Govt. must sustain advances made under Canada/Guyana health project - CSIH official
Kaiteur News, Wednesday December 13,2006

A senior functionary of the Canadian Society for International Health (CSIH) has underscored the need for government to find a way to sustain the advances made in the health sector under the Guyana/ Canada Public Health Strengthening Project, which is scheduled to end early next year.

Technical Coordinator of the CSIH, Curtis LaFleur, lamented that while many inroads have been made in areas targeted by the project, failure to sustain and expand on them could result in a relapse of these achievements. He highlighted tuberculosis as one critical area where this unfortunate potential exists.

This is especially against the backdrop of the recent announcement by the President of the Chest Clinic, Dr Moti Lall, that a whopping 220,000 persons — almost a third of Guyana 's population — have developed the micro bacteria for tuberculosis infection

In 2002, the Government of Canada, through the Canadian International Development Agency (CIDA), provided CAN $5.6 M for the public health strengthening project in Guyana , managed by the Canadian Society for International Health, and implemented collaboratively with the Ministry of Health. The goal of the Public Health Strengthening in Guyana (PHSG) project is to improve and maintain the health of Guyana 's population by supporting an integrated approach to disease prevention, diagnosis, management, and care at the national and regional levels.

The project is also aimed at strengthening the public health system by enhancing the capacity of the Government of Guyana to better manage, deliver, and monitor disease prevention and control programmes in the areas of STI's /HIV/AIDS /TB, and effectively plan, manage, and evaluate health care services.

LaFleur reported that in the last four years, the CSIH has catapulted the Tuberculosis program in Guyana . In order to improve Guyana 's National Tuberculosis Prevention and Control Programme, the project has developed and implemented national technical and operational guidelines for the diagnosis and treatment of the disease, and provided technical and administrative support for the national program, he said.

In this regard, he added, the project focused on capacity building, which saw training workshops and seminars being held locally and internationally with various categories of staff employed in the public health sector. The project has also developed implementation strategies for the Directly Observed Short- Course (DOTS), which is the approach recommended by the World Health Organisation for treating with the disease.

Using the DOTS method, the national programme, which targeted prevention and control of Tuberculosis, was introduced in Regions Four, Six and Ten, and was then expanded to Region Three. Initially, the DOTS program only existed in Region Four. Additional funding has been provided by the Global Fund for the further expansion of the DOTS programme to Regions Two, Seven and Five.

This is scheduled to begin in the near future. Another major highlight of the project was that it resulted in the strengthening of Guyana 's laboratory capacity to better support the diagnosis of the disease.

“We were able to assist the national programme to institute a network of laboratories to diagnose and treat Tuberculosis. Labs were set up at the Georgetown Hospital , and the West Demerara Regional and New Amsterdam Hospitals , so that patients in those areas can now have their sputum checked and diagnosed at those facilities,”LaFleur said.

He stated that, additionally, the Central Medical Laboratory at the GPHC has been enhanced, and can now facilitate TB cultures.

Prior to the introduction of the CSIH programme, La Fleur noted, an inferior method was being used to diagnose the disease.

He added that the programme was also able to establish a home and community based training programme for the care and support of HIV/AIDS and TB clients in Linden , Georgetown and New Amsterdam .

The laboratories are all functioning effectively, and one reason for this may be because the CSIH has undertaken the responsibility for the procurement of supplies. However, this responsibility will now be handed over to the government, and La Fleur expressed optimism that the efficiency of the facilities will be maintained. La Fleur reported that the CSIH project has achieved all its objectives. These were identified as the implementation of a national programme for the diagnosis, prevention and control of STI's and HIV/AIDS in selected centres in Regions 3, 4, 6 and 10 according to national and international standards.

The demonstration and establishment of an adaptable and expandable module of an electronic health information system to collect, process, and communicate disaggregated health data on STI's , HIV/AIDS and TB, contributing to national health policy and planning in agreed on sites, was also accomplished under the project. In acknowledgement of the need for sustainability, CSIH has signalled its desire for an extension of the project to the Guyana Government.

Funding from other sources in this regard is also being explored.

Tuberculosis, once thought to have almost disappeared in the 1990's, has reappeared with ferocious intensity in the new millennium, and continues to increase in prevalence around the world.

Tuberculosis affects several sections of Guyana , 650 cases have been diagnosed so far for this year, and the World Health Organisation estimates that the figure could reach 800 by year's end. A considerable portion of the 20,000 Guyanese living with HIV are also co- infected with Tuberculosis, an opportunistic infection of AIDS, which, according to La Fleur, makes treatment more challenging.

This is because such patients have to be treated with regimens of drugs for both ailments, sometimes resulting in adverse side effects.