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Health care management in Guyana is deficient. There is an absence of serious scientific approaches to inform policies and programmes. Often time Guyanese are made aware of the gravity of various illnesses in Guyana from internationally written reports. From these Guyanese learnt Guyana is rank highest in the world for suicide (mental health) and second in the Americas for diabetes.
Given the statistics, suicide and diabetes are public health crises. It would therefore suggest the urgent need for rethinking the role of the people in informing and guiding their health and wellness. This is where the research works of Dr. Helena Ann Mitchell, a Guyanese residing in the United Kingdom (UK), could prove to be of great value.
Helena described herself as “an academic with a specialist interest in feminism and BME [Black and Minority Ethnic] communities.” She is a Lecturer in Mental Health Nursing at the Open University, UK. She was born in Guyana and attended Catholic primary and secondary schools. After obtaining her General Certificate in Education, she entered the Government service and worked in the Accounts Department. In the 1970s Helena migrated to the UK and accepted a nurse training position in Surrey.
In 2014 Helena submitted her Doctor of Philosophy thesis, ‘A Participatory Action Research Study with Guyanese Women Living with Type 2 Diabetes in England’ to the University of Surrey. Said thesis examined “People from Black and Minority Ethnic groups, in particular Guyanese people, [who] have a higher incidence of Type 2 Diabetes.”
Her interest in diabetes is due to having family in Guyana who have been diagnosed and living with the disease for years and she was “intrigued by their cavalier attitude towards managing their” condition. She stated that despite the prevalence of this chronic illness, “there is a paucity of research which explores women’s experiences of living with the condition.”
Her research was conducted using the Participatory Action Research (PAR) methodology to delve into her subjects. PAR, according to the United States National Institute of Health, “differs from most other approaches to public health research because it is based on reflection, data collection, and action that aims to improve health and reduce health inequities through involving the people who, in turn, take actions to improve their own health.”
In using the PAR methodology Helena made known her reliance was on “data generated [that]included storytelling in one-to-one interviews in the safe environment of the women’s own homes, followed by 14 PAR group sessions.” According to her thesis, the “Participants drove the research by determining what should go on the agenda and they decided on the resultant actions.”
Helena worked as a former nurse in community mental health in the UK. Where mental health remains a stigma in Guyana, and some who are affected would rather suffer in silence than reach for help for fear of being ridiculed, shamed or ostracised, PAR could be an effective tool to propel acts of empowerment. This is the methodology Helena and her team, who came to Guyana in 2019 on a one-year research project, utilised to study three communities facing their own challenges- Enmore; Yupukari, an indigenous community in the interior; and a community refuge for abused women.
She was the Principal Investigator of the Open University Action Research Community Led Initiative Guyana Health Team (ARCLIGHT) that was awarded approximately £ 50,000 from the British Academy’s Knowledge Frontiers: International Interdisciplinary Research Projects Programme. The ARCLIGHT blog noted theirs was “an ambitious new research project which will develop, implement and evaluate a capacity building and intervention programme for addressing the challenges of mental health in Guyana.” It went further to state “Mental health services are barely functional, with Guyana’s public health minister describing the country’s national psychiatric hospital as ‘not fit for human consumption.’”
At the conclusion of the project a handbook was published to reflect the lessons learned through the research. According to the Open University “The handbook can be widely used by health and social care professionals for developing community resilience where adverse circumstances affect mental health…In the current climate the handbook should prove a valuable tool for anyone needing to address community mental health.”
It would not be unreasonable to think Dr. Mitchell would expect the sacrifices and resources expended on the project would be used to improve health care management and the lives of citizens, not gather dust.