– has plans to further expand cardiac services
By Sharmain Grainger
Created with a vision to offer an invaluable, and at the time, non-existent service to the Guyanese populace, the
Caribbean Heart Institute (CHI) for the first time opened its doors on October 14, 2006.
It was an auspicious time for not only its founder and Chief Executive Officer, Dr Gary Stephens, but the health sector as a whole – which was at the time headed by Minister of Health, Dr Leslie Ramsammy – was taking immense pride in the undertaking. This meant open-heart surgery and a wide range of other heart operations were going to be readily available at a facility strategically situated at the Georgetown Public Hospital Corporation (GPHC).
Moreover, the venture was and still is being dubbed a public-private partnership.
And even as CHI prepares to celebrate eight years of existence, there will be no little reflection on the inroads that have been made to offer quality heart services that are comparable to what is offered in the Caribbean and even further afield.
In an invited comment, Dr Stephens reminisced on the path to making CHI a reality, even pointing out that “I still remember fondly the opening of CHI and all the big dreams we had”. He is therefore convinced that the institution in many ways is a representation of what is possible even when resources are limited.
Having achieved what many thought was an impossible feat, Dr Stephens was eager to pinpoint some who were instrumental in CHI’s existence.
“We owe a debt of gratitude to Pastor Fontanelle and the Revealed Word Ministry. This is especially important, as it was Pastor Fontanelle who introduced me to President (Bharrat) Jagdeo, that made CHI possible,” Dr Stephens recounted.
Moreover, he was keen in highlighting that CHI “still represents a source of pride for me, especially since we have been able to stick to our mission of providing a service, while making a (profit) margin that was important only to the extent that it made us sustainable.”
He however noted that although significant progress has been made over the years and the potential to do even greater things is evident, the facility still remains at a crossroads.
In order to achieve the possible, Dr Stephens is adamant that there is need for greater partnership with Government.
“In the last few years the relationship had felt less and less as a partnership. The uncertainty with Government has made it difficult to raise private capital to invest in moving to the next level,” Dr Stephens reflected.
“The ideas and vision that made CHI possible still exist. I want to spend less of my time fighting Government and bureaucracy and more fighting to ensure patients get quality care.”
A Guyanese by birth, Dr Stephens is a leading Cardiac Surgeon in the United States, and has not failed to render his expertise, through CHI, to his homeland. Although at the start of the institution he was responsible for undertaking all surgical operations, with the aid of an overseas-based team, he had subsequently recruited Interventional Cardiologist, Dr Pratik Soni, an Indian national. Dr Soni has since parted ways with CHI.
Currently the resident Cardiologist is Dr Mahendra Carpen who was hand-picked by Dr Stephens to function as the institution’s Medical Director.
However, all major decisions at the institution are made by Dr Stephens, who is therefore ultimately responsible for the quality of work that is provided.
“My commitment to my fellow Guyanese remains unshakable, and anyone entering CHI can rest assured that they will receive the highest standard of care,” said Dr Stephens as he lauded the work done by Dr Carpen and the team at CHI.
Dr Carpen, in speaking to the value of the institution to the local populace, credited its survival to the foundation laid by Dr Stephens and all those who supported the vision of CHI. He acknowledged that since its introduction, there is no denying that the institution has considerably grown to a great extent with regards to the service provided to the patients seen.
“I don’t think that you can overstate the importance of an institution like this to Guyana,” said Dr Carpen of CHI. He has classified the services offered by the facility as “immeasurable…you can’t quantify it.”
Though he was not there from its inception, he noted that the facility started out offering services conducted by visiting Cardiologists but “we have moved from that time to where we have our own Cardiologists on the ground who can do all procedures that can be done pretty much elsewhere in the Caribbean, and we are set for even bigger growth in the near future.”
Outside of the basic Echocardiogram, Stress Testing services, CHI also provides angiograms, angioplasty, stent placement, open-heart surgery, and has expertise to address congenital defects such as holes in the heart. Of course there is implantation of devices such as pacemakers, intra-cardiac defibrillators and cardiac resynchronization. The latter was in fact an historic procedure undertaken by CHI a few months ago.
Currently CHI’s track record suggests that it is able to conduct some 200 angiograms on an annual basis, while for last year alone, about 50 open-heart operations were conducted, an increase from previous years. Its open-heart success rate stands at an all-time high of 98 per cent, similar to reputable overseas-based cardiac facilities.
Last year, too, about 25 pacemakers and device implantations were done, and according to Dr Carpen, weekly clinics attract about 500 patients and are likely to attract more with the planned expansion of cardiac services.
According to Dr Carpen, “in the very near future, as early as January, we will be introducing cardiac electro-physiology where basically that is treatment of heart rhythm disorder.”
And it is the expectation of the Cardiologist that this venture will see CHI being able to forge an especially crucial partnership with Government through the Ministry of Health, thereby allowing the institution to be in a better operational place.
To undertake this level of operation, efforts have already been made to procure an advanced Cardiac Cauterization Laboratory, and according to Dr Carpen, “I believe that within the next couple of months we will be the envy of many of the Caribbean nations.”
With an increased demand for the services offered, Dr Carpen noted that CHI has been challenged to accommodate, as far as possible, all of its clientele. In fact, he recalled that for a long time the facility had been alone servicing the cardiac needs of the population.
“If you can imagine a small group of about 15 to 20 professionals trying to accomplish advanced heart care for that population, then you can imagine the challenges that are inherent in that process,” the Cardiologist noted.
He went on to explain that apart from a space constraint, another challenge that is faced is that of a financial nature, whereby some patients cannot readily afford advanced cardiac care.
“It is unfortunate that this is so, but with various means, especially with support from the Ministry of Health and the National Insurance Scheme, we have been able to provide a lot more to patients who would have otherwise not had the option of accessing advanced cardiac care.” Dr Carpen added that “like any place that is doing well and wants to expand, there are challenges, and we are no exception to that.”
The vision that CHI is currently embracing, according to Dr Carpen, is to provide quality cardiac care to all patients in need in a timely and effective manner. Added to this, he said that moves will be made to undertake more population-type researches that are relevant to the local population. This is in light of the fact, that “not everything that is relevant elsewhere is relevant to Guyanese patients. If you practice cardiology for any period in Guyana, you would recognize very quickly that some things are just unique to Guyanese patients.”
But realizing the results that CHI has been able to achieve over the years has not been without the dedication and commitment of staffers, ranging from the administration to the nursing and other support staff, Dr Carpen emphasised, “The quality of service that we offer here is something that we take pride in…we take pride in going beyond and above what is routine or normal prior to CHI’s existence. You can talk to families (and) patients who have passed through here and you will get the same response that ‘this is a surprising breath of fresh air’…the way the services are offered here.”
As part of observances for its eighth year, CHI will for this month be seeking to give back to the society. This, according to Administrator of the facility, Karen Pereira-Debidin, will be characterised by the free implantation of devices to address heart conditions.
According to Pereira-Debidin, the devices, which amount to in excess of US$100,000 were donated by American Device Company, Biotronik, and include pacemakers and complex cardiac devices that will be offered to selected patients who access the services of CHI.
“The beneficiaries are among those who we would have profiled and realized that they really can’t afford it, so we are going to donate the devices to them for our anniversary.”
The implanting processes are expected to start tomorrow, with two patients being the first to benefit and others being assisted throughout the month.
“That is our big thing for our celebration; to give back ‘big time’ to our customers,” said Pereira-Debidin.
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