Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694834205207.pdf (Guyana)
., •• MINISTRYOF HEALTH ANNUAL REPORT 1!93 • TABLE OF CONTENTS 1.0 EXECUTIVE SUMMARY .............. .

2.0 MISSION STATEMENT AND OBJECTIVES ......... 2. l MISSION STATEMENT .......... 2.2OBJECTIVES ............ 3 .... , 3 .................... ................. , .

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4 ORGANIZATION AND MANAGEMENT .

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3.1 MINISTRY 4 OF HE AL TH ........................................ 3.2 GAHEF ....................................................... 7 4.0 SUMMARY ANDREVIEWOFPROGRAMMES .

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4.1 PUBLIC HOSPITAL GEORGETOWN .

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4.2 PUBLIC HOSPITAL GEORGRTOWN: IDB HEALTII CARE II .

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9 .

.. 9 PROJECT .

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4.3 PTOLEMY REID CHILDRENS' R EHABILITATION CENrRE .

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4.4 DISEASE CONTROL .

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4.4.1 VECTOR CONTROL PROGRAMME ......................... 4.4.2 HANSEN'S DISEASE (LEPROSY) PROGRAMME .

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4.4.3 TUBERCULOSIS 4.4.4 ENVIRONMENTAL HEALTH ......... 4.45 LABORATORY INFECTIOUS _............... NATIONAL LABORATORY FOR SERVICE: .. .

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23 DISEASES .

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PROGRAMME .

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22 10 13 15 15 19 4.5 MATERNAL AND CHILD HEALTH ........... _ ................... 27 4.6 TECHNICAL SERVICES AND STANDARDS .

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..... 30 DRUG PROCUREMENT AND DISTRIBUTION .

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4.6.1 DENT AL SER VICES ..................................... 4.6.2.

4.6 3.

NATIONAL BLOOD TRANSFUSION SER VICE .

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4.6.4 X-RAY SERVICES .. .

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4.6.5 PHYSIOTHERAPY SERVICES 31 .

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38 4.7 HEALTH PLANNING UNIT .

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4.7.1 HEALTH STATISTICS .

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UNIT................... 40 42 .

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4.8 CENTRAL BOARD OF HEALTH .

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45 4.9 NUTRITION AND FOOD POLICY .... .

..... 47 4.10 4.11 VETERINARY PUBLIC HEALTH ... .

FOOD AND DRUGS DEPARTMENT .

.... 49 -,, ...... ,_ 4.12 UNPLANNED FOR BUT IMPORT ANT ACTIVITIES UNDERTAKEN .

........................... ............... 54 5.0 REVIEW OF SPECIAL INITIATIVES .

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55 ... 55 ............. ..................... 5.1 HEALTHPLAN ......... .

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56 5.2 MEDICAL TERMINATION OF PREGNANCYB'ILL .

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56 5.3 HEALTH LEGISLATION ....................................... 5.4 DISSOLUTION 56 5.5 FORTCANJEPSYCHIATRIC HOSPITAL.. ............. 56 5.6 BUILDING NEW RELATIONSHIPS .. .

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OF GAHEF .

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ADMINISTRATIONS WITH THE REGIONAL .. .

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5.

7 NEW PROGRAMME AREAS .

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5.8 MANAGEMENT AT THE MINISTRY AND GEORGETOWN .. .

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PUBLIC HOSPITAL .................... ...................... 5.9 HEALTH CARE II PROJECT DESIGN ............................. 58 58 6.0 BUDGET INFORMATION .......................... ...... 58 6.1 BUDGETED AND ACTUAL RECURRENT EXE'ENDITURE .

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58 6.2 BUDGETED AND ACTUAL CAPITAL EXPF.NIDITURE .

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........... 58 1.0 EXECUTIVE SUMMARY For the Ministry of Health, significant accompli shments despite 1993 was filled with challenge the constraints which i1 faced.

s and transition .

as well as some January, !

993 found the Ministry of Health working diligently to prevent from Cholera to the densely spreading team work within the Ministry and timely international organizations and heartening such as PAHO, CAREC and UNICEF.

areas along the coast.


This exercise was a success through from financial and technical assistance populated Building the Ministry established on this successful effort that was due mainly to collaboration and coordination staff meetings which we re chaired by the Minister monthly senior of action.

of Health.

In addition.

the Ministry focused 011 strengthening the traditional programme activities.

and gave special attention to planning, policy and organizational aspects of the Ministry.
Specific areas of action included: Preparation ensure that·there of a National Health Plan.

A broad based committee was established to was consultation with participation of all relevam sectors.

Review of existing health ( 1953) care were outdated.

and the Mental Health Act ( 1933).

legislation.

The process of updating Many of the legislation which govern the delivery Health Act began with the Public of Reorganization the functions comprehensive of the health services.
The Ministry began the process of reabsorbing performed by GAHEF.

as a means of providing health care that is more and integrated.

to the population.

Two major institutions were also targeted for special attention the Georgetown Hospital and the Fort Canje Hospital.

At the Georgetown rative Administrato Hospital.

a council was appointed.


and a Hospital r with both medical and Su perintendelll of consultants with the management of medical was established to backgrounds admini;1 support me Administrator professionals and Medical at the institution.
In addition, to the administrative improvements., rooms were rehabitated and put back into operation the operaling theaters during the fim quarter of 1993. and recovery Fort Canje Hospital was designated works began to rehabitate as the National the kitchen, Psychiatric laundry and bakery.

infrastunctional Hospital.

and The accomplishments under extremely difficult were few, but significant, circumstances.

in view oflhe fact.
in view oflhe fact.

that the Ministry of personnel of trained delays in financial releases, and the deplorable state of the team built during 1993 in planning, policy development.

the will undoibedly serve to strengthen A sevcse shortage plant.

However, and strengthening the foundation stroctures., of organizational vacancy rate in some areas), Health functioned ( 400/o-80% physical building health care delivery system and improve the health status in the years ahead .
...... � .. tfal, .......... � .. , far.

E. Lee (Pennanent Secretary) (� V 2.0 MISSION STATEMENT AND OBJECTIVES 2.1 MISSION STATE\1ENT "To ensure population appropriate of Guyana."
, adequate and competent health care is available to the 2.2 OBJECTIVES 2.2.1 Define acceptable nonns/stan dards of health care 2.2.2 Ensure acceptable standards are maintained 2.2.3 Ensure levels managerial technical, system of the health care delivery and administrative support is provided to all 2.2.3 Ensure health care institutions/programmes are provided with adequate nwnbers of suitably trained personnel 2.2.4 Ensure appropriately resources distrib allocated to the health sector are equitably uted to all levels of the health care delivery and system 2.2.5 Ensure that curative, preventive and rehabilitative facilities are promoted and available to the population 2.2.6 Evaluate of health the effectiveness care programmes 2.2.7 Develop systems a long tenn plan to ensure the coordinated delivery of health care 2.2.8 Ensure access to the resources health of international care agencies 3 3.0 ()R(;ANIZA.Tl()N AND MANA(;El\1ENT 3.
I Ministry of Health During 1993, the Ministry of Health shown at Figure I and was headed to the Minister Reporting Officer of the Ministry.

strnctural Teixeira.


Executive the heads of which report to the Permanent is the Permanent Secretary, The Ministry is organised Secretary These are: who is the Chief into three within operated by the Minister of Health, Ms. Gail the organizational major sections, Officer *The Chief Medical *The Hospital Administrator Services *The Administrative of Public Hospital which include Georgetown Finance and Personnel (a) The Chief Medical Officer is responsible for the supervision and coordination delivery.
service of health each of which is headed by a Director.

(I)The Department Tuberculosis, Hansen's of Communicable Disease, Diseases, Control Vector There are five major divisions that carry out this task, which is responsible and AIDS programmes; for the technical for the and enforcement of standards l services i.e.

X-Ray, in both public and for all technica and the National for Physiotherapy Blood Transfosion and some aspects The Service.
of the which is responsible in the Regions, delivery service and the Central Environmental Health Services -responsible the Maternal and Unit; for the establislunent, ( i1) Regional Health Services, supervision Child Health of health pro,b>ramme; (iii)Standards pro1,>ramme, and Technical implementation, monitoring health and private sectors, Laboratories Phannacy, department is also responsible Nursing (1v) The Planning monitoring of the National planning and management capacities.
undertaking health developm policy and centre acts as a catalyst providing and related analysis coordination for human resource develop Department, of health for externally-funded Unit which is responsible given the who reports analysis, care provision hospital: at this facility, key role and teaching referral and Heafth Plan, and assisting for the development of It is also responsible in the building for elated advice projects on resource allocation, health-r of information on The Unit ent and evaluation.
research and for providing and and technical assistance, ment.

The Statistics to this Unit also reports on the technical and financial aspects as the national which serves and of data in planning; 4 (v) Epidemiol use of health monitored Cholera The Chief Medical ogy Unit which is responsible data so that the health situation and analysis for the generation, and a in Guyana is tmderstood (e.g.

so changes that services could respond approprately out-break; a dengue alert).
Officer also has responsilulity y regulator for three important and the Board of Health, the Central the Guyana Medical boards/co uncils: Phannacy and Poisons aspects of the nursing and staff promotions, Board.

The Principal profession to the CMO also reports directly e.g.

training, Council, Officer who is responsible for all Nursing certification, standards, transfers of staff Officer.

The Hospital Administrator Administrator.


of the Public Georgetown is responsible for the overall Hospital is the Chief (b)The Hospital Executive management technical and surgical The supervisio through matters and functioning by the Medical Superintendent who is responsibl e for the medical for the Nursing services activities n of diagnostic, and the Matron who is responsible finance Administrator.

dietary, the Office of the Hospital and other support services is done of the hospital.
The Hospital Administrator is assisted in (c)The non-health Administration staff to deliver technical and Supplies care.

health programme departments provide the supportive i.e.

Finance, Personnel, mechanisms the that enable 5 The organizational chart of the Ministry of Health is at Figure I. MOH organisational Structure Minister Permanent Secretery CMO PHG Others Dir comm Dia B T - 1 I i°ir RHS l ���. ''""
Dir •lannin; rintnc, C-MCH -Pharmacy ta t!stics i-Hansen' I-Environment �Dental s I-vector Control Nursing t LAids taboratotieit .

-Phy:,iotherapy Blood Transfusion 6 J.2 Guyana Agency for Health Sciences Education, Environment and Food Policy ( G AHEF) presently falls under the purview of the Ministry of Health.
TI1e organizational chart ofGAHEF is at Figure 2. of the five major divisions G AHEF consists * Administration * Health Sciences * Environment; * Veterinary * Food Policy Public Health: and Nutrition.

Education; and support to all of the other (b)Health departments, in relation (a)The Administrative provides division to finance and personnel.

Education is and development as liaison Sciences education also served needs.

monitors between professionals, materials.


Health health The division in relation ( c)Environment to training responsible for the training of health of health learning UG and Ministry of the impact and seeks to control harmful effects on the environment.

(d)Veterinary Public through activities, inspection Health ensures that zoonotic of meat products are prevented of food processing and monitoring diseases especially in the fish and poultry industry.
(e) Food Policy and Nutrition is responsible for nutrition and implementation component.

of all progranunes and activities policy, planning, utition that have a n As with the MOH, the Minister the Executive However, to the is the head of this agency.

According Chairman of the Agency reports to him/her on Chairman resigned in April, and from the Executive the five major divisions shown in the chart reported directly to the of Health.
The Environmental in the Office of the President, and the Environment to the President on Science, Technology Unit was placed -but to use of the staff who continued of Health continued to pay the salaries structure, activities.

organizational the Agency's this month onwards Minister under the Advisor the Ministry offices at GAHEF.
7 Figure Chan of GAHEF 2 -Organizational CURRENT ORGANISATIONAL ARRANGEMENTS AT GAHEF ECUTIVE CHAIRMAN Food Polley Enwonment Director Env.-on ment Division ot Healt� Educ:ition Leaming ie�ltll Unit Mate1 ials a 4.0 SUMMARY AND REVIEW OF PROGRAMME 4.1 PUBLIC HOSPITAL GEORGETOWN Main dutieslresponsibilities main fi.mction in the health care delivery system is to provide Hospital's Georgetown specialized volume and high-cost.

residents country.

In addition, and paramedical trained.


of Region 4 including Georgetown tertiary health care services.

low­ These services tend to be relatively Hospital However, the hospital also, serves Georgetown Hospital staff, and is one of four locations in the country where nurses are Public for as a Regional -the most densely populated part of the hospital for doctors .

is a teaching Main funding Sources Georgetown Public Hospital was funded by the Ministry of Health.

Objectives and Targets (if set).


and Analvsjs of Success or FaUure (if Objectives and Targets not set) /Summary of Main Activities {N,i ... 1ftWr IM.nU •'blltl I"' dr¥lll.>p ft<K-Ml .._,..

rala.

:'!CillJllpS atN!1Jt f�f'hr>r<tlilf 1 >t,vel"J>UltltlS!,•" f'l"""'b ffl'.ill'JltflMI'" lfyil To ...-, ,� Yu � .... �,.aw(' Thali""1: �--bu!�._ ___ Semo."

!riffl Wffl Wll'J.

Ml� fl\,)[ bull wedlm'm, fw"l't<,'«, � im)l'l"ffllW 11i'•n 1111".11 ffilWC(l !hill� ;<;do(ltt<!
Wl!trt lhffl 11111 �<:"llUll<III <»C-11 \lll �II haJ a:ccp1.W aw IIKI �- Workshops/Conferencesrrraining Courses Held or Attended One workshop the outbreak deal with the epidemic was held during and prevent an the cholera outbreak to assist epidemic as will as put Hospital in the campaign to halt on alert in readiness and satellite areas.
to were it to hit the densely populated capital Major Successes/Achievements Some of the successes • the recruitme of 1993 worth mentioning were, who had both a medical and nt of a Hospital Administrator administrative back1:,>roun d, • the establishment of a Council of Consultants, the reinstatemen t of departmental meetings and Heads of Department meetings 9 on a regular basis; and • increased accotmtability to the hospital.
improved management Furthennore, concerning the use of donations a new adminstrative sirucntre designed Ministry.

Service to the Public was submitted and dmg supplies sent to facilitate Major Problems Faced and Suggestio ns for Problem Resolution With the the retiremen during 1993 was the absence year.

The Chief Medical this recurring problem, and abroad, and salary being offered.
t of the Medical of a foll-time Superinten det in May, the major problem faced dent for over half of the Medical Superinten Officer had to fill this post on a part-time basis.

To resolve the MOH needs to continue some inducement/reward to supplement to advertise system the post both locally the must try to devise t of medical specialists to be extremely from Cuba and China lUlder the tenns of joint as well as United government Nations difficult.
There is a agreements these countries and the Guyanese continue The recmitmen high dependence on doctors between Volunteers salaries for post-1orraduate with specialist theprovision training training.

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If more Guyanese nationals of more scholarships If specialists and other working is required.

overseas conditions also makes it difficult to find Guyanese nationals in colllltry need to be improved.

are to be recmited to these positions.


The lack of scholarships are to become more widely , available 4.2 PUBLIC HOSPITAL GEORGETOWN: IDB HEALTH CARE II PROJECT Mission Statement "To improve the delivery of Health Care at the Public Hospital Georgetown".
l\1ain duties/responsibilities are: of the Project The main duties/responsibilities Outpatients -Medical seven clinics nts Department, • Bringing Outpatie Skin, Ear Nose and TI1roat Ophthalmology, and Medical -into one location; Department, Surgical Obstetrics and Gynaecology, • Upgrading and Intensiv the faciliti e Care Unit; es offered in the Operating Rooms Recovery Room 10 • Automating • Improving • Improving the X-Ray facilities; the receipt and delivery the laboratory facilities; of phannaceuticals and medical supplies; • Introducing Central cross-infection Sterile Supply and post-infection; Department to reduce considerab ly • Improving the anesthesi a facilities through centralised medical gases supply system; • Improving Department • Improving improving • Improving • Introducing • Improving • Providing boilers; the facilities offered by the Accident and Emergency House.
Boiler Laundry, in the Kitchen, the facilities the stand-b y generators; the telephone system: two Simplex system and sewerage systems; the water supply, steam and hot water with the installation Bedlifts; drainage of three 80 h.p.

and • Providing stand-by from the Guyana Electricity Corporation generators which will automatically take over the load • Providing an incinerator for pathological during blackouts; and infectious waste.

project came under review.


block of the Ambulatory/Diagnostic/Surgical design of the was re,ised fn June-July 1993 the entire southern s pace would be used more cost-effectively.

desi1:,'Iled operations of an Accident and an intermediary to allow for the inclusion block of the centre was re­ room, 14 private and Emergency Unit, a minor sur1:,>ical The interior The southen Care Centre care unit.

rooms, so that Staffing Level 'llilllna l'r,;ne,.1�1Mer ,\.

'o/llM!ll Pfl.llll�l Manltl:!


E:.t�lltltt Secmlu'¥ /il�!IIAmd''"'l \"elude l'.lfwtr ' " " 11 :\1ain Funding Sources Inter-American Government Total: Development 0$ 182 600 000 of Guyana: 0$ 977 600 000 Bank (IDB): G$ 795 000 00.0 A(:tual f;'xpenditure: 0$ 820 733 000 Total Project Funding 1989-95 US$ 3.1 Million Total US$ 31 Million °" US$ 27.

9 Million from Government from IDB + of Guyana \ Objectives /Summarv and Targets • (if Objectives of Main Activities or Failure and Targets not set) (if set}.
and Analvsis of Success l>Nt-t"OH• l"'Yt>"l riot ........ ....._..- • '"li'lt\i,ll<'ll ''.11:�11.lli.

''tnllf c>l �;:w .•Vfll>i>Lw>r) • \ \IIC, l-'laJ!

;!k'4X MU �-,�m lll'hl tn!laltdlHm "' Klld!tii ,,nu • i,,,,,:,m:mcnl ai,.J lnAf:;illaq.m,>f LaumJrv F;,1 !•1,,,¥1.� aa<i fnstJIIIQ<DO(II �>t11et:U<t� ,<>:llfd ,,t <:1�dtliU lt'f i:kmffli )t�l \"K�•) y, .. 1:'1>.r, I,• "' l':wuull*'/U< a;nJ ln� »t h,etnn-1lhA' No \war,j <'l o"<'fltl".11,,1 ,.11 .. 1 �,.m ,,t <1�<1.ll!
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TIIM-•.-..,.--..,, ...--tt.l"btds-� •• ,.,..�ll�lllll'lf�aldlC�llnP �ottNNJ� �,;it·�-�-D-� A- tJi �-- $ilc-ml110 ,�&IIIIIOB woiap f«IM ... 01 �}bqMillf �-loti.�lfltllCollfflP;llf ........ t'�4da� ��--��('!pu<Xtelll/OMC --111vu-..mful'hidnrmber,;,�11, ,':19,1 oy,.
'flllr.11 TelltlOf oft'WWd Major Successes/ Achievements The major successes • the recruitment were of two overseas-based Guyanese to assist the Project Execution Unit, • more active participation of MOH personnel in the project (both at the level of Georgetown Public Hospital and at the Director level administration within the Ministry • redesi1:,rn of the Centre within itself), be more responsive Project Execution Unit by the Ministry of Health.
to the needs of the hospital, resulting in less wastage of space and facilities that will to the more support and provide 12 Major Probl ems Faced and Suggestions for Problem Resolution There were major difficulties with the constniction of the riew Centre The initial archite that would facilita ctural archite required ctural plans did not include te the operation of this equi;pment.

this problem, (a) an equipment layout and (b) details of the services needed to be produced.
an equipment layout plans that include this equipment To resolve to fimction to enab.le eith-er or services during the year.

It also took a very long time to obtain needs from staff turnover, with foreigh bi-latemal joint at:,rreements.

consultants medical consultants.


This is reflected, at least in part, the relatively high infonnation on equipment and phannaceutical only spending 18 months in the country under -t3 PTOLE!\tlY REID CHILDRENS' CENTRE REHABILITATION \ Mission Statement i I "To pro,·1de \ physical service a national care so as to facilitate rchabiliatitive for all children in Guyana who are in need oflong tenn their inte&>ration irno the ,vider society".

es !iVlain duties/responsibiliti I !The main duties !
• Providing of the Centre are: clientele; a range of rehabilitative services in response to the needs of the • Providing Centre • Urging -dormitory, parents a range of social services for those clients schooling dining, and recreation: in the of cluldren to be more involved and to benefit from its provision and relations who reside at the of counselling functioning and education; 1> Strengthening of the Centre the financial well-being of the Centre by seeking to attract resources outside • Making provision of the government sector; for the supply of orthotic/prosthetic to appliances physically disabled clients.
13 Staffing Level --v- .

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l\tain Funding Sources sources for the Centre Sector Community's The main fonding Guyana/European PAHO/WHO, SIMAP/IDB, donations Centre contributors the payment include from local of staff salaries Programme for Health and Education, Fund, user charges, to the 1l1e MOH's contibution of G$5m annually.

and and a subvention are the MOH, the Government of Food for the Poor, Futures e.g.

Rotary, Lions.
Rotary, Lions.

Objectives /Summarv Success and Targets (if set), and Analysis of or Failure of Main Activities (if Objectives and Targets not set) < >:,i,.,ln<' I�,,,., \l:umarn "''''·"'«ltl' , *'<><'lUd,;, i'r,.,,1,1r e.�1,· H,,m, ll1ntt-w«k.ly ,LJh ·11,;-:ir,,, ,,., ;,, «>>tlU!dtlOn ,= -li � Ui,IJrc,:(!f C,>11'.

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'\1,:t UW;t�!-1t,-atu:falfillliaHsh.�iiM · ----·�"""*-t--�� -�---mdj�Wffltll'lr.nl,;,Wk lull-d.r!

,-.wtittly f<""'l;z!f� ·!• .... ">�l«-�l�etUp./1.

;1,..r.,�� ��----"""'�j!,oo<>tmeal:i,;,.t� ... ��"'- '"""""' -iw:t��lkve>!d!"!

!l">.,an Tb.e���--..;:;t,o.$ r�6-•V'SO�llllfflet\milh:.l!f,,1ll1,,c11 wm fnr6,iu'1Cfli.

'l;pr"'1'.l,l \)Jllll;uJ!

Vl'<',IJOful!


JkJ.Ll � fll'O� (r.ul (I.it.--� ,,n,ei>tt , .. ",: �·•1""'' l'f,,�1[!t l::Jllttmn .u"!

c,;u,.1 <l,�i" 1a14,/lni, i •ni,l�t>tt ,,M,xi, .lllol f>"'"'� )fpll;un:*8 prn,m1111m� II\ Linden.

New AJnurdam ,:,u;.n:art, 1) i., •ht f,,,...,,�o,, \(ieflv?!o!

'll'l�l tor HM (1-: :u ,lmu�---�eld� l'��lll� outn:a:h ,.,wi<1I....Wemuca�<111tk>�,,,;,•1nutJhJ 11\ITCBlllJf\'.
!�°'� Workshops/ConferencesO:raining Courses Held or Attended Workshops Atte11ded: • 2 teachers attended a workshop for "Sports Training with for people 14 Trai11it1g Co11rses Physical Attended: Disabilities"; • in-service training was held.

for nurse aides,.

· Major Successes/Achievements The maJor achievement of 1993 was the smooth transition status.

The Management meetings has been fairly high.


non-governmental management status, exten1al fi.mding onhopaedic workshop of existing_physical plant from major funders for has been acquired.

was also acquired.
was also acquired.

to Committee is in place and attendance at As a direct result of the switch to NGO from governmental the building and equipping of a new Funds for the rehabilitation and renovation Major Problems Faced and Suggestions for Problem Resolution -especially The major problem facing the Centre in the nursing area.

staff available to supervise each of the three in-charge personnel in place.
TI1is lack of supervision affects the quality of service -especially and two staff nurses is that of staff shortages and the quality for one sister­ of The establishment shifts.

None of these which leads to a number of problems, during the night shift.

calls To solve these problems, there is an urgent need for a trained sister-in-c harge A retired sister could be re-employed and at least to be assigned.

I and for staff nurses \ one staff .

4.4.

DISEASE CONTROL nurse assi1,'lled per shift.

4,4.


I Vector Control Proaramme M" · S 1Ssmntatement "To ensure the effective throughout diseases \ Vector-borne and efficient monitoring, Guyana".

preventio of n, treatment and control iMajn duties/responsibilities he main responsibilitie s of the V Service are: Control: the VCS is the MOH's main arm for diagnosis an Control ector d • Malaria 15 of malaria in Guyana.
The mit presently interlaces on a treatment collaborative diagnosis and treatment at diree points Hospital, New Amsterdam Rqional Hospital, along the coast: fever) surveillance in • Filaria Public process of being implemented} basis with the P1iuwy Health Care system; in Guyana: Georgetown five hllalth centres • Aedes aegypti (the vector and at urban Georgetown and Port New Amsterdam larvae in � mosquito imported yellow which uausmits the walci fionts of Port Georgetown Springlands (these last two involving the detection of ships and vessels); in and (cummtly • Dengue surveillance; • Laboratory diagnosis of leishmaniasis.
Staffing Level I tH \J.

Main Funding Sources " ,, • " ,· Ira!

MOH: GS 9 065 129 EEC/GOG Sector Programme: G$ 25 917 500 SIMAP: G$ 7 000 000 The MOH finances staff salaries and most operational activities.

funding by Geographical location below.

of and by budget sub-head is shown in the two tables TI1e breakdown MOH Financial Breakdown (By Geographit:al LtH:sdon) l)M .... 114� 16 By 1lfOH Sub-Head � .. 1,.11,�.111 ,�m,.it..!llt,Lun�n;JeJ ,,,11.nm<.
'N Objectives and Targets (if set), /Summary of Main Activities and Analysis of Success or Failure (if Objectives and Targets not set) 1 �'"""" ..... ,n.i ...

·a,.,..

1,,,un1� me ,\..uv� ,_·au 1}t!t<:utm tA(.

"01 111 \'.193 ,wer 1•)'11'! ""

,·,'111.f'•ue� <I� n� i"l'"ta«na :,y<\em a HINdql.l.i'l11ffl '" nwwwamt '" <11 IM ne!J, e.

Taf1!"ri�••tl"!

1'c,1"1> mt u,,nn ·,,u�"""' .iy,«m c ,111.m:r, -11;,r,""' ,.,rm� 1NU,tn& !

'!.mntll!.

"1 'qH A,"1,rc ,,..,�, droJ.I!


u,,;t,L•=n .,,,,..,,_ .. • t1m.s!� C,•n<Jli P.\Hu,,,11rnnu1.pn r,,,..,11,1Jn "' .ti.f.1"'1111"1 p�N Witt!

'ull('f',1.-.

")· ,1,m:; tty"'1l!<'.lf 'S'.UI 41 nth r¢.,..m ('.1.nl\.'1!l<II!.'

<4 .m¥ • ffltl!tflll ,;.,� lhlr<li::r � I '.11111,1tdt l'·1ni.w.11� "' ""I ,, : oi:une \el,�<:•t ,.,,e ,,,:;i,.u-;:,:var.i ,oj -'U•:· -�'*0'1,tl'T°" I><" ,� .._, Yt, ho :.., h.,; ,,, �-'*-hollr!?

M.'Oi-,.-.� ml fflDOCf «-- roSI -1(1'.M---�� :.


;""°'"Wffl!lor '*-trP111 f«OJ'WI �-----...- ---- .... l.llllt.W.lillal"' C.llllplllttdD--,�ll<llC"llll!lla•i"ri!

:� w"-ellOl� Nal-..p)t� boa!Ul!

:I� l"."Mua�--hllW..

p,Mbhoqm.ittollllpnM ·� w«bfioo �41,1ni.-wa1deDl.

'lffl:lille10 -AIPAHO��or"cmll'Ql!ICIIX:111� --M:illy-llillCIIO��doeWl!s--fll� No<blt-•9'1ttM:\.
"�--...w,,a -"""""'"' kT U.t' OUMloR ci $'rai:bul ......... ,\lfflmlcllel,i above, Aside fro,n tile infonnatio11 malaria, to specific progra,nmes: it is also importm,t to report 011 actil•ities aedes alf)'f}ti.

and filaria.

related l\'lalaria J shows the number of malaria cases detected by Region.

TI1is shows that type of is the dominant in Regions l, 8, 9 and 7.

P. Falciparum Figure malaria is most severe malaria being detected.
IA variety j( 15 ruinine, of dn1gs are currently mg), primaquine (7 .5 primaquine ( 15mg), primaquine used in treatme nt: chloroquine, quinine, prescribed are The most commonly mg) and fansidar.

and chloroquine.

\ 17 Aedes Agypti The table below summarizes activities related to the conµ:ol of aedes agypti.

;_• �:(; 5 also shows the number of maritime inspections carried out in Demerara, Nev, Figure Amsterdam and Springlands with New Amsterdam.
The proi:-,yamme aedes ae1:,•ypti rather proi:-'famme, requires special and review if real success analysis l11e progmmm e also needs to become a truly national in the control of is to be achieved.

than being confined to Georgetown.

Filaria The fil aria programme -down from 2 344 in 1992 and 2 818 in 1991. has sta1,'llated.
The number of �,nears done fell in 1993 to l 266 1Iajor Successes/ Achievements \ Major successes of 1993 were: • the SIMAP project successfuJJy • GOG/EEC project worth G$ 30 000 000 began in November; service a1 Dr. Validum, who had left the service in 1991, resumed completed in March; with the VCS as its Director in Februai:y, • a physician • computer-aided tabulation and the elearonic data processing at the malaria clinic: was again placed is now section and analysis of data collected was introduced to the pro1,'famme, established.
'.\1ajor Problems Faced and Sugg,:stions fen: Problem Resolution The major problem below: s faced in 1993, and suggestions for problem resolution, are listed difficulties being faced in recruiting and retaining • there are tremendous qualified appropriately worse.

To solve this problem, a Opportunities for upward mobility improvements in working condilions would also help; general matters; in processing salaries ana benefits review is proposed.

also need to be improved., while staff.
This is an old problem but it is getting personnel • delays • disparity workers in field allowances - a review of allowances is required; between VCS workers and other government • acute lack of transport in the malaria programme -priority needs to be !,>iven for the acquisition of transport for the programme; • lack of coordination between sub-sections of the programme -regular meetings intra-departmental need to be instituted 4.4.2 HANSEN'S DISEASE (LEPROSY) PROGRAMME Mission Statement "To enhance and improve the effectiveness treatment of leprosy patients and leprosy control process eradica ofleprosy control tion of the disease".
into the general of the existing medical service in the by initiating health services, eventually leading to and accelerating the M .

d .

.

"bT.
amuties1respons1 ut1es T11e main responsibilities of the programme are: all new cases before deformities develop; s to comply with standard all patient treatment regimes: service; an effective and efficient surveillance • Finding • Encouraging • Maintaining • Maintaini • Educating ng a care service for all needy leprosy patients: health providers and the community about the signs and of Hansen's Disease; area/school surveys; 14 dermatological of the programme into primmy health clinics monthly; care services; SY1nptoms • Conducting • Servicing • Integration • Preparing budgets, ILEP B Forms, annual reports and work plans yearly.
19 Staffing Level (*indicates position funded by donor agency) \!tdn P,wu- ' (rut!IM �,J Iker l\1ain Funding Sources ., ' ., " The main funding sources Association.

are the MOH and the Netherlands Leprosy Relief Objectives /Summary and Targets of Main Activities and Analysis (if Objectives of Success and Targets not set) (if set), or Failure I >hll'dlVf" I :arL,M h�n<Hlttp,,n�tlll<>�ll«,lt,hC.., "- H«lt1a lrauutljt� tm �� ,.,,�,.

!IUl'W':I.

mt!

'tl(al 1111dodt.

� �-wfd.

,i;;uc:au,;:lut,cN er.


h111ctA� Yn Y«,N<) Tn1m.,>\lf1J111\l�;(ll\l!Yltand� •.

l!

!UW.� XldbHT10flJJllj,"'11lllto!.h1� nlOIUhiV t/1.t'CUi OQ all �rw'I& s...va <,11o:emcQUdy...w.-a«11T�C ,, IIUl!Wl p.su:n!

rtCUNI and...,.
rtCUNI and...,.

IUWW:ll <Uia i'U11 Thuttday t,1-, _,.. � w 1 riwt" new laool'll,;,ry•tcluuaal l<>be"11Clw:d "" �·� Tim-�-'*-" i.· lt.t J>uMlr Heii!lh C'lirul: t-,, 1th�ofjll,i; i.,aa:Junt - �mOlll.il.�Yllia.,._..on ...... � _\�9f,._talllm>' Zil lllllllll ..- - �--pr-.--:...,,..

..r ......, ..... dia'------·�-elbatiO ............. 1,-;hul,tl � temnd �--�- tie.ul'Mmri \\0 -did UO-,Ull--:lflla:bwl"'1Uldrttr .pnlpmoicfdtlt�•Ulll..,_....._�-..,lllr fllll)aj(�l....,..,..p..a.ta..-•-dW,c' v(>lmanlv}.
u-.. ....... flk,_cabe�in t9'M lt1£w..>f'lbnot1Jq1,tllll• .. •<4mi:Jla0il<a ...... 1.13 8a'lnlnm; �.,...,.,...,.. """""'""

�--��-� :,.,>m,w c� - ****'° UII PalltK fWfl: i..'Wllc m �lhadunbe�---""�· wodtslllC-.pm'!ffll.._C....(lQl:ll'l'Ollalll.

kri: � • • ltJltml' pEJer&.

The .... tnlll'W � holl no( hM!

toCllltv r,-d !<J I.ho t'undvtt ,i;h0oliina INrYNt ,\h11nu11.1 ,11 P11bllc < · \.W f il•IDIN<:1 M.nlllUl 13 rut11i!
krmaol.., _...... fur"- ,._,.-n,;ofp&lt11U He!WI C'.w,:, \J� tOOt\«�--....,._ ..... dllW )m WIii: ......... _\lit� , __ �.,.

c1mnu�di1ru �ol--.... �c,_..._...__,._ ---s1,--.-� _ _,.,_ .. J_,__ Tim,r.,;aoon �fTfl> K,(,W..h<>lil !,'i)IWll;l:I -�dlruup:�� CA$£ HvLD!!

'<O A.."ID SURVEIU.AN(.

"E A4frmwbt MOT kl .n diapo,,ed-1 ,,...... � :\Jn'tulmcf �on.

of lilll lU T. p,U1IU wlK, �llt li'.>r toMw,11p lOCN.,a,;M-4'0'1lbP,B z.L'l1(,� MB .fXi>(� ., _ _,..,.,..._ 20 l'.

'\flf:NT t',\JU!
'\flf:NT t',\JU!

A.NO REJ{Af;!L[TAT/ON \!aln-<:.f� f�t,:;JmWedp,aMTU � ofu;re a!

'd ,.\s1ii!iaJI\IIN Ufflll)lnCt for lhoN iNI !

)1-!Wle .-..

!

'teed:tof ..... ____ thtoumMlilllt,-_.

pllfflio_.,....,,-..t.

pvtnromll....,.....•canm.

... ..._....._ Gl'80- ,., .... ,.,MaT� HEALTHE'.

)UCATION EqlaniJlllflh&@h��IQ ... n .

:<'lfflmlltiltiet thto,1@11 w !lltdul p-.-.

'-k.t�m'A<l;,.i,.J AM) Dr,.11.uot.

::,,U rq,,1ru h'VALUA11UN �»etroma•llr llm&IP'*___... fl¢flodiicall¥ ,�....,...._.. ...,.
... "'"� ...... ---� ,,....__......__IONSL.

...... Held: Works/tops courses Hefel or Attended • two workshops were held \ Workshops/Conference/fraining I I I Major Successes/ Achievements I \ The main achievement in April and June: a total of 1993 was that 4 medex, and 21 CHW s ).

the pilot project in Region 2 ( 4 trained doctors, in Region 2 was a success.
were of 29 people \ Major Prohlems Faced and Suggestions for Problem Resolution 1 \The major problems \resolved, are listed below: faced in 1993, together with suggestions for how they might be to work with - a two year old problem.

A new • there was no microscope microscope is needed: • a clinic vehicle vehicle is required; • no laboratory required major repairs from September-December: a new technologist for much of the year.
TI1e technologist was sent off duty in August, and no replacement was made; • no working computer, wh ich makes the work oftbe programme director than is necessary.

The provision of a much more time-consuming computer • no social is recommended; worker.

Leprosy work is social work, and the vacancy needs to be filled urgently; • clinic is in poor physical shape.

General u pgrading of the facilities is recommended: approached to fund such a project.

this will also help improve staff morale.


SIMAP could be 21 4.4.3 TUBERCULOSIS PROGRAMME Mission t Statemen "TI1e ultimate fonns of TB cases and improvement in the identification on of the incidence of TB through the adequate reducti of all cases of TB".
of all treatment !\'lain duties/resuo nsibiljties ies of the TB progrmmne are: The main duties/responsibilit the identification • ensuring and adequate treatment of TB cases throughout the country; • obtaining • undertaking surveys sputum smears from all symptomatics in selected personnel; small teams of trained and contacts; areas of high or unknown incidence using • develop further traini ng for personnel in the Primary Health Care system, with emphasis • establishment for each region, on CHWs in hinterland and maintenance in computerised form.
preferably areas; and riverain ofa detailed data and recording system Staffing Level l',,sU><)n Main Funding Sources 1l1e funding source of the TB programme is the MOH.

Objectives /Summary of Main Activities (if Objectives and Targets (if set).

and Analysis of Success and Targets not set) or Failure PuttttiVC' I an:M :.M l:7!pN"* tµ<aM'l!C!<;>p:al ll,!f\'fillmw:t ,;u:nw<U:u' ro ih<mwMrap-y IA t\tl.ud ·- - SIIMlllla<:t-"'*� '" T Urtr; Adlltff«!'
11.itHmnd- ThiJ-�� ililaibvnoo of ctmua tn �.tS-.atFt"'" 111 IMlCl'IOl .-,,�Ill vtnU-lO�lr'IU ana!M ti� ?,:,:,,,,:am T.wi l\eall/\ ner<onnel ,,1 ,11111uwS11r r111tl.1\fS Yu ,._, �tul ffl ,il ._...

mvolvl!!

�,, l]l'lifll,"tlll - *"-lablt 22 I I Workshops/C onferencesa:raining Courses Odd or AtteNki No workshops, conferences, or training courses were heldorattaided.
Major Successes/Achievements of the year was the implementation of the sllort-cow-se treatment to all TB cases -not just those in Region 4 but also those in other parts of the The main success regimen country, including hinterland and riverain areas.
lVlajor Problems Faced and Suggestions for Problem Rf!SQhuion TI1ree major problems were raced over the year: • there was no Medical Officer attached to the paogtalllllle if the programme is to be adequately staffed; -one is needed • irregular drug supply: more financial input is needed if regular dn1g supply is to be assured; • it was not possible • Recruinnent • Further training of additional personnel; of health personnel.

to hold training sessions for health personnel.


4.4.4 ENVIRONMENTAL HEALTH UNIT Mission Statement I \ "To promote \ health ·disposal: and improve general environmental health conditions which impact on the status of the population: solid waste disposal; water supply, and agricultural and industrial food safety and hygiene; sewage pollution".

M .

d .
M .

d .

/ a1nut1es respons1 1 1t1es .bT' TI1e main duties of the Environmental Health Unit are: water supplies for quality and safety; of all foods intended • Monitoring • Monitoring quality: and fut; and the conditions displayed.

• Monitoring the food is inspected distributed, served and conswned; designs and standards of fucilities for human consumption to ensure for prescence of disease, its wholesomeness under which food is stored.

prepared.
prepared.

of sewage and excreta 23 disposal to prevent water, food, and soil contamination; • Monitoring solid disposal to prevent vennin etc.

; waste disposal sygems as to collection, disease transmission by breeding of insects, storage and rodents, of disease; • Doing surveillance • lv1onitoring • Ensuring • Organising • Fonnulation industrial enforcement the Environmental HeaJI.I Assistant training ofan environmental health infonnation system.

programme; and agricultural.


pollution of public healdi laws and regulations; of communities; Staffing Level htlld.

l·ll\'U� Heallh t:<111 l"-\' tidd.

1·l!tl �<'tltl'r H\.\'\t(l,tlffllmlll Hallh Ot'lk.r r· ,..,,, 1 1.:rt: ........ ftffllillN I • " " N--�V--- ' Main Funding Sources The Unit is fonded by the MOH and receives tedlnical assistance from PAHO/WHO .
Objectives /Sum ma rv of Main Activities and Targets (if set), and Analysis Suttess or Failure (if Objectives am Taraets not set) I U�atnf\·t· I �r·,� \1,>AA1>rl;I\V11'¢!U11cnt.ifHew;;.

;u,.,11or111ffill� R,;t,.,w 1"1,hl,.

:H""11 l..1.,....3bd� (:.,11�1 tJ1\'V\IM'IIIIQiHull.hJaatnwt 1,,rmn1._o( ;aif.11� (,'Jl>l11n mkll: {!l"OIKt m R- .t kfPCDS HIIIUI 1�.,.._ ' r.t ... T Ys v. _,,_ �.., ...... �--� -fll!�-----' Tkpdul:P.-i ..... ............. � ...... �-tow,d.

Pwk::U.-�-----lly•loxa� .. -� ....

.,...,_.
.,...,_.

-• PAHO Courses Hrkl or Attended Workshons/Conferences[frainina Worksilops Held: • "Reorga nising Regions", Atte11ded: Works/tops Environmental Health Services at the MOH and in the attended by 40 people; • "Environmental Health Infonnation • "Environmental Health: ion"; and Sanitat Systems"; Food Sanitaiion, Solid Waste Disposal, Water 24 Co11fere11ces Atteuded: a a Rebrional Conference on "Environmental Health and Sustainable Tourism Development", Chief Envirorun ental Health Officer.
held in Nassau, Bahamas, was attended by the l\1ajor Successes/Achievem ents The Environme while the review ntal Health Unit benefited from teclmical assistance from PAHO/WHO, of the Public Health Laws and Regulations was begun.

l\1ajor Probl ems Faced and Suggestions for Problem Resolgtjan The Unit faces several years now.
TI1ey field materials continui little and supplies ng education problems -problems include a lack of leadership, that have been present for a number of a lack ofhmnan resources, of for reporting purposes by the regions), very shortages ( e.g.

stationery for staff, and few opportunities for promotions.

The department needs to plan the MOH r.e.

budgetary reviewed.

a budget with a programme of activities in order to guide Salaries allocations.
and conditions of service also need to be 4..4.5 LABORATORY SERVICE: INFECTIOUS DISEASES NATIONAL LABORATORY FOR Main duties/respon sibilities The main duties of the service are: • testing sen1m samples hospitals Clinic, private B, and HIV; syphilis, Hepatitis teclmologists and other health and private • training from the Blood Transfusion practioners Service, the G.U.M.
for the prescence of workers in die administration of tests • providing similar • providing infonnation/training in the safety techniques necessary for laboratories statistical and health workers data to the Epidemiologist who deal with sampling; 25 Staffing Level iVlain Funding Sources The main fonding Community (through the Blood Transfosion Service), are PAHO/WHO, and the MOH.
the European sources of the laboratory Objectives /Summary and Targets of.\1ain (if set), and Analysis of Success or Failure Activities (if Objectives and Targets not set) :,,.., '<·<HtrC'<JH,,e «\;q(S ,�, :me: "l.r•>b.J'il\>"f' wr µt'rlWl!

'll 1Tf11t\ f'l.4tli.11>;o: PAfIDsupp�tl,t:ftCl;- latll �lfllw�OII 5.ir--..:ft$1fiV_ ttr.>wt11tt.rJictupply,:,flhelilfhli-- �..,-.. _ Ulll)"\11,...,_..,....._l.a.....,,lllll;l\�k' �-aurlCllllor The� .Vllt It> W'ldffllb.
llltlt I� ¥Ott � -�u,ro� ··,.,on1ro1 lid ot�Wll l'nh!K Homui 1'#­ !

'AHO, !n.11 l\<'I all new•tst�3ll.l \Vorkshops/Con[erences/fraining Courses Held or Attended Works/tops Held: 0 Assistance was given to workshops held through Regional Health Services, where health care workers were trained in RPR testing.

\'lajor Problems Faced and Suggestions for Problem Resolution problem �.nd delivery The m;,jor suppiy country finance and the EC).

Supplies faced throughout delays.


for ordering TI1is could be ameliorated (they are currently reagents could also possibly due to if there was an injection of in­ through PAHOIWHO other agencies.

the year was the short supply be requested through of reagents ordered 26 .i.5 MATERNAL AND CHILD HEALTH PROGRAMME Mission Statement optimum "To deliver childhood".

care to pregnant women, ensuring safe motbemood amli healthy M .

d .

/ uties a1nuues respons1 "bT.


1l1e main responsibilities intra-natal of the MCH progmnme are: • providing 111 providing • monitoring • providing vaccination • maintaining pre-natal, care for neonates: gro\\-th and development in children up to dlei£ fiflh birthday: services for pregnant women and caildren: surveillance care for women; and post-natal of EPI diseases.

Staffing Level (*) indicates Central HQ position in MQH's MCB Unit!

...... ,11 ....

la<>W,u.


: " ., " " " " ' • • • ' Main Funding Sources The MC, I probrrammes CIDA, Rotary major funding lnten1ational, and the European Community.

sources are the MOH, UNICEF; PAHO/WHO, ·"Number Municipalit,·, and "Numh,.

'f of Vacancia' li@IRS we for R�ons 2.

J.

�!own), 6, 7.

9 and IO F',pres """' collected from RCl!ional Sup,rvi...,.. httt cscludin!

!, in Position'' � (WI B.tnk.

Eas, <:, .. st. 27 .

:', ' Objectives /Summary and Targets tifset).


and Analysis ofSuccm or F;mure of Main Acti,·ities tif Objectives 1nd Targets nor set) I �r�l'l !

'4'• .. riwu,mJ!

mm1,l!lly m,m isu, !U· • <rt"' !ll>ittt1.-r: ,< ,.,1u.

h·h•w ;,•)· Rruu,t 1r.1mv m>Jr:iw;yrMe� 11"1114''-!ll<•.·U,.e i"·h'W• !rH• ,, .

., h1·e lnnlll h\'t l".rJ,� b111.11$w� bu, btrUU"' -....\,;-- r, At1'1nf'!I �'Mwl rat:Of" �/J(ll•>ln,i llitW-lflllil:\lNIO hieflln� 41-iw; pttPllt!
'lt>l cta mt'f 1<> � ·= 1ew,1.., ,'1,,:.rgnllQ' !�,....-;.-S-l'r<• l"J·:.

'I�-tll'C 11,:,wtrN ,n -all "',-,J,;.

;t 1,-.

., .. , ... ·.t•� 1,Nnu1n•1o"' ,,. ""'""

r� \1<,iw,.c ,,1 du1diren m h� ,,'11'.rn:nnt, �11.un \, ... ,,•wmec rtt,, 111,·,.ithi c.¥1>.

!1> .-iJ ,icnu.,µl'lltni ,_,._,ouu,"t .,,.�,.

,•!


rnm,,111'""".t ti'"""� _\,,·)IJfitd i"ft.llblfh'I-*" ......... \,ctlutnd .·�IHl\'\'<14 ..... ... Yd"'---�t,· �fll� t. ..... ,....- ... ----.......-•orunibll� � food.,...._»saitcfllillra:Pt� --I - -- -...................... ,......,...,...._,....----.

...

.

:a ...... .....---- lftNww.tiM .......... p(lll- � .... ...,..._ .. tntf\l ('.-y._.

,,,.

... _.
•• ' (lfdiild:tat inU.W \illllRI -, ...... _tnlMd ............. ('llfi' ................. Htdi'""4r� --.- -titinrlw <nir,'hl!Jn,'e ,....,tm ---···�· \Vorkshons/Confere ncruntining Courses Held or Attended Workshops Held: • 11 "Expanded and sub-region surveillance); Programme of Immunization" (these included vaccination activities and disease workgiops in each region • I "Control of Diarrhoeal Disease" workshop to improve case management • l 3 Primary Health • I Control of diarrhoea; Care workshops -330 people trained: of Diarrhoeal Disease and Acute Respiratory Infections Co11f ere11ces workshop; Atte11ded: • Expanded Atte11ded: Courses Trailli11g Programme of Immunization Managers Meeting; • One member of staff attended a training course in Upsala, Sweden.
:\1ajor Successes/Ac hievements The majr,r successes of the year were: • the incidence of poliomyelitis, at zero; was prepared was maintained for field staff; measles, Gt an MCH manual • an EPI manual • preparations for the conducting of a pilot 3 were made; Matemal Record in Region • the surveillance system for fil!ld staff was developed: study on the Home-Base d was strengthened by increasing of the number diphtheria and neo-natal tetanus sentinel surveys.
28 :Vlajor Problems Faced and Suggestions for Problem Resoln1imt Major problems faced • inadequate reach communiti es; by the programme over the year were: human resources to deliver care on a regular basis in hard-to­ I) inadequate transportation: there are not enough Iandcmisers, boats or care in Regions I, 3, 6, 7, 8, 9 and If); to deliver engines o mal-functioning • inadequate required and non-functioning solar systems atheafth facilities: fi.mds for periodic visits to geographic areas where aircraft is and where there are no regular scheduled air services.
Solutions to problems faced by the programme include: • improvements in client the measures education with respect to be taken when high-risk conditions do develop; to their levels of risk and a significantly improving mechanisms of referral including home visits to higher level care e.g.
providing do proceed to ensure that clients co1mnunication access to emergency exist; facilities at all coastal health evacuation services facilities; providing rapid where these do not currently the quality of care at facilities, transfusion major referral facilities ensuring there is 24-hour capacity to by providing for the management surgery, • improving emergency perfonn emergency phannaceuticals ensuring a pre1:,'llancies two doctors hospitals: • providing lectures, poor outcomes; standardised through management are to assist teaching on-going approach continuing aitical care and by making available complications: of high-risk to the management o protocols; f high risk in improving delivery care at the main referral medical education through didactic rounds and case reviews, especially where mere are • improving the infoITI1ation system through improvements in retrieval and processing.
• Maintain zero incidenc e of EPI diseases.

-1.6 TECHNICAL SERVICES AND STANDARDS i\lission Statement "To establish care system health must function".
and monitor the nonns and stan dards within which all components of the ''lain duties/responsibilities The main responsibilities department are: of the Standards to their establish nonns and standards relevant and programmes, services with the heads ofteclmical consultation and the demand for services managerial the technical, and advise o with reference (public nationally necessary for meeting administrative the Chief Medical Officer accordingly; to nonns and standards identify these standards and private), functional area, in support and o establish reporting agreed nonns and standards provide and indirect direct schedules health which enable in all institutions (public services.
of that and private) a continuous monitoring Staffing Level Position Director \1anager.

Techn,cal Secretarv Standards Services Number in Position I and 0 I 0 Number of Vacancies \1ain funding Sources The fi.mdm; source for this department is the Ministry of Health.

and Targets Objectives /Sum marv of 1\1ajn Activities of Success or Failure not set) (if Objectives and Targets (if set), and Anah-:sis o/•t ro,,uJ "''""' J 1,rnc,-n ,,,;;-',-,,:.i.

:"a !h •·e.uls am.I ,ia.rhwrQ!

IHl\'<t 11,,lt I>«!"


,vi:hfr,f f<ltVW;l\l tt..•hnl('>l(t� 11,;ii 1./:Mc lilt ,,/ :t,hru,,d """''"ti\ r.>.,,u,e "'",,,,1;r..-i<111 "-"'� 'IL� f,'n,,-J( 11,'l<(ffial j"��'IN:llf 11;1111 TCl.ilt<J :,Y"-, i,millu,,.,..x;n 1,, "i>dait �i,ilaw!

!J -,.

'"� 11:t,-..li!J> ,..,,;u11,ai :'.'<'Mi!:tl\!

!11( lvsvu.il< ''"'° '•' <l&'�S ,,1 ht\!Jlh 0'111= m¢ho.J ,Jt,.,rn-0nt< prOltff!ill>�h 111 j"lihh<; .md ,·:m,-•• "'h•rtvertl1c-.·t'Q.
!OI and pm•:;114 30 A P,:«ellto'�•-,b;111'*1<>n -� TI!#'ubl,,;MIJidlry,tcl'I\W""IWI�� W \!!

'WIie h,"'!•¢.U>i �,- •miwkl wll/l.11:tf'fflat.+.

"'f'>!al• �-- �A,;,,:r.....,..A..1 ,11,;�,wmr I-' U..ll.-11:0,silcfflhlll™"tnl.�ilr..rt.u\1t,'':\1: \\; f'n\'\Jlt .• ,,,..,:11 Ho>•pu;,J h,qlffi:ll'r.it,r, no.>r,...,: 111\d Thr..>11!1,)', .i,,tJ i,;ue rei,ml� Mte t>.·almre; .,r fle>11.h "'1th rHJ*11,, "lnw1or \1'>1lc re .·,·11,1MH0.

!11ID1,,; h> :J1, 1i1, !••<'''"" i •lll pr,�°"'' bll,f!lll«L� ,,.
,11,,.., renu�� •f'@ ""�"'1m1J...me nm-�ntl1.-uL'l''•1M;111, .-!lilt-t;,.oe(�tp;j,-l).i.(lllll.J<)JIS.u!l.

'1jl -*'8.Viam Major Successes/Achievements as an achievement W11at can be regarded people (the Private Hospitals Inspectorate) conscientiously relevant institutions and during the year to set standards for all hospitals to the issue of standards.
that worked consistently is that for the first nme there was a group of and to sensitize the '.\1ajor Problems Faced and Suggestions for Problem RtSolution Two major problems •the department are faced by this department: lacks trained personnel.

years, though the situation within the MOH.


l11e unit requires training to those staff; has improved This has been a problem in that the problem is now recognised for several more staff, and the provision of relevant • the department is a relatively only in 1991 or the recommendations of a Peat Marwick Consultants report.

new one, having been established 1992 following Clear parameters and temis of reference resolve department this issue, the MOH must clarify are to be.

have not yet been agreed upon.


To of this what the ex:.

::t fi.mctions 4.6.1 DENTAL SERVICES l\1jssion Statement "To provide endodontic Service.

appropriate and prosthodontic preventive, restorative, dental care to the population staff".

and para-professional surgical, both professional utilising orthodontic, through the National periodontic, Health Main duties/responsibilities The main duties education.

of the proi,,ramme services are providing are also provided.
Curative preventive care, including oral health 31 Staffing Level Region I: Region 2: Region 3: No dental staff 2 Dental Surgeons 1 Senior Dental 2 Dental Surgeon Surgeons t Dental Officer Dental Region 4: l Principal 3 Dental 2 Dental Nurses Aides Nurse 2 Dental Aides Dental Surgeon Surgeon 1 Oral and Maxillo-facial l Senior I Training Coordinator 5 Dental l Dental 2 Senior l Dental Region 7: l Dental Regions Region IO: I Dental Surgeons Surgeon Dental Surgeon l Dental Nurse Nurse l Dental Aide Surgeon l Dental Nurse 8 & 9: No Dental Region 5: Region 6: Surgeons 1 Dental Nurse Staff I Dental Aide I Dental Aide 3 Dental Ardes Areas which are significantly Mabaruma, Monika, Port Kaituma (Region Lethem, 7); Kato, Monkey Mountain, Mahdia Aishalton, populated Sand Creek and Annai (Region and Matthew's 9).
lack services include: I); Waramadong Ridge (Region and Paramakatoi (Region 8); and but which severely !\Jain Funding Sources The main funding sources Guyana Dental through Association, CIDA, also assist.

is the MOH.

The Colgate Palmolive Company and the Objectives and Targets Activities /Summarv of l\1ain (if set).

and or Failure of Success not set) and Targets (if Objectives Analvsis ta1c,uto11 '•<'JUOOai 0..111,,!

; '.

: ,tri .

'11111U>ff {» l';,ll,eet� SN'.

'n Ii 6JQ ').,:ill.
'n Ii 6JQ ').,:ill.

V<l'nHrnnl l<e<1,1,11n1 !h>< ;,.,,wAml!ltro.wn '-uddit m,,n1ta1 \i'lham:mv C<>ltlljl,e F<1rtW """,w F E f'<)Uiifd Prum ,,1a; 1'.

:JO H ...$�J7 - :�% ,i o::s I "'99 !

r: ro S(hOf'I "" � , 'clU<tkZ i>r<'uamrne '.<.,,n,i, VW'fpl<'WTI t,,e�omlary :',di.oo, 1-IAS 1 n;; "'il2 <'fl:l0¢kfll'!\ Vtlh<·t m !Cenm,I CLJUc ·,, ,.., � 'Jt>I 13!11 Nun:ihff of lhlr$ctlooa 0alH' ""' �umlM'l'ot,-•�� " '' '"' ,..

.
.

:n '"' " '"' " ,, .. " '" '" : ..... :,n '" 'l19' ,PO : fJI )ll ;, �21) 32 0.,M '\tlml:w'ro(C"l<":i "' " " ,� " " '" ' ,,. "

" ,, 19, fxp1r111w:rn fa,,,-1jlj � d, :>i:ill alld �l.llwlv­ L\4 nwmr l!JJ� lll�r� l�t ¥� During the year dental the table above illustrates.

service work was almost exclusively focused on elClractions, as Workshops/Conferencesn:raining Courses Hekf or Attended Trai11illg 18 dental Courses: nurses 1:,rraduated.
Major Problems Faced and Suggestions for Problem Resolution The major problems below: solved, are listed •despite the severe faced over the year, and suggestions for how they might be •the oral health disparities assiduously to procure of dental personnel, shortage of staff in relation in the distribution the Regional location Officers have not worked establishment Administrative of dental staff very difficult.

system, there are significant This is mrunly because of to population.
which makes national On the whole, planning Regional Executive of the the required in their conditions respective for the system authorities.

of curative by the regional of Dental services from lack of manpower, care.
No visits were due to lack of for Dental Health education regions; because services has been emasculated and/or fortification of dental aspect education of the tremendous void in the back-up made to schools or other locations fonds and/or transportation suffers during January, May and August stoppages Centre of material Demerara Regional Hospital Secondary School power outages, have to be given greater Cost-recovery could assist services: Work Dental at the National at West s; 67 work days were unproductive and at North Georgetown due to lack of supplies, of equipment of the clinic.
Dental Health will are to be lessened.

of curative as well as the rehabilitation if these problems priority in the improvement Curative care itself and materials.

eight days were lost due to breakdown occurred due to lack equipment, instruments in the quality national and •there are few opportunities for staff to benefit from continuing educa,ion.

33 4.6.2 DRUG PROCUREMENT AND DISTRIBUTION l\Hssjon Statement "To provide leadership country by ensuring and operating".
to the functioning of the phannaccutical services standards and procedures throughout the are in place that appropriate policies, :\1 ain duties/resuonsibi lities The main responsibilities of the Phannacy are: activities Department -including •drug supply distribution management and storage; drug selectio n, procurement, •policy policy; activities - including development dn1g and implementation of national •re1:,•1.datory functions: the Chief Phannacist is a member of the Pharmacy and Poisons •education Board and the Hospital Inspectorate Committee; and training · including training workshops .
of pharmacy assistants Staffing Level -· t1uefl'hilll1Ml:UI l'h.ltJJl&i:M� vnar-""""�tt ,,,_ \(J:Ul• , 1ark, />u;Mbff ._ Pfl"'IJl)fl ' ' " .. : ' �-,.·-lldet ' Main Funding Sources 1l1e main funding source for the Pharmacy also been provided programme the Health through have also been received by IDB through CIDA and CPHA.

Department is the MOH.

Some support has Care II project.


Drugs for the MCH Objectives /Summary of l\Iain Activities and Targets (if set), and Analysis of Success or Failure (if Objectives and Targets not set) flfllf'CU¥f'1 I Art!

... >'lr,am"°""' r>1,lfll!t/!

!Wnl<llhes tnt41'111 I Nifflbule dlllf$ #W •'4.lwf lltedlfa.l � l ,� st,'IIIU .and 111vem,11y a,:U'llll} lM•NAr.� ',fJ",..,j1 Wtft� .»1#,lffillle.\ tll:"11.SW Nd �--llillOIINkm ,·,,n<tua.

:u "",,.,_ h.l relsv.u� hl'Sll!III .

, " i't!I ,, .
, " i't!I ,, .

34 or SIM:illeW¥dln' i�a o t4Rw-*"" t.:i: "*1: -.11fW<i rw of di� ��prevtfSeddle7)'1Ultlrom_DC1!1118fJC1.�l\'f W.kmldriw••�..-.h�aulU!fft:'111 ,..;1Uff1g,-aerlla M.J.-.

:ffllb� Li,:i;.

<rt ,ruf'lu:ttnlJy inlJwe,d p1r1an-, u I�, 11j'.

)l:l,ll ptOJM _4 ...... tll,>.-.lrhl Wif oftu,cba� Lhl& ;t,,:trnty ru.l.!

!lltlli: Major Successes/Achievements of the year The two major achievements • were supplies and increased • distribution activities improved markedly.
Major Problems Faced and Suggestions for Problem Resolution The major problems below: faced, together with suggesaions for their resolution, are listed •staff shortages contiune to be acute, and salaries would go a long way towards this problem.

More training for smft' already within the system would solving also help; problems at storage locations.
Replacement/renovation unnecessary wastage of drugs and other medical •there are infrastructural is needed to prevent of stores supplies; •inadequate •inadequate transportation would make distribution support staff, transport policies and communication such as clerks, board supervisors, hampered distribution.

More flexible -this problems and cleaners; need to be adopted to alleviate logistical much more cost-effective.
4.6.3 NATIONAL BLOOD TRANSFUSION SERVICE Mission Stateme nt The Service does not have a Mission nt.

Stateme Main duties/responsibilities The main duties/res ponsibilities •provision of wholesome •provision of adequate supplies of the service blood to patients are: country-wide; of blood to patients country-wide.

35 Staffing Len�I h'S.im.>l.'i!

!<t • "'"'"' 1 •hw,a,,.

;-, \1<.k< \u\•-·•:,., !Wain Funding Sources The main fonding sources of the prOb,'famme are the EC and the MOH.
Objectives and Targets /Summary (if set), and Analysis of Success or Failure (if Objectives and Targets not set) of Main Activities �ota.-Fallllh' ,\ll*fff-*lltood.,...--,, w-.. Wffll �-n-••Mllll'or• �-ml1,mus,-,1td11U \Vorkshop s/ConferencesITraining Courses Held or Attended Co11fere11ces Attended: •the Medical Director attended an international AIDS conference in Gennany: Courses Atte11ded: Trai11i11g " the Senior ii the Director Technologist attended a one-month CAR EC training Bi1111ingham, benefited from a 4-month Fellowship England.
in transfusion course; in medicine Major Successes/ Achievements The major successes of 1993 was continued I 00°/o safety in blood donation products.

Major P•·ohlems Faced and Suggestio ns for Problem Resolution Major problems below: faced by the service, for their and suggestions are listed resolution.

GI inability financial to effect efficient overall administrative autonomy was given to the service if more management resolved •delays •staff vacancies in disbursement of funds and assistance from the EC.
-there has not been a driver for the mobile unit for one year.

and 3E there proper is no accountant.

The employment of these people is needed to ensure of finances administration activities; •effective maintenance oflaboratoiy and outreach equipment.

4.6.4.

X-RAY SERVICES Main duties/responsibilities The main responsibility of the service diagnoses.
in making assist doctors is to provide adequate quality radiographs that Staffing Level '"'"""" -·· ' la Pn1111on °" WTI f'U\•b� HOl<flfti Rad111foa:11 I "" I S.nwr Rad! ""

X-Rav Ttcluucta, Nflr Am!l'l•tdmn R� Sudikc R.wi>M1 • Wto1t O:menn RmQtllll H<> X-Rlv Tffflllldsn R fhrrkroom T «hniCWI X· T,1,•J:tnid4n Dllfkn'><m, Tnhru..1sn Main Funding Sources I J ' • I I I I I ,11......,.«v� • ' ' ' I I ' ' • • ., The main funding source of the X-Ray service is the MOH.
Objectives /Summary and Targets of Main Activities (if Objectives and Targets or Failure Success not set) (if set).

and Analysis (mi,l'Cd\l,t,lar11i't .W.mmlt •t;11.fu, Tr� ,,: Rak<>o1.tJj:llm.aml X·RIQ' !

""hniutm r!lllllt110t1P<,;J Qll ,;\e ••Af'hk"\l('fft i'l<l> Yes T.;; � !IC �>V�'Til"l<lll W l'!

'UUl'l4!$ nt'<"-.J.l'Y'" -.,.t rnd!uu,11,i,• PrQvidt \11181',t'OO!hl�>,>nll!OOll<'fU\fl.Q.!

!ll!�M�ff N" It� X•Ray dep,.&runwt,; w,tb.


x., ,,my '1« «1mlltl3"!lll snd to I'r_n,,rll .. -,ro,...111,..."'-;'p lrtttm>Vt!U>t tt!\�h:.

',o.� 11,itll WORK Prllf0RMi4'<'t: v,tnctt;Jn,den�Difrt!

1• � No U.Or,;e111vm: l'»billt lfo!

!Jillll � VIJO f*WtflH ht bl: X-Rayl:ll No Rt111<>na.l Hullptllli 4 m.:, paIJtnl'll to be X- !

'/,, I-kw An1llll:fllflm .

.,..


.,, .. St4<11.bt Rmonal lfo"!lllal, �IO� I() bt X.Rayed \v� Dt"ntlmlTll Rcg.i"na.l !IOW'Jll,I: 4 iJ-00 pa!W"lli 10 be X· '" 37 ,Of!Ul'lffial'dm�--i.r T�,ol�tlAllffltl'll:edmM•m�:.li�y $t!om;pit -0( .- media IWld X-Rsy tifm:!

were txpern,n(t:'1 A, """""'""'"' N<lt-'U&h - An _ .. --«Uffd -.. .,,�1111<1ican"a:11111®trrtt1ll!it Lat mi\lll!of� ttom llSI\ Ille rtterp,; fttlTII l>ul>Ulbo, ... �"-·--'"- -bltmlwsh-� .
'ihoru13n <>f lllm:t. l>N&\1,.Jwn <'f eqwpmtlll n�- of tqlJlp,Mnl ShO!
'l�of�lcdt�lllfdu; powt1rct1U liriU(WW'lt of equ.qlft1tfll lvlajor Successes/Achievements The X-Ray services there were no notable to suffer in 1993. successes continue from a variety of problems (see below), and !Vlajor Problems Faced and Suggestions for Problem Resolution The major problems faced are listed below •shortages of, and breakdowns in, antiquated •acute shortages •indiscipline •shortages among some staff; of some dmgs and film types.
of staff, which are getting and absenteeism worse; equipment; 4.6.5 PHYSIOTHERAPY SERVICES Main duties/ responsibilities services is the provision of quality The main responsibility services physiotherapy of the physiotherapy at a national level.
at the national These services referral and rei:,.rional include: New Amsterdam Regional Regional Hospital; Hospital, •in-and out-patient care (Georgetown Public Regional •provision •provide •physiotherapy •the Cheshire Hospital of ante-natal classes input in the training and West Demerara reeducation classes; programmes Home, the Rehabiliation Centre, and the Sports Clinic.
Programme, Rehabiliation for children; of Nursing; of the School Based the Community hospitals Suddie Hospital, Staffing J,,.evel Prm,'lnaJ Pt.v<101l,,1,�"" I S,1(1t1'111!�!1den1 P:,•·'<'•hi:r,Iflls1 i<leorr.etc>wn PHPbe fl a/) l\1ain Funding Sources Funding comes from the MOH. '

38 Objectives /Summary and Targets of Main Activities Failure Successor Ta(lfts not set) (if Objectives and and Analvsis (if set), No specific summarises objectives the work of Physiotherapy Services or targets were set for 1994.
However, over t� year.

the table below s are provided in Regions 2, 3, 4, ti and I 0.

In Regions Physiotherapy Assistants and is limited are provided by environment.

service Physiotherapy services hospital from providing hospital-b e.g.

ante-natal, other services department the physiotherapy Rehabilitation Programme, the provision Workshop in ased services also extend post-natal, has been actively sports medicine, school as well as the special clinics of prosthetic and orthotic senices.
2 and 3 in the to treatment who, apart and provide In Region visits.
6, In Ret,,:•ions 4, 6, and IO there are 4 physiotherapists into m'Ie community involved: in the Community-Based by the Orthopaedic eonducted \Vorkshops/Conferencesffraining Held or ,.\ttended Courses Workshops Held: •on-going continuing 01ganized education/clinical Assistants were held for Physiotherapy sessions by Department their to up.grade skills: Trai11i11g Physiotherapists Atte11ded: •one physiotherapist attended Collrses a 4-month training course in acupuncture in China from March-June; •one physiother apist attended a six-week Based Rehabilitation Sri Lanka: September/October programme training l 993 at the University in Commtmity ofKeylanyia in Other: •one Physiotherapist accompanied meet in Paramaribo Suriname in August l 993. the !nter-Guianz Games team on duty at the Major Successes/Achievements There were four achievements worth noting: •some much needed small equipment and supplies from the were acquired Prestons (_ 'orporation: •the Physiotherapy Department the attachment of a Canadian •the Physiotherapy Department at Georgetown Volunteer at New Amsterdam Public Podiatrist for five months: benefited Hospital benefited from of two physiotherapists from the Queens University from rhe pan-t11ne Medical Outreach services Pro1,,rramme: • the Physiothera of an Occupational Association.
py Department al New Amsterdam benefited Therapist from the Students International from the assistance Health i\1ajor Problems for Problem Faced and Suggestions Resolution The major problems below: for their faced over the year, and suggestions resolution, are listed •Severe staff shortages for both physiotherapists for upward mobility/promotion for a number of years, but the situation the situation, and physiotherapy assistants is getting (a) salaries ed need to be expanded need to be re,·ie\, and I c 1 and skills education to improve available; and update has been present worse.
To improve This problem prob,rressively (b)opportunities oppo11unities knowledge for continuing need to be more widely of equipment better preventive equipment and availability •limited and poor maintenance is needed; maintenance practices: some ne\\ in acquiring •Difficulty physical •Deteriorating supplies; stn1ctme of the building in which the Physiotherapy Department is housed; •two physiotherapists they never returned were also trained July.

However, 2 physiotherapist had cost USS 120 000).


living expenses were trained in Jamaica to Guyana.

but failed to return (though and were expected in This is a repeat their to return of 1992.

\\ hen and training 4.7 HE.\LTH PLANNING UNIT Mission Statement "To provide including and resulting overall necessary intervention strategies".

direction policy development, identification planning, for health services and analysis and evaluatior.

priorir::s monitoring of health M .

d .

/ .bT .


amut1es uties respons, TI1e main responsibilites for health heads/managers, of the nnit are: care throughout •planning Guyana in collaboratioo with programme •coordinating MOH, external programming/planning •monitoring •establishing lo ensure and evaluation and maintaining the MOH and the Regions; health between •recasting planning.

agency, non-governmental an integrated of extemally-fimded and.
private approach to health projects; for ensuring effective mechanisms sector y: care deliver co1mnunication data in such a way as to make it useful for the purposes of Staffing Level Hµa!l..,,::!l""!ll."

---------�11-'�, Sffl=-::.:::..'"

"""="""-" H !

)'� ... --------1-1..:; •.

'.,:=-= ..... -------;I!

"':.

:':s•Gl=- r. Pl'll'll'IUl£ • • Main Funding Sources The Unit is funded from MOH budgetary P AHO/WHO and the Overseas te.
Institu Development funds and receives technical assistance from Objectives /Summary and Targets (if set).

and (if Objectives and of Main Activities of Success or Failure Targets not set) Analysis " l"""fMl!etSet!

WM w;luucAI --t fn,m., and m C<il!ttxlnlwn WM PM�.

Ctlfldud lwoibh®cn� � for-or ll'mlllf"'nl in IN MlnilV)' .. _ Rtfux am!

mmriimn � l!WlfK'Wet proVldf illti:lmw,m OU t�!waM Qff-ill l.lu, MOH and 1111 �'lltlneS I<> dubase TU•l'lAcb�'.'

'"" - ...

tcbe.:\'IITRtl,,lll.


t,1,,1f1,·"�:., AUMi!efSII� A�of� ,demfy��Wl'iilll�-™•'f:.h� �S,-...v Minl!lry'Jffl�� upemrn:cd.. � - - ot,ea,\'t!

llllWI tMffi,.

�ar pa,1.

,,f lhe C'-rtmn �•rer� ..... ,mly p-.r.

:Lc, in up-4ln�.2.U1� rt;N<li' Cmallt(lflllln!IIU-� otliJ!M�il:�U..w!xu,m,m�ftcf,'nt Jt,:mtl,.f � lllts.

lM di!ip,ikh of ,;:mnp!e� wvJ.t<l rq,,omw W � Tu.

of'linr in � �-.,ied l>a<IHffl Tl<)�� made .

:hep dWJ fnmt.M ?obi!� Stn-�t« zt:.$ thtt!

�lopml,fll.
�lopml,fll.

ofr1,xe��� n,t.ic,nal he:ihb pbu rl'k\ ·t11110 th,.�" of, \Ullll 7� R�lt altd pt"!

)Wll a �aft lWakh Scr\'ii:es Phlnnlng fl'!lm*Wml.

®Curna,1t ln,ptmtent ,,.,�Olli ot jj\ oo��programm,: tc�tutical�bU\lrffnPAHO,"'-OOmdtlteMOH y.., ot "Q.8(1\t� 41 du, MOH 'IJld Rtpmai pen..·�,ntt c1 l);m;igW M qWlff oithc yclt.
U!Ut was �;;,11�,'n � atNOrffllWlllll"l"m ..., ,,f tlic dewlvpc:lfflf oflilt'(lfOCft!.1111 mev1111.1 t,., 11'\e reahsx, • !.he ob!IL This: � t>1,1,,1.t11Cl:ft8ful �w•p�·WiAif.lmilUl1t-0mc:-.ai,,n;1ir.-!

'4AA w- �ofWJlfl(U'lllll1W�fclt',·w.p'.=mi:11J S�'lkfflic�fJIMll@dUl.t-,,..._1<m1,'I"'-" .

nr-·1atte1 cmtwlittee ., *'Id ,.

,.,,,-1> =..i.


\Vor�hops/Conferences/Training Hetd or Attended Courses Worksl,ops Atte11ded: • 3-day PAHO lnfonnation Management workshop, attended by Director, in January; •"Second Workshop on Human Resources Developme April nt", held in Barbados 28th-May 8th, attended by Director; •"Second Regional Workshop CARICOM in Trinidad.
in November; on Data Collection Techniques", held by •"Guyana Administration Project", f,ebniary, attended by Director: Trai11i11g Courses Public Attended: •4-day training course by State Planning on "Application on in March, of Manpower attended Commissi by Director; Planning Techniques".
held Major Successes/ Achievements of 1993 was the development of the processes of a draft National Planning TI1e major success preparation Health Framework draft Heath Services many years the integral role that planning health the development sector has been recognised of an embryonic to the Plan, and related research of a and preparation for the first time in Furthennore, document.

can play in making improvements relevant to the of this is that One manifestation and encouraged.
planning unit was commenced.

Major uroblems Faced and Suggestions for Prablem Resolution There were two major problems *One was delayed follow-up faced by the Planning by senior which were planned at the Information Management Unit in 1993. workshop held in January.

MOH managers in comleting activities *The other problem was lack of personnel to maintain the Human Resources data base.

UNIT 4.7.1 HEALTH STATISTICS !\,1 ission Statement "To provide health statistics on a timely basis".
decision-makers and other appropriate parties with reliable and accurate 42 Main duties/responsibilities The main responsibilities of the Statistics Unit are: of Births; notification of Deaths: notification •the official •the official •Immunization Returns; •Notification •maintenance •maintenance •respond to requests Diseases; of Communicable Diagnostic of an In-Patient index; Returns: of Out-Patient for retrieval of specific data from time to time to assist MOH in decision-making; •Daily Ward·Census •data entry and analysis reports from hospitals; of Primary Health Care reporting form.
Level Staffing ,,_ ,i4!nior Sl�1m1 :;i:�lllll Slatii;t,ca!U!litei �ilti&t!£ul(-1crk fl Stabm!•>ll CJ,:11( J T 'C!ffl:: ,�:t1mM In t'Mldoa l ' ' : l Nunbtt ff \ilfC:IDQt!

'.I 0 " " " " " Main Funding Sources The main funding source for the Unit is the MOH.

Objectives and Targets (if set), and Analysis of Success or Failure /Summary of Main Activities (if Objectires and Targets not set) 0"'tlct!WIT11r,"' l',1m.

;lel., 19'HAnmla.!1<.

,:.iUert.

O!lit.

llU<1.

.


:,ldf MN oottliedwUK M:inisb'ym 19!ll C,;,beit.

e.Ji; .o,,; .

:,� tw:ihs noutied w me JI, m tm c,ooe and utt;' 01, ��,rnpat'r detlhs !l:Qm Ille� R-.

:�n l>lfiw r,w 199:l�nd.,:� 1992 <.:,,lk.

:1., �pi.wt.

th'Uh,,•f,· (<J.(1.

"� '�nJ 1ruw11:e.1" tu w� � �;,�'1111.11\K\\tde fur !W) !Ind eruq ,mm rar-A�t'd'l' ,� Ye1 -15'-•�rt.hcw«t ,..-.tmt1pl$1ed Yn -'Ii!-� of the work 11;wdone YewNQ lffioompi(,I� Na wed; done <'II !99J Y�-'j(j'>·oJfwottdoinc, IC!tJm:( '"'ffllllluaJ.
r.lth.ef Affffllhl)(S.--F� S!lbmllkd CQ time lOO'io.- lllllil::ltilm:d�OJ fhan-�-dl'.DCllll'V.IIRdlatru� !ii".

Ill){ done� t..,'dung_dmlt �IM�i- OlTk, !U"·,111(11.d<ioll,::luewbl�lll�>nlll nipo.,u oftU allbmi,lol,lns tNml'.M �Repm;, for l'i'JJ� rttemw«n dcla)5m Stnd � w C.\R.6(" ml re<ir.t!4 ,tu fN>m !mmllnWfion Tra,u1l:r ,:.--·ui,n- \ \1mpltw !lam IH>m 1M Husp:,tal:r lb.11 11n1 dmnt, the Jn-p- !>\a2tU)'llJC !m.h:i h>t Ill'!� Cd.le,..t ;;·miaus frr,m h<'lll�!

;oh c<.IJI anti Wl�la!� m.i<lnml.


!Monlb.� Daily W;G"d Rblum f"vnrui to ( • ,•Ue,.

"t ,du :11\<.1 tfl!Cf re.

:eiv«I &om lw.do.ll fai:iimw, "fll<> ,·<IUIPIJU.l' lll.l "utl)lbem: (I� !l<:!

'!.t•r-·-- Yet!,lOO"'oufW�i"lltt:lul«n� \""')'�<lllllCl-wmtrr�blltl, >rd.iilal::nl.r;' '""!J.,y1.

TbettWllln<>� forll\llVdl�,1tu, H.�<lllS•OSQUc,.1 -.

;x._ Yea -IOO'io J(!Ju, wort 6t>nr Very �onilO«IQQus � �bte Jul" tlus "'"tk )"t',!

• JOO".

,;ft!ti, "''"" 00111< \'ery c...-flli<lUS "'"'ter �<$;.Ole IN ti".:.!'
<Ullae>ltf) 43 \Vorkshops/Conferencesffraining Held or Attended courses Workshops • Held: 2 weeks workshop on Medical a follow-up regions.

28 persons attended Records Records and Data Collection at HQ and Clerks for Statistical and gained knowledge and of timely in July and in the hospitals concerning l\.1edical and accurate collection and the importance in November submissi on of data.
Workshops Atte11ded: Regional Workshop • Barbados April 28th-May for Human Resource 8th, and in St. Kitts 1nformation October 4th-8th.

in System :\1 ajor Successes/ Achievements The major successes of the year were: •the unit was able to code and generate infonnarion from tile on deaths Registration of Deaths coverage •improved •I 00%, data from Immunization fonns from 1991 and 1992; on births; forms received ofinfonnation was computerized.
Major Problems Faced and Suggestions for Problem Resolution The major problems faced during the year, and suggestions listed below: for problem resolution, are and/or late release for necessary visits •insufficient available budget for travelling field visits • im: Jequnte traming •high turnover accordingly; staff training is required: was provided of finances to the Regions.
meant transportation always was not This could be resolved Unit, who could then plan to the Statistics if a specific in data-processing and especially data analysis: farther of staff in the regions and resulting constant need for training.

44 4.8 CENTRAL BOARD OF HEAL TH Mission Statement "To make provisio ns for promoting the Public Health of the country".
Main duties/responsibiliti es The main responsibilities are: of Health of the Central Board on all matters when so required the Minister connected with health in •To advise the country; •To take all such measures as may be desirable to secure the preparation, effectual •To have and exercise carrying out and coordination the general of measures supervioon and control to public sanitary conducive of all public health; authorities; •Make investiga and practical of persons Public Health; tions with respect to the causes of diseases, literature for the training and certification distribute infonnation, and make provision as it may be for health services deemed necessary in the interest of •To frame regulations, of the duties enforcement furtheranc Ordinance which it returned Level e of sanitation, into effect.
may consider shall be performed.
Staffing and if necessary imposed and generally If deemed advisable, necessary, issue orders for the due and effective and for the general the provisions to prescribe, of this among other things by the Ordinace for carrying the time and manner in which any duties Persons/Org anisations the Board are: that are represented on Officer (Chairperson); Georgetown; New Amsterdam; Development; of Regional •Chief Medical •Ministry •Mayor and Town Council, •M'1vor and Town Council, •Guyana Water Authority; •National Congress •Mayor and Town Council •Medical •Hindu Dhannic Sabha; •Central Practitioner; Islamic of Linden; of Guyana; Organisation of Local Democratic Councils; 45 •Gt,yana Nurses •Wolllen's •Lands and Surveys.
Organisation: Association: Main Funding Sources The Board is funded staff and facilities.

by a subvention provided by the state and is supported by MOH Objectives /Sum.J11a and Targets (if set), and Analvsis Success or Failure ry of :\lain Activities (if Objectiv es and Targets not set) l.trtt'I\>�' '" ':'hr dr1tl!

ha t.rr<:11 ptt:parecl :uul ,,.emt,,,r< h¥ fflur .


:,"'1J'l'ltn1£ "'II be ,:-,.,nmi ,,, h,>11(1 Course Held or Attended Workshops/Conferences[fraining Worksllops Atteuded: attended •the Secretary Laws: Public Health a workshop hosted by PAHO/WHO on the drafting of Training Courses Attended: •the Typist/Clerk Etiquette Telephone attended to Work.
and Attitude a three day training course on Time Management, :Vlajor Successes/ Achievements Board of Health The Central Chapter revised therefore notable J 45-Public b:, a Parliamentary in very difficult to report operates su..:cess�s is a Statutory Ordinance.

amendment Body governed The Ordinance if they are of and fines need to be to act as a real deterrent.
It there are no and as a consequence circumstances, is outdated by the provisions Health Major Problems Faced and Suggestions for Problem Resolution Three major problems •there is an acute shortage have been faced over the year: of Environmental Health Officers.

of Though a wtal 76 persons employed is provided in l 993.

Some rei,,rions for under the establishment, there were only 27 officers are without any Environmental Health 16 Officers, and two regions have only one officer each.
•Local government bodies have stagnant budgets because no elections have been held, and find themselves responsible.

unable to maintain the areas for which they are among government Greater collaboration departments is required: •finance: •some statutory representat the Board operates bodies ives due to financial/ at the municipal with limited resources: •there are problems of leadership issues.
body to the Minister advisory on policy personnel and difficulties difficulties: that it is an in recognising and regional levels do not send 4.9 NUTRITION AND FOOD POLICY Mission Statement and advise "To assist nutrition matters policy, connected with food and nutrition".
the Minister on all matters and implement pertaining policies food and to a national and plans in relation to all and to formulate !Vlain duties/responsibilities The main responsibilities of the programme •ensuring •providing nutrition a high standard of nutrition general pro grammes; nutrition education are: for all age b>roups; for the population through community •serve as the Secretariat •assist in the development and in-service for the National well as staff of other agencies, in applied and operational reference •participate particular in the principles research to indigenous foods.
Food and Nutrition Council: Health Staff as training of all Public of nutrition: and practices with related to nutrition, Staffing Level l'osltlon IJlfC(h>l """'"' Tcdnu,ai ,·,mccr '\umu,m SlllV•t!h1sirc 11ttkcc Nuab'-'1" In t'IKQoll ,,rnn"""'v r,.,um"'", ,nicer 47 IVlain Funding Sources The main fonding PAHO/WHO, of the Nutrition and FAO (specifically programme sources UNICEF, for ICN activities).

are UNESCO/NORAD, Objectives /Summary and Targets of iVIain Activities (if set).
and Analvsis Success (if Objectives or Failure not se1) and Targets c: ?

!!!

.·t n-,,rn1<1ncJ ·nrpr.is lt�h�--.,,, m,•e 1v,ei ,>I ,m:rJ_,,,.

J"u::e,,e« p,,,mde m1.�,, i,;4•/h ,in.

!.o,;r ncfiMW M�,c,11�•·,k,;, l,•f <'!

:h� .l1�J-, .h:1/lij• w 1,,,,..i ·hr,111"'1 !l1t,,J,cla 11,,,mhs >l,t,.< !.•r ;I,� P.��·.cr,, .l,r,;,,v, -,, "'•>c· 11,«"-•t ,m"i�•,.c ;;mi rr.,..-:u,,.,n ,,1,,:,e�uv -re!111tJ tl,rParl, ,,,.,rea,;eu n•mb.. uhlc·'llh1f1 W,, ,,I m�v< Ofl<l<iNCll w,..,.., ,..,_ Tl,c A!."'

:ic.,,u.
:ic.,,u.

:i1 otlllw.

- H.il rtal�,J dart ,� a nee.i f.,, rr� '"""; ... mxm fr,,,.._/losr¥al >hJ'I' /(><)"> ul �'l!Vl!IIX.e p,&lil'OI t<lun11w11 "1)!tt1l>'t:s r ( K1ih1.�• •eali>lt'<t :,;fl,t:v,.,J l!J'\� .,1 I, ,r,;,,,'H \Vorkshops/Conferencesffraining Courses Held or Attended Works/tops Held: Education for volunteers of Melanie their improved 8 Diseases Programme: and conduct basic educational to prepare ability Chronic •Continmng participants ies; activit •Workshop knowledge infonnation for nurses r.e.
diabetes, delivery; for Womens· Groups •Workshop initiative; and CHWs: 14 participants upgraded their and skills in thier skills and improved hypertension and obesity, to acquaint them with UNICEF's breast-feeding Workshops Atte11ded: •one member of staff attended a two-week Health in Promotion workshop Trinidad; Co11fere11ces •the Director Atte11ded: attended the Caribbean in Meeting Nutrition Co-ordinators Jamaica: Trai11i11g Courses Attended: •one member of staff attended a two-week course on "Lactation Management" in Barbados; •one member of staff left in in Community Diploma Nutrition; June for a one-year award in India to study for a l\1ajor Success es/Achievemen ts Major successes/achievements were: of the Nutrit of 1993 and improvement to it.
•the continuation response positive ion Surveillance Bulletin, and the •continuation and improvement on the dietary with emphasis diabetes, •completion of an anthropometric of the Chrome Disease mamgement programme of this disorder: -mainly in survey of primary school entrants the nutritional to determine -this was the starus of first time there had been an attempt children •the introductio in the 5-7 year age group; n of" Support Groups" into the breastfeeding programme; Major Problems Faced and Suggestions for Problem Resolution The major are listed problems below: faced over the year, together with suggestions for their resolution, •transportation continues to be problematic: this stopped the practical aspects of nutrition various education communities over the last year.
vis-a-vis demonstratioos and displays at strategic places in •there have been limited government counterpart funds available education programmes.

Production into the regions have been hindaed nutrition general and travel useful if there were specific there was a review of the present system is very bureaucratic and impractical.

programme system alk,cations.

foc disbursing It would also be useful if funds.

as the current to conduct materials of educational It would be as a consequence.
4.10 VETERINARY PUBLIC HEALTH Mission Statement "Reduce utiliz ation of veterinary skills and knowledge".
zoonoses and foodbome diseases and intoxications through the maximum Main duties/responsibili ties The main responsibili ties of the Veterinary Public Health Unit are: •the prevention and control salmonellosis; of zoonoses, principa lly TB, rabies, leptospirosis and 49 •collaboration and eradication with national of all zoonoses; and mtemational agencies in the prevenlion, control a food supply that is safe, healthy, wholesome, nourishing.
•assisting pleasant •reducing •assisting in achieving and inexpensive: loss and damage in the producti in improving for competi food market, conditions so that there mtemational countries.

on and marketing of foods; tion on the national and is a reduction in rejections by importing Staffing Level i\1ajn Funding Sources The main fonding sources of the department are the MOH and PAHO/WHO.
Objectives /Summary of Main Activities of Success (if Objectives and Targets (if set), and Analysis or Failure not set} and Targets O�i«tl"'°-fl<""� Wf &!run, ;;d,.,,>I f,,,,u , lwW l�c'M<l'Wtillb ma, �Ml 1 se.

:,;nd.v'y Khoo!!

: d.ildrlln rn .J the i;,rru1rt11 �ulaee � aw&lt ,;,f rnnllo!

PT�e<lJQfl ;:m.t Z.Wr,'•L' m...ucp I .u"f"'I A<'t\lt!

'l'<"'t' .\f!�ll(�Of//'IIIM'f' h<tid e<m1111,i.nrty ..,mu,.

:wi for t� IUld f-000 lulml!m m M=<>ll'I.

fo 'i<)"·.
fo 'i<)"·.

-lwltl twn produ,:.- -nsn for t�por,m ,;f•� Md ll&mnel Thm: wen Vtry !

(<Xld � m<III • ,tt1df'l'll.

'I C�W!IA'l'lall!Wlillt.lut\n!,dl!l}DfoJ\e "-� -ellOI \11&11Cd.. la,-¢Ya1<> llrnNllillabll.

!t\ ,,t "-"'""" 10ilr1'f'l..d f'mJm·eand lNJ.nbutl f,xxlhomt UIJ'ITTl!llffl, !

"<!<I pOUIOfifflgll'ld � \JJ pn>,._.,, IIMtN ,,....., ,:reu,tw b'fu, mfo!

'1'1'111C<m J.ebvtmi�ontlltk!pl.

:cf�fll;cboo:ftt RatwL �Wld�-..U<> tl'tvaidinGuvma, pa,mpl:J$ flllndbool:.I< and p.:!4t111 01: Ytt.
p<,,;,l,mr ('II W<>nooa' ,;,iK,k• lli, � tllpl<.llpl('(ltru' lllld !i.� � Ed paffpirldl: wm14ehllN JlJtu'i4 lielrJ �1:ru saim<md.l,:,u,, Wlff pr� t,i:-.,..,.f� -� p(l!

"o'll.ltnt l<- WI/ft pto,JQlW' wort.orr,, 1«-d handhtl Wld � ID $<�,WI,.

,wmt,w,:,a I.All<klit,®, ,,,...i � vichruque:s •.-re on O,e �llllbmd�e� NIMlSled fwiudl ;in; v� Dmnbule 00,.,k.lf\3 pubi1, heallh pef'loniu,I on ro,;-, � fo<'(!
: hyptm !O «!kY\llll Yes htll'OO� h""""d A.n:11Jyi;11 (f/ACCPI 111 \!l!ill"dnlee- pr<'.i�r l'll�e ,;,r m.q<>t ri.

!l.h pr,ous!IUl!!

; pt&,!!

as a Qun!.uy c.m1.t<>I: Alll:unna p,3ruce �-"'!

"",,ed and f<'( fu,:d hlll!.Jins'm:-,n Yes all,n,t;« !Jrn �tllhw\d Ct'llli;al Cootrul P-01111: :sys,i�i Y«ll· semm3nl weu lvil wr v_,, Pubik Ht,ai!h WUT ai1d :>eafoods llkh·- cvlllwtee ftt OIi,.,,.
of lMIMg p!i1111 - !Ke/lets >U,d Heaih ��)i; IMfe WIiii Wutul� milrt:lk>l'U':@, ,,,.fmarme produ(tlt...i:llltff-�on of 1-d<.m, ,;nnmlJOllll-.inURII & die fO<!d dum FM\udSoe-lloodil"ptWl>Gltq;pl:!111,!Wffl u:i00*"1!ldll.li��wCND'C)1!11da;; (dim:m•U �•=��lU!En",,_nl.al � Wld 1111 e'VW.1'&d <JI1 Ult� �i..�1hem �a.I'll shuwed a ;.

- � Iha rt,e HACC'P �- Uw best aud prvu<ill - <:>f rnSUMc.

l,'.k:l,l ,,u..., Mi��,.

!,,/.- reveal llllfia'IOUi!


p:ri,,,a:ru,- !ll<JSI Jsinu,ho!lllb ,-li-rotilo� mff'IIL'ltm Pl°'-� wht1 (t,!< f<XIJ!tf?ffu:.hCl'ldpP'N-�Wllll,l'al,�, ,·ef'Jfid'IU'F � b1.

;,l<.>19�;,J ,<1Q!Y,..,.

d,,,ne h*'11!

:d m !he,..,_._ �41 \Vld Tl.e HACL"P� Mf.�>"f!f'!

�m.S>.

!pp<llllilf •lt�>ru illq�ant��t ,\,Km!ll.11 t.l1e pr,,do,,--Uan &J'\d � ,;it w�e po1Ulry meil )tll threelar!l"'.Ka.t��oc�uru!.ll"'ffl!

?o� fantlffll -4 pr.� !lflllW\ ,:,,•ply \1>1U-, C<'M,11>.

't .
't .

.l!ld�OIT�,'lCU<>n5-Cl'lfMa-dwhe11 mc�lll'l:lrinowle�'IIW:W....nftOll<ZH nmlill,,,.ed ""''""" 50 R�md.u'dfrolm.hal��� ,,_ __ """ -it....adf�4(futi.-i -�-�l)ftlata..,_�.._ -�of��-�� �blllplmoa ,\MeSoltllc.

!qQlli,t!,,•rlllltil.Rll'P4*lk>�---• -rtiepm.isirltl1�1o(wfloNlomtfflllk: • ·�-isir t!IISSOO�fa-.to_....MdllllMIOI!'-,.

---��Uilll,MMII);� • Ev.1hlilllr �uu lllll!Md .... ... '" "" '· ,'11/ff,I IM lll"t\'ilMl�C ;uuJ, tn�(lf ratlUi ca!Ue -� .... �'1*4 H ,:,.-.n1s <Xml(!
)1 arnur.irtica rB "" ..._aldlltNOH.mdPA.IKYilllfllll - ._, ........ ........,._.

.. ._ �°"....._ ............. 111& ... C'IIIIIISoi _ _..,._.

........ ftl'�OUl� J..a.of,..,._applw_ .Wda_....,.,.

-· ' ----.

:;11.t....-,.�i'\'.IIU!tl!l!ffts ...... _, -------'----r;,(�b,c,, '_,....,.,.
appiXl da5CliUal pw:in,: � CIUh'ma.diil� ti.>:" alfPf4 Workshops/Conferences/Training of Attended Courses Held Trait1i11g •a 4-week Courses Attended: training course on the HACCP food safety and quality control system Aires, Argentina, by the Deputy Principal Veterinary was attended Public •a 3-week in Buenos Officer; Health attended course on cholera and food quality conlrol, held in Barbados, was Public by the senior Veterinary Health Officer.
Major Successes/Achievements ,, ;..·u,: ments for the Veterinary Public Health Unit for the year both relate The major achieve to training.

One staff member was granted a Fellowship best techniques used in Food Safety and Quality Assurance i.e.

the HACCP system.

One staff member was also trained in the diagnosis, These were bothjoint ventures between PARO/WHO aad the MOH.

prevention and control to study the most modem and of cholera.
Major Problems Faced and Sguestions for Problem Besmdoo The major problems faced over the year, together below: be resolved, are listed •inadequate with suggestions fur how they might transportation; the assignment of a vehicle to the Unit would prevent many of these problems; •lack of identification •delays in or no release more efficient system cards for the Unit to be recognised to accomplish on field visits; targeted activities: a of funds required for the release of funds is required; •difficulty needed.
in enforcing regulations: early amendmem of the Public Health Act is 51 4.11 FOOD AND DRUGS DEPARTMENT Mission Statement "To ensure dn1gs, that safe, sound wholesome and nutritious good quality potable water and safe cosmetics foods, safe and efficacious reach the consumer".
lVlain duties/responsibiliti es of the department are: activities; The main responsibilities e1 food quality control; •food inspectorate •dmg quality control; •dn1g inspectorate •water quality •food contamination services •forensic for the Police control; monitoring; activities: department.

Staffing Level !

'osillon , ,,rcc·tor I ,crmrv I J1rc..:•<>r I '111� ln.,occ1N ln,necwr •-,,.1,!

f·smcww .
f·smcww .

vt.U>1Kal S..:icnnric lH!icn '1ricer vi.U,ncal Sc1enriric \ rcchm�al As.sl.Olum \nah11rn1 ·1·cduucal Tra,nee !\tlilJVIICal ',mridcnllaJ Scncl;u-v :,mst< 'lerk i\;;slstant 1 .• �,,,1ms, [erk Main Funding Sources The main funding sources of the department are the MOH and PAHO/WHO.
Objectives /Summarv of Main Activities (if set), and Analysis (if Objectives and Targets of Success or Failure and Targets not s et) Tv!H' or rest F0od Chenus:try Target" 600 Number D0ne - 19 Target� �011 'Ir- Done � 1r,c, 52 A......., of Sua:ess, J•ll.llure, Shonajl:e or techrw:-.ll.

swt IJlilllllmMS.

equipmerv., �:ienucaLi.

-�- rt.lRe1US 311d M.n waer and seato.,d ieas wen: lhlne man a; tl.:i\lal.

nus -,.- ,1era >11r!Jre'1k nffi<::e malenals WiHt <.

'htmtstry war Mtcrnb\Ok\t)' �,.

;J� D::uJ1.


\w::rol!tolOJI) l'.l<CIM farpt" 600 Number D<>m = J f�,o,(1111) Number t)(lne "' l38 fl!il1W "'300 NtrmberDone "'<I T«g:et"'t,O!J l'>'umberf.kfflt "'" .-\matml 0- - ; I ,\m<'"Offl lJ,.
)M"' "16 A,;JO(f,.M,i,� A£ .. fl)od 1..,1WUIQ'y ,\;r,�i� Alf f,ido.,,i Cbmmlry ""*"---dmmlis"oa ,�OOM�l'II� "� Food Inspectorate Division 70 markets/supennarl.ets/outle were approved, 1178 import licences were processed, 403 customs and 22 wharf inspections In I 993, 260 food factory inspections, bond inspections, 14 storage licences processed, 29 certificates 85 consumer's were examined, unfit food was destroyed in 45 locations, ID cards were issued for manufacturing/repackaging investigated, and 131 articles were seized.
and 129 violation notices served.

ts inspections, were done.
63 manufacturers' entries were granted, 43 food labels 3 IO food samples collected, In addition, complaints 97 Drug Inspectorate Division were done: 13 drug factories, 68 pbannacies, 29 hospital 9 cosmetic dispensarie s, 3 factories, 4 shops, inspections In 1993, the following 42 drug bonds, device factories, medical shops, 93 patent emergency factories, 5 cosmetic - 4 drug factories, and 89 dn1g products -32 dn1g importers -4 71 customs complaints consumer to CRDTL, 260 expired submitted GPC1NOC orders were examined, entries were examined, 739 import licences were investigated, 37 labels examined, were processed, 15 were 53 samples 40 samples were taken, 20 drugs were destroyed, and dn1gs were held/seized in 217 instances.
and 30 port-of-entries.

and 3 device factories were registered.

were licenced.

Workshops/Conferences/fraining Courses Held or Attended Worksllops Held: •7 food safety and cholera seminars were held by the Food Inspectorate Division; p held by the Guyana National Bureau of Standards on the HACCP Worksllops Attended: •a worksho system Conferences was attended Attended: by one member of staff; •Conference on food legislation; Training co11rses •Inspection Attended: of food factories; 53 •FDA attachment.
l\1ajor Successes/ Achievements which are worth noting: There were three successes •translating •a campaign against •the up!,,'Tading factories.

of hygiene labels into English on all foreign labelled foods: unlabelled over-th e-counter drugs: standards in food, dmg, cosmetics and device Major Problems Faced and Suggestions for Problem Resolution The major problems faced over the year were: •inadequate laboratory supplies •insufficient •inadequate •power outages.
nwnbers of trained transportation; and relevant technical instruments; staff; :lJ.l lfNPLANNED FOR BIJT IMPORT ANT ACTIVITIES UNDERTAKEN IN 1993 are likely In any year, there which were Health, had to cope -and did so successfully not foreseen at the year's where epidemics to be important are always outset TI1is is especially a threat End of l 992 and in 1993 the Ministry -with an outbreak of cholera.
so of a Ministry which were undertaken but of activities Coping with a Cholera Outbreak cholera alert, so that in Guyana training began in May of that year, followed in August and radio systems in cholera management systems In early 1992, there was an international workers health establishment of surveillance the year.

In Guyana the first cases were detected and on the 7th, a campaign the began to ensure that all cases were taken to hospital the point of dehydration reached hospital.
reached house-to-house visits, warnings nationally on television, focussing on encouragin g people to boil water, not to eat stale food etc, was the brigade was sent to Mabanmia.
An extensive had 6 never -of the 8 deaths that occurred due to cholera, the radio, and through wash hands, towards the end of 6th 1992 in Region l, Mass education mobilization before patients of the Ministry of Health's of by the major element on November medical 54 --- - -- ��� � - response Ministry's to the cholera work until threat.

This cholera campaign was a major element of the June 1993, when the threat wa., officially declared to be over.
It is important nwnber of diarrhoeal 21 000 cases of diarrhoea to note that through the education campaigns, benefits in terms of the cases detected nationally have been reaped.

In 1992 there were recorded, but in 1993 this fell to just 11 000.

5.0 REVIEW OF SPECIAL INITIATIVES special A nwnber of • the initial steps towards • work to wards the decriminalization the development initiatives of a National Health Plan; were taken in 1993.
These included of abortion through the Medical Termination of Pregnancy Bill; • the communment towards the the dissolu Health: of the revision tion of GAHEF and its reintegration into of all relevant Health Legislation, the Ministry of teitiatives taken • a change in the status of Fort Canje hospital; • building between the new relationships Ministry of Health and the Regional Administrations; • the development • steps to improve management of new programme areas; within the Ministry and Georgetown Public Hospital: • changes • discussions and to the design of the IDB-fmanced re absorbing GAHEF into the MOH.
Health Care II project.

5.1 HEAL TH PLAN a mediwn tenn plan.

This was required to give overall direction to the care in Guyana was going.

for the future.
This was especially Over the year it became clear that the Ministry of Health, and the health sector as a needed whole, so that it was clear where health sector a "road-map" sector needed crisis management, health National Health relevant bodies private GUYSUCO, PAHO/WHO, IDB Consultants, broad membership Planning Committee, (the Ministry of Health, hospitals, for example), was established the development a lack of coordination tion, with membership drawn from a variety of the Ministry of Regional Development, care, outdated Bureau, health professional and severe staff shortages in many key areas.
A in September.

Such the Statistics of a plan through a to facilitate is designed legisla among fragmented agencies delivering In short, the health so in light of pervasive associations, 55 consultative, small team of technical atory process experts.
particip - a move mwy from plan development by just a 5.2 MEDICAL TERMINATION OF PREGNANCY BILL rates are very high in Guyana, and studies show that abortion is the To address this important health issue, in May 1993 to advise the Minister on what a mortality e was established be taken on the issue.

cause of maternal death.

Maternal leading third Ministerial committe action should representation from etc.

• met from May to October.


It advised the Minister to proceed order to reduce December 1993 the Medical for its first reading.

The Committee groups, professional of abortions and to provide Tennination the number of Pregnancy Bill church - a broad based one with womens organisations organisations, with legislation safe tennination fn services.

in parliament was placed in 5.3 HEALTH LEGISLATION in certain Much of the existing legislation Health Act (which 1907).

developed.
developed.

A Hospital is out-dated, health legislation new areas.

Work has therefore and there is also a need for begtm on updating dates from 1953) and the Mental Health Act (which Accreditati on Act, and legislation on HIV/AIDS, is also being the Public dates from 5.4 DISSOLUTION OF GAHEF are the responsibility of a variety of the Ministry of Health, GAHEF, the Ministry of to cause fragmentation and poor issues, and health (for example care delivery, 1l1is has tended in Guyana Development).
Health agencies Regional coordination the health sector, Health.

GAHEF to see how this could occur.

In addition, in early 1993. was relocated in the Office of President began in mid-1993 Discussions it was decided in the sector.
As a first step to provide for a more integrated into the Ministry of and that GAHEF be reintegrated between staff of the MinistryofHealth apporach in the Environmental Unit at GAHEF 5.5 FORT CANJE PSYCHIATRIC HOSPITAL In 1993 the hospital at Fort Canje was designated a national psychiatric institution.

As such, this now receives a subvention directly from the Ministry of Health, rather 56 · - as a regional hospital financed by Region 6.

The hospital years of neglect.


In 1993 work began on the rehabilitati than being supported very poor state, of the kitchen.

patients was also put to the Basic Needs Trust Fund -the female accommodation in a particularly poor state.

and bakery.

A proposal to build 3 new chalets for female was following laundry, is in a on 5.6 BL'ILDING NEW RELATIONSIUPS ADIVHNISTRA TIONS WITH THE REGIONAL Given that it is the Regional provision e partnerships budgets for the first time in 1993, for example.
In addition, the care in Guyana, initiatives Administrations.

for much of the have been taken to Meetings of health with the Regional s who are responsible Administration were held and 9, these were previously has assumed responsibility for medivac operations out of Regions who often did not have paid for by the Regions, and actual financing build constructiv health to discuss of Health Ministry 1, 7, 8, the finances average.

at least one medivac cases.


In Regions supplies direct than the previous reliance to health available to facilitate such operations.

operation a week, with most being complicated 1, 7 and 8 the Ministry also now sends drugs and other medical on The Ministry now finances, obstetric facilities, in recognition through on distribution of the fact that this is more efficient capitals.
regional It is also important to note that for the first time in three to Mabaruma and Lethem, posted areas as part of their and that the transfer of doctors obliga tions has been resucitated.

contractual years doctors have been and rural to interior 5.

7 NEW PROGRA!\1ME AREAS for uterine are being being developed: A number of new programme cancer detection/screening project PAHO/WHO also financed Ministry of Health areas have been introduced by the Ministry.
cancer and a community-based Health A both are again supported a project to strengthen the institutional Mental by PAHO/WHO.

of the capacity Medical Outreach programmes were resuscitated in the interior areas and riverain e.g.

Berbice River, Amerindian villages 5 and 8. in Regions 3, 4, 57 5.8 t\tlANAGEt\lE�T AT THE l\-llNISTRY HOSPITAL AND GEORGETOWN PUBLIC To improve were initiated.

better coordination management These allow for improved of decisio n-making.
within the Ministry, regmar monthly Directors meetings and hence and cornmunciation, participation A Council of Consultants has also been established at Georgetown Public Hospital.

This has well-defined professionals at the hospital.

tenns of reference, and should improve management of medical 5.9 HEAL TH CARE II PROJECT DESIGN June and August of a new Ambulatory/Diagnostic/Surgical the all work on the IDB Health Caren project (i.e.
Care Centre at Georgetm,vn Hospital) was brought structure of the building of the to a halt.

This was to allow fur the redesign and so that so that better use could be made of space, rooms/wards, the accident and emergency department, within intensive clinics, care surgical ward could be included of all out-patient fur the inclusion Care Unit, private and a special gn also allowed Bet'ween construction Public interior an Intensive minor operations the building.
The redesi except for the dental and psychiatric clinics, within the building.

6.0 APPENDICES 6.1 BUDGETED AND ACTUAL RECURRENT EXPENDITURE Bud!

!d Head Ilud(t'led Esp,:nditun,> tGSl .MWai Eq:,eadi-..tGSl of ffoallh 280100000 \linllim· ),!Ullll1ry of Health: - N11KIWII Ho,:ni1.11b :..hnllirry oflkaltb.

• Other 163 000000 ?mm,mmos 411 300000 2I0070000 ....... Actll.llt K1pe•diltm!'

Budl!

('f.ed Er-·'"'··re es •4 100.01•.,;.


·Ul 330000 16.3 036 000 100.oi-• 6.2 BUDGETED AND ACTUAL CAPITAL EXPENDITURE Hem Bud� Ei:pt"nditutt IGS Million:u Xurnit•l C'are C em:re Cil .. 'Of'81:1Pw11 H�itai Hullh Care ll 977600000 Project� ( ·o�n.1C1Km of new A.mbula1vry1 Diaimnsticl R.:habilitalroo lslfheakb sd::<:ted l'Cflioo/i PT02Jannue EC(K)O s,.

'Vtor (Jilk,; fumiwre: aud Equimnt:nt 2 �00000 Equipm,.
'ffl buildings in 24000000 100000 000 4600000 Ad.ail �t6S: MYl:icnt,J ,\dual Ei;penditurr u � BudftUd r,�nditu� 84<1:.

120 733 000 << l3 155 000 0 l 391000 � 58 �-U% o•, 55.9-i>