Sun, Apr 28, 2019

Open Letter to the President of the Cooperative Republic of Guyana


I am a 37-year-old mother of two boys. Nine years ago, I was diagnosed with lupus. Less than two years after this dreadful diagnosis, both of my kidneys collapsed.
Prior to the diagnosis and the subsequent kidney failure, I was employed in a supervisory position at one of the Natural Resources Agencies where I earned a decent salary where I was able to take care of my two boys and me. However, this all changed when I lost my job as a result of the illness even though I was never declared medically unfit by any doctor. As you might imagine, I was devastated, since I had a seven-year-old and a three-year-old who depended on me for everything.
Mr. President, this letter is not about the fact, that I lost a decent paying job and now earn a very meagre salary (gross salary of GY$70,704.00 as a Modern Language teacher in a public Secondary School); this letter is an appeal to you to be afforded an equal and/or similar opportunity to survive a little longer so that I can see my boys become productive citizens of this dear land of ours. You and I both know that ultimately, it is not medical science that dictates the longevity of our lives on this earth but the Almighty God who sustains us. I believe that we can both agree that medical science and doctors certainly help.

As is public knowledge, you have been undergoing treatment in Cuba for the cancer that you have been diagnosed with. Please give me this opportunity to say that I admire the courage and strength that you have displayed throughout this time, that I am sure, is difficult not just for you but for your immediate family, so I say continue the good fight on the road to a complete recovery.
Unfortunately for me and many of the kidney failure patients, we are not privileged to afford the luxury of seeking oversees treatment as you are. As it is, many of us cannot afford the haemodialysis treatment that is necessary for our survival. I am currently a patient of the Doobay Medical & Research Centre Inc. located on the East Coast of Demerara. I had started my haemodialysis treatment in the neighbouring city of Boa Vista, Brazil in 2012, where ALL of my medical treatment was surprisingly FREE of cost. Even though medical services were free in Brazil, the cost of living was very high and so I could not afford to continue living there and so decided to return to my beautiful country after eight months.
On my return to Guyana, I started my search for a dialysis treatment Centre since I hadn’t known anything about dialysis prior to me leaving for Brazil to seek medical attention. At that time, I found that the cost per session was a minimum of GY$15,000.00 and a maximum of GY $38,000.00.

I did the obvious thing; even though Doobay Medical Centre (as it was called then) was a far distance, it was the cheapest Centre so I started treatment there and continue to be there after six years. Doobay Medical Centre has been providing an exceptional service to its patients. This Centre has helped many kidney failure patients in many ways. In my opinion, they were able to make the dialysis treatment in the country a little more affordable because of their competitive cost per session. Other dialysis Centres saw it necessary to reduce their high costs per sessions and now the options are wider for patients in the country. Doobay Medical Centre continues to attract many patients because of the relatively low cost and the fact that fistulas and grafts (access points to do haemodialysis) are done free of cost by Canadian doctors who voluntary visit the Centre every six weeks to review the progress of the patients. Patients have also benefitted from occasional free sessions and or reduced cost per session ($6,000.00). Over the years, costs per session at the centre have been fluctuating between GY $9,000.00 – GY $12,000.00 and the current cost per session is currently at GY $9,000.00. Unfortunately, beginning May 1, 2019, the cost will once again increase to GY $12,000.00, and patients will no longer benefit from free and or reduced costs per sessions.
Mr. President, I just want you to imagine how it is that I, as single mother on a $70,000.00 salary, can afford to pay for two sessions of dialysis per week. Due to a broken leg, I am forced to take a taxi to and from the dialysis centre. A return trip cost GY $4,000.00. Presently, transportation alone is GY $8,000.00. Some readers may say, maybe she has a wealthy family; well no I don’t or maybe I have a lot of savings, no I don’t or maybe I have medical insurance; no I don’t. NIS is my only medical insurance.
You may ask, doesn’t NIS cover the cost of the dialysis sessions? The answer is NOT quite – NIS pays 80% of the cost, which they usually make available every 36 sessions. After these sessions are depleted, I am required to re-apply for another 36 sessions. The approval process takes three to four weeks. During this waiting period, patients must pay the total cost per session. In my case, in the coming weeks, I will have to find $32,000.00 per week ($24,000.00 for two sessions and $8,000.00 for transportation).
As you may have realized Mr. President, I have not included any of my other monthly expenses. I am sure you being 100% Guyanese and a man of the people of this country that you are fully aware and well informed of the average cost of living of Guyanese households today. It is not my intention to highlight this. My intention is for you to intervene in this dire situation that kidney failure patients on dialyisis are burdened with, which is the cost per session.
I am sure you and the readers want to know why the centre is once again increasing the cost per session. Patients including myself have been informed that due to the high taxes and duties that the centre have to pay to import the materials/products necessary to carry out the dialysis treatment, and the non-existence of tax exemptions, they are facing difficulties to cover these high costs and so we the patients are forced with the ripple effects of same. Let me make it clear that I am in no position to investigate whether this is indeed factual.
What I do know for a fact is that many patients die because they cannot afford to pay for even one session. There are patients who cannot even afford to reach the centre. I sometimes miss my sessions because of lack of funds to get there.

One the other hand, the Georgetown Public Hospital, do provide the service free of cost. However, it is ONLY for in-patients, or persons can make the bold decision to check one’s self into the hospital, and some patients are indeed forced to do this. However, this is not necessarily the best choice since the probability of infections is higher but desperate situations lead to desperate measures and dialysis patients are often in desperate situations.
Therefore, Mr. President, I am appealing to you and your administration to make dialysis affordable and accessible to ALL Guyanese who need this treatment for their survival. I certainly may not have all the solutions but I am confident that you along with your competent administration will come up with effective, socially and economically viable solutions.
Nevertheless, I would like to take the liberty to suggest the following for considerations:
1. Make dialysis treatment FREE, not only for In- Patients of the Georgetown Public Hospital but all persons affected.
2. Dialysis machines should be installed at all Regional Hospitals in the country, this will make it easier for patients to access this service, who are currently travelling, from places such as Lethem, Bartica, Essequibo, Linden and Berbice to access this service. This will require nurses and technicians to be trained in this field.
3. Facilitate tax exemptions on the importation of materials and products necessary for dialysis treatment, which will allow centres such as the Doobay Medical and Research Centre Inc. to maintain cost per session at a minimum so that more lives can be saved.
4. Make available subsidized payments for patients on dialysis.
Mr. President, I did not write this long correspondence because I enjoy writing, I wrote it so that you may have a clear understanding of the challenges that patients like myself are faced with in a resource filled, blessed country like OURS.
Mr. President let me thank you in advance, because I am confident that you and your administration will not disappoint me and the Guyanese people on the promises of the GOOD LIFE FOR ALL.

Yours respectfully,
Romayne Atkinson
Kidney Failure patient on haemodialysis.

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