MONDAY, MAY 08, 2006

Despite being well down on the list of donor countries that contribute to international development, Canada is making an impact on the lives of ordinary people in Guyana thanks to CIDA and the Canadian Society for International Health.

Microbiology technologists training at the University of Guyana. Photo courtesy of the CSIH.

If Canada wants to have a bigger footprint in the world, possibly the easiest way to achieve that goal is by increasing the amount of money it commits in overseas development assistance (ODA).

Former prime minister Lester Pearson called for developed countries to allocate 0.7 per cent of GDP for ODA. Only a handful of countries have reached that goal, notably – Norway, Denmark, Sweden, the Netherlands and Luxembourg.

Currently, Canada is about halfway there, however, the government has not committed to reaching it by the United Nations stated goal of 2015.

That is not to say Canada is not involved. You only have to ask the people of Guyana how big Canada’s footprint is.

The Ottawa-based NGO – Canadian Society for International Health (CSIH) – is working on strengthening the public health system in Guyana (which is one of Canada’s 25 development partners). CIDA is funding the $4.8 million project. The CSIH contributes another $900,000 of in-kind services.

Working with the Ministry of Health in Guyana, the CSIH is undertaking a project to improve capacity, recruit and train medical professionals, reduce the impact of HIV/AIDS and tuberculosis (TB) and improve community care.

Guyana is a small country in South America with a population of approximately 800,000. One of its major challenges is emigration.

“There is a human resource deficit in all the social sectors, but you are really feeling it in the health sector in Guyana,” said CSIH Executive Director, Janet Hatcher Roberts in a telephone interview from Ottawa.

“Large components of our project are really addressing this deficit through training, re-training and upgrading the skills of existing health care professionals. We are not just talking about doctors but a system-wide approach to human resource deficits. That means nurses, nursing assistants, community health workers, laboratory technicians, so we are really looking at the whole spectrum of individuals who feed into the health system. This is a problem that is particularly severe in Guyana,” said Ms. Hatcher Roberts.

Guyana Project Director Roumyana Benedict added: “There is no animosity (towards Canada or other wealthy nations) because people want to leave. It is a poor country and the economic situation has been pretty bad, so people are looking for an opportunity to leave.”

The CSIH has sent many Canadian medical professionals to Guyana to help train health care workers. In addition, many Guyanese nationals living in Canada have returned home to help improve the lives and health of their fellow citizens.

One of those is Dr. Karam Ramotar, a 52-year-old molecular microbiologist at the Ottawa Hospital. Dr. Ramotar immigrated to Canada to study medicine. He earned a PhD in medical microbiology from the University of Manitoba in Winnipeg. He has been in Ottawa for a decade.

“When this project started back in 2003, I was not on board yet, but the other infectious disease people who were part of it were trying to upgrade microbiology services in Guyana to support the clinical needs for sexually transmitted infections (STI) and TB,” said Dr. Ramotar. “They were having some problems and one of them contacted me and I was asked to go there to see if I could help.”

Dr. Ramotar's main function is to ensure that microbiology services for STI diagnostics and TB are established and kept in place. He has been back nine times in the last two years. He usually stays for one week. The last time he was there (in February) he visited three lab sites to ensure that the TB control work was operating properly. In addition he made two side trips to assess services in the interior of the country.

“We do lectures in the labs and in the universities as well as skills upgrading and bench training,” said Dr. Ramotar.

It is hard for most Canadians to think of TB as a major health concern, but in fact this curable disease kills two million people per year.

“The reason TB is still a problem is because there has been a breakdown in the primary health care system that have been picking these problems up,” said Ms. Hatcher Roberts.

“I remember when we first started the project going to the chest clinic and this man had clearly gotten up early in the morning and walked a long way in the heat and climbed about 30 very steep steps up to this rickety old building at about 10:05 in the morning, only to be told he has to come back the next morning because the laboratory cannot deal with any samples after 10 a.m. The reason: there is only one lab technician. There was no other chest clinic in the country. One of the things we did was build that up so there would be more than one technician,” said Ms. Hatcher Roberts.

“It is estimated that about 14 per cent of the population is infected with TB,” said Ms. Benedict. There are about 2,900 active cases.

It is difficult to know exactly how many people die of TB each year in Guyana. The reporting methodology is vague and not computerized.

The four-year CSIH program ends in June 2007.

What happens after CSIH leaves?

“They will be able to carry on,” said Ms. Hatcher Roberts. “They will have a national program. They have people trained. What they will have to rely on is the Government of Guyana’s commitment to allocate resources to that issue,” she said.

CSIH has trained more than 800 new health care professionals in the treatment of HIV/AIDS, TB, and STIs.

“What we have done by integrating the TB program within a public health system strengthening approach is the way we have to go globally. We just can’t come in and say: ‘We’re going to do TB.’ This integrative approach is essential. And this is where now some of the other donors are realizing that they have been a bit deficient. So clearly CIDA was quite visionary in their approach and Canadians have brought that approach to this project,” said Ms. Hatcher Roberts.

Dr. Ramotar is pleased he became involved with the project and credits the CSIH for its efforts.

“They (CSIH) have made a lot of strides and made a lot of the goals they had set out. It is quite admirable that they have been able to do that. I think if programs like this can continue to be funded they can go a long way to improving the health care system. It’s just getting that initial push,” he said. POSTED BY PETER DUDLEY AT 4:48 PM 0 COMMENTS