Health in Guyana

One of the most unfortunate consequences of Guyana's economic decline in the 1970s and 1980s was that it led to very poor health conditions for a large part of the population. Basic health services in the interior are primitive to non-existent, and some procedures are not available at all. Compared with other neighbouring countries, Guyana ranks poorly in regard to basic health indicators. In 1998, life expectancy at birth was estimated at 66.0 years for Guyana, which is much less than surrounding countries. Malaria is a leading cause of death in Guyana. Although Guyana's health profile falls short in comparison with many of its Caribbean neighbours, there has been remarkable progress since 1988, and the Ministry of Health is working to upgrade conditions, procedures, and facilities.

Service delivery

The delivery of health services is provided at five different levels in the public sector:

• Level I: Local Health Posts (166 in total) that provide preventive and simple curative care for common diseases and attempt to promote proper health practices. Community health workers staff them.
• Level II: Health Centres (109 in total) that provide preventive and rehabilitative care and promotion activities. These are ideally staffed with a medical extension worker or public health nurse, along with a nursing assistant, a dental nurse and a midwife.
• Level III: Nineteen District Hospitals (with 473 beds) that provide basic in-patient and outpatient care (although more the latter than the former) and selected diagnostic services. They are also meant to be equipped to provide simple radiological and laboratory services, and to be capable of gynecology, providing preventive and curative dental care. They are designed to serve geographical areas with populations of 10,000 or more.
• Level IV: Four Regional Hospitals (with 620 beds) that provide emergency services, routine surgery and obstetrical and gynecological care, dental services, diagnostic services and specialist services in general medicine and pediatrics. They are designed to include the necessary support for this level of medical service in terms of laboratory and X-ray facilities, pharmacies and dietetic expertise. These hospitals are located in Regions 2, 3, 6 and 10.
• Level V: The National Referral Hospital (937 beds) in Georgetown that provides a wider range of diagnostic and specialist services, on both an in-patient and out-patient basis; the Psychiatric Hospital in Canje; and the Geriatric Hospital in Georgetown. There is also one children’s rehabilitation centre.

This system is structured so that its proper functioning depends intimately on a process of referrals. Except for serious emergencies, patients are to be seen first at the lower levels, and those with problems that cannot be treated at those levels are referred to higher levels in the system. However, in practice, many patients by-pass the lower levels.

The health sector is currently unable to offer certain sophisticated tertiary services and specialised medical services, the technology for which is unaffordable in Guyana, or for which the required medical specialists are not available. Even with substantial improvements in the health sector, the need for overseas treatment for some services might remain. The Ministry of Health provides financial assistance to patients requiring such treatment, priority being given to children whose condition can be rehabilitated with significant improvements to their quality of life.

There are 10 hospitals belonging to the private sector and to public corporations, plus diagnostic facilities, clinics and dispensaries in those sectors. These ten hospitals provide for 548 beds. Eighteen clinics and dispensaries are owned by GUYSUCO.

The Ministry of Health and Labour is responsible for the funding of the National Referral Hospital in Georgetown, which has recently been made a public corporation managed by an independent Board. Region 6 is responsible for the management of the National Psychiatric Hospital. The Geriatric Hospital, previously administered by the Ministry of Labour, became the responsibility of the Ministry of Human Resources and Social Security of Guyana in December 1997.

Health conditions

The US State Department Consular Information Sheet warns "Medical care is available for minor medical conditions. Emergency care and hospitalization for major medical illnesses or surgery is limited, because of a lack of appropriately trained specialists, below standard in-hospital care, and poor sanitation. Ambulance service is substandard and may not routinely be available for emergencies." Many Guyanese seek medical care in the United States, Trinidad and Tobago or Cuba.

Maternal and child health care

In June 2011, the United Nations Population Fund released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Guyana is 270. This is compared with 143.1 in 2008 and 162.3 in 1990. The under 5 mortality rate, per 1,000 births is 36 and the neonatal mortality as a percentage of under 5's mortality is 60. The aim of this report is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Guyana the number of midwives per 1,000 live births is unavailable and the lifetime risk of death for pregnant women is 1 in 150.^[1]

The leading causes of mortality for all age groups are cerebrovascular diseases (11.6%); ischemic heart disease (9.9%); immunity disorders (7.1%); diseases of the respiratory system (6.8%); diseases of pulmonary circulation and other forms of heart disease (6.6%); endocrine and metabolic diseases (5.5%); diseases of other parts of the Digestive System (5.2%); violence (5.1%); certain condition originating in the prenatal period (4.3%); and hypertensive diseases (3.9%). The ten leading causes of morbidity for all age groups are, in decreasing order: malaria; acute respiratory infections; symptoms, signs and ill defined or unknown conditions; hypertension; accident and injuries; acute diarrhoeal disease; diabetes mellitus; worm infestation; rheumatic arthritis; and mental and nervous disorders.

This morbidity profile indicates that it can be improved substantially through enhanced preventive health care, better education on health issues, more widespread access to potable water and sanitation services, and increased access to basic health care of good quality. A number of non-governmental organisations, including Health and Educational Relief for Guyana (HERG, INC) and Guyana Medical Relief (GMR, INC) are currently working to address these issues by improving healthcare access and educational infrastructure.

Guyana has experienced an upswing in violent crime and homicide in 2007 while the numbers of murders reported actually dropped in 2007 over the previous few years, with a murder rate of 15.1 people for each 100,000, in contrast to 2008 (up to the end of July) that number has risen to 26 per 100,000 ^[2] similar to the rate experienced in 2003. Guyana suffers from the highest suicide rate of any South American country. Guyana Health Minister Leslie Ramsammy estimates that at least 200 people commit suicide each year in Guyana, or 27.2 people for each 100,000 people each year.^[3]

References

1. ↑ "The State Of The World's Midwifery". United Nations Population Fund. Retrieved August 2011. 
2. ↑ "Guyana’s murder rate is up this year". Stabroeknews.com. 2008-08-01. Retrieved 2010-05-02. 
3. ↑ "BBCCaribbean.com". Bbc.co.uk. 2008-01-11. Retrieved 2010-05-02.