Guyana is located on the northeast coast of South America, bordered by the Atlantic Ocean to the north, Suriname to the east, Venezuela to the west and Brazil to the south. Approximately 730,000 people live in Guyana, 90% of those living on the narrow coastland area. Georgetown is the capital city, situated on the right bank of the Demerara River, one of the three main rivers flowing into the Atlantic Ocean.
The official language is English, however most Guyanese also speak Creolese (an English based Creole). Guyana is often referred to the Land of Six People’s due to the multi-ethnic composition of its population. The largest ethic groups are East Indian (51%) and Afro-Guyanese (43%) with the remainder being European (mainly Portuguese), Amerindian and Chinese. Christianity is the predominate religion (57%), followed by Hinduism (33%) and Islam (9%).
Health Care in Guyana:
Over the past few decades, several health care professionals (especially doctors and nurses) have left Guyana for other countries. Currently Guyana lacks several important medical specialties such an oncologist and cardiologist. With the rapidly growing number of people with diabetes, hypertension and heart disease, this poses a problem as several individuals are required to fly to Trinidad for treatment, however many are unable to afford to do so, considering the average income is about US $200/month. The same goes for individuals requiring chemotherapy or other cancer treatments.
Guyana has a two-tiered health system, which includes several small hospitals with free health care. However, the 10% of the population who live in the interior of the country have no access to medical care. Several individuals rely on "bush medicine", using roots, leaves, flowers, fruits or seeds of plants and herbs.
Disabilities & Rehabilitation:
Currently awareness and education on disabilities is very minimal in Guyana, and stigmas about these individuals are quite prevalent in some areas. A large part of the problem is that there is a lack of resources, and in several areas where basic health care is so scarce, this issue is not a priority. The majority of the buildings are not wheel chair accessible, doctors offices are on second floors of buildings (with no elevators), and the traffic at any given intersection is so chaotic is makes it difficult for a healthy person to safely cross the street.
In terms of physiotherapy, there are only a handful of physiotherapists in the country. To help fill this void, there is a rehabilitation assistant program offered in Guyana, where they learn about physiotherapy, occupational therapy and speech language pathology. These individuals work independently in the smaller hospitals throughout the country, where a physiotherapist may visit for a couple of hours once per month to answer any questions and help with difficult cases.
Personal Experience:
I have a strong passion for traveling, and when hearing about the Queen’s Medical Outreach Program at Queen’s University, I thought it would be a perfect opportunity to see a new country while putting my physiotherapy skills to practice. Queen’s Medical Outreach, a non-profit student initiated and student run organization dedicated to improving individual and community health, was developed in 1987 by a small number of medical students. The Guyana project has been running since 1989, and it has grown to include students from all health fields as well as other faculties.
Our main focus was to do health promotion activities in schools, communities and health clinics. This included teaching sessions on various health topics such as disabilities, diabetes, hypertension, nutrition, maternal health, hygiene and HIV/AIDS amongst others. We worked very closely with the Red Cross and Ministry of Health, and one of the highlights of the trip was running the education sessions for a National Youth Health Group Camp, organized by the Ministry of Health, where students and teachers from across the country meet for a week three times per year.
Being the lone physiotherapist in the group, I wanted to put my skills to work, and developed my own initiatives while I was there. My largest accomplishment was helping to set up a cardiac rehab program at the Georgetown Public Hospital, the largest hospital in Guyana, which will be complemented the Cardiologist they are hoping to bring in to the country in the near future. Other things I was able to do were home visits to children with Cerebral Palsy, teaching rehabilitation assistants in an out-patient clinic in a small town hospital (Bartica Hospital) which only has a physiotherapist visit once per month to answer questions and help with difficult cases, treat some sick and abused infants in an orphanage and provide some sessions at prenatal clinics on pregnancy, back pain and urinary incontinence.
Each day brought out new challenges and experiences. We had no set schedule as one day we may start off giving a session on nutrition at a pediatric or prenatal clinic, followed by running a session to the community on diabetes and hypertension at the Red Cross Headquarters. After that we may head to the orphanage to treat some infants and play with the children, or go to the Children’s Aid Society where we would help teach math and spelling lessons. On another day, we may spend the entire day traveling to and from a rural school to give a session on diabetes and hypertension. This flexibility is what made the project so exciting and interesting, because each day brought about new adventures and experiences.
Several challenges arose throughout my experiences in Guyana. As a new grad, the biggest challenge I faced was having confidence in myself and my skills as a physiotherapist. Jumping right from the role of a student to the role of a teacher, in a country with very limited resources was quite challenging. Walking into a rural rehab clinic or into a patient’s home to assess and treat a patient with two rehabilitation assistants looking up to you to teach them what to do, was definitely the most challenging assessment of my abilities and confidence, then any test I could have ever faced in school. But the appreciation of everyone involved made the experience so rewarding, and provided me with much more confidence in myself as a person and as a physiotherapist.
However, not all the challenges were as rewarding. I found myself in a couple of situations where my help was being asked for, but there was resistance in actually accepting it. Some of the health care workers knew that they could use the help, but had a difficult time accepting it, making it difficult to successfully follow through with some of the tasks we were asked to do. I never knew my minor in cultural anthropology would ever be put to practical use. In cultural anthropology, they always stress “participant observation,” understanding and learning about a culture by participating and living in it. This “participant observation” provided me with knowledge and a greater appreciation of the people we were working with, and helped guide me through these difficult situations.
My experience in Guyana was very difficult to put into words, as no article or picture can really capture what I experienced. Living and working with very limited resources really puts into perspective how much we take for granted, but also makes you appreciate what you do have. My personal gains both as a person and a physiotherapist are infinite, and I can’t wait for my next trip!
