Falsehoods being peddled about health sector

Dear Editor,
There was a letter in the January 13 issue of a publication — written by a Leyland Roopnarine — that was highly critical of me. It is revealing that Roopnarine had nothing to say about what I had written on free speech; since, I assume, he could not disagree with what I had to say. But he was angry that I wrote in defence of Bharrat Jagdeo.
First and foremost, Bharrat Jagdeo does not need me or anyone to defend him, or to polish his considerable stature in Guyana, the diaspora, or globally. In this regard, I would not respond to any name-calling that the anti-Jagdeo usual suspects apply to me. In any case, name-calling is not my forte, and I usually leave it to those who need that approach, instead of dealing with facts. I have better things to do working every single day in the various communities of the country of my birth, which I love so very much.
When they need me, many of the usual suspects know where to find me. They usually find me in one of the communities working; and I am always respectful and always offer my help — something none can dispute. As promised, I will deal only with the falsehoods Roopnarine referred to.
He wanted to know what happened with the specialty hospital money which the PPP Government mobilized when I was Minister to build the specialty hospital. Actually, he is asking the wrong person. Mostly, the persons that he needs to direct that question to are his friends in the former David Granger-led APNU/AFC Government, which include Ramjattan, Nagamootoo, Jordon, Volda Lawrence, George Norton and Karen Cummings.
In 2010, on a trip to India, President Bharrat Jagdeo had requested me to prepare a concept note for a specialty hospital. It was agreed that the Indian EXIM Bank would fund the project at a cost of US$54M. It took a while to finalize the agreement; and with various budget cuts and rejections in the Parliament when the APNU/AFC used its one-seat majority to sabotage the project and the development agenda, a contract was not signed with Surendra until 2013, at a time when I was then the Minister of Agriculture.
In 2014, clearing of the land just east of where MovieTowne is presently located and site preparation began. The funds for site preparation in 2014 were from the regular budget.
In 2015, APNU/AFC became responsible for the project. In fact, APNU/AFC terminated the contract and abandoned the project. A different use of the EXIM Bank’s funds was then negotiated, focusing on primary health care.
To this day, we cannot determine how APNU/AFC used those funds, because there is no visible evidence of improvement or building of any health centre; there was no improvement in any of the various district or regional hospitals that occurred between 2015 and 2020. No specific project was developed that targeted the EXIM Bank Fund. Most of the work started by APNU/AFC in the health sector was incomplete in 2020, and most could not be completed for the purpose construction started. Almost $300M was expended to build a maternity wing at the New Amsterdam Hospital.
In August 2020, the building was a shell, with windows, doors, floors still to be completed. The operating room area needed total redesigning and new construction, because each of the rooms had pillars spreading across the middle of the room, leaving no place to fit functional operating room tables.
In Suddie, the APNU/AFC started building a $45M OR suite that was never designed for an operating room. It was incomplete and leaking badly. On January 12, 2024, Minister Anthony commissioned a new NICU in that space. In August 2020, after spending more than $1.5B, and after commissioning the former Ocean View Hotel as a new Infectious Disease Hospital for COVID-19 twice, we discovered an unfinished building: with major sewer problems, no beds, no equipment, no oxygen, and incomplete electrical work.
This is the kind of disarray that APNU/AFC foisted on our people, which should make all of us angry. Those who defend the 2015 to 2020 record in health are callous, and have no interest in the welfare of our people.
In October 2020, President Irfaan Ali agreed that the EXIM Bank money would be added to funds which would go toward building new hospitals to replace West Demerara, Suddie and Bartica hospitals. To our great chagrin, we discovered that the APNU/AFC Government had squandered most of the money, with just US$15M remaining. This money is what is being supplemented to build the new Bartica Hospital, the design of which has been completed, with construction starting before June 2024.
I encourage Leyland to take some time and asked his friends in APNU/AFC to account for how they expended almost US$40M.
I left the Ministry of Health in December 2011. Even the PNC/APNU/AFC conceded that my leadership was transformative, stating openly that “one must give Jack his jacket”. We gained national, regional and global recognition for the work we did in health.
Everything Roopnarine stated was false. Far from being in disarray, the health sector was being transformed, resembling nothing we had before.

The statement that the sector was suffering from major medicine and medical supplies’ shortage is appropriate for 2015 to 2020, when his friends were in charge. At the beginning of 2012, the sector was providing reliable supplies to all health facilities between 95% and 100%. From an essential medicine list with about 140 medicines in 2000, the essential medicine list bulged to almost 1,000, with no developing countries matching our list. Cancer medicines, antiretrovirals for HIV, hepatitis, heart disease, medicines were all being provided for free. From a time when Guyana could not guarantee people a simple HB test result, Guyana was providing at GPHC and all regional labs diagnostic testing that included all the regular tests that doctors requested.
In 2020, none of this was any longer true. Shortages had returned, with reliability at only 35%. In Augst 2020, we were forced to dispose of $11B of expired medicines, and estimated that about $50B of medicines and other supplies had accumulated over the five-year period. This is the legacy of Leyland’s friends.
The number of surgeries increased. In fact, from the cataract backlog which was about 20,000 in 2001, Guyana eliminated the total backlog, and by 2006 we were searching for patients to help for free cataracts in Suriname and the Caribbean.
We also introduced, for the first time, modern cataract surgery such as phaco-emulsification and laser surgery. Surgery for glaucoma was introduced for the first time in Guyana. Laparoscopy, which is a minimally invasive surgery technique, moving away from large incisions (cuts), was introduced also before 2006. Today, about 30% of our surgeries are using laparoscopy at GPHC, New Amsterdam and Linden. Open heart surgery at GPHC was introduced in 2006. Dialysis was introduced in 2005.
Radiotherapy, CT and MRI were brought in between 2002 and 2004 via a public/private partnership.
New training programmes were developed. Guyana had no post-graduate training programme when I became Minister of Health. The first post-graduate programme was in general surgery, together with McMaster University and with support from several top US universities. Today, Guyana offers training in 18 different specialties for doctors and five for nurses. More than 300 specialist doctors, children of fishermen, cane cutters, farmers, miners, children coming from all ten regions, are our specialists. We have our own cardiologists, our own neurosurgeons, our own hip and joint specialists, our own burns care doctors.
We have become the transplant center for Caricom using totally Guyanese staff. These represent only a short list of our accomplishments.
The results speak for themselves. In 2001, life expectancy was 64. In 2011, it had reached 69, almost touching the elusive 70.
Maternal mortality, which was over 200/100,000 in 2000, had fallen to 80/100,000 by 2008. Child mortality, which was about 48/1,000 in 2000, had fallen to 27. HIV overall rate which had reached 3% of the adult population and 8% among pregnant women had dropped to less than 1% overall, including among pregnant women; and mother-to-child transmission had almost disappeared. From more than 120,000 cases of malaria, by 2010, we were recording less than 10,000. From between 170 to 200 suicide deaths, we were between 140 and 170 by 2010. Incidentally, in 2023 it was 129.
There is a long story to tell, but I will resist the temptation. It does not bother me what names the usual suspects apply to me, but I do hope, as an intelligent person, people like Leyland Roopnarine are better informed.
Sincerely,
Dr Leslie Ramsammy