Jan 17, 2010 News
– Plans apace to extend service to Caricom countries
More than 11,000 patients have been able to access the National Ophthalmology Centre in Port Mourant, Berbice, as at the end of last year. Of those seen, about 989 received corrective surgery for various eye problems, including cataract. Just under 170 cases of cataract were operated on.
Minister within the Health Ministry, Dr Bheri Ramsaran, shared these statistics during an exclusive interview with this newspaper. The modern state of the art facility, which was completed at a cost of $140M and commissioned July last, is intended to be a part of a bigger package in Government’s quest to afford citizens equitable health services.
He described the facility as one of the best in the Caribbean in terms of equipment and staffing. Additionally, he disclosed that the ophthalmology service is integrated with other services that were previously offered at the Port Mourant Hospital which was refurbished in order to house the Ophthalmology centre.
This approach, the Minister said, is called “the efficient and effective use of and optimalisation of real estate and tax payers’ dollars.”
The national facility is currently manned by 28 staffers including specialist Cuban doctors who are filling the gap until local doctors are able to complete training in the area of eye care abroad.
And since it is anticipated that a maximum of 10,000 operations could be possible in a single year, Dr Ramsaran said that there is the likelihood that Guyana will lend its capacity to Caricom countries and Guyanese in the northern Diaspora.
But implementation of the visionary move has several years in the making, according to Dr Ramsaran. He recounted that it was in February 2006 that President Bharrat Jagdeo, accompanied by a small team, undertook a three-day official working visit to Cuba.
The group, which included Dr Ramsaran, who was then the Director of Regional Health Services and Dr Ashni Singh, who was Director of Budget at the time, met with the then Cuban President, Fidel Castro, and commenced bilateral discussions.
“That small team had discussions on many things…We celebrated long and fruitful co-operation between Cuba and Guyana in the diplomatic field, culture and especially in the area of health and health education,” Dr Ramsaran disclosed.
According to him, President Bharrat Jagdeo, back then, recognised some weaknesses in the local health sector including the inability to deliver quality services on a mass scale and in an equitable way.
Unwilling to be overwhelmed with the evident challenges, Dr Ramsaran said that President Jagdeo sought to take immediate steps to revamp the health sector. The area of eye care was among his targets, leading to the introduction of the first phase of the Mission Miracle Programme to Guyana.
Mission Miracle is a programme based on co-operation between Cuba and Venezuela and countries of Latin America and the Caribbean. It is funded in part by the Venezuelan Government while Cuba provides the technical capacity to deliver the actual services and to host patients free of costs.
The third party, which consists of the countries of Latin America and the Caribbean, provides the patients and the in-country technical facilities for screening of patients for onward transfer to Cuba.
It was around mid-2006 that President Jagdeo and the Cuban Embassy here were together able to work out arrangements allowing for the start of the programme. “They came in with three specialist eye doctors and we immediately fanned out across the country visiting places countrywide,” Dr Ramsaran recounted.
It was within 10 days of the doctors’ arrival that the screening of patients for cataract and other treatable eye problems was extended to Suddie, Essequibo Coast. Some areas, he said, were visited on more than one occasion because of the vastness of the population.
Accompanied by immigration officials, the screening process netted over 90,000 Guyanese over a two year period of which 6,000 were identified for surgery in Cuba. They received travel documents and other necessary mechanisms to facilitate their trip to Cuba. Those identified were not required to pay a single cent not even to travel from their homes to the airport as government stood the cost, Dr Ramsaran divulged.
It was a costly undertaking, he admitted, even as he noted that some persons had to be airlifted from their homes in the interior to Georgetown. About one third of the patients had received surgery for cataract. Some were also treated for Retinitis Pigmentosa commonly called night blindness. This disease is said to be hereditary.
But even with miracle mission in motion, the Guyana Government was yet eyeing a more sustainable way of rendering eye care to the populace. It was in this regard that phase two of miracle mission was put into action.
“We are thankful to the Cubans and Venezuelans for helping us but we needed to do something that could create capacity to treat people right here.”
Work on the Ophthalmology Centre was streamlined and geared at providing quality health service in an equitable way.
According to Dr Ramsaran, persons across the country are today able to access the service, adding that patients are transported from the Diamond Diagnostic Centre to the Port Mourant facility and back free of cost.
Even before the commencement of Mission Miracle, Dr Ramsaran recalls that the President had put in place a spectacle programme for the elderly. The aim of this programme, which was eventually expanded to cater to younger people as well, was to help the seniors be able to access free spectacles.
Some $30M, Ramsaran said, was initially allocated to that programme which was overseen by him in his capacity as Director of Regional Health Services. “Special facilities and mechanisms were set up to reach out to the regions to find people who were blind with preventable and curable causes.”
The elderly, he said, were the primary target then because during a Cabinet outreach programme one of the major concerns highlighted was that many senior citizens could not afford cataract surgery which reflected on their family life.
Dr Ramsaran disclosed that although cataract is a manageable disease it was a costly operation to undertake at a private level.
“At that time to do one side cataract was around $250,000 privately. If you take surgical intervention the cost of the intraocular lens and of course hospitalisation and follow up the cost would add up. Very few people could afford to do one side much less two.”
But there was some level of capacity, predominantly at the Georgetown Public Hospital and to a lesser extent at the New Amsterdam, Dr Ramsaran noted.
Foreign ‘Good Samaritans’ teams rendered occasional assistance. The service offered was however compromised by some surgeons who were “hopelessly underperforming.”
“If I remember well there was one surgeon who did 16 surgeries in a year in a public facility most likely because he was busy otherwise. It was frightening because the backlog of cataract cases would not have been addressed at that pace.”
Persons’ inability to access eye operations resulted in a backlog of eye diseases that were treatable, a scenario which served to mount the President’s frustration. He recognised, Dr Ramsaran said that the principles of equitable access, value for dollar, clientele satisfaction and quality of service were not being heeded in the sector.
It was against this background, Dr Ramsaran revealed that the Cuba mission was planned which has since paved the way for Guyana to have its own state of the art eye care centre.
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