50% of Guyana’s Medexes serving in hinterland regions – Chief Medex

…says workforce playing vital role in remote communities

Chief Medex within the Ministry of Health’s Regional Health Services Division, Carleen Howard-Mohabir, has revealed that approximately 50 per cent of Guyana’s Medical Extension Officers (Medex) workforce is currently stationed in hinterland regions, playing a vital role in expanding access to healthcare and strengthening preventative medicine in remote communities.

Speaking during the televised programme Health Matters, Howard-Mohabir highlighted that Regions One (Barima-Waini), Seven (Cuyuni-Mazaruni), Eight (Potaro-Siparuni), and Nine (Upper Takutu-Upper Essequibo) account for half of the country’s Medical Extension Officers (Medex), who often serve as the primary healthcare providers in villages where doctors are not permanently stationed.
“At least 50 per cent of our Medex are employed in the hinterland regions—Regions One, Seven, Eight, and Nine—and even along the coastal riverine communities,” she explained. “Gone are the days when a patient had to wait days or weeks to reach Georgetown for treatment. Through technology and telemedicine, that’s no longer the reality.”
Medex training is crucial for Guyana’s healthcare system, particularly in providing primary care, especially in remote and underserved areas. Medex are mid-level healthcare professionals trained to provide a wide range of services, including health promotion, disease prevention, and basic medical care. Their training equips them to manage common ailments, identify those requiring referral, and even perform deliveries in some cases. Howard-Mohabir traced the evolution of the Medex programme, explaining that over the past 15 years, the Ministry of Health has introduced two training pathways: the traditional programme for midwives and registered nurses transitioning into public health, and an alternative pathway for new applicants with Caribbean Examinations Council (CXC) or post-secondary qualifications. “We launched the alternative pathway in 2006 to expand access to training and reduce human resource gaps in the system,” she noted. “Since then, we’ve trained several batches of new Medex officers, and we continue to balance both pathways to ensure we maintain adequate coverage across all health regions.”
She added that many of these trained Medex are returning to their home communities, reducing turnover and strengthening trust between health workers and residents. “When regions identify and send their own young people for training, they tend to stay and serve. It builds ownership and stability in the community health system,” she emphasised.
Describing the Medex as the “bridge between doctors and nurses,” Howard-Mohabir explained that these officers perform a diverse range of duties depending on their postings—from managing outpatient clinics and administering pharmaceuticals to assisting in deliveries and chronic disease management.
“Wherever a doctor cannot go, the Medex is there,” she said. “We are legally registered with the Medical Council and guided by the Chief Medical Officer. While we don’t perform surgeries, we diagnose, prescribe, deliver babies, and lead health promotion activities.”

Local recruitment
With this in mind, Howard-Mohabir made a strong appeal for regional leaders to identify and support local candidates for the Medex programme, emphasising that healthcare capacity improves when communities train their own professionals.
She also highlighted the numerous scholarships and online study options now available through Government initiatives, which allow health workers to advance academically while remaining employed. “Many Medex officers have gone on to become doctors, optometrists, or postgraduate professionals,” she said. “You can start as a Medex and still elevate yourself through continuous learning. That’s the beauty of how our system has evolved.” With the continued rollout of telemedicine, training expansion, and stronger community engagement, Howard-Mohabir said Guyana’s Medex corps remains a pillar of the nation’s primary healthcare network, particularly in regions where access to doctors remains limited. “Our Medex officers are the heartbeat of primary healthcare in Guyana,” she affirmed. “We are ensuring that no matter where you live—on the coast or deep in the hinterland—you can access quality healthcare when you need it most.”