Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694834093283.pdf (Guyana)
MINISTRY OF HEALTH ANNUAL REPORT 1996 TABLE OF CONTENTS Programmes Pages 1.

Executive Summary .............................. ............... .. 2.

Ten Most Prevalent Diseases ..................... .. .. ........... 3 2.

Office of the Project Coordination ............................. .

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Standards and Technical Services ............................. .

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Health Sciences Education ......................... .

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Maternal and Child Health ........... : .......................... 16 .

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Food and Nutrition ............................................... 19 .

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Food and Drugs Department .................................. .. 22 8.

Vector Control Services ......................... ............. ... .

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34 12.Ptolemy Reid Rehabi litation Centre .

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46 2 EXECUTIVE SUMMARY ( Malaria continued to be the most frequently reported disease in 1996 with a total of 34.075 new cases.
It needs to be noted that infectious diseases as a whole represent the most frequent reasons reported for using the health IO.

It should #1,7,8,9,and services.

Malaria was diagnosed most frequently in regions noted that in Region #4 it was the second most frequent cause of use of the public health services.

Accidents and injuries should be noted are the fifth leading cause of use of the services recorded.

The major causes of death continued to be diseases of the cardiovascular system.
Strokes, heart attacks and other undefined cardiac causes were the three leading causes.

These were followed by HIV/ AIDS and injuries.

It should be noted that tbe total number of deaths due to all injuries, were 579.

Cancers of all causes were of significant note.

The public health services as a whole faced many common problems the shortage of professio nal staff being one of the most common of these.
Availability of adequate medical supplies and their distribution is a problem, which is slowly resolving itself.

Those programmes where outreach is of critical importanc e face a constant problem of transportation.

1996 saw the commissioning of the New Ambulatory Care and Diagnostic Centre of the Public Hospital Georgetown.

This centre has increased the availability of specialist services to the population as a whole.

Six new operating theatres have been opened.


A new emergency suite, an intensive care unit and a pre-and post-operative unit have all been opened in this central referral facility.

The emergency room has appended to it, two theatres which though intended to be used for day surgery can be used for surgical toiletting.

There is now one central pharmacy for all the services in the hospital.

The new x-ray facility has the capability of ultra sound.

The Central Medical Laboratory is likewise located.
All the specialist clinics and a few private beds are also located in the facility.

This facility was the jewel in the IBD Health Care II project.

Other facilities associated with this project were commissioned earlier: the central sterile unit, the kitchen, laundry, water supply, gas supply and the emergency generating plant.
3 Other investment activity on-going at the end of 1996, included the construction Mahdia Hospital, the Bartica Hospital, the National Blood Transfusio n Unit and the Beterverwaagtin Health Centre.

Work was as well being projected for Kumaka District Hospital to improve the facilitie s for training Community Health Workers and Medex.

The donors are the in this sector European Union and the Caribbean Development Bank.
A project for the reconstruction of the New Amsterdam Public Hospital was presented to the government of Japan.

1996 saw as well the further development of the World Bank funded Primary Health Care Study.

This aimed at the development of a workable primary care model in urban and rural communities in East Berbice.

During this period, inventor a computerized y system for pharm aceuticals was completed.

This would assist in improving the general management of pharmaceuticals including distribution.
This department continues to need improved facilities for storage and inventory control.

In Health Sciences Education, the completion of the Health and Family Life Education Curriculum for the Teachers' Training College was a positive step in assuring the preparation of teachers for the broader tasks.

educational The Health Careers booklet can also greatly assist in the preparation of young minds for health careers .

Twenty-five Community Health workers were trained during this year.
Ten Psychiatric Nurse Practitioners their completed in training Berbice.

Fifteen Community Health Workers were trained in microscopy in region 8.

The curriculum for rehabilitation assistants' training has been completed.

This course will replace the physiotherapy assistants' programme.

The Maternal and Child Health programme completed the planned Mumps, Measles and Rubella booster immunisation campaign among 1-4 year olds.

76,362 or 90% of this group were vaccinated.


A pilot programme for the use of a simplified perinatal clinic record was introduced into the Public Georgetown Hospital along with four health centres in Georgetown.

The revised Maternal and Child Health manual has been introduce d at health centres.

The Final evaluation of the Canadian International Immunizati on Programme Phase II was concluded.

The review was positive and we were prompted to apply for a third grant.
One 'Baby Friendly' hospital has so far been assessed.

4 Ten Most Prevalent Diseases • The Vector Control Programme has resumed UL V fogging in Georgetown to suppress the mosquito nuisance and reduce the density of Aedes Aegypti.

There was an innovative study in West Ruimveldt, which related secondary cases to an index case from the interior.

malaria There was stepped up surveillance for bancroftian filiariasis.

There has been acknowledged an increasing trend in tuberculosis.
Amerindians and HIV patients are the prime targets of this increase.

The use of the WHO Direct Observed Treatment Short-course has been proposed.

A Draft revision of Food and Drug Act has been completed.

The Hazard Analysis Critical Point (HAACP) has been introduced in fifty percent of the seafood industry.

The investments in the sector have been substantial in the past year.

There are however a number of issues which remain unaddressed in terms of their real needs.
The need for a more broad based mental health program addressin g substance abuse is such an issue.

Strengt hening adolescent health programmes especially in schools remains a formidable challeng e to the health system.

With the investments in new infrastructure and training, continuous improvements in quality are the way forward to improve the cost effectiveness of our interventions.

!lJ)J ____ · ·········· Otfc;er Chief Medical ···············#·· 5 GUYANA'S MORTALITY-1996 565 486 321 290 'IJd.u1 Dis.
Disease Cerbrovascular Isch.

Heart Dis.

Other Health Dis.

HIV/AIDS Undetermined Diabetes AR!s Residual Hypertensive Intestinal Inf.

Dis.

Injury 273 254 244 204 189 176 Rate/Ratio S.14 per 100,000 /:.em.ale.

Milk.

m J1JfJ.

74.7 1il 2112.

- 64.2 42.4 ill ill 28.

38.3 36.1 .i.i.

ill lDfJ.

33.6 lJ.1.

].Jg_ 32.2 11.D.

27.0 21.

25.0 lJl.

11!!.

1l 1Jll 23.3 2fJl.

ill GUYANA'S MORTALITY-1996 MALE Disgrp Cerbrovascular Dis .

Isch.

Heart Dis.

Undetermined Injury HIV/AIDS Other Heart Dis.


AR!s Residual Cirrhosis, Liver Disease Inf.

Intestinal Diabetes GUYANA'S MORTALITY-1996 FEMALE Rate/Ratio per 100,000 80.5 77.6 55.0 5.15 45.4 34.9 29.5 28.5 27.1 26.8 Disgrp Rate/Ratio per 1 OIJ,000 Dis.

Cerbrovascular Isch.

Heart Dis.

Diabetes Other Heart Dis.

Hypertensive AR!s HIV/AIDS Residual Intestinal Undetermined Injury Inf.

Dis.

265 197 154 152 119 114 98 94 75 68 TEN MOST PREVALENT DISEASES ALL REGIONS No I.

2.

3.
2.

3.

First Visits 34,075 Infections 28,602 & ill defined or 16,653 Diseases Malaria Acute Respiratory Symptoms, Signs unknown conditions 9,041 Hypertension 9,933 Accident & Injuries 11,976 Acute Diarrheal 3,637 Mellitus Diabetes 7,198 Worms Infestation 4,143 Arthritis Mental & Nervous Disorders 1,952 .

Rheumatism Disease Total 4.

5.

6.

7.

8.

9.

10.


Total Visits 34,075 33,541 19,763 19,687 12,251 11,976 8,768 8,031 6,587 2,687 175,366 * Total number of visits for ALL Regions = 203,318 * The ten most prevalent diseases accounted for 86.3% for the total visits in ALL Regions.

TEN MOST PREVENT DISEASES REGION I NO.

I.

2.

3.

4.

5.

6.

7.

8.

9.

10.


FIRST VISITS DISEASES 5,632 Malaria Infections 4,323 Acute Respiratory Symptoms, signs & ill defined or 4,143 unknown conditions Accident Infection Acute Diarrheal Hypertension Helminthiasis Eye infections Arthritis rheumatism 1,277 864 797 545 672 501 373 & Injuries disease Total Total number of visits for Region I= 24,110.
TOT AL VISITS 5,632 4,436 4,359 1,405 880 797 704 673 505 401 19,792 * • The ten most prevalent diseases accounted for 82.1 % of the total visits in region I.

7 TEN MOST PREVALENT DISEASES REGION2 Infections 4,594 No I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Diseases or & Injuries signs and ill defined Symptoms, unknown conditions.

Acute Respiratory Hypertension Accident Malaria Diabetes n Worm Infestatio Disease Acute Diarrhoea Mental Arthritis & Nervous Disorders Rheumatism Mellitus Total .
First Visit 4,875 Total Visits 5,040 2,592 1,923 1,746 778 809 890 684 503 4,924 3,598 2,114 1,746 1,145 943 890 774 544 21,718 * Total number of visits for Region 2 = 27,238.

* The ten most prevalent diseases accounted for 79.

7% of the total visits in Region 2.

TEN MOST PREVALENT DISEASES REGIONS3 NO.

DISEASES I.

2.

3.

4.

5.


6. ion & Injuries Acute Respiration's Infections Hypertens Accident Worm Infection Diabetes mellitus Symptoms, signs conditions Acute Diarrhoea Arthritis Rheumatism Infection Disease & ill defined or unknown & Nervous Disorders 7.

8.

9.

10.

Mental Total FIRST VISITS 5,729 2,263 1,881 1,914 1,018 1,774 TOTAL VISITS 6,333 4,861 2,185 2,093 2,079 2,023 1,762 847 637 359 1,762 1,115 682 463 23,596 * Total number of visits for Region 3 = 31,697.
The ten most prevalent diseases accounted for 74.4% for the total visits in Region 3.

8 TEN MOST PREVALENT DISEASES REGIONS4 NO.

DISEASES Infections FIRST VISITS 5,642 5,519 1,630 5,313 unknown 1,822 TOTAL VISITS 7,672 5,519 5,519 5,313 3,278 signs & ill defined or 1.

2.

3.

4.

5.

Acute Respiration's Malaria Hypertensio n Acute Diarrhoea Symptoms, conditions Diabetes Arthritis mellitus Rheumatism Disease 6.

•7. '

8.

Worm Infestation 9.

Accident 10.


Asthma & Injuries 801 971 1,507 948 433 2,760 2,036 1,671 1,290 736 35,794 * Total Total number of visits for Region 4 = 45,333.

The ten most prevalent diseases accounted for 79% for the total visits in region 4.

TEN MOST PREVALENT DISEASES REGIONS or unknown 2,580 NO.

DISEASES 1.

2.

3.

4.

5.

6.

7.

8.

9. l 0.


& Injuries Infections signs & ill defined Acute Respiratory Symptoms conditions Accident Hypertension Diabetes Mellitus Acute Diarrhoea Arthritis Abscess Mental & Nervous Disorders Wom1 Infestation Total Disease Rheumatism FIRST VISITS 3,478 TOTAL VISITS 3,765 2,806 1,512 907 450 849 571 289 303 390 2,231 1,971 1,280 849 707 552 486 396 15,043 * Total number of visits for Region 5 = 19,994.
*The ten most prevalent diseases accounted for 75.2% of the total visits in Region 5.

<) TEN MOST PREVALENT DISEASES REGION6 NO, DISEASES Infections I.

2, 3, 4.

5.

6.

7.

8.

9.

IO.

Disease & Injuries Acute Respiratory Acute Diarrhoea Hypertension Accident Arthritis Rheumatism Diabetes Mellitus Worm Infestation Symptoms, conditions Animas Scabies signs & ill defined or unknown Total Total number of visits for Region 6 = 18,790.
FIRST VISITS 2,703 1,768 521 1,192 615 322 777 556 TOTAL VISITS 3,482 1,768 1,562 1,409 1,327 973 970 810 363 462 503 499 13,303 * The ten most prevalent diseases accounted for 70.8% of the total visits in Region 6.

TEN MOST PREVALENT DISEASES REGION7 NO, DISEASES conditions I.

2.

3.

4.

5.

6.

7.

8.

9.


10. signs & ill or unknown Malaria Infections Acute Respiratory Symptoms, Hypertension Worm Infestation Accident Diabetes Gynecological Arthritis Rheumatism Scabies & Injuries Mellitus Disorder Total Total number of visits for region 7 = 4,974.

FIRST VISITS 3,181 148 43 12 74 69 2 - 34 8 TOTAL VISITS 3,181 363 314 243 120 113 111 79 62 42 4,628 * *The ten most prevalent diseases accounted for 93% of the total visits in region 7.

10 TEN MOST PREVALENT DISEASES REGIONS NO.


DISEASES l. '2.

l 3.

4.

5.

6.

7.

8.

9.

IO.

& Injuries Infections signs & ill or unknown Malaria Acute respiratory Symptoms, Accident Hypertension Gonococal Allergy Anaemias Acute Diarrhoea Disease Infection Infection c onditions Total Total number of visits for region 8 = 10,818.
FIRST TOAL VISITS VISITS 6,927 6,927 639 948 427 579 321 460 139 219 133 188 123 176 136 77 132 132 98 129 9,894 * • The ten most prevalent diseases accounted for 91.5% of the total visits in region 8.

TEN MOST PREVALENT DISEASES REGION9 NO.

DISEASES conditions I.

2.

3.

4.

5.

6.

7.

8.

9.

I 0.


Infection Malaria Hypertension Acute Respiratory Symptoms, signs & ill or unknown Worm Infestation & Injuries Accident Arthritis Rheumatism Acute Diarrhoea Disease Scabies Gastriti s Total Total number of visits for region 9 = 11.190.

FIRST VISITS 8,913 13 128 186 80 99 34 100 II 6 TOTAL VISITS 8,913 297 275 273 171 163 102 100 90 80 I 0,464 * •The ten most prevalent disease s accounted visits for 93.5% of the total in region 9.
11 )- TEN MOST PREVALENT DISEASES REGION JO NO.

DISEASES I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

& Injuries Infections Malaria Acute Respiratory Worm Infestation Accident Hypertension Acute Diarrhoea Symptoms, Arthritis Rheumatism Infection Diabetes Mellitus Disease Total number of visits for region 10 = 9,175.
Total signs & ill or unknown conditions FIRST VISITS 1,707 1,369 896 711 419 356 247 171 200 84 TOTAL VISITS 1,707 1,508 900 881 713 356 281 255 214 170 6,985 * *The ten most prevalent diseases accounted for 76. l % of the total visits in region I 0.
12 OFFICE OF PROJECT COORDINATION INTRODUCTION The office of Project implemen tation coordination, managed by the Office included: Education New Amsterdam American was also provided to joint agreements brought Developmen projects Project with Japanese Coordination and monitoring of projects.
for overseeing During the year, the profile has responsibility the preparation, of projects for and Health, Caribbean Development Bank/Basic Integrated Primary Health Care; Sector Programme Needs Trust Fund (CDB/BNTF); t Bank (IDB) and Poverty Grant Aid; Portuguese Alleviation under SIMAP, PL480 as well as the Caravel Foundation Adviser.

Trust Fund with the Inter­ Technical Programme.


of the Project to the attention and other Assistance OBJECTIVES/TARGETS were set with regards to spending were behind schedule ion of tenders, project agencies, to some degree.
to assist to the relevant action inadequate staff to cope with the volume of work, logistical The main reasons proper project officers, Targets many projects evaluat channeling executing projects inadequ information inadequate Regions, being lengthy preparation, delays feedback from a few contracts for projects ate guidelines of projects.

and completion in outlying management.


in awarding delays By December 1996 technical in difficulties with • SECTOR FOR (EDUCATION AND) HEALTH_PROGRAMME The EU through programme a General being used by the Health second over G$200 million.

Pakera, Vector Control Georgetown infrastruc Nursing ture and their Unit, Community diagnostic The Programme The projects capacity.

School.

Import Programme Sector.


funded include: (GIP) supported Expenditure Hospitals at Suddie, in the first Programme was Fort Wellington and this programme.

It is the Development at Moruca and Region 9 and the has a general emphasis on improving the health the contract for the management of the year was off schedule.

in the course of the year.


Thus project By year-end, There was delay in awarding have been executed should the first quarter to five with the addition projected expenditure Hospital was under construction the tendering process.

ofBV Health Centre and National would amount to G$ l 63 .5 million.

by December.

1996.

The others of the three projects that preparation activities during the number of projects was expanded Blood Transfusion Service.
The Only one (I) project-the Madhia of in various stages were still In addition, the Office provided at Suddie Hospital, completion at Suddie of X-ray installation completion Oxygen System Refrigerators to Pakera 1996.

The installation at Suddie.

Wellingto Oxygen System approved and the System cessor, Thus the automatic pro n, minor construction works had not done because be installed Hospital.
of X-ray Units was affected at Suddie was Of these, should supervision to conclude and Fort Wellington the following Hospitals, of Electrical works at Suddie only the last named was completed the and supply of at December, GIP 1 activities: Installation of by the non-completion although installed to be carried out to accommodate could not be used.

At Fort the X-ray Unit.

The of the electrical works of a lack of funds.

Funds have however been early in the New Year.


13 BASIC NEEDS TRUST FUND This funding comes from the Caribbe were built.

an Development During 1996, construction Bank.

In 1995, three Chalets at the began at the Bartica Hospital at a cost Fort Canje Hospital of US 5 million.

This project was about 45 percent completed.

management to prevent was to be provided.

was targeted for completion This project cost over-runs,which with its limited could in tum ffect budget has demanded scrupulous completion.
No new equipment in April 1997.

At the end of the year, the project INTEGRATED PRIMARY HEALTH CARE Under this project, a Primary Health the Ministry opted to carry out a series Care Model, of diagnostic studies to tation of the the implemen and projects in the National which wo11Id support Plan.

Health develop programme several aspects assistance several effort.
which project Implementa re-negotiated purely technical project went through operational man-months during Corentyne) Office assisted Assessment computing research tion began after a lapse of nearly one-year as the Ministry of the project of Health from was changed of the Project.

to TA institutional The emphasis strengthen modifications A switch in the course of lead consultant resulted because in the lost of approximately it was an 3 ing provision of the year, essentially inputs.
The of operational preparation activities in the Pilot Test Region (East Berbice/ in the execution of were at a standstill.

Apart from the technical assistance two (2) surveys: y the Office was unable for the Project.

Survey.

Unfortunatel and vehicles equipment to complete the Health through consultancies, Facilities Needs and the Health the of the the procurement By the end of 1996, the unallocated financial resources were US$ l I 7,000 out of a total of US$89 I ,OOO.
NEW AMSTERDAM HOSPITAL PROJECT was seeking Hospital.

financing from Japanese Grant Funds to Information available to the Ministry of Health being considered at the end of 1996.

Feedback from the this year, the Ministry Public During the New Amsterdam that this project Affairs of Foreign rebuild suggested Ministry indication action Guyana has not been able to secure approval on its project b be still of such grant aid projects.

of this slow rate of progress efore Suriname.


has been less than satisfactory.

may be ascertained Yet the Surinamese has been slow.

An Progress from the fact that Guyana initiated project Study Mission has been funded, while which must precede the visit of the Japanese ,� PORTUGUESE TRUST FUND This Trust Fund is under the management of the Inter-American Development Bank (IDB).

The Ministry' proposition ACDC Georgetown utilisation donors s proposal for utilisation of these funds was not approved.
An alternative was made to use the funds to develop an equipment maintenance system at the Hospital.

Also, the funds identified were reduced the Ministry's inability to US$150,000.

The to assure the of these funds has been bogged down because of to retain that it would be in a position staff after training.

POVERTY ALLEVIATION PROGRAMME Inadequate guidelines p funding.
This reduced the amount The Ministry had requested revented the Ministry from preparing projects for suitable of funds the Ministry , but finally obtained from the Programme.

G$15 million in October actually obtained , 1996.

G$105 million PL480 raised by was administered This programme Queries by the Ministry were not adequatel 1995.

The Health to take steps to oversee the Project directly.

arrangements Health.


implementation proceeded This forced the Ministry responsibilit of authority also had the effect of eroding the value of work the budget of Works on behalf and project y answered Centre y to follow-up the issue.

over Project the Ministry in December, But the administrative implementatio n did not occur.

at Plaisance was demolished.

The DCMO was given the to effect this transfer The delay in implementation funds could have accomplished in 1995 .
of the Ministry of 15 STANDARDS AND TECHNICA L SERVICES.

OVERVIEW The Directorate Pharmacy, Diagnostic of Standards and Technical Services monitors ory Services, Qllality and supports Assurance.

Services Laborat areas.

the following During 1996 the Pharmacy expenditure to face many problems.

on drugs and medical supplies, Unit continued availability, access, Despite and equity increased remains government major problems.
fundamental To understand these deficiencies, infrastructure required to effectively one needs an understanding manage a Drug Supply of the programme.

Problems Technical management training are lacking.

human resources remain in short supply.

Continuing education and Inventory A recently measurable this system management installe improvement is a serious d computerized invento to this area however concern.
ry management system has the ability and capacity brought to sustain Distribution Some difficulties Community Health department lacked workers the staffing were encountered in this component.

Distribution problems.

of drugs to The this activity has faced a number of logistic to conduct capacity effectively.

Accountabilit y While improvements personnel in stores' ma were recorded in this area, of experienced nagement and procedures constraint in this area.
shortage is a major Poor working visit A simple conditions can verify this.

structure of the Pharmacy The present organization deliver effectively progressively expenditure needs to be addressed as a matter of service on drugs and medical and efficiently increasing the quality of urgency.

is not designed to In light supplies, of this matter services, demanded.

from the Laboratory services, K-ray and Physiotherapy are provided in Reports other sections.
16 HEALTH SCIENCES EDUCATION Health Learning Materials.

Sciences Education has three units, Health Education, Training and Health (a)Health Education focuses on training on matters the public and supporting that affect their health health.

on and evaluation.

informing workers; include Activities h, programme planning implementati and educating researc (b) The training unit is composed established to train nurses, community Pharmacy Assistants, Medex etc.
of the formal programmes health workers, that have been and X-ray technicians, (c) Developing health in learning materials, producing materials and reproducing support of the health sector.

The activities of the Ministry sectors Control, of this Division are influenced and detennined of Health.

provided During 1996 Health Education by the needs of all the support to Vector and among others.
other Maternal and Child Health, National AIDS Programme Secretariat OBJECTIVES/TARGETS Target Achieved Analysis Yes of Success/Failure Workshops several was held in regions.

to the reduction Partially The VCS and other health e of malaria in in the education Objective I.Train health workers use of health techniques.

2.Contribute in the incidenc Regions community 1, 2 and 9 using particip ation.

3.Training in HFLE for teacher and school education institutions children.
a 4.Plan and implement KABP survey on Drug Use and Abuse among school age children.

5.Organize debating AIDS among 2, 4, 6 and 10. in Regions and implement a on HIV / school children competition Yes workers in Region I. this the community, Involved resulted in the reduction of the # of malaria cases.

HFLE Curriculum developed for CPCE.

HFLE programmes conducted of four schools Georgetown.

Partially Data collected in 2 Regions.

for students in Southern areas of by was sponsored Competition COURTS.
The quarter finals and knockout competition were held among schools each regions, the semi finals were held between the s in Yes 17 from a TB Manual to be workers 6.Produce used by health 7.Collect hospital data on resulting injuries and accidents.

violence and in planning 8.Assist implementing the Micro- Nutrient 9.Prepare booklet a Health Careers for school children Survey.

Training Yes Yes Yes Yes j wi� ng schools · region.

of each and Report compiled submitted Health.


Data collected to the Minister of in all regions.

The first draft of this booklet completed.


The Training professionals unit initiates, monitors and coordinates at the basic level; health the training programme that prepare The intake population for the three Schools in 1996 was as follows: Schools Georgetown New Amsterdam Roza Charles Professional Nurses Nursing 29 19 Nil Assistants Nil Nil Does not train this Category Schools Georgetown New Amsterdam Roza Charles Professional Nurses Nursing Assistants 19 19 2 23 18 .
For 1996, training of several categories of health workers was undertaken - through the these schools, Georgetown, administration Health Workers, Pharmacy of MOH during the year review Midwives, New Amsterdam and Charles Roza which can under X-ray Technical, Dentex, Assistant and Psychiatric Nurse Practitioners Nursing the Community X-rayTechniciaos 3 x-ray technicians, diagnostic services in specific regions where x-ray facilities programme to be prepared are located.
were taken into the training simple to provide Dental Auxjljarjes (Dentex) During 1996, fifteen persons were admitted to the dentex training programme, by the end of the year, three persons had withdrawn from the programme.

18 Community Health Workers (CHW's) 25 persons from all regions except# 5 were Health Hospital.

and was conducted at the Kumaka District for 4 months as Community trained Worker.
This programme is residential Pharmacy Assistants Medex and Public Health Nurses During 1996 review of the curriculum Nursing Progr for the recommencement and plans are ammes progressed, Health of Med ex of the training in place to begin the training and Public early in 1997.

Psychiatric Nurse Practitioners 10 Nurses in Region 6 completed of problems, the programmes in Georgetown their training a series as Psychiatric Nurse Practitioners.

Due to and Linden had to be discontinued.


15 Community Health were trained Tuberculosis and Worms using the Microscope.

included training Educatio Workers in Health from Region 8 to diagnose This programme was conducted Malaria, at Kato and n and Administration of Vaccines.

Physiotherapy Assistants The Curriculum for Physiotherapy Assistants whose duties tion Assistants, was reviewed.
The decision has been made will include to expand this Programme and to train Rehabilita Occupational Physiotherapy, Therapy and Speech Therapy.

19 MATERNAL AND CHILD HEALTH PROGRAMME BACKGROUND: The Maternal and Child Health programme in the Ministry pregnant particularly the of Health is one of the woman and children.
Its services that targets health services preventive are offered mainly through the network of approximately scattered throughout the IO Regions District of women complete and Regional Hospitals their pregnancies.

and the National 140 Health centres and health posts of Guyana.
There is also a very close relationship with the PHG, where more than 90% Referral Hospital, The National Supervisor MCH programme is coordinated who is an experienced by the by the MCH officer, ably assisted the level, Health Nurse.

At the Regional Senior Public Nursing programme is supervised by a Senior Public Health Nurse.

The main responsibiliti es of the MCH programme are to: • Provide • Monitor • Provide • Maintain diseases.
intranatal and postnatal prenatal, growth and development vaccination zero infant and childhood morbidity services care including family planning up to five years old.

services to women; in infants and children for pregnant women and children.

and mortality from vaccine preventable • Maintain surveillanc • Reduce infant and childhood e of vaccine preventable morbidity infections.

diseases and acute respiratory diseases.


and mortality especially from acute diarrhoeal SUMMARY OF ACTIVITIES There were a number of activities conducted during 1996 which were aimed at fulfilling the above mentioned.

I.

A Measles Mumps Rubella Immunization Campaign was conducted from April to September 1996 in which 76,362 or 90% of children 1-4 years were immunized.

2.

The simplified centre, surrounding introduction.


Prenatal Clinical Record designed by the Latin American Perinatology was adapted for use on a pilot basis at the Public A series of training sessions clinics.

were conducted Georgetown of its in preparation and Hospital 3.

The Revised Maternal and Child Health Manual was introduced with workshops in 3 Regions.

4.

A one-day workshop was conducted on the use and interpretation ofMCH data for Senior Health Visitors.

5.
5.

Quarterly Immunization Meetings by were held to evaluate the immunization coverage Region.

20 6.

A research project on safe motherhood was developed in I 997. for implementation 7.

Surveillance reports faxed to the Caribbe on Rash/ Fever and acute paralytic an Epidemio logy centre.

illness were compiled weekly and OTHER ACTIVITIES During 1996 there was also an evaluation of the expanded International .

Programme in two programm e of immunization had been funded by the Canadian The programme phases.
Phase I extended by Dr. Debra Louisy Charles As a r.esult Guyana was able to secure US $26,000.

consideration from 1988-1992 conducted A proposal for a phase III of the project the evaluation a six month extension Immunization In July a team received with funds to the value of and submitted for high marks.

headed ofCHP-11 has been prepared and phase II from 1992-1996. and the programme During 1997 there are several areas that have been considered for special attention: I.
Pilot testing of the Simplified rds at the public Hospital Georgetown and surrounding Health Perinatal ClinicReco 1997.

Clinics from Jan-June, 2.

A Respiratory Health and Allergy study among school children aged 6-7 and 13-14 years old.

3.

An evaluation of the existing anaemia control programme.

4.

An adolescent health survey with the view to outlining health an adolescent policy.

5.

The Safe Motherhood Project will attempt to gather information on of the domicillary The extent deliveries.
The perception of communities about to ANC.

The reasons for late admissions deliveries teenage pregnancies.

and the community perception of such The major constraints continuously of the programme continue the programmes to be the shortage identified.

that have been monitor of staff to establish and The areas for strengthening are the ARI and COD programmes.

21 M.C.H.

SERVICE /NC/DATORS COMPARATIVE REPORT 1995/1996.


1995 18,133 80,857 33% 12% (2,250) 74% (13,589) 31% 47,556 52% 30% 7,461 18,360 15.2% 23,462 114,971 47,366 94,140 30% 1996 17,476 72,908 32% 11% (1,976) 89% (14,314) 28% 42,211 43% 35% 7,058 17,219 14.7% 20,782 101,801 51,950 92,027 33% Attendance 20 weeks Clinic Return Visits Visits< Antenatal Antenatal Antenatal Teenage ( < 1 7 Total# of women tested for Hb No.
of women withHb IOg Family Planning Clinic Methods used: Oral Pregnancies years ) Attendance Condoms Attendance Postnatal clinic Total Births Low Births Weight Infant Clinic Infant Clinic Return Child Health Clinics (I" visits) Child Health Visits Children (return Visits) at 3 months Fully breastfed Attendance (I" visits) visits 22 FOOD AND NUTRITION The department of Food and Nutrition has the responsibility I.

To assist Policy; and and advise on all matters pertaining to a national Food and Nutrition 2.
To formulate n. with Food and Nutritio and implement policies and plans in relation to all matters connected OBJECTIVE AND TARGETS For 1996, the Department Chronic Diseases concentrated and Education.

namely The successes on four areas, -Nutrition Surveillance, and failures of the activities are Breastfeeding, outlined below.
(}bjective/1'ar1;et Tar1;et Ac/,ieved AnalJsis of Success/Failure Surveilla11ce Nutrition To find out the infonnation needs of who levels, at different decision-makers relate to food and nutrition.

Yes : A report has been submitted.


market To collect regions accessible food prices from all Yes Regions Region #5 was added to the list of Breastfeedi111; To coordinate promotional and implement I activities To assess selecte improvement status Baby Friendly at plans for and prepare d hospitals One Hospital was assessed.

Partially To improve practices management of health the knowledge workers attitude and in lactation l I I Partially Workshops and l 0.

Training Workshop absence of funds.


of trainers was cancelled due to were held in Region 2 community To provide Breastfeeding Support for mothers .

Yes i To improve component Curriculum.

the breastfeeding I School's of Nursing i 23 Participants was held to train personnel n Workshop Community are providing in their support This task is at the analysis No recommendations yet.

stage.
stage.

have been given as woman-to-woma communities To educate and stimulate public interest Breastfeeding Ongoing Distribution radio of posters, week activities, programme has been carried out.

interest Professional in this sub- Partially program has not been high in some regions.

Draft report to be reviewed plans of action in Regions To implement Regional for Breastfeeding 1,2,3,4,5, 7, 10.
Chro11ic Diseases data collected To analyse and on beliefs at clinics practices Buxton Centre and Leonora Cottage Hospital.

Organise a half day meeting and Supply Health to discuss of diabetic patient 90"/o No Implementation of Diabetes in Buxton and Leonora To develop activity education Health Centre No completed Hospital.

.

information Day.
.

information Day.

and Supply Cottage a public for World Diabetes 100% Food Policy A Public of data for report was not Analysis completed Analysis of data for report was not lecture was organized and Guyana Diabetic 60 persons attended.

by Association for Morbidity data collected To collect Diabetes data Mortality and morbidity 90% 1993, 1994 and 1995 by sex and To develop a draft National Programme 1996 by December Diabetes Educatio11 Nutritio11 To improve education to the public.
the level of Nutrition 45% Yes n programmes To strengthen existing national Yes nutritio by developing and or enhancing in nutrition (Modified Programme) CFNI UWIDITE knowledge and skills Chronic Diseases to collect analysis.

region developed Questionnaire data for situation sent to Public with diabetic was formed.

A planning Committee Some epidemiological data was collected from the Georgetown Hospital.

and Private clinics.


This was institutions of Harmony Gardens with 50 200 episodes were aired on Radio along talks.

The programme was nutrition well received Course participants Participants made good use way Guyana's structured.

of the was Programme was well received by the radio listeners by the and resource persons.

A workshop was conducted for GUYS UCO workers of Skeldon Estate, 5 persons attended.
A Workshop was conducted for Peace Corp Volunteers 24 Nutrition Education UWIDITE Basic Nutrition for a changing society 19 persons attended.

Professional skills in Nutrition.


Competence by developing and or enhancing knowledge and 25 FOOD AND DRUGS DEPARTMENT CONSUMER PROTECTION AND SAFETY MISSION STATEMENT The Analyst/Food and Drugs Department has a mandatory responsibilit y to enforce the Food and Drugs Act Cap 34:03 of 1971 and its supporting Health and well-being of the Guyanese Regulations populous in the following areas.

of 1977, to safeguard the I.

Safety and Wholesomeness of food.

2.

Efficacy and safety of drugs 3.


Safety and effectiveness of cosmetics and medical devices.

4.

Examination of labels for truthful, honest, information.

5.

Appropriately packaged regulated products.

6.

Identification and correction of violative products on the market place.

The Food and Drug Analyst focused on 4 major areas during 1996.

Microbiology Laboratory, Drug Chemistry, Food Chemistry Laboratory and Food Inspectorate.
In addition, to the activities conducted by the various units, the department completed the draft of the amended Food and Drug Act, and forwarded it to the Attorney General's Chambers MICROBIOLOGY LAB ORA TORY The main objectives of the microbiol ogy lab are: 1.

To analyze and evaluate pharmaceutical the microbiological and products; quality of food, water, cosmetics and 2.

To provide information to the Water Authorities on the quality of potable water available to consumers.
During 1996 the laboratory (from P AHO.

These facilitated improved storage conditions freezer well led to an enhancement of the aseptic ons.

microbiological manipulati received one refrigerator and one conditions for samples.

This as for the required necessary one air conditioner, Of the 600 samples targeted, 451 samples were received.

412 were completely analysed.

26 Drug Chemistry: OBJECTIVE I.

To analyze products includin g registration submissions.
a wide range of locally manufactured and imported pharmaceutical 2.

To identify markets.

substandard and counterfeit drug products within the domestic During l 996, the Food and Drugs failed to achieve t, chemicals and drug testing equipmen the above objectives There is also a need for a trained due to the lack of reagents.

necessary analyst and supporting junior staff.

Samples were submitted Laboratory (CRDTL), is lenthy.

The analytical entering the local market.

Jamaica.
Jamaica.

information on a schedule The process for submission basis to Caribbean Regional and analysis the prevention Drug Testing of samples of substandard at CRDTL products does not facilitate Food Chemistry and alcohol Laboratory conducted chemical to determine acceptability.

analyses of food and products water containing Equipment Received The Drug and Food Chemistry laboratories received the following equipment during 1996.
Equipment Source Remarks Dr 700 Water Analysis CEHI Ohmicron Pesticide Instrument - Analysis CEHI numerous quality will be made modules.

on water to determine The tests require specific reagents and of which only two were Hence efforts additional This instrument can conduct analyses specification.

however modules received.


to obtain This instrument analyses determine However, it requires specific apparatus, These have to be procured equipment can conduct on water and food products of pesticide reagents which were not and supplied.

before the numerous to residue.

levels like the Dr 700 instrument, can be utilised.

useful in improving for samples.

storage conditions air conditioners, PAHO/WHO Will be Refrigerator, s, reagent stabilizer equipment.
and small 27 Failure Sixty two percent (62%) of the one hundred to complete the analyses were analysed.

method for the determination of Sodium Benzoate jellies, for the particular carbonated Beverages were not available.

marmalades and analyses and eighty of all samples (180) food samples was due to the fact that the submitted could not be perfected since samples of jams, could not be tested.

In some cases the instruments A system occasions, however, sealed cupboard.
was implemented for receiving samples could not be properly and labeling samples.

stored due to lack of refrigeration On a number of and a Work has begun to draft a manual of procedure for laboratory To date the Guidelines safety are to be developed.

and routine logs have been introduced.I.

Analysis of food materials for percentage crude fiber, percentage protein iron have been planned.

However, the first two analyses have been shelved controls to perform such analyses.
could be obtained and percentage until standards or Food Inspectorate This unit should The responsibilities of 2 Senior consist of the Inspectorate included Food and Drug Inspectors.

7 of the 11 posts are vacant.

Objective I.

Registration of all Importers of food and raw materials used in the manufacture of foods.

2.

Inspection all food factories for licensing purpose.

3.

And for Surveillance of all food factories to ensure conformity to the required GMP's.

4.
4.

Sampling of potable foods for analyses.

water and wide variety of locally manufactured and imported Problems and Constraints from the Customs in consignments I.

There is a to lack of Co-operation of imported Hence it was impossible that effective with the department's which resulted knowledge products imported entry into the country.

offered for sale.

It should goods is best achieved of this department.
be started and Excise foods being "released" the Department without violating control of regulatory at the point of involvement to control 28 VECTOR CONTROL SERVICES MISSION STATEMENT To ensure the effective monitoring, prevention, treatment and control of vector-borne diseases in Guyana.

DUTIES/RESPONSIBILITIES The main duties/respon sibilities of the Vector Control Service are: I.Malaria Control of cases of malaria, and appropriate treatment of cases throughout a.

Early detection Guyana.


b. Insecticidal control c. Early detection d. Research of vector.

of outbreaks to guide program� and control 2.Fi/aria Control a.

Detection b.

Implementation and treatment of cases of filaria of appropriate public health interventions.

3.Aedes Aegypti Eradicatio11 a. Surveillance to detect importation oflarvae in ocean going ships and vessels.

b. Surveillance for mosquito c. Insecticidal control larvae in Georgetown and seaports.
of Aedes aegypti mosquito larvae in Georgetown 4.Dengue Fever Surveillance a.

Detection b. Aedes aegypti control of cases ofDF and DHF/DSS.

in urban areas, seaports and airport s .

.

5.

Laboratory diag11osis and treatment of other vector home diseases.

e.g.

Filaria, Leishmania, Chagas Disease.

6.Entomolo gy a.

Its provides information density, on the identification, distribution, and biology of the vectors.

b.
b.

To evaluate the impact to control interventions on the vector and parasite population s c. To assist in forecasting of changes regarding augment the potential for vector borne diseases vector bionomics .

transmission which will 29 Malaria Co11trol Programme Objective Activity Target Achieved Success/Constraint and 1.Passive case100% Staffing was Early detection treatment of cases of detection Malaria in all regions.

surveillance.

in malariaAll malaria centres laboratories were functional.
and stretched to limit.

2.Active detection endemic case Mass smearing exercises in malariaundertake areas.

transmission Surface n in high transportation timeliness areas.

affected of activity.

Control with Spraying of houses DDT indoor all areas with malaria Two cycles in malarious transmission.

in Vector residual spraying regions.

100% Increase over 1995 of DDT in coverage residual house spraying completed.

activities .

of localities sprayed.


completely Prevent re· establishm malaria Detect, ent of investigate A number investigations oflimited and No Anopheles outbreaks on the undertake It that n in Cane was concluded were darlingi detected.

on the coast.

of malaria coast Mahaica, West the vector Grove, Anopheles Ruimveldt in Georgetown.

(TheWest was aquasalis.

Ruimveldt study was supported by a team from CAREC.)

Fi/aria Increased Aedes Aegypti Aegypti surveillanc e coastal Expansion to New Amsterdam.
of Aedes ULV fogging Lack of surveillance transportation, in and its wages and undertaken Georgetown environs, for Airport and other areas disincentives work.

adult Aedes spontaneous to decrease Aegypti health All hospitals, health Little populations.

at Timehri allowances were poor Increase surveillance.

dengue To sensitize care workers about centres, private doctors dengue consequences.

to the facts of fever case surveillance and epidemic in surveillance.

the private sensitized dengue the Caribbean.


support from for sector Increased and To strengthen improved coastal services surveillance Filaria.

and management.

for laboratory the Increase in active and 'foe programme at VCS for passive case detection.

need to be diagnosis A drug schedule in To on WHO Guidelines keeping with the Health Primary based restructured the services was implemented.

Care expand 30 entomologica countrywide.


Increased To conduct Entomological parasitlolgical/ l to to detennine Entomological investigations assessments vector activities.

evaluation planning, Malaria and the coast; control implementation Aedes aegyti of vector prevalence; activities.

which provided to guide support control reasons and investigations done staff were the major for constraints during on there.

transmission Filariasis; concepts.


I surveys Transportation and the Vector control programme with infonnation for decisions and control strategies.

on treatment, Filaria Control Programme During 1996, efforts were made to improve on diagnosis service to New Amsterdam Hospital.

at the Filaria Clinic in During the year, Georgetown a significant and to extend the diagnostic increase in bancroftian filariasis was recorded.

A total of 4109 smears were taken from 1902 persons at night clinics.
I 00 I persons were found to suffer from filaria.

Of these, Of the persons symptoms 739 had clinical nights.

The remaining 262 smear examination for three consecutive Treatment was administered to both the clinical and smear positive screened, but were negative persons were cases.

on blood smear positive.

Aedes Aegypti Programme The Aedes Aegypti eradication and the seaports an examined for breeding Ogle Aerodrome, were visited larvae Aegypti.
were treated programme of Georgetown focused on Georgetown and New Amsterdam.

, the Timehri Airport, Houses and buildings for Aedes Aegypti of Aedes Aegypti.

Premises positive with abate.

A total of32,726 houses were inspected, of 13% had Aedes Maritime Surveillan ce Ships entering the ports of Georgetown Aedes Aegypti.

The ships were negative and New Amsterdam for Aedes Aegypti larvae.
were also examined for Special Surveys A number of surveys were under when by the Entomology staff sites for the mosquito Aedes Aegypti by the vector to ascertain the levels of es.

These surveys infestation were conducted and the breeding Bartica, at Timehri, Ogle, Georgetown, New Amsterdam and 72 Village - 31 Crabwood Aegypti Creek.
Of 1015 houses inspected, 206 were found to be breeding sites for Aedes 32 TUBERCULOSIS CONTROL PROGRAMME MISSION STATEMENT The mission and transmission of the tuberculosis control it no longer until of the disease programme is to reduce poses a threat to public the mortality, health morbidity in Guyana.

OBJECTIVES/TARGETS OBJECTIVES Target/Indicator detection of infectious cases from the Case finding- sputum smear analysis.

70% of infectious by of adequate t to all treatmen 85% of all cases.

j I.
j I.

Ensure : population.

provision 2.Ensure cases.

detected protection 3.Ensure one year of age.

4.Increase .

community groups I detection, , 5.

Effective (prepare centrally.

l 995 annual report and conduct management participation treatment with BCG to children under I 00% coverage of target of the Regions, society) in and NGOs (chest and TB control.

Regional community meetings.


workshops and of the TB program 1997 work plan, budget, and supervisor y vi sits -1997 work plan -1997 budget -l 995 annual report ' . '

' .

v s , schedul i I I e of 1 11s to regions.

L to regions).

ANALYSIS The fight against in Guyana and its the increasing !rend over the last 3 years tuberculosis has improved in 1996.

Case finding continued 296 in 1995, to 314 in 1996 .

of 8% in the actual an increase 40.19/100,000).


Since there was no significa incidence rate of tuberculosis over the period of reporting nt population growth by almost 20% from over this period, was seen (38.27/!000,000 to Major high risk groups High rates were also observed are affected in Amerindians.

HIV positive patients, the elderly and young adults.

The number of cases from the coastal since 1994.


Over the past year, 46 deaths 2,3,4,6 were recorded, regions Region doubled been attending the Chest Clinic.

and Region IO has almost 32 at PHG and 14 who had Even though the actual number of cases has increased by sputum analysis has actually mainly from Regions 1,8 and IO (Regions decreased.

Seventy over the last year, the number of cases - one (71) positive existed).
where sputum/smear 4, where 52.98% of cases were found, only 11.8% were confirmed 73.5% were diagnosed Facilities by chest radiographs, at PHG.

West while 3% were identified Demerara for sputum examination exist by pathological Regional Hospital and cases identified were notified In Region analysis.

methods.

facilities by sputum 33 Lethem Hospital.

done at these labs.
done at these labs.

Due to safety concemk and a shorta'e of staff, no sputum examinations were Case holdings of drugs were adequate, only 38.3% of infectious posed the major challenge to the programm e in 1996, and even though 1996.

Forty three percent defaulted after the first 4 months treatment.
This trend is very unsatisfactory and as such, TB cases were reported from June during the 6 of treatment in 1997, the programme re-adjust to focus on Direct Observed Treatment, Short-course (DOTS) strategy supplies 1995-June month-course would obviously as proposed by PAHO/WHO .

34 VETERINARY PUBLIC HEALTH During the year under review, activities: staff of the Veterinary Public Health Unit undertook the following l .The development other food related of a National departments Food Safety .
and institutions Plan of Action utilizing input from 2.The implementation of HACCP (Hazard Analysis Regions the seafood Industry- 3,4 and 6.

Critical Control Points) system in 50% of 3.The development oflegislation's with regards to FISH, POULTRY and RED MEAT.

4.The collection and analysis of meat samples.

5.Routine Inspection and Certification of Fishery Products for export and local consumption.

6.Routine Inspection of Poultry Meat and Poultry by-produ cts at the port of entry.
7.Visits to poultry Farms to ensure that farmers carry out basic hygienic practices.

8.Lectures to butchers in Region IO.

9.Review of Draft Tuberculosis Booklet.

l 0.

Dissemination of information of these diseases on Foodbome/Zoonotic through Diseases, handbooks, as well as, the prevention talks and the lectures/school pamphlets, and control mass media.

I I.

Conduct a survey on the prevalen ce of foodbome diseases.
35 MEATINSPECllONREPORT A total of twelve million five hundred and twenty-eight thousand one hundred of poultry meat have been inspection.

and eighty One thousand six point three pounds (12,528,186.3lbs.)

nine hundred and twenty pounds (l,920lbs) were condemned.

A total of twelve million one hundred and fifty six thousand five hundred and ninety three point four pounds (12, 156,593.4lbs.)

Squid etc) were also inspected.


of Fish and Seafoods (Prawns, Shrimp, Crabmeat, Three hundred and three pounds (303lbs.)

of these meat products were condemned.

36 SEAFOODS INSPECTED PRODUCTS QUANTITIES FROZEN FISH · · ·· ·· · · ·· ··· · ·· · · · · · · · · · · · · · ·· ·· · · · · 6,554,585.2 LBS FROZEN SHRIMP .

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3,167,060.2 LBS FROZEN FISH HEAD · ·· · · · · · · · · · ··· ·· .. .

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.


180 LBS FISH CARTILAGE (BONE) .......................... .

3,000 LBS FISH (SHARK) FINS · ··· ·· · · ·· · · · · · · · · · · · ·· ·· · · · ····· 40,480 LBS FISH GLUE · ·· · · · · · · ··· ·· ··· ·· · · · · · ··· ·· · ·· · ·· · · 17,400 LBS DRIED SALTED SKINLESS SHARK .............. .

52,000 LBS CRAB MEAT .

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29,270 LBS CRAB BACK SHELL · · · ·· ·· ·· · · · · · · ·· ·· · ·· · · · ·· · · · · · · SALTED FISH 23,000 LBS 488,959 LBS ·· · ·· SALTED SHRIMP · ·· ····· · · ·· · · ·· · · · · · · · ···· · · · · · 246,959 LBS SQUID · ·· · · · · · ·· ··· ·· ·· · ··· · · · · · · · ·· · · · · · ·· ·· · · · · · · · 1,700 LBS LIVE CRAB · ·· ·· · · · · · · · · · ·· ·· ·· ·· · · · · · · · · · · ·· · · ·· ·· · · ·· · · 1,532,000 LBS TOTAL LBS l 2,156,593.4 37 HANSEN'S DISEASE CONTROL PROGRAMME The Mission Statement of the programme To enhance and improve and leprosy of leprosy control into the general patients control service, by initiating eventually leading health and accelerating the process of leprosy to eradication of the disease.
the effectiveness of the existing medical service in the treatment To achieve the objective of the programme, the following tasks were undertaken in 1996: I.Find all new cases before deformities have developed.

2.Maintain an effective and efficient surveillance service.

3.Educate disease.

health providers and the community about the signs and symptoms of Hansen's 4.Service 14 dermatological clinics monthly.

CASE FINDING of patients.


100% achievement clinics of 4 rural dermatology screening of weekly Maintenance for routine Maintenance dermatological/consultant Conducting Screening clinic school/area surveys Two school contacts 236 person of household at P.H.C.

l 00% achievement.

surveys were done.

were screened.

3 new patients through contact tracing.


were diagnosed CASE HOLDING AND SURVEILLANCE MDT to all diagnosed and 100% achievement 6/12 for P.B 24/12 for Administer registered Surveillance patients patients.

examination of all RFT who were present for follow-up.

examined.

M.B.
examined.

M.B.

Most patients on surveillance were PATIENT CARE AND REHABILITATION Maintenance care and rehabilita of ongoing programme tion to disabled patient of The needs of patients on care were met s. throughout the year and Assessment plastosote insoles.

Programme of patients should start in February 1997 .

given to 93 needy patients for shoes and An NSL representative paid us a visit.

The food hampers through SI MAP.

were .18 HEALTH EDUCATION Health Expanding patients and communities media.
Drafting all reports.

programme to Education the through for leprosy week in January and was done Planning time spots about leprosy periodically.

All quarterly and the annual reports prepared NSL.

financial were sent to and checked of Hansen's into Primary Health Integration disease Care Region I 0 Partly TRAINING Good.

i I for health personnel Nurses.

This attachment.

and med.

Students, two weeks clinic of staff on leprosy Training course interns, includes Training integration.

control e.g.
control e.g.

140 health 26 nurses personnel the clinic.

did attachments at received lectures and Every 4"' Thursday and dedicated Answers are also prepared.

to teaching.

of the month is Questions SUPERVISION Monthly Bi-monthly on all functioning clinics.

to Leprosarium.

checks visits visits Once monthly Tuesday of every month.

made on request.
made on request.

done at Mahaica Other visits on 4"' are 39 REHABILITATION SERVICES PTOLOMY REID REHABILITATION CENTRE This centre in need of long-term was established Rehabilitative to provide a care to facilitate National Service for children in Guyana who are integration into the wider Society.

DUTIES/RESPONSIBILITIES I.

To provide on a daily basis a range ofrehabilitative Therapy, Vocational Services: -Physiotherapy, and Training, Occupational Orthotic/P Therapy, rosthetic Speech Services.

2.
2.

To provide a Recreatio range of Social nal Activities for Residents.

Services:- Special Education, Living, Dormitory and 3.

To provide as outpatients counseling and educational services and those who live in the center.

for parents of children who attend 4.

To boost the Financial Status by attracting resources the Traditional outside Sector.

5.

To provide Guyanese through who require the National Orthotic Orthotic/Pr or Prosthetic osthetic Services.
Workshop appliances for all OBJECTIVE/TARGETS Objectiveffarget Target Achieved Analysis Success/Failure PHYSIOTHERAPY Increase Outpatients Coverage.

No NURSING SECTION Training Programme for Nurse Aides No Quality due to was not programme not ofrequired Target not achieved shortage of staff level.

of service standard.

Training completed due to problems for Tutor.

with remuneration will be completed during 1997.

Appointment Therapist programme.


ofV.S.O this to facilitate Speech SPEECH THERAPIST Target achieved �o PHYSIOTHERAPY DEPARTMENT The Physiotherapy Unit at the Children Convalescent Home provides services to the in­ patients.

These sessions usually occur on Mondays and Wednesdays mornings.

Children treated were mainly from six (6) months to two (2) years.

ages ranged malnourished ones who suffered delayed milestones.
Their PTOLEMY REID REHABILITATION CENTRE SPEECH AND LANGUAGE THERAPY DEPARTMENT INTRODUCTION: Speech and advice and Language Centre.

The present Rehabilitation treatment was offered children from and Thursdays including Hospital.

the centre.

mornings.

the Convalescent therapy is a temporary therapist is working service available Reid to the Ptolemy during 1996, agreement under V.S.O.
Wednesday on Mondays, An outpatient's service part of the week was spent at various locations The remaining Cheshir Home, The David Rose School, the s and Fridays to the afternoons, e Home and the Public has been available intermittently on Tuesdays THERAPY 1.

Input has included individual sessions, and nurses.

Sessions advice therapy have been inhibited by a lack of porters.

teachers and discussions with 2.


Averages of Thirty-five were made per month with an obvious drop in contacts during the school (35) contacts holidays.

3.

Individuals have made varied progress with a general increase in knowledge of signing.

HEALTH A satisfactory year was spent by all.

Illnesses such as colds, to hospital and lacerations as with illnesses such were treated here at the Centre.

Some of the children were admitted Pneumonia.


Dr. Jeffrey the Orthopedic Surgeon visited the center to see outpatients, and children who were referred to him.

There is still the children at least need for a Pediatrician once a month.

to visit the centre, to provide medical attention for 41 A Filaria Survey was carried out at the Centre.

Four of the children were tested positive.

They were treated for the diseases and are better.


PTOLEMY REID REHAB/LITA TION CENTRE EDUCATION DEPARTMENT The year began with thirty (30) childre of the year one migrated course and there were three admissions.

n on roll.

Twenty boys and ten girls.

During the ACTIVITIES: This year our participation of National Songs, Recitation of Poems and a Dance.

in the Internal Mashramani singing Celebrations was limited to Six children particip ated in a National Colouring Contest sponsored by Jed Enterprises.
One child was awarded a prize.

Craft items produced by the children of this Centre were on display and sold at two exhibitions during chair backs, pin cushions etc.

Neither which are valuable this year.

These items included scrap mats, baskets, of these were financial successes, crochet -centres nevertheless lessons, and for life, were learnt through these experiences.

As a result of a new system which was introduced at Special Irregardless Olympics.
Our student s did of this we earned three Gold not participate Medals, Two Silver and Two Bronze.

in as many events as in previous years.

The Annual Able-Disabled show once again afforded us the opportunity of exposure.

Three students that we were asked to repeat Annivers ary.

sang and one did a dance.


Some members these items at a concert of the audience held in honor ofUNICEF's were so impressed, Fiftieth During the latter for ten of our children 4:00 p.m. part of the year the Management of the Pegasus Hotel gave permission to use their playground on Wednesdays between the hours of2:00 p.m. - 42 GEORGETOWN HOSPITAL MISSION STATEMENT The role and other appropriate efficient and purpose of the Georgetown care to all persons manner.
and effective Hospital referred to this hospital, medical, in an acceptable, is to provide quality agreeable, nursing, The ObjectivestTargets set for 1996 are described below OBJECTIVE/f AR GET TAR GET ACHIEVED ANALYSIS OF SUCCESS/FAILURE and Ensure that protocols guidelines for use in all departments, sections of the Hospital.

are formulated and Partially There are still which have to complete & guidelines some Departtnents and sections their Protocols .
Partially Partially in certain sections benefited Employees from training Courses, workshops Seminars during 1996 Procurement administrat and of supplies ive inefficiencies.

was affect by were to give Hos pi ta!

conditions of Drugs and supplies, Create working and Settings that will encourage Employees of their best.

Ensure that adequate amounts Medical office Materials and supplies, print and Non-print Materials in the Georgetown system at all times.
Ensure that there were adequate fuel and lubricants of a good quality to keep generators, pump, etc., working well.

Provide appropriate maintenance buildings Make certain that Janitorial and Cleaning Services function well.

Ensure that the drainage system is well maintained as to avoid flooding Hospital in the Compound.

so No Yes of hospital Partially Partially This was successfully accomplished.

because Block and success of the Surgical Wards were started.
This was a partial rehabilitation the Maternity The ACS DC was just above average.

The old sections average or just below.

It was only during the last quarter of 1996 that the Contract was awarded to rectify this situation.

were of the Hospital Ensure that all staff members understand the importance of not wasting electricity.

Ensure that travel claims are Partially In certain areas where lighting is unnecessary during the day, lights were inadvertently left on.
The processing time varies from month 43 paid on time to staff members.

a high care and towards the all staff Work diligently goal of imbuing with members at the hospital the 'Team Concept' idea through lectures, etc, Ensure that Georgetown Hospital maintains service, standard of attention at all times.
Ensure that Revenue Collection applicable) diligently Ensure that the Finance (Accounting) section of the hospital is provided with adequate, well qualified and Refund (when are properly and experienced carried out.

staff.

YES NO and Partially to month, sometimes they are quickly done at other times is a staffing problem.

It is somewhat Partially persons from the individualis tic to the team concept.

difficult changing there are delays.

It Partially areas.
It Partially areas.

More trained staff were needed in all This is being done in a successful manner.

This is yet to be accomplished.

of the present staff are unqualified.

Many .

There were a number of small Successes departments.

several that impacted positively on the functioning of PHYSIOTHERAPY DEPARTMENT: I.Extensive repairs to the ceiling of the gymnasium, and replacement of beams and partitions in various areas of the Department.
2.Replacement of flooring, entire the eastern wall of the Department, Department thereby and erection enhancing of grill work to the windows on of the Department.

the security CENTRAL MEDICAL LABORATORY� I.Removal of the Central Medical Laboratory (the C.M.L.)

from its old location to the New Ambulatory Care Surgical Diagnostic Centre.
2.Preparation and completion of the following viz:­ manuals, ( a)Laboratory Protocol (b)Laboratory ( c)Quality Safety Guide Methodology Contro I Guide and Procedures 3.Introduction of Automatic Techniques for Analysis.

44 4.Introduction to Principles of quality Assurance.

5.Introduction from the Medical Records Division.

ofa new type of Laboratory Request form, to coincide with recommendations DIETARY DEPARTMENT: I.Moving into the new kitchen in the northern compound of the Georgetown Hospital.
2.Establishment of an on-going formal training programme for staff members.

3.Improved quality of dietary services to patients surveying trays, so that meals are always served at a warm and proper and the introduction eating and use of insulated food temperature.

MANAGEMENT INFORMATION SYSTEMS I.A computerized Accounting systems were set up.

Medical Records, Pharmacy, Material stores, fixed Assets Register, and 2.Computer Operators were trained to operate the Medical Records system.
3.Job descriptions were prepared for all categories of staff within the Division.

4.A Medical Records Consultant (through l.D.B.)

provided training during the year.

THE WARD MAIDS: was given to the Permanent to hire additional of the new Ambulatory Permission Service Ministry Commissioning 1996.

This is considered human resources to accomplish a major success Ward Maids.
This increase Secretary, Ministry of Health, from the Public was necessary because of the Centre on the 24'h May, Care Surgical due to the great importance of having enough Diagnostic the tasks that have to be done by this class of employee.

The Permanent Secretary contributed to the success in the Maintenance Field at the Georgetown Hospital by agreeing to and approving the Contracts listed below :- • NUMBER I.

PERIOD START UP TIME COMPANY SERVICE I YEAR I" August, 96 Stain Masters Housekeeping 2.

3.
3.

6 months 16'" September, Cyri I Walker Attendant Guyana Limited 96 6 months I ' 1 October, 96 Frank Gaul General Carpentry Associates Limited Service 45 4.

5.

6.

7.

8.
5.

6.

7.

8.

Services Services 6 months 9'" September, 96 Frank Gaul General Handymen 6 months IO"' October, 6 months IO'" October, 96 Guyana stores Ltd. Electrical 96 General Plumbing Services Service Construction & consultant services I Year 3 months I" June, 96 Cops Guyana Ltd. Security Neil Powley Medical Services gas x-ray Department Training of the staff in the proper use of all the new x-ray equipment, which were installed in the department in the new ACDC.

Nursing Department Nurses Record.


Clinic in the OB/Gyn Department (I 0) were trained in the use of Simplified Perinatal Four ( 4) Nurses Hospital .

started the Anaesthetic Training Programme at St Joseph Mercy Additional Important Successes: I.The establishment of a Surgical Teaching Unit in the Northwestern half of the Lady Thompson Ward.
The renovation Governmental comprising Faculty, and some Physicians Group, of this wing was paid for by Futures Private Citizens, Fund through a Non­ Medical Sciences of Guyana, from the Georgetown University Hospital.

2.The transformation of the Old Police Ward into a new Pediatric Ward.

This was a joint venture funded through a Private Canadian andthe and International) Citizen Ministry of Health, Guyana.

(resident in Great Britain), Rotary C!ubs(local, 3.Opening during the renovated Wards.
Although 1992, it was only opened during early March 1996.

Seaman's' the renovation had been complete d 4.The Commissioning May, 1996.

This new Facility the disposal treatment of the Patient of the citizens.

of the new Ambulatory Care Surgical and with state of the art equipment Diagnostic and apparatus the 241h Centre on has been put at to be used in the care and Hospital, Care staff of the Georgetown and others in Guyana.

living 5.Removal of the I.C.U., new ACSDC with exception Clinic.
A&E, the Operating Theatres, and all the ambulatory Clinics into the of the M.O.P.D., the P.0.P.D., the Psychiatric and the Eye 6.The opening of the new power Laundry Northeastern area of the Northern on the same site as the previous of the Georgetown Hospital.

Laundry, Compound 46 7.The use of two Guard services.

The COPS Security service for the new Ambulatory Care Surgical Force) for the remainder of the Georgetown Hospital.
Diagnostic Centre; and the special Constabulary (an ann of the Guyana Police 8.The Development of the Outline ofa strategic plan for the Georgetown Hospital, 12'h January, 1996, by the Hospital Administra tor, Dr. Vibart Shury, F.D., DPH.

• 47 BIOMEDICAL ENGINEERING MISSION STATEMENT The Biomedical department, equipment.
Engineering providing technical service medical Department expertise in the repair at the Georgetown Public hospital is a support and preventative of maintenance DUTIES/RESPONSIBILITIES Monitor day to day operation of medical equipment and other related systems.

Cany out maintenance and repairs to medical equipment and related systems.

Keep record of all repairs and servicings P.erformed on all systems and equipment.

Provide advisory service for equipment users.


Monitor work by external contractors, related to medical equipment and systems.

MAIN FUNDING SOURCES I.D.8.

Canadian Exchange Programme Overseas Organization and groups European Economic Community Ministry of Health.

The following were defined for 1996 Objectives/Targets OBJECTIVE/TARGET TARGET ACHIEVED training Training was carried out by Completed ians to Assign technic clinical areas.
Technical programme suppliers Identify parts for each piece of the new year.

equipment.

and test Service of new equipment.

and stock spare Would be completed early in OF ANALYSIS SUCCESS/FAILURE There were set backs due to staff reduction.

More in-depth needed.

Replacement spares are arriving.

still training Some were supplied by I.D.8.

Acquisition of servicing -18 equipment.


in health care project (I) and testing equipment for such as the and tic machine special units Anaesthe x-ray units is being addressed.

are visited A users guide would be early in the are in introduced Improved with users.

that areas Ensure communication regularly and logbooks place.

Preventa tive maintenance Regular inspection Programme.

maintenance new year.


and Would be fully of all medical implemented in the new establish the year as warranty periods based on come to an end.

equipment schedule of frequency manufacturers' dations.

recommen Equipment record and log.

Develop to Cards for this system were history designed a record sys!em keep a comprehensive of each item to include: This would be fully Record of all Inspections introduced Record Record of Schedule maintenance.

Partially of all repairs parts used of preventative year.
and ordered.

in the new achieved.

This has already been Safety Programme introduced to staff and would be extended to the departments.

different SUCCESSES/ACHIEVEMENTS Acquisition of modern and comfortable work environment.

Inventory of all assets.

All spares and consumables have been stored and catalogued.

Budget proposal was submitted to the Ministry.

Repairs and maintenan ce of new equipment.

-19 CENTRAL SUPPLY UNIT MISSION STATEMENT The Central Supply Unit is responsible for the I.
Purchase of stationery, cleaning and dietary supplies and printing of Medical/ Accounting forms; 2.

Issuing of stock to Health Facilities on a timely basis.

OBJECTIVES/TARGETS OBJECTIVES TARGET TARGET ACHIEVED ANALYSIS OF Availability items.

levels Achieved control Achieved in relation to of stationery and detergent.

SUCCESS/FAILURE budget was An appropriate developed.

of funds was a problem as CSU is not a fund holder.
a budget Achieved To develop appropriate to meet the needs of public Health Facilities supplies dietary To manage a budget for the Not Achieved CSU does not have a single source of funds, but derives the CSU, so as to attain funding from three (3) greatest economy in the heads.

purchase of priority Stock levels were adequate To maintain reasonably of stock.

Wastage and shortage were quality To exercise kept at a minimum.
in order to minimize wastage and shortage To keep the Ministry Not Achieved Reports about the status submitted.

informed of the status stocks and budget status submitting reports.

To keep the Ministry Achieved informed of the cost of all supplies Facilities basis.

To take steps to ensure the Not Achieved Continued growth in stores management employees with the support Ministry of Health.

To provide This was done on a timely basis.

Cost of stocks issued by the CSU were sent to all Health Facilities.
training is need training.

Issued to Health on a monthly the Ministry Achieved by quarterly of all skiIIs within the CSU stocks were well maintained.

Shortages have been on the job of the of of was done but there for more external 50 to the attended of brought the MOH.

of critical and to apprise with early notice of shortages supplies Ministry of actions improving the service provided by the CSU.

the for 51