Short-term arrangements identified to boost capacity of N.A. Hospital Doctors to be equipped with cell phones or beepers By Mark Ramoutar
Guyana Chronicle
December 9, 2001

A GENERAL audit of the crisis-plagued New Amsterdam Hospital will soon be conducted, and a number of short-term arrangements are to be implemented in a committed effort to strengthen the institutional capacity of the Hospital.

Health Minister, Dr. Leslie Ramsammy, told a news conference yesterday in his office that over the last several months, he has been trying to address the concerns of Berbicians over the state of the health services in Region Six (East Berbice/Corentyne) and particular, the services at the New Amsterdam Hospital.

He noted that the recent death of a patient, Mr. Shahabadeen Kassim has highlighted the state of emergency services at the institution. The Health Minister, who shared the news conference with Chief Medical Officer (CMO), Dr. Rudolph Cummings, noted that the latter has already made arrangements to establish a commission of eminent physicians to review the deaths of Kassim and another patient, Chatterpaul.

The commission will comprise three physicians. The Health Ministry is to provide the secretariat. The Minister said consultation with physicians has already begun and two of the doctors have already agreed to sit on the commission. The Ministry is awaiting the consent of the third doctor.

Ramsammy said that Cummings and Director of Standards and Technical Services, Dr. Dennison Davis, have begun to put together the `terms of reference' of the commission.

He said the Ministry hopes that the commission will meet by next week-end and to have a draft report thereafter.

In the meantime, Ramsammy said he has begun to put in place arrangements that will help to correct the deficiencies at the New Amsterdam Hospital. In recognition of the obvious communication problem, the Health Minister said he has instructed his Permanent Secretary, Mr. Doorga Persaud, to make arrangements to provide either beepers or cell phones to doctors and medical personnel.

"I have also instructed that the accommodation for doctors on call at the hospital be immediately upgraded," the Health Minister said. Work on the on-call accommodation will begin this week, he said.

Ramsammy also noted that the Ministry has taken into consideration the resource constraints of the institution.

"We have already signalled through the auspices of the Guyana-Cuba Joint Commission, our interest in acquiring additional physician staff for this and other hospitals where staff shortages exist," he said.

The Guyana team has just returned from Cuba and a reported positive response from the Cuban Government to Guyana's requests.

Additionally, Ramsammy said short-term arrangements would be made with the Georgetown Public Hospital Corporation to have some junior staff members transferred to the New Amsterdam Hospital.

“This, we hope, will strengthen the on-call and emergency response capability of the institution,” he said.

The Health Minister said he is open to other suggestions such as having physicians in the private sector undertake emergency duty at the hospital on a sessional basis.

Ramsammy said too that he was encouraged by the response of the Berbice Medical Association with whom he met on Friday evening.

"They have agreed that individual members would be willing to provide service on a sessional basis," he said.

Dr. Joseph Kalikaprhashad, the Regional Health Officer, Region Six, has begun compiling a list of private doctors who would be providing such services and this could start as early as next week.

Ramsammy noted too that over the last several weeks, Dr. Clement McEwan has been working with the New Amsterdam Hospital to improve their blood banking service and this collaboration will be enhanced in the coming weeks.

The new x-ray unit will be commissioned shortly to support diagnostic activities, he said, noting that Dr. Madan Rambarran, Director of Medical and Professional Services at the GPHC, has agreed to organise a training programme in emergency medicine for the clinical staff of the New Amsterdam Hospital and of the other hospitals in Regions Six and Five.

According to Ramsammy, he as asked the staff of the Ministry of Health to begin, in the New Year, a programme of audits throughout the country, beginning with the large clinical institutions to ascertain their true potential and to take such steps to optimise the functions of those institutions.

Dr. Davis will begin to put together the first such audit team which will be responsible for the audit of the New Amsterdam Hospital, Ramsammy said. This will be arranged within two weeks, he said.

According to him, the audit will look into the present staffing arrangement and services and make recommendations for strengthening the institution. The audit team will include management consultants. Ramsammy said the Ministry is also open to suggestions from the wider communities on reasonable ways in which the service at these institutions can be improved.

"It is my view that a really effective way of improving the relations between communities and institutions is to form joint community/hospital management units to improve community participation," Ramsammy said.

"While I am conscious of the constraints that exist in the sector and while I am committed to removing these constraints, I will not be oblivious to the concerns of the public (and) I will not excuse acts that further contribute to the public's anxiety," he added.

"It is my view that a really effective way of improving the relations between communities and institutions is to form joint community/hospital management units to improve community participation," Ramsammy said.

No `war’ at the Health Ministry - Ramsammy
HEALTH Minister, Dr. Leslie Ramsammy, yesterday strongly denied that there is a rift between himself and the technical officers at the Ministry.

Ramsammy was clearing the air on perceived differences between himself and Chief Medical Officer, Dr. Rudolph Cummings, over a report of an initial investigation into the death of a young businessman at the New Amsterdam Hospital about two weeks ago.

Ramsammy had asked Cummings to investigate the circumstances surrounding the death of Shahabadeen Kassim, 25, at the New Amsterdam. Kassim, 25, of Vryheid, West Canje, Berbice, was shot by bandits two Saturdays ago and was rushed to the New Amsterdam Hospital at about 16:30 hrs. He died about two hours later as surgery was being performed on him.

While Cummings’ report - which was leaked to the Stabroek News newspaper - found “no gaps in the medical and nursing care which would indicate negligence”, the health minister had recommended disciplinary action against medical personnel at the hospital.

According to Ramsammy, there are different kinds of responses that a person makes and because of what happened, many are under the impression that there is “this big war” at the Ministry.

"There were probably some errors in how things were approached, but there isn't a war going on at the Ministry," Ramsammy told a news conference in his Brickdam office yesterday.

He was accompanied by Dr. Cummings, who stressed he has no discord between the two.

According to Cummings, the whole issue was blown out of proportion by the media, which subsequently fueled public perception that there is a rift.

"We are all committed to the same goal of continuing to improve health services in Guyana at this Ministry and we will continue to work at this," Ramsammy said.

"I think Dr. Cummings and other members of the staff understand me very, very well. I am very enthusiastic and impatient and technical people sometimes, even if they are impatient, they try to go at things in a different way, but that doesn't mean that our goals are different," he added.

He said too that the staff members at the Health Ministry "quite accept that I am totally committed to the improvement of the health sector and that I am impatient and therefore I call on them to be very aggressive..."

"I sometimes want to see things done much faster than maybe it is possible sometimes...and I will not change either; I will continue to want things to happen fast and my impatience will continue to be demonstrated," Ramsammy added.

"We will, like everybody else, have our own little quarrels, but the fact of the matter is that we… must not make these little quarrels get in the way of our overall objective," the Health Minister cautioned.

Ramsammy noted too that he and Cummings have worked harmoniously over the years and that they will continue to do so.

Added Cummings: "I remain, as I have been committed to every Minister of health whom I have worked with...I do not expect things to go smoothly at all times. Ministers are politicians and I think their imperatives are different from mine which is as (a technician) and we will have disagreements sometimes..."

Addressing the issues of the Ministry’s "capacity to respond" at the two main institutions - Georgetown Hospital and New Amsterdam Hospital - the Minister said in that regard, he is not satisfied.

"I am not satisfied at the moment that our capacity to respond is adequate…The New Amsterdam hospital is far behind Georgetown Hospital and that gap needs to be reduced."

According to Ramsammy, it is accepted that there will always be a gap between the Georgetown Hospital and the New Amsterdam Hospital, but he said this gap should not be as wide as it is right now.

Cummings also spoke of the deficiencies in the system, pointing to what he termed the continuous shortage of human resources, especially in the health sector. (Mark Ramoutar)