Another area that Mount Sinai will work alongside the Ministry to accomplish is the integration of a national electronic medical system so that patient data is accessible by medical personnel throughout the system. These support areas will be available to both the public and private sector.

Mount Sinai has a global health department and is presently working in many countries as they seek to improve health in developing countries. Mount Sinai’s cost for being in the Guyana partnership will be through a direct funding arrangement with the Hess family. There is an agreed list of activities between the MoH and Mount Sinai. Hess will not have any veto rights. Guyana has always, at least since 1992, pursued partnership to help develop the health sector. Presently, Guyana is working with partners such as Mount Sinai, Northwell, Harvard, Vanderbilt, Columbia University, McMaster University and many, many others. These institutions raise their own funds to partner with Guyana and other developing countries. To optimise the partnership, Guyana will need to invest in technology and infrastructure and training costs. These costs, for example, personnel travelling to the US from Guyana, will be borne by Guyana.

When COVID-19 came to Guyana, Guyana was able to begin PCR testing because, as early as 2008, Guyana’s National Public Health Reference Laboratory (NPHRL) was established for high-end laboratory testing. Working alongside partners facilitated by PEPFAR, Guyana was able to establish the reference lab. While its development to a world-class facility was stymied for a while, Guyana is now resuming the trajectory to have one of the top public health labs in the Region. Partners, such as Harvard which is supporting the MoH to introduce DNA sequencing testing will enable Guyana to meet its objectives. This will ensure that in future variants of infectious organisms, such as COVID-19 variants, can be identified right in Guyana.

Guyana today trains its own specialist doctors in fourteen different areas. There is also training for nurse anaesthetists. There are also training in echocardiology and in ultrasound diagnostic techniques. Since 2006, Guyana has developed cardiac services, introduced radiotherapy and chemotherapy, rolled out an aggressive transplant program and is gradually making laparoscopy a routine surgical intervention. Guyana has already rolled out a teleradiology and teleophthalmology service where specialists from GPHC are providing services in other parts of Guyana virtually. These have all been made possible by partnerships, where partners invest their own resources. We need more, not less.

As the MOH continue to embrace partnership, no one is pushed aside. All partners that can make a meaningful contribution are welcome. Guyanese with skills in the diaspora are already part of the partnerships and partners like Mount Sinai and Northwell Health have brought on Guyanese and Caricom professionals in the diaspora. Where Guyanese organisations and professionals in the diaspora could contribute, the MoH is open to those discussions. Some of the programmes in place at this time is with the help of diaspora contributions. For example, through the initiative of the Vice President, Guyanese professionals from Atlanta will work alongside the Ob/Gyn Department of the GPHC to introduce a urogynaecology programme, targeting incontinence in women which is a major public health problem plaguing women in countries around the world.

The Minister of Health and the MoH will ensure that all partners work to build a healthcare system that is recognised around the world for its agility, its capacity to ensure all Guyanese receive the best healthcare possible. This will happen over time. Our hope is that with partners such as Mount Sinai that the trajectory toward this goal is not slow, but as rapidly as possible. The Mount Sinai health partnership, like many other equally important ones, is a cause of optimism and celebration; it ought not be another reason for pessimism and division.

Dr Leslie Ramsammy