Last week the staff, including doctors and nurses, of the Linden Hospital engaged in a sit-in to protest the lack of medicines and supplies. This week the staff at the Skeldon Hospital, similarly, are protesting the lack of medicines and supplies. The shortages of supplies being highlighted by these unprecedented actions by the medical staff of these two institutions are not unique to them and have been reported in public hospitals and health centers throughout the country for the last three years. Sadly, medicine and medical supplies shortages have become chronic in the public health sector. I cannot recall such staff protests while I was Minister of Health for twelve years and in the public health system for twenty years.
The most recent sit-ins – last week and this week – sandwiched the observation of World Health Day, April 7th. This World Health Day, the Ministry of Public Health held elaborate celebrations and made commitments of access to universal health for the citizens everywhere in Guyana. It is a laudable goal. But the government must also realize that universal healthcare is unachievable unless we can ensure that medicines and medical supplies are available in the public sector. Citizens have a right to healthcare and that right means that when people come to the hospitals and health centers they can access medicines and other medical supplies. There is no quality care without safe and available medicines.
In this regards, the Ministry of Public Health has failed the people. Medicine shortages is a prominent feature of poor governance since APNU+AFC assumed office in May 2015. We have heard repeatedly the excuses for the last three years and have endured many broken promises that the situation will change. The people have been told by the Ministers of Health in and out of Parliament that the APNU+AFC administration is reforming the procurement system for medicines and supplies, implementing a new warehouse system and a new distribution system. Minister Norton promised a more efficient, more effective, more reliable procurement and distribution system several times in 2015 and 2016. Minister Lawrence promised in 2017 and 2018, more than a few times, a first class system. These promises have been like a broken record. Yet the situation keeps deteriorating.
Other than staff sit-ins, the health sector has also highlighted the shortages in other troubling ways. We have had several incidences where operating rooms have been closed and surgery suspended because basic surgical supplies have been in short supply. Eye operations have been suspended in Port Mourant for almost three years now. In several hospitals, including the Georgetown Public Hospital, x-ray machines have been out of operation and patients referred to the private sector. Routinely now, patients must purchase their own medicines. Vaccine coverage has dropped each year since 2015 and several vaccines have been in short supply. Supplies such as contraceptives and laboratory supplies are often in short supply. Blood bag shortages have also plagued the sector.
In the meantime vast sums of money are being expended, supposedly to procure, store and distribute medicines. In fact, in January and February 2017 alone, APNU+AFC paid out more than $2.1B for contracts to supply medicines, contracts that abrogated all the procurement laws of Guyana. The 2018 medicine budget for the public sector continues the increased allocation since 2015. The question is where are the medicines? Rubbing salt into the wound, the government is spending almost $175M on renting a house as a warehouse in Georgetown, one that is barely used to store non-medicine supplies. Adding even more insult to the injury of medicine shortage, APNU+AFC engages in questionable transactions such as the more than $600M medicine contract with Ansa McCal at a cost almost three times the normal cost.
It is good we celebrate World Health Day with our sisters and brothers across the world and reaffirm our commitment to Universal health Care. But we must recognize that there is tangible erosion of the quality of health care in Guyana. Universal Health Care is a laudable goal and the Ministers are on the right path when they promise they are working assiduously to achieve it. Yet the persistence of medicine shortages make the goal elusive. In fact, these ministers inherited a health system that made considerable progress towards UHC and that had an equitable and reliable supply chain for medicines. In addition, UHC is a goal of the UN’s Sustainable Development Goals which Guyana signed on to in 2015. After three years, APNU+AFC has only succeeded in making people think UHC is increasingly an elusive goal.
Dr. Leslie Ramsammy