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And women in childbirth will continue to die. Patients after routine surgeries will continue to die. Children with abdominal pain will continue to die. Covid-19 patients will continue to die. For the underlying reasons will astound;
1.The Medical Council is politicised, not fit for purpose.
2. Health institutions aren’t monitored
4. Doctors with political connections free to misrepresent their credentials.
5. Doctors not regulated.
Regulation and monitoring
Indeed, all Medical Councils overarching responsibility is ensuring doctors are safe to practice and safe for patients. To that end, there are medical registers, universally established for doctors. However, inclusion on the medical register isn’t automatic, since Medical Councils have a statutory responsibility to confirm doctors’ credentials. In fact, even if the doctor undertook
So on this backdrop, two cases are shared;
Dr. Kishore Persaud, having undertaken a fellowship in Canada, self-certified as a Transplant Surgeon, despite the Calgary Medical Council website explicitly stating- THIS DOCTOR ISN’T A SPECIALIST. However, most concerning, the Medical Council hasn’t taken action, despite coverage many times in this column.
Dr. Mahendra Carpen, having undertaken fellowships, also self-certified as an Interventional Cardiologist, despite both the Toronto and Massachusetts Medical Councils haven’t certified him as an Interventional Cardiologist. Again the Medical Council hasn’t taken action.
The fact is, only Medical Councils have the statutory powers to certify doctors, with the requisite qualifications, as specialist. Doctors can’t certify themselves(self-certify) as specialist, since that would entail Medical Councils arrogating it’s statutory responsibility to doctors, placing lives at risk. In fact, if the Medical Council that supervised a doctor’s fellowship, determines that the fellowship training isn’t a qualification for specialist registration, then that should be the position of all subsequent Medical Councils. As a matter of fact, it’s universally established that standalone fellowship training, isn’t a route for specialisation. However, that’s not the case in Guyana, for doctors with political connections can self-certifying with impunity, accounting for the high maternal among other deaths.
Having said that, like health professionals, health institutions are mandated for monitoring by a statutory Bodies, with the following qualities;
1. Should be independent
2. Should be evidence based.
3. Should be empowered to intervene when concerns are raised or identified.
4. Should be credible.
Where the rational is, monitoring informed by number and nature of deaths, complaints, staff numbers etc, illuminates safety.
That said, with our shocking hospital mortalities, unsurprising it will be that regulation and monitoring of health professions and institutions respectively, aren’t being undertaken. As a result, our health service is critically unsafe, evident with the high numbers of unexpected deaths, low staff morale and high turnover. However, rather than addressing these urgent concerns, PPP remain laser focused on politicising the health service, speaking of the complex whilst shockingly failing at the basics.
A painful death
Mr. Subryan, a 74yr old man, presenting with abdominal pain and bloody stool, was assessed by two doctors, who unbeknownst to him weren’t specialist, despite their claims.
Nonetheless, Mr. Subryan had a tragic death, necessitating investigation
1. “The clinical management of Mr. Subryan’s was grossly sub-standard at many stages.”
2. “Autopsy report documented the abdomen was filled with pus and adhesions along loops of intestines.” Additionally, his kidneys were bags of pus, evidencing severe infection in his abdomen, caused by the doctors perforating his intestines. Additional, the sutures in his bowels were incorrectly done, leading to leakage, severe infection and ultimately death.
Prof. Cawich recommendations;
1. I recommend that Dr. Kumar and Dr. Persaud should face appropriate disciplinary action.
2. The Standards Unit at the Ministry of Health needs to send teams of assessors to all health facilities to inspect processes and adherence to protocols.
3. The Medical Council, along with the Ministry of Health and other partners shouid assist hospitais to strengthen their due ditigence, credentialing and privileging committees.
4. There is an urgent need for creation and publication of the Specialist Register as requested by CAMC. The public has a right to information about a physician’s expertise in a particular area.
5. It is time for the Caribbean to emulate the USA which requires physicians to undergo periodic examinations in order to maintain their Board certification.
6. I propose that we ask CAMC to create and execute refresher examinations for general physicians and specialists. This aims to ensure that physicians remain updated in their specialty.
Which means, with PPP unregulated and unmonitored healthcare,
However, likely these deaths are multifactorial, nevertheless it can’t be ignored they coincided with the discontinuation of APNU+AFC maternal care policies, that were informed by PAHO and Dr. Gobin’s guidance. In fact, similar interventions were made, when arrogantly PPP discontinued the WHO Covid-19 guidance, that brought successes to APNU+AFC.
The reality is, not many have confidence in PPP Wild Wild West Politicised healthcare. However, with their cluelessly disposition, shocking deaths will remain a painful reality, even as they play Russian Roulette with our lives. As a result, we will forever draw the short end of the stick, with their masquerading doctors providing our care. We will forever draw the short end of the stick, as the bed placed on, tragically collapses. We will forever draw the short end of the stick, on the ventilator when blackout presents, with the generator not working.
However, Albert Einstein once said;
“Insanity is doing the same thing over and over and expecting different results.”
And with PPP resistant to change, we have to steel ourselves for more deaths