What ails the New Amsterdam Hospital?
Guyana Chronicle
December 2, 2001

THE death of a young businessman shot by bandits last week Saturday night has turned the focus on the New Amsterdam Hospital.

PRESIDENT of the Georgetown Chamber of Commerce and Industry, Mr. Edward Boyer has called on the Government to enact measures to raise investor confidence so that Guyana can be an "investment paradise".

Medical experts feel that Shahabadeen Kassim, 25, of Vryheid, West Canje, Berbice, may not have survived even with timely medical intervention, but troubling questions include why did it take so long for a senior doctor to look at an emergency case?

Health Minister, Dr. Leslie Ramsammy is pulling no punches - he has appointed an investigative team to look into the practices of the New Amsterdam Hospital, which he has dubbed the "worst administrated regional hospital in the country."

He has also recommended disciplinary action against medical personnel at the hospital following Kassim's death.

But some differences have apparently surfaced over the matter between the minister and Chief Medical Officer, Dr. Rudolph Cummings. Ramsammy asked Cummings to investigate Sunday and an initial report was handed in.

However, that report was leaked to the Stabroek News newspaper which reported Friday that Cummings found there were "no gaps in the medical and nursing care which would indicate negligence."

Ramsammy is reportedly looking into how the report submitted to him was leaked to the Stabroek News.

He Friday said the report is not final and he did not authorise the release of the information.

However, at a news conference the same day, he maintained that investigations at the hospital at this time are not only focused on the Kassim incident, but on the entire operations of the hospital.

Relatives and friends of Kassim were very upset at the slow response from the hospital when the badly wounded man was rushed there for attention and horror has been expressed about the non-responsiveness of doctors.

While the probe is to get under way, Berbicians are worried that unless something is done urgently to address the acute shortage of medical practitioners and poor conditions at the hospital, there may be more such cases down the road.

Residents are alarmed that at a time when there is so much emphasis on health care, and with the fast growing population in the region, the complement of doctors which should be 24, now stands at eight. Some said there is only one senior General Surgeon.

In addition, there is no Anaesthetist working in the theatre of the New Amsterdam Hospital to prepare and monitor patients before, during and after surgery, the Chronicle was told.

And to compound the problem, the obsolete conditions under which blood is stored for transfusion leave much to be desired, staff said.

Informed sources feel the system of having to remove blood from a domestic refrigerator and leaving it to 'come down' to a temperature compatible with a patient's body temperature, can only prolong the procedure if there is an emergency.

In cases of scheduled operations, such a system could probably be overlooked. However, where a patient has to be operated on immediately, the system poses a problem.

Sources expressed outrage that 'in this day and age' such a thing should be allowed to happen and the hospital should have a blood bank.

Reports said that when Kassim was taken there two Saturday nights ago, three doctors were summoned to attend to the patient before the lone Senior Government Medical Officer (SGMO), a general surgeon, was called in.

Investigations reveal that when he was taken there after being shot in the groin, there was no doctor on duty in the hospital to attend to a patient requiring emergency attention.

The patient reportedly arrived at the hospital around 16:30 hrs (4:30 p.m.) but surgical procedures did not commence within two hours. This situation was blamed on the fact that the institution has only one senior Government Medical Officer who would have been competent to handle such a delicate case - possibly involving the shattering of the patient's lymph nodes.

However, it is understood that the SGMO had worked during the day and by that time had gone home.

Attempts were made to get a doctor to attend to the patient and the first called was someone who was "just out of Medical School", a source said. He responded to the call by showing up at the hospital, but was reportedly not capable of dealing with the emergency.

Attempts were made to get a second doctor who, unfortunately was at that moment preparing to travel to Georgetown to catch a flight out of the country.

A third doctor was called, this time a Cuban Orthopaedic Surgeon, but again it was determined that such a case was not his forte.

By then it was near two hours, and finally the Senior GMO was called in. At that time, the patient, who was bleeding over a prolonged period, had probably gone into shock, officials said.

As the patient's condition seemed to be worsening, arrangements were quickly made to have a Guyana Defence Force helicopter flown in for him, but sources said that when it arrived, the patient was already being prepared for the surgery and could not be removed. He is said to have died while being operated on.

Citizens claim they have long been calling for a blood bank for the New Amsterdam Hospital but without success.

Informed sources argue that even if the Senior Surgeon had been called in immediately, the surgery might still have had to be delayed while waiting on the blood to be processed.

While agreeing that there were many times when persons turned up at the hospital outside of clinic hours and had to wait to be seen by a doctor, some people said this was because the eight doctors all work full time during the day and when they go home at nights, they are still 'on call'.

"It is not a different team of doctors who are on standby night call," one said. "It is the same set of doctors who have been working under stress all day, and must get some rest if they are to continue functioning efficiently and effectively."

One citizen said the doctors at the hospital are trying their best, using the resources at their disposal, and are known to work beyond the call of duty, but experienced doctors and at least three general surgeons are needed.

There is wide support for Ramsammy's call for improved conditions and residents want to see more doctors stationed at the hospital.

The minister Friday told reporters in Georgetown that he more than anyone else knew of the "unacceptable" administration of the hospital.

He said that since he became Minister of Health he visits the hospital virtually every other week.

"I know what I am talking about, I find it totally unacceptable. Sometimes I'm in that hospital early in the morning for more than an hour and no doctor shows up. I go during the day and I don't find doctors."

"When you go 10, 12, 20 times and you don't see a doctor, something is wrong, seriously wrong," he argued.

Ramsammy said that since he took up the post, he has seen the senior doctors of the hospital once and "that's because they heard I was there and they came and joined me." (Reporting by Shirley Thomas and Neil Marks)