Health Minister downplaying Chikungunya situation – Dr Norton

“We have got to forget about tourism and think about the health of the nation” – Dr Norton

Claims by Health Minister, Dr Bheri Ramsaran that all of the confirmed cases of the Chikungunya virus have been

Minister of Health, Dr Bheri Ramsaran

transmitted in the Ancient County of Berbice, has been described as “almost unbelievable.”  This description was offered by a very vocal Shadow Minister of Health, Dr. George Norton, as he indulged this publication in a conversation on the matter yesterday. According to Dr. Norton, “when one takes into consideration the Chikungunya virus situation in St. Lucia we can possibly be in a worse situation here in Guyana.” Reports are that the virus, which surfaced in the Caribbean for the first time last year, has reached disturbing proportions in the Windward Island. And according to Dr. Norton, since the mosquito – the Aedes Aegypti – that transmits the virus is very prevalent in many sections of the country it is therefore not impossible for it to already be in many parts of Guyana.  In fact he theorised that since the symptoms of the virus are very similar to that of dengue fever, the possibility exists that a number of Chikungunya virus cases are being passed off as dengue fever. “We have the mosquito here, we have all the conditions here, and we have persons coming down with the symptoms so we can very well have a high percentage of the Chikungunya virus right here in Georgetown,” the Shadow Health Minister speculated. This publication had received reports of the virus being confirmed in sections of the city but the Health Minister had assured that the virus had not entered Georgetown or any other part of the country for that matter.  He disclosed that the virus had been “imported” to the city, a process, he said, entailed the victims travelling to Berbice and being bitten by the mosquito before returning to their Georgetown residences. The Minister told this publication that there were only two such confirmed cases. But according to Dr. Norton, a Member of Parliament, representing A Partnership for National Unity (APNU), the utterances by the Health Minister are unrealistic. “We know that that is not the case, that only Berbice has the virus,” said Dr. Norton. He went on to substantiate his argument by pointing out that there are absolutely no measures in place to ensure that the virus remains in Berbice. “There is nothing that is stopping the people from Berbice coming to Georgetown and some of the people from Georgetown going to Berbice, nothing…stopping the virus from being in other parts of the country,” said the Shadow Health Minister. He even observed that there have been no moves by the Health Ministry to quarantine or isolate persons with the virus in an attempt to help reduce transmission. He recalled that a few years ago Guyana was able to guard against the Foot and Mouth Disease by ensuring that there were extensive screening processes even upon entry to areas such as the Rupununi. But according to him, such measures have not been employed by the Health Ministry to combat the Chikungunya virus which he recognised as a real public health threat. Health before tourism Dr. Norton has also vocalised his concerns about disclosures by Dr. Ramsaran that his Ministry has been seeking to tackle the virus quietly so as not to scare off tourists and investors and create panic. “I have a problem when the authorities are going to say that we are trying to not create a situation of alarm that would upset the tourist industry…that I cannot accept,” asserted Dr. Norton. “We have got to forget about tourism and think about the health of the nation,” he passionately insisted.

Shadow Health Minister, Dr George Norton

And according to Dr. Norton, Guyana’s current inability to test for the virus is also another disturbing development.  Dr Ramsaran during an interview with this publication said that while Guyana has in place all the equipment to test for the virus at the National Reference Laboratory situated at Thomas and New Market Streets, Georgetown, there are currently no trained personnel to undertake the process. As a result, Guyana has been depending exclusively on the Caribbean Public Health Agency (CARPHA) in Trinidad to confirm suspected cases of the virus.   Dr. Ramsaran in justifying the utilisation of CARPHA, noted, “We are happy that our CARPHA in Trinidad is doing what it is intended to do. We speak about regionalism and this is where regionalism is in action.” However, Dr. Norton is certainly not buying the Minister’s explanation even insisting that “you can try to hide under the inefficiency and come out with a statement and say the reason we cannot test for the Chikungunya virus here is because we are maximising on regionalism.” “In other words because it can be done in Trinidad then we mustn’t do it in Guyana? Trinidad don’t look at it that way, Barbados don’t look at it that way, Jamaica don’t look at it that way; no Caribbean island don’t look at it that way and say ‘oh we are maximising regionalism’ and that is why they don’t do things in their countries that can be done in Guyana.” According to Dr. Norton, “that is a lame excuse and it is a direct reflection of the inefficiency of the Ministry of Health not to be able to diagnose the Chikungunya virus here in Guyana when according to them we have the equipment here on the ground.” Minister Ramsaran has belatedly disclosed that moves are being made to have at least one person trained to test for the virus, an undertaking that is slated to be done with support from the Pan American Health Organisation and the Centres for Disease Control. In the meantime though, Dr. Norton noted that Guyana will have to remain reliant on CARPHA to be able to confirm suspected cases of the virus. “We have about 100 samples waiting there and I don’t know up to when we can wait…” disclosed Dr. Norton who intimated that “our track record of sending samples abroad, even for the simple DNA test, is not one that anybody is proud of because either something is left behind or some never return…something always happens with our samples.” Moreover, the Shadow Health Minister is convinced that not enough is being done to effectively deal with the Chikungunya virus in Guyana.  “I don’t think that we have done enough at the level of the health centres or even the hospitals where there should be systems in place so as soon as people present with symptoms there is somebody who takes off the samples and gets them to Trinidad…I don’t think we have a system specially in place to look at that,” Dr. Norton speculated. The symptoms of the Chikungunya virus include: fever, muscle and joint pains, headaches, rashes and nausea. Since there is no cure for the virus, like dengue, efforts are focused on treatment of the various symptoms. However if the symptoms are not treated there are debilitating effects including curved limbs, paralysis and even death due to certain pre-conditions.  According to Minister Ramsaran, as at last week, his Ministry has been able to confirm 19 cases of the virus.

More Chikungunya cases confirmed in Berbice

At least a dozen more cases of the Chikungunya virus have been confirmed even as the Ministry of Health continues fervent

Chief Medical Officer, Dr Shamdeo Persaud

efforts to control its impact. Last week Guyana recorded its first two cases of the disease – a four-year-old girl and a 50-year-old woman. The two cases were among 30 blood samples from patients with symptoms including fever, that were sent to the Caribbean Public Health Agency (CARPHA) laboratory in Trinidad for testing. The latest cases were among a batch of 130 samples that were taken in recent days. All of the cases thus far were found in the Berbice area, with the first two coming from Canje and some of the recent cases also coming from sections of Canje and Corentyne. This development has been confirmed by Chief Medical Officer, Dr Shamdeo Persaud, who told Kaieteur News that the total number of confirmed cases currently stands at 14. This publication understands that health officials are viewing this latest development as worrisome but not at all unexpected, since the possibility exists that the situation will escalate before it subsides. But in order to keep the situation at a relatively manageable level, Dr Persaud said that “we have increased our vector control and awareness efforts.” The Chikungunya virus is a disease that is transmitted by the Aedes Aegypti mosquito. Reports are that the Health Ministry is still seeking to ascertain how the virus was able to make its entry into Guyana. It is being suggested that the virus’ entry might have been aided by persons who might have traveled from territories where the virus has already been detected. On December 12 last year, CARPHA was informed of 10 transmitted confirmed cases on the French side of the Caribbean island of Saint Martin. Since then more than 1,800 confirmed cases were reported from Anguilla, Antigua and Barbuda, Aruba, British Virgin Islands, Dominica, Dominican Republic, French Guiana, Martinique, Guadeloupe, St. Lucia, St Vincent and the Grenadines, St. Kitts and Nevis, St. Bartholomew and Saint Martin.  Three confirmed resulting deaths were reported by Martinique and Saint Martin. While Chikungunya itself is not a high cause of death directly, it can however have some long term effects such as joint pains. Aside from joint pains, its symptoms generally include: fever, rash and muscle pains.

The disease is transmitted by the Aedes Aegypti mosquito.

The resulting fever together with pain, particularly in young children, could also cause bouts of convulsions and even dehydration, Dr Persaud said.  There have even been rare occasions, he disclosed, when the virus has been known to be associated with the Guillain Barre Syndrome which is a disease that causes the body to become paralysed. “Even with medical care you might still experience this pain depending on how the body reacts beyond the incubation period,” Dr Persaud noted. This period can span two to six days with symptoms usually appearing four to seven days after infection. There is no cure or specified treatment for the virus hence infected persons’ recovery is dependent on medical management. Guyana has been on high alert ever since reports surfaced of the virus’ entry into parts of the Caribbean last year, even heightening its monitoring at ports of entry and intensified fogging activities. The ministry’s intervening actions also include an awareness campaign to enlighten residents, particularly in the affected areas, of ways to safeguard their environment and by extension themselves from the virus. The Ministry has also been relying heavily on its Veterinary Public Health Department, since animals can also serve as reservoirs for the disease.

Mits,

When I was there, a lot of people contracted Chikungunya. The people who went for medical attention got shots and medication did get relief from the symptoms. I have not heard of anyone complaining about a recurrence. My cousins had the disease.

The people need to stop dumping their garbage anywhere and everywhere.

Not only in Berbice, it is prevalent in the three counties. Dr Beri Beri does not have a clue.

Meanwhile in Guyana

Dr. Persaud: There is no cure or specified treatment for the virus hence infected persons’ recovery is dependent on medical management.from the article posted here.

I think you may know the person who spoke to me. Anyway, I hope the fogging is effective to contain and kill the mosquitos. I am happy to hear that you are safe. I am sending off some nettings.

Concerns mount over increase in Chikungunya-like symptoms

The approach being embraced by the Ministry of Health to tackle the Chikungunya virus outbreak is one that currently

Shadow Minister of Health, Dr. George Norton.

borders on negligence. This is the conviction of A Partnership for National Unity (APNU) Shadow Minister, Dr. George Norton, who informed this publication that “I think the Ministry can be guilty of negligence to a large extent if they do not change the way they are dealing with it now.” In fact, Dr. Norton noted that “we somehow got the impression that the Ministry don’t want to talk about it because they (perhaps) don’t have the means of controlling it or treating it.” He alluded to the utterance of Minister of Health, Dr. Bheri Ramsaran, that the Minister is tackling the outbreak with caution so as to not create an alarm.  “We have got to err on the side of caution and it might be better for us to create an alarm than have persons coming down with this virus,” theorised a concerned Dr. Norton. From all indications, the Ministry of Health, in recent weeks, has been divulging little to no information regarding the outbreak which was reportedly first detected in May of this year. This publication has on several recent occasions attempted to solicit comments regarding the outbreak from senior key Ministry of Health officials, including Minister of Health, Dr. Bheri Ramsaran, to no avail. This lack of communication comes at a time when there is reportedly an increase in the number of persons, countrywide, suffering from Chikungunya-like symptoms which range from joint and muscle pains, rashes about the body, headache, nausea and high fever. Although Guyana has in place a National Reference Laboratory complete with equipment to test for various viruses, the facility is currently not able to test for the Chikungunya virus. This is in light of the fact that there are no trained personnel to carry out such tests. However, Resident Representative of the Pan American Health Organisation (PAHO), Dr. William Adu Krow, has confirmed that PAHO is collaborating with the Health Ministry to train at least two local laboratory personnel to test for the virus here. In the interim, Guyana, like a number of other Caribbean territories that have been plagued by the virus, has been utilising the services of the Caribbean Public Health Agency (CARPHA) in Trinidad. Although the Ministry of Health has only publicly informed of 31 confirmed cases, this publication has been reliably informed that the actual number of cases surpasses this reported amount.  In fact, reports are that there are even a greater number of unreported cases since the Ministry has only been facilitating random testing of persons manifesting symptoms of the virus. Some persons have expressed concerns to this publication that although they turn up at public health facilities with Chikungunya-like symptoms, no blood sample is taken from them for further testing.  It was related that the approach that has been adopted by (identified) health facilities is to simply give medications such as panadol to treat the symptoms of the virus.

The Aedes Aegypti mosquito which transmits the Chikungunya virus

But according to Dr. Norton, treatment should never be administered to patients without first confirming their condition. “One has got to be careful with treatment like panadol because for instance if it is dengue and it is haemorrhagic, panadol anti-inflammatory can cause an increase in the haemorrhage…so you’ve got to be careful with just giving these symptomatic treatments,” said Dr. Norton. What should have obtained, according to him, is a move by the Health Ministry to establish a protocol to be issued countrywide to educate the general public that if anyone is found to have the symptoms of the disease they should present themselves to a health facility. This, he noted, should have been in place to allow for blood samples to be taken and sent to a specified location where they could be sent to Trinidad in bulk. In fact Norton noted that the ideal situation should have seen the Ministry organising even a makeshift process where the samples were tested right here. He continued that in spite of the fact that Guyana does not have the capable personnel to undertake such processes, the Health Ministry should have solicited support from PAHO to contract expertise. “Let PAHO come on board, let them bring in somebody to work in Guyana for a few months…I don’t think that is difficult to be done…” said Dr. Norton as he pointed to the impact the virus has had in St. Lucia. St. Lucia, according to reports, has had to struggle to combat the disease so much so that health officials were at one point unable to issue the number of actual cases. The Chikungunya is a viral disease transmitted by the Aedes Aegypti mosquito and in practically the same conditions in which dengue fever is spread. And according to Dr. Norton care must also be taken in treating patients with related symptoms since there are instances that persons could be plagued with both conditions simultaneously. “Because we have to depend on clinical symptoms alone to decide on whether we are dealing with the Chikungunya or dengue…we tend to believe that there is an increase in the Chikungunya because the clinical manifestation of this virus is much more pronounced than it has ever been before,” said Dr Norton. As part of the pronounced manifestation of the disease, he noted is the presence of rash and joint and muscle pains that are being seen not only along the coast but in interior locations as well, the Shadow Health Minister said. Although health officials have informed that the Chikungunya virus is not life threatening, there are reports that failure to treat it early could be detrimental. And since the transmitting vector is known to thrive in relatively clean but stagnant water, calls have been made by the Health sector for residents across the country to ensure that they remove all possible breeding grounds. Even before the onset of the outbreak, when there were reports of the virus in some Caribbean territories, the Ministry of Health’s Vector Control Unit had started to conduct fogging and spraying activities in the city. Similar activities were also undertaken in Region Six where the virus was first detected.

I am getting worried that these things have been brought to Guyana by the Chinese workers. Now they all over the place in Guyana, the musquitoes have a source of infected blood supplies.

T, lucky GY nah gat ebola.

I think people just dimp everything all over. It's a breeding ground for diseases. They don't burn their garbage anymore; they just dump them.

Friend of mine from ST LUCIA said it is prevalent there,some relatives

came back a week ago from Berbice and became ill with the symptoms.

I took 3 cans of OFF. I also had a netting and used the mosquito coils. The mosquito coils and netting worked well.

The Ministry needs to look into this allegation.

A resident of Albion, Berbice yesterday told Stabroek News that hundreds of people were lining up at the hospital to be treated. She said people were travelling from Crabwood Creek and West Coast Berbice to visit the New Amsterdam Hospital.

 

She said people were so desperate to get treatment that they were spending their money on injections to relieve the pains. She indicated that doctors with private practices were charging people $5,000 to administer an injection that is believed to bring relief.

 

But their relief is short-lived because after a few hours, she said, the pains and fever return. She further stated that pharmacies were selling the injections for $3,000.

quote "The situation in Guyana in terms of the disease is not much different from CARICOM jurisdictions, GINA claimed; adding that there are currently 921 confirmed cases in the entire region."unquote

I would not be surprised if Guyana has more than 1,000 cases as at August 2014

Misplaced priorities

People living in Guyana would be understandably less than confident about this government’s handling of health issues.  The current Chikungunya virus outbreak which has been detected here seems not to be treated with the level of seriousness a situation of this nature demands.  There seems to be a very high degree of vacillation and evasion in official circles is certainly not helping matters, especially where the Guyanese people’s peace of mind is concerned. With almost two million cases of that mosquito-borne virus detected throughout parts of Asia since 2005 and with outbreaks in Africa and the Americas, it is to be expected that health authorities in countries even remotely likely to be affected, would develop and have in place the appropriate response capabilities.  To be now scrambling to establish protocols to deal with what is a major viral infection is a clear indication of misplaced priorities. The posture of the local health ministry does not seem to reflect similar sentiments.  Citizens are left in a state of life-threatening ignorance because of a proven lack of competence in the health sector to treat with similar outbreaks.  The confusion reportedly surrounding patients seeking medical attention with the potential for misdiagnosis is not one which should be taken lightly. Confusion about whether people are affected by Chikungunya or Dengue will not do much to bolster sufferers’ faith in the health system. According to medical practitioners, a patient suffering with Dengue who is misdiagnosed as being infected with Chikungunya and treated for the former is at greater risk of dying. This can be avoided by having trained personnel in place to conduct the relevant tests; something which apparently we do not have. What is even more worrying is the fact that the conditions which breed the two ailments are one and the same, and parts of Guyana make for a convenient habitat.  Another very obvious reality is that if these matters are not addressed sensibly we will be headed for the fate wished for by a former local government minister. This is the time when our politicians who are medical doctors should demonstrate a high sense of nationalism and maturity by putting their heads together to take us out of our misery.  It might even be better if politicians of all shades could just take themselves out of our lives. Up to now there has been no definitive word from government, through its health ministry, to allay our fears and provide reassurance that this situation is under control.  If anything they appear as clueless as the Abbot and Costello duo. The way the World Health Organization (WHO) is looking at the Ebola outbreak which has claimed more than 1,000 lives in West Africa will be instructive for local authorities.  Tellingly that virus has been declared an international emergency.  Although the significant difference between Chikungunya and Ebola, is that one is communicated by the female Aedes Aegypti mosquito while the latter virus is transmitted by human contact. Now fast forward to reality.  Guyana is not known to be a country which exercises strict immigration controls whether at official points of entry or along its porous borders.  This country has an amalgam of nationalities residing both officially and illegally within its various communities.  There are in addition to Asians, whose home countries have been affected by the Chikungunya, people from Nigeria, which declared a national emergency in the face of Ebola having confirmed seven cases recently. Lax immigration controls in a virtual ‘whosoever will may come’ state, places us in an even more precarious predicament.  The reasoning here is that if the government cannot organize and respond to episodic health hazards which befall the nation, there is definitely no guarantee that the proven life-threatening Ebola will be contained if it arrives on these shores. Does anyone in the quarantine section of our port health agency even know what signs and symptoms to look for; and is there any protocol established between that section and immigration officers to deal with any suspected cases?  From all indications, citizens are not being provided with the information which assures them that everything is being done to prevent and, if necessary, contain the spread of communicable and non-communicable diseases.

Minister of Health, Dr Bheri Ramsaran

This man is clueless, to come on the airwaves and say that there are only 62 Cases, is damn laughable just like the rest of the Corrupt PPP/C, a visit to anyone of the Regional Village Health Center, will confirm that more than 100 people is there in any one day, with the same symptoms. Public Hospital in Georgetown might be (on a daily basis) five times the amount, and then there is the Private hospitals....who knows what is the score there?

Dr Bheri Bheri, is now getting more worse than the Corrupt Birth Certificate Man.

God help Guyana.........these fokkers that calls themselves the PPP/C is clueless.