No Panadol in Rupunau, no cold syrup in Karasabai

During my last visit to Region Nine earlier this month, I fell ill and as I happened to be in Rupunau, a Wapishana village in the Deep South Rupununi, I visited the health centre in search of Panadol to calm my throbbing headache. There were none.
We all have been hearing about a massive drug shortage, but many of us living in coastal regions have not actually felt the full impact of this deficiency, because our health facilities are more easily provisioned for and alternatively, we still have access to private pharmacies and hospitals.
In the Rupununi and the hinterland regions, the reality paints a rather dismal canvas. A visit to 15 Indigenous communities in the region and to the Lethem hospital revealed that after two and a half years in office, the coalition Government did not apply any measures to enhance the quality of service delivered in the public health sector. As it is in developing countries, health care remains a challenge especially when proper infrastructure, trained personnel and financial resources are lacking. But in Guyana, poor service is also strongly tied to mismanagement and disorganisation in supplying the drugs to meet the needs of public facilities.
In Paipang for instance, the last supply of drugs was received in July 2017. Based on the Community Health Worker (CHW) report, the village did not receive MMU vaccines in 2017 despite several requests made through the Karasabai health centre. In Tipuru, the last medical supplies were delivered in June and the CHW reported an absence of basic supplies such as bandages and IV fusions as well as a dried-up supply of treatment for diabetes.
The CHW of the Rupunau health centre reported that the village received its last supplies in March. The Moco Moco health centre received its last provisions in September. Meanwhile, the Tiger Pond health centre possessed only six small bottles of Chlorophane for children. In Sand Creek, the Toshao bemoaned the absence of treatment for viral conjunctivitis (commonly called “red eye”) while in Karasabai and Rukumuta, both Toshaos indicated that basic medication for colds was lacking. Because the severe drug shortages have become a chronic problem in the Region, some village leaders, such as in Nappi, indicated that their people are starting to revert to local remedies.
The shortage of trained medical personnel further complicates the access to primary health care in the hinterland. Most health centres are operated by CHWs who are trained for a period of three months (under the HEYS programme) to administer basic treatment to patients.
Health centres are generally opened once or twice a week. There is only one trained health worker assigned to Nappi, Parishara and Hiowa, with two others currently on training. Because the Nappi health centre is the largest in the Region, villagers believe that a more trained or experienced health professional should be on duty. In Kumu, there are currently no trained health workers as is common in health centres across the hinterland. Some health centres cater for up to nine communities at a time, as is the case for the Sand Creek health centre in South Central Rupununi or the Aishalton hospital.
Aside from working against this setback, health facilities, including the Aishalton hospital, suffer from inadequate transportation. There is a general absence of ambulances, and most patients, including pregnant women, are transported using ATVs, motorbikes and where possible, tractors and other village vehicles. The health sector in the Rupununi is deficient to the point where in some communities, mothers are forced to give birth at home.
The fact that doctors from the coast sent to work in the hinterland have a difficult time adapting to these strenuous circumstances does not alleviate the challenges confronting Indigenous communities. For example, in Karasabai and the neighbouring South Pakaraimas communities, complaints were made by villagers and councillors concerning the alleged negligence of the doctor on duty. What’s more is that a discussion with doctors in the Region revealed that most of their colleagues coming from the coast are not experienced doctors, but, on the contrary, have either just completed their training or are sent to complete it in the Rupununi.
The Public Health Ministry’s excuse for the chronic drug shortage is that the procurement procedures are being changed – an excuse for now two and a half years that is no longer admissible. Additionally, about one third of the $100 million allocated to the Lethem hospital for emergency purchases (drugs) has returned to central Government by request. Meanwhile, there is no Panadol to calm a headache in Rupunau.