Jan 08, 2014 News
“Treatment leads to cure and cure leads to better health outcomes,” was the assertion of Chief Medical Officer, Dr Shamdeo Persaud, even as he commented on a reported shortage of some medications within the public health sector.
Reports reaching this publication are that several public health institutions during the course of last year were without various medications, a trend that has reportedly continued this year.
Dr Persaud in acknowledging the state of affairs, during an interview with this publication yesterday, said that the situation can be deemed rather ad hoc and sporadic in nature at health facilities Region-wide. However, he noted that “it is very disturbing to me, because it could be that this vital item (medication) when needed is not there and that’s worrying and we would really like to correct that.”
According to him the Health Ministry in recognition of the daunting dilemma has been seeking to reverse the trend plaguing the public health sector.
“We would like to know that the medicines that the Government and taxpayers invest in are available when each and every one of us and our visitors need them.”
This is particularly important, Dr Persaud said, since there cannot be a good outcome if the health sector is not able to provide the proper health care, which includes the availability of medication.
And according to him, the non-availability of medication at some health facilities can in fact translate to a real shortage. “We do have stock outs from time to time of some very essential medicines and this may be due to a number of reasons,” said the Chief Medical Officer.
He explained that one of the primary reasons is in fact linked to the tendering process which sometimes sees the supplier(s) failing to comply with the recommended delivery schedules. However, Dr Persaud noted that the Permanent Secretary of the Ministry has been working in collaboration with the Deputy Permanent Secretary to address this situation that has the potential of greatly affecting the proper delivery of health care.
Persaud in his deliberation disclosed that while in previous times the Health Ministry hadn’t the capacity to store its own medication, such a challenge no longer exists. However, he did mention that there yet remains caution in procurement since there are some medications that have a relatively short shelf life.
Moreover, he explained that although the Ministry would tender for medication for an entire year some are delivered in tranches to cover the need for three to six months.
And since the utilisation of these medications are likely to vary at various health facilities there is a possibility that the limited supply may not span the entire period it was estimated for. This could therefore result in the shortage situation, Dr Persaud expounded. “So some of that shortage do exist I think all of us – myself, Minister, everyone – have already said that we know there are times when we just don’t have the items,” he said.
Another way in which the shortage situation can occur, he explained, is through the process of distribution even though the medication may be in stock. According to him, “sometimes the items maybe present but it is not getting to the peripheral levels, especially at the health centres and some of our hospitals and so on.
It might be held in a bond or somewhere, but we are working to see how best we can strengthen those (regional) distributions with the Ministry of Local Government and Regional Development.”
In explaining the process whereby the distribution delays could result in the shortage of medication, Dr Persaud described a scenario where such a situation could develop.
He noted that even if the Ministry’s Bond efficiently dispatches supplies to perhaps the Mabaruma Hospital in Region One, there are instances when they will still have to be taken to other facilities that really need supplies such as Port Kaituma.
And according to Dr Persaud, “there could be delays along that chain of delivery.”
Also the Ministry is also closely looking at the re-ordering time of medication by health facilities, intimated the Chief Medical Officer. But re-ordering, according to him, could be hampered by the absence of certain levels of health personnel which could result in orders not being made in a timely manner.
“Sometimes the doctors are rotating and this might not be under their guidance…so a set of drugs may be ordered for a particular facility based on the presence of a medex or a nurse but when a doctor goes to work there, there has to be an order for additional items that goes beyond the (mandate of the) medex (or nurse),” said Dr Persaud.
He noted that a Medex, for example, though often in a supervisory capacity, can only order and prescribe some medication. However, once a doctor is charged with that same health facility additional medication can be procured, and according to Dr Persaud, “we will then have to fast-track the mechanism for them to get all the drugs needed there.”
But while there are instances when the medication is unavoidably unavailable to patients, Dr Persaud noted that the most disturbing situation that he has encountered is when patients are asked to purchase their own medication when they are very much available at the health facilities.
“I was horrified myself to see a prescription being written for an item for the patient to go and buy it (medication) and the item was, according to records, at the institution’s bond but maybe it was locked up and the person with the keys wasn’t there. Reasons like that do spring up at times too,” Dr Persaud lamented.
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