Project to reduce maternal deaths at risk of collapsing
(Originally published in Guyana’s Kaieteur News on 09 January 2011)
– Former Medical Council Chairman quits after conflict with GPHC officials
By Michael Jordan
A project to reduce maternity deaths at the Georgetown Public Hospital has been dealt a major setback after a physician who was playing a major role quit abruptly. Kaieteur News confirmed yesterday that former Medical Council Chairman, Dr. Galton Roberts, left the project on Tuesday after GPHC officials failed to implement major changes that were suggested by some private physicians to improve the Maternity Department.
One of the main recommendations was that the GPHC’s operation theatre be ready to handle maternal emergencies around the clock. However, this has not been done. The unavailability of the theatre on a 24-hour basis had endangered the lives of three high-risk maternal patients as recently as last week.
“On Monday night we had a patient who was scheduled for a Caesarian section, but never had it because there was no theatre time (for maternity cases),” an official said. Instead, the woman had a vaginal delivery, which caused her uterus to rupture. She has since undergone surgery.
Kaieteur News was told that on the same day, a patient with an ectopic pregnancy, (a high risk pregnancy in which the fetus implants outside the uterine cavity) , had to wait almost four hours to be taken to the operating theatre.
A third high-risk patient with the same symptoms that caused the death of Linden maternity patient Inga Nieuenkirk, was forced to wait three hours before being taken for surgery.
“The next day there were four maternity patients waiting to be taken from the maternity ward to have surgery, and when Dr. Roberts asked two senior officials why they were waiting, he was offered a copy of the protocol to take patients into the theatre,” a source said.
Kaieteur News was told that after this discussion, Dr. Roberts informed the officials that he no longer wished to be involved in the project. Dr. Roberts, a gynecologist/consultant with some 25 years’ experience in the field of obstetrics, had been working at the GPHC with the junior staff and assisting in re-organising the maternity department. A health official said that the physician, who has a private practice, had offered to close down part of his clinic so as to work at the GPHC full time.
The former Medical Council Chairman was among a group of private physicians who had given their commitment to assist at the GPHC to reduce the recent spate of maternal deaths at the institution. But this promise had hinged on health officials following a series of recommendations that the physicians had put forward. Among the chief of these recommendations was that the operation theatre be ready at all times for emergency maternity cases.
Explaining how vital this is, an official revealed that when Inga Nieuenkirk was transferred from Linden to the GPHC, it took staff more than one hour to move her from the maternity ward to the operating theatre, “and another hour and a half waiting for the operating theatre to be prepared.”
“She died from loss of blood…She had to wait because the Maternity Ward is not provided with operating theatre time,” a source said. The private physicians had also suggested that at least eight junior doctors be seconded to the Maternity Department. Kaieteur News was told that six doctors have been seconded to the department.
The group also suggested that a Consultant/obstetrician be recruited for the institution. Kaieteur News understands that it was likely that the United Nations would have helped to foot the bill for recruiting an overseas obstetrician.
The physicians have recommended that the consultant be recruited from a Caricom country, partly because of the language problems that non-English speaking staffers have presented in the past. In a recent interview with Kaieteur News, Minister of Health Dr. Leslie Ramsammy had expressed optimism that the measures would have led to an improvement in the maternity department and a reduction in deaths.