Whenever I’ve heard people reflect about their international medical experiences (especially among my colleagues who have worked here in Guyana), there tends to be a few common themes that emerge. There are statements about the gratitude of the local population, and their resilience in the face of adversity in nearly every aspect of their lives. They discuss the lack of resources available; how the hospitals/clinics can lack the most basic of amenities (gloves, bandages, water), or how few and far between medical practitioners are located. Universally, people say the experiences have changed them at their core; they now have a greater appreciation for the resources/opportunities available back in the US, and will continue to work to improve the plight of those less fortunate.
Sometimes the most difficult parts of a job produce the situations you learn the most from. Often doctors will remember their most challenging patients for the rest of their lives and rarely forget what they’ve learned through those interactions. Working at Georgetown public hospital has afforded me a wealth of opportunities such as these in my short time here.
Whenever I’ve heard people reflect about their international medical experiences (especially amongst my colleagues who have worked here in Guyana), there tends to be a few common themes that emerge. There are statements about the gratitude of the local population, and their resilience in the face of adversity in nearly every aspect of their lives. They discuss the lack of resources available; how the hospitals/clinics can lack the most basic of amenities (gloves, bandages, water…), or how few and far between medical practitioners are located. Universally, people say the experiences have changed them at their core; they now have a greater appreciation for the resources/opportunities available back in the US, and will continue to work to improve the plight of those less fortunate.
One of the best things about healthcare delivery in Guyana is that it is nationalized. Care is free and available to every citizen. It is financed and managed through the Ministry of Health working together with regional and local government. There is an independent private sector. However, despite a national health system, there are several gaps in the delivery of health care in Guyana.
We are taught during medical training to be very cautious and to only proceed with decisions and procedures when we are well prepared. Putting in a breathing tube, for example, when a patient is having difficulty breathing or has lost consciousness, is a procedure that can be done with just a few simple pieces of equipment. But in an attempt to ensure success, we bring in advanced tools for back up, cameras to get a better look down the throat, smaller tubes in case the size we have chosen doesn’t fit. Once we are prepared for anything we are ready. But in many places around the world, including Georgetown Public Hospital in Guyana, those backups are simply not available.
Prior to my arrival, I had the opportunity to spend a considerable amount of time with one of the Guyanese EM residents as they visited Vanderbilt. In one of our various discussions, he brought up a fact that surprised me; the majority of Guyanese in the world do not reside in Guyana. Instead, they are scattered throughout North America, namely New York and Toronto. In his family for instance, only 10-20% remained in the nation, with the rest living in one of New York’s five boroughs. When I asked him if he would eventual join them in the US, he said no. His colleagues, however, had a much different approach.
I paid a visit to the local hospital called Makelekele, the second largest hospital in Brazzaville where I visited the different sections in the hospital and spoke with the staff. The hospital was a little crowded due to the explosion that occurred a few weeks ago. A number of people are still receiving treatment from the hospital.
All I can say is, I don’t know how they do it. I have finished my time in A&E and have been on female medical ward for the last week and a half. The female medical ward is housed in a new facility that opened several months ago. There are approximately 8 patients per room. Patients have to bring their own sheets, clothes, toilet paper, water, and any other supplies that they might need. There are many nurses and even more nursing students around, but I have yet to figure out exactly what they do. Care by the nursing staff is haphazard at best.
Over the past two weeks, I have continued to work on the research paper on the status of the Framework Convention on Tobacco Control (FCTC) supply strategies in the African Region as reported by the Parties to the Convention. My plans to have the first event of the employee community service program in March have been stalled. We also had an unfortunate incident in Brazzaville on the 5th of March. A fire started at a military arms depot and set off a series of explosions killing more than 150 people and leaving thousands displaced. This sad event was felt at the office as many workers lost their homes. As a result, things were a bit slow at the office this week. The event has been postponed to April to allow time for things to settle back down.
Prior to my arrival in Guyana, I had the opportunity to spend a considerable amount of time with one of the Guyanese EM residents when they visited Vanderbilt. In one of our discussions, he brought up a fact that surprised me: the majority of Guyanese in the world do not reside in Guyana. Instead, they are scattered throughout North America, namely New York and Toronto. Only 10-20 percent of his family, for instance, remained in the nation, with the rest living in one of New York’s five boroughs. When I asked him if he would eventual join them in the US, he said no. His colleagues, however, had a much different approach.

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