There is no dispute, between 1992 and 2015, Guyana made tremendous progress in health. But the truth is that, in spite of five times increase in annual budgeting in the last five years, health has regressed.
That 26 pregnant women died in 2019, with the Ministry of Public Health claiming 18 actual maternal deaths in 2019, is testimony not only has Guyana not made any progress in health in the last five years, but Guyana has regressed.
Yet, Guyana spent minimum five times more in health in the last five years than for any other five-year period in our history. How come we spent greater than five times more in health and have nothing to show for it? Is anyone being held accountable? As elections loom, the party responsible for this scandal demonstrates total cluelessness in its manifesto in recognising the problem and how to fix it.
There is no question Guyana needs a Specialty Hospital. How the two main parties embrace and plan for such a hospital is informative. APNU+AFC voted against the Specialty Hospital in 2014 and then abandoned the project in 2015, begged India to approve utilisation of the funds for investing in regional hospitals, insisted throughout the last five years the Specialty Hospital is a waste of time.
Lo and behold, it is proposing in its 2020 manifesto specialty hospitals in all regions of Guyana. But this proposal is not made under health, it is made under investment promotion and job creation. Nowhere under health is any such proposal made.
Clearly, they were throwing darts, cutting and pasting from different sources, with no cohesive plan.
In the meantime, the PPP has aggressively promoted the proposal that it will restore the Specialty Hospital as part of its health and development agenda.
In the last five years, from 2015 to end 2019, APNU+AFC spent $125.8B on health, an average of $25.2B annually. The PPP/C between 1993 and end of 2014 spent a total of $122.2B on health, an average of $5.6B annually. Thus, APNU+AFC spent more in five years than the PPP spent in 23 years, but failed to achieve as much as the PPP did.
The actual state of health in Guyana does not correlate with the amount of money spent. Money is needed, it is critical, but without a sound plan, throwing money at it is like throwing water on a duck’s back. This seminal wisdom was lost on APNU+AFC, since that is exactly what they did, spending money aimlessly.
The PPP/C in its 23 years took a health sector that had collapsed and transformed it, improving the lives of citizens. It did so, not only by investing increasing amounts of money, but because it had a sound plan. The results are plain for people to see.
Life expectancy increased from about 60 years at birth to more than 70 between 1992 and 2015. In addition to reducing overall deaths from greater than 14,000 annually, to less than 7,000, maternal, infant and child mortalities decreased in that period. In fact, from about 2,200 annual child deaths each year, by 1990, annual numbers of child deaths were reduced to under 200 by 2015.
One reason for the dramatic reduction of child deaths was the 100% coverage for all the relevant childhood disease vaccines. Infectious diseases, like malaria and filariasis, were significantly reduced. Guyana reached elimination levels for filariasis and leprosy by 2015.
Guyana’s HIV and TB Prevention, Treatment and Care programmes became globally recognised for its robustness and effectiveness. Guyana became one of the first developing countries to attain universal access to HIV medicines and one of the first countries to be recognised for elimination of mother-to-child transmission.
While primary health care truly became universal, a growing menu of quality secondary and tertiary health care became evident across the country. While a thriving private sector contributed to this success, the public sector took the lead in introducing advance care, such as open-heart surgery, kidney transplant, brain surgery, dialysis, etc. In addition, the government increased the number of doctors and nurses and other technical staff, such as medical technologists and pharmacists. The public sector also introduced graduate programs to increase the number of specialist doctors and nurses. Besides these tangible service improvements, the PPP improved the infrastructure. Major hospital construction led to new hospitals in every region, including new hospitals in Georgetown, New Amsterdam, Linden, Mabaruma and Community diagnostic hospitals scattered around the country.
Guyana’s first Ophthalmology Centre was constructed in Port Mourant and a Cancer Centre, and new Blood Bank were constructed at the GPHC. Guyana’s, and one of CARICOM’s, first Public Health Research and Reference Labs was established. A State-of-the-art warehouse was built.
From around 150 health facilities around the country, by end of 2015, there were 28 hospitals and 450 health centres. The diagnostic capacity also improved, with new labs, X-Rays and other imaging facilities. These were real advancements for the health sector, even as the government struggled to increase expenditure.
In the last 5 years, in spite of massive spending, the health sector of Guyana has deteriorated badly under APNU+AFC. Not surprising, therefore, people are asking the present government – what have you gotten to show for spending five times more on health than the previous government? No new hospital has been built, few health centres have been constructed, very few have benefitted from maintenance work, very little new equipment, no dramatic change in staffing and extensive medicines and medical supplies shortages.
Where did all the money go? Who can blame the average Guyanese for their suspicion that not all of the $125B went to health?
Dr. Leslie Ramsammy
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