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Budget Speech DR Norton - 2012

Hits: 3957 | Published Date: 10 Apr, 2012
| Speech delivered at: 2nd Sitting - Tenth Parliamant
| Speech Delivered by : Hon Dr. George Norton, MP

Dr. Norton: I rise to make my contribution in this Hon. House to the Estimates of Expenditure for the Public Sector of 2012 as presented by the Hon. Dr. Ashni Singh, Minister of Finance. This is the Minister’s first of a maximum of five budgets for the Tenth Parliament, but we in the APNU are well prepared for those who wish for it to be less than five.
The Government in 2009 allocated $12.8 billion to the health sector, $13.2 billion in 2010 and $14.5 billion in 2011. While this amount is increasing on an average of $0.6 billion per annum, the percentage allocated to the health sector from the national budget decreased by an average of $0.45 billion per annum, during the same period, remaining at nine per cent of the national budget in 2011.
This year, 2012, that allocation is $16.9 billion. This large sum of money is for the health care infrastructure development, the training and development of health care personnel and provision of equitable access to quality health service. We do recognise the grand total of these allocations and hope that this amount will be sufficient for the different plans and programmes of this year. I say this to point out that it is the practice of this Government to come back to this Hon. House for approval of supplementary appropriation which has been already spent.
The Hon. Dr. Ashni Singh has brought five budgets to this National Assembly before 2012, totalling $627.5 billion, but he has returned to this National Assembly with fourteen supplementary Bills totalling $67.5 billion. With abated breath, we await to see what will happen this year.
In last year’s budget, approximately $1 billion of that $14.5 billion for the health sector was allocated for the construction and maintenance of health sector buildings and infrastructure nationwide.  Of this $1 billion, $235 million was budgeted for the completion of the two hundred and eighty-five-bed inpatient facility of the Georgetown Public Hospital Corporation, declared open on November 21st, 2011. The then President on that occasion repeated his recurring call of getting value for money. He said, and I quote: “In a country like ours, we have to make sure that we get maximum value for every dollar we spent, particularly in health care.” Apparently, the President was not getting value for money in that sector by his insistence. However, what we found in this facility is a far cry for value for money, especially since it was constructed at a cost of US$8 million. What we found: The floor is already cracked and peeled and stained by dirt because of poor construction work and the inferior quality of materials used for the finishing surface. A little gust of wind passed by that building and zinc sheets, from the roof, were blown off. More shocking, are the episode similar to that which took place in the so-called state-of-the-art  $2.2 billion Linden Hospital Complex where the nauseating stench emanating from overflowing sewage had both patients and outpatients running out of the hospital to escape the noxious fumes. This new facility had many episodes of overflowing sinks, toilets and washrooms on the upper floor of this spanking new building. That is not to say that the plumbing problem at the Linden Hospital Complex has been solved, for only recently the X-ray room was non-operational for three days owing to this sewage backup. 
At this new inpatient facility, the ceiling is swollen with moisture and can fall and injure someone as what has happened, in December 24th of last year, at the Linden Hospital Complex. This, somehow, seems to be the work acceptable by this Government. For it was the Attorney General himself who said, and I quote: “Inefficiency is not an offence.” Or probably this was the demonstration of what the Hon. Dr. Bheri Ramsaran described as efficient and effective use of real estate and taxpayers’ money. Whatever it might be, this new institution can never be value for poor Guyanese taxpayers’ money. Some of the patients’ wards in the facility have no ventilation, except for the single door of both entrance and exit. There are no windows. While some of the wards have ceiling fans, those windowless wards have none. The wards on the western wing, with windows, have no blind and one can only imagine what happens to patients during the afternoon’s sun. Of course, there are wards maids to clean, but they have to share their mops and, besides that, they were told that they have to wait on this budget so that they could get enough cleansing solution - inadequate proportion to do their cleaning.
The promise of new and modern equipment by the Chief Executive Officer on the commissioning of this facility remains still a promise. Just to cite an example, the bio-microscope that is so necessary in ophthalmology is old and not working. In last year’s budget, $60 million was allocated to this institution for the purchase of medical equipment and this year another $50 million is allocated. We hope that this time around we would be able to get a new one.
When this facility was declared open the public was informed that there are elevators to take patients to and from the different wards on trolleys and wheelchairs. The elevators are still working, but there is a dire shortage of wheelchairs, stretchers, trolleys and attendants for patients who need them to move around.
I work at this Georgetown Public Hospital, and I have been there for almost a quarter of a century, and it is a fact that I am aware that the Hon. Minister was enquiring about my contract. I say this, because the things that I am saying are factual. I do not say this because of any political expediency. I do not say these things which have nothing to do with me getting votes or me wanting to be the Minister of Health. This is about getting value for hard earned dollars, as the President has repeated with such frequency.  Besides, that is what I am here for. I am here to point to the Government, to advise it, remind it, to criticise it when it is not doing what it is supposed to do. I must tell it of its shortcomings when I see its failures, its poor implementation and its less than effective policies.
No stone must be left unturned to prevent the ever so often screaming headlines in the daily press, critical of the health system, as has happened only recently: GPHC denies that 3-hour delay caused baby’s death. What does it say? “A mother claimed that her baby died in child birth because she had to wait for more than three hours for a caesarean section, even as the baby’s hand dangled from her vagina.” This is the kind of headlines that we are getting about the Georgetown Public Hospital Corporation (GPHC).
The Accident and Emergency Department is described as a place of accidents but no emergency on the part of the staff. There was a mother who waited for six hours with her five-year old little girl, dressed in school uniform, who had her finger squeezed by the door at school. She got to the hospital at 11 in the morning and at five 0’clock, we still found her there still waiting to be tended to. This is the centre that the Minister of Health refers to as the “centre of excellence”.
Medical services may be free at the Georgetown Public Hospital Corporation, but they do not have to be substandard. There is so much need to correct these inefficiencies and the Administration should take into consideration the various recommendations made and the shortcomings pointed out and make changes necessary to optimise patient care.
Take, for instance, the situation of the Gynaecology and Obstetrics Department of the GPHC. This is a very important Department because it deals directly with maternal and child mortality. Besides, the Georgetown Public Hospital Corporation is the main referral centre of the country.
At the opening of the inpatient facility, the Chief Executive Officer (CEO) loudly declared that the problem of bed-sharing has been eliminated. Not at all, for this still remains the trend of the day in the Gynaecology and Obstetrics Department, that is, mothers with their new born babies sharing one bed.
There is need for an operating theatre for emergencies and minor cases in this Department. This will certainly reduce the level of both morbidity and mortality, with the necessary anaesthesia support along with the reduction of waiting time for treatment and bed occupancy time.
It is recommended that the hospital should reintroduce, in this Department, the use of forceps and vacuum, along with acquisition of the necessary equipment such as cardiotocogram, cardiac monitors, defibrillators, amino hooks, pregnancy wheels, and dopplers.
Once again, we will be looking forward to seeing how that $50 million allocated to the purchasing of medical equipment for this hospital will be spent. We are holding the Government accountable for finding the money that is necessary for the above and we refuse to accept the excuse that there is no money, as was pointed out by Guyanese rights activist, Joy Marcus, who said, “There is money. It is a question of what you make a priority for spending.” This situation, as was mentioned before, exists not only at the Linden Hospital Complex with respect to the ultrasound machine which never functioned, but also up to very recently at the Suddie Hospital. I think it took the intervention of the Minister himself to correct that situation, only recently.
A Partnership for National Unity (APNU) and other Guyanese are worried when news continues as in only last weekend when we heard of a 17-year-old mother who died in labour while being transported from the Linden Hospital Complex. We call on the Government to do all that is necessary to prevent maternal mortality and for that rate never to go back to what it was in 2010. These tragic and preventable deaths are the culmination of human rights violation against women and girls. Let us not forget that failure to provide available, accessible, acceptable and quality health care, especially emergency obstetric care for women during pregnancy and childbirth is a violation of women’s right to life, health, equality and non-discrimination. It is heart breaking when the hopes and dreams of expectant patients are dashed to pieces, when the mother – and possibly the child - dies during delivery when it could have been prevented. Any preventable death is one too many.
It is of some concern to note that the much publicised waste disposal system of the GPHC is not functioning properly, if at all. High airfares during the last Christmas season was blamed for the delay of this US$1.2 million plus World Bank Funded Hydroclave waste disposal system. According to the CEO, the facility was ready for operation, but GPHC made a decision to postpone the consultant’s inspection to avoid purchasing tickets during the holiday season, owing to the high cost during that period. One reads in the newspapers of the modern disposal system to be completed since April 2010. Later, it was expected to commence on 1st November, 2011 of the following year, but it was postponed to mid-January of the following year and then again by the end of February this year. The Attorney General said, “Inefficiency is not an offence – cannot sanction.” We wait for the denial or some form of explanation for what was said in the print media last Sunday. The article states that there is a price difference of US$400,000 between the cost for the two pieces of equipment (Hydroclave and truck) and a quotation from the Canadian supplier which included charges for training. So far, we heard no response. This begs the question of if these inefficiencies that were pointed out will disappear, automatically, from the health system when the much talked about multi-million dollar specialist hospital is built. We are talking about $672.5 million. There are so many other questions about this hospital.
In the 2011 Budget, an initial sum of $150 million was provided for works that included a design of the hospital, land preparation, bridges, et cetera. Then an additional $29.1 million was sought as provision for mobilisation payment on infrastructural works. This is tax payers’ money and so we need to know and must be satisfied with how it is spent or is being spent. There is the opinion that the money allocated for preparation works for this hospital has been improperly and imprudently spent.  In other words, to use the words of the past President, “We want value for our money.” For this reason, on 16th February, 2012, when Parliament was asked to approve that expenditure and no reasonable explanation was given of how this sum was spent, we, APNU, voted against it and will do so again if needs be. This is not to say that APNU will not support plans and projects that are in the national interest. APNU will support any plan and projects that will benefit all Guyanese, irrespective of their race, religion or creed or irrespective of the country which is funding such plans and projects. APNU’s action of voting against that expenditure is due to the lack of accountability and transparency on the part of the Government.
This whole Specialty Hospital, to some extent, like so many other projects that we are hearing about these days, is shrouded in clouds. Could not the details of this project be brought to the open public in the local newspaper rather than leaving it online? Not making the details public gives rise to a series of questions in the print media. Were it not for these open questions in the media, it might not have been now clearly revealed by the Minister, himself, that Guyanese medical personnel and other support staff will be working at this facility and that they will benefit from on-the-job training and formal training. Of course, one would have expected the same from the National Ophthalmology Hospital in Port Mourant that is run by the Cubans. There should have been, by now, Guyanese general practitioners working along with the Cuban ophthalmologists to receive on-the-job training as is being done at present at the Georgetown Public Hospital Ophthalmology Department. I seize this opportunity to remind the Hon. Minister of his Budget Speech last year when he promised three post graduate scholarships in Ophthalmology. The Government Medical Officers (GMOs) in that department are anxiously awaiting that scholarship.
It was interesting to note what was brought to light by the Minister, himself, in an effort to justify the accusation of someone being racist because the person asked questions about the hospital. He said that Cuban doctors were brought by this Government and, to quote the Minister, “cannot speak one word of English” and no one protested. I can assure you that the Hon. Minister was wrong on that note. Yes, people are complaining when the physicians who have to impart medical treatment to them cannot speak English. This is being done right now at the Linden Hospital Complex.
We are grateful for foreign doctors to come to Guyana to work and help the Guyanese people, but one of the conditions for them to work in Guyana, which is according to The Medical Practitioners Act 6 (1) (b), the Medical Practitioner must be able to communicate satisfactorily in English. In other words, this law was being observed in the breach. The Hon. Minister has a moral obligation to bring such cases to the attention of the Medical Council for appropriate action rather than publicising it in the press. Some, in the Guyanese society, including the doctors from the Georgetown Public Hospital Corporation, of the highest level, have expressed the view that probably the upgrading of the existing public hospitals to provide specialist service could be the better way out, at least for now.
It is a known fact that private health care is a lucrative business and already the private sector has its tentacles tightly around Guyana’s pharmaceutical industry which is a multi-million dollar market. The Guyanese public needs to know if this Speciality Hospital is going to provide free specialist services to local Guyanese, such as the pensioners with their $600 increase, who cannot even pay the so called “affordable costs”. At present, the Government only assists with 25% of the costs of a Computerized Axial Tomography (CAT) Scan and poor Guyanese patients have to pay, at times, as much as $50 000 to get a scan, and in case of radiotherapy, 50% of the cost. Would this hospital be operating under similar conditions? What seems to be the likely scenario is that this hospital, which will be built by the Guyanese Government with Guyanese money, is going to provide a market for private health care providers with a heavy subsidy from the Guyana Government. 
We are indeed happy to hear of the plans to expand and enhance the ambulatory services of the Georgetown Public Hospital Corporation and when we saw photographs of three ambulances in the daily press, only recently, one could not help thinking that the GPHC had just acquired three new ones, which it so badly needed - since in 2009, in my budget presentation, I asked for that. Last year there was $6.7 million allocated, specifically, for the purchasing of an ambulance for the GPHC. The CEO was right here saying, through the Minister, that this ambulance will be furnished. Not so at all. It is the same, old three ambulances that were there at the hospital all the time, furnished only with one stretcher. One of the ambulances is not working at the moment. The other is for internal hospital use. In reality, the Georgetown Public Hospital Corporation has only one ambulance. And if two patients need to be transported, then one of them has to lie on the floor of the ambulance. This particular ambulance crashed three times already. We are now waiting to see if the $11 million allocated this year to the GPHC for the purchasing of vehicles will be used to purchase the much needed ambulance. APNU, like all other concerned Guyanese, wants to see an end to situations like, “Ailing man dies at Parika while waiting for ambulance for two hours”. There were three other patients with him, coming from Bartica.  Even if this were not an accurate account of what took place, it is only a matter of time for something like that to happen. This incident only took place a week ago.
At the moment, all that is done is an ambulance is sent to pick up some injured body or sick person from wherever. As much as there is the need to train personnel in Emergency Medical Care who can accompany the ambulances, there is a dire need for more new and equipped ambulances.
In 2010, $280 million was expended on training and, in 2011, it was $345 million. Yet we are below that ratio of health caregivers to patients which is required, even by Third World standards. We hope that the now the over $450 million that is earmarked in this Budget for Health Sciences Education and training is sufficient to take the human recourse capacity to where it is supposed to be, especially in the services provided by the nurses.
Let me point out that from 2007 to now, that is over the last five years, the largest number of nurses per 10,000 population was in 2007 – five years ago. The figures for all the years later were less. Only a few nights ago in the Georgetown Public Hospital Corporation in the Female Surgical Ward, there were two nurse assistants working with 56 patients. This institution is the country’s main referral centre and has a vacancy for 50 midwives in the maternity section alone. In the Intensive Care Unit (ICU), of a nursing staff of 35, there are only 28. Of these, 25 staff-nurses are needed, but there are only 16. In the High Dependency Unit (HDU), of the total 18 nurses required, there are only 10. We now hear from the Hon. Minister that the health sector is preparing for its greatest influx of nurses, with just under a 1,000 nurses in training, with the talk again of getting value for every dollar spent. Sorry to say that the Nurses Association of Guyana has a different and sad story to tell. The Minister boasted that the 1,000 nurses in training are of the highest quality, but what is the Nurses Association saying? “We are creating weapons of destructions. No need to go to Iraq. We have them here in our health centres in Guyana.” As such, the Guyana Nurses Association is calling for a temporary halt to the nursing programme until the necessary issues are properly addressed. But they are being totally ignored by the Authorities. The Hon. Minister intends to start a new batch of nurses soon, in spite of being informed by the Association of the adverse conditions that exist at the moment.
In 2009, for instance, a total of 255 professional student nurses were taken in, plus nursing assistants. For all these students, there are a total of 11 tutors, 4 of them retired for many years now, and, as such, are very advanced in age. According to the President of the Association, there are classes with as much as over 250 nurses. The student ratio, at its highest, should be one tutor to 25 students in the class room, one tutor to 12 students in the clinical setting and one tutor to eight students in the critical area. Many times there are no instructors for the students while they are on the wards and the clinical training is such an integral part of the nurses’ formation that it is mandatory. Most of the time there are more students than patients. Quite unlike the Hon. Minister, the Association is of the opinion that it is not producing nurses of the necessary quality since the facilities and environment are not appropriate and conducive to the production of properly formed nurses. It is convinced that the quality of nurses in Guyana was at a higher level in years gone by and it would really like to bring it back to where it once was, before it is too late. The Association added that one of the contributing factors to this state of affairs is the fact that many non-nursing persons in authority are making decisions for nurses without an iota of knowledge of what nursing is all about. It was pointed out that the Nurses Association has no part to play in the selection process of students, which is done entirely at the level of the Ministry of Health. The tutors do not know who are coming and how many are coming. The Association suggests that a selection board should be established for this purpose where an interview can be conducted with the applicants before the selection is made. It has reported situations where persons sent to the school cannot even write a proper sentence; some display signs and symptoms of drug addictions and drug abuses, even leaving traces of drugs in the class room; students displaying outburst of abusive and, at times, psychiatric behaviour; lack of interest in the course; indiscipline is at its highest; unwillingness to adhere to the school rules; punctuality; dress code; students sporting tattoos from the neck to the ankles; absenteeism; pregnancy and hence maternity leave; and abuse of sick leave. This is what the Association has to undergo all the time.
What is of much concern is that the Georgetown School of Nursing no longer has any authority to discipline any student; rather, this is done at the level of the Ministry of Health. So it is not at all surprising that there is an 80.5% failure rate at the Georgetown School of Nursing. We hope that the $25 million air marked for the rehabilitation of the School of Nursing will bring some relief to the overcrowding and poor ventilation at that institution. The few toilets are inadequate to meet the needs of the school population. This is compounded by a faulty and outdated sewage system and whenever it rains the sewage backflows which results in an unpleasant situation created by the accompanying stench. It is hoped that the staffing problem can also be addressed, as well as that the money owed to the trainers of the Patient Care Assistants for last year could be made available to them.
The Nurses Association is convinced that the Ministry seems to be only interested in the quantity of nurses being trained rather than the quality, hence the slow pace being exhibited to have continuing medical education for nurses to become mandatory. In Guyana, unlike other countries, nurses, assistant nurses and midwives are not mandated to present credits for their re-registration; they only have to pay a few dollars every two years.
The Nurses and Midwives Ordinance legislation is dated sometime in the 1950s. It is time that the Hon. Minister of Health stops talking the talk and brings a draft Bill to the National Assembly to correct this situation. Of course, passing legislation is not all, for we see daily what happens in this beloved country of ours with respect to abortions. Women are still losing their lives even though the Government has legalised abortions more than a decade ago. When this happen, persons look for all the different, wrong reasons to deceive, to shift blame and to hide the true causes, including the use of lack of education on the part of the victim, as was attempted only recently. That was to explain why an 18-year old teenage mother of two died in December last, after she had an abortion performed on her, illegally, by an uncertified physician in an unlicensed clinic. The fact is that none of the public hospitals here in Guyana offers pregnancy termination services. None of the public health facilities does abortions. This PPP/C Government is failing the Guyanese women folks once again. The Guyanese mother who needs an abortion must have $10,000 to $30,000 so that she can seek private medical assistance to end her pregnancy. Those who do not have that amount buy non-prescription drugs and prescription pills, at times, drink various concoctions: the famous “bush tea”, throw themselves down: we know of the “slip and fell”, and use more drastic measures such as pushing knitting needles or umbrella bone wire inside themselves. Some succeed and survive, sometimes with serious injuries; others do not, and pay with their lives. These women do not die because they do not know that abortions are legal in Guyana now; they die because affordable abortion services are not offered at any public medical facilities. Just a few doctors are authorised to do abortions in Guyana, none from Georgetown Public Hospital. The CEO says if such a service is provide by that hospital, it will open a flood gate that he is not prepared to cope with. Today, mothers in Guyana with unwanted pregnancies are not much better off than they were decades ago. Terminating an unwanted pregnancy is every woman’s right in Guyana and the Government needs to move immediately to provide the necessary service. It is not enough to put the law on the books. If a woman who needs an abortion cannot afford or cannot access proper medical care in the public domain and is forced to go to unlicensed, incompetent, bottom house clinic, this problem will remain.
In his budget speech of 2010, the Hon. Dr. Ramsarran claimed – and I remember this carefully - that this Administration has put, over the past few years, eye care on the front burner, quietly. I made no comment then. However, the exact words were repeated in his budget presentation in 2011, with his loud praises for the National Ophthalmology Hospital at Port Mourant. I am expecting that he might make such a similar comment again in his presentation this year. For that reason, I want to offer a comment. I am indeed happy for all the patients who presented themselves and benefited from the services provided by the Ophthalmology Hospital at Port Mourant. I am sorry for those who got there but could not benefit from it because of lack of consumables and broken equipment. And I am happy for those who were there and were sent back to the Georgetown Public Hospital and had their problems solved.
The Hon. Dr. Ramsammy, on 21st November, 2011, said that in the 1960s Guyana was recognised in the Caribbean as having the best healthcare facilities available. He said so; I do not know. When I came back to this country to work at the Georgetown Public Hospital as an Ophthalmologist, what I found there in that department would support what the Hon. Minister did say. The Ophthalmology Department was a complete unit with clinic, wards, operating theatre and pharmacy. There were two wards, male and female, separated from each other, complete with nurse’s station, treatment room, stock room and rest room with bed for the nurses. There were 40 male beds and 20 female beds. There was also a large lecture room. Both wards had a designated Eye-Trained Ward Sister in charge with eye-trained staff nurse always on duty.
The Eye Theatre had two operating suites, anaesthetic machines and change rooms for doctors. Similarly the Eye Clinic had a triage room, waiting area, two doctors consulting rooms, a pharmacy outlet and a room for minor operations. What is there now at the Georgetown Public Hospital for the eye department since it was placed on the front burner? There is only one operating suite with old, rusted and badly damaged instruments. In spite of the constant appeal for replacement, we are unsuccessful.    [Mr. Neendkumar: Is that what you are using?]    We are using it. Sixty million dollars last year and $50 million this year were allocated to the GPHC for purchasing medical equipment. We are hoping that, at least, we can get some.
The wet-field cautery machine is broken for more than a year. The Hon. Dr. Ramsammy stood in this honourable House and said, “We are doing phacoemulsification cataract extraction in the Georgetown Public Hospital.” That is something of the past. That machine was broken and cannot be repaired. Consumables like balance salt solution; the intraocular solution Miochol necessary for cataract operation cannot find favour with the authorities to get them to purchase it. Adequate types and amounts of sutures are not available, even suitable needles for retrobulbar injections are not available, and the anaesthetic solution that is there is not of the correct strength. Is this bringing eye care on the front burner quietly? Probably this is the reason why patients are gathered from downtown Georgetown and taken to Port Mourant to have their cataracts operated by an outreach programme by the Hon. Minister.
Let us further analyse the situation of the eye wards, if there is any. There is a room for two beds with no windows and one door that is supposed to be the Female Ward in the new inpatient facility of the Georgetown Hospital. Likewise, there are four male beds which, at times, will have to be share with females. There is no nurses’ station for the eye nurses, no dressing area and no storage area. The eye trained nurses are moved to other areas while nurses who have no eye training are made to tend to eye patients. Is this bringing eye care on the front burner? Maybe this is why the Minister is saying he is doing it quietly. Probably this is why some of us will never go to the Guyana Public Hospital for any form of treatment regardless of how minor it might be. We see you in private hospitals. Probably it is because we fear that something might happen to us quietly.   
Of the $14 billion allocated to the Health Sector, $400 million went to immunisation in 2011. In 2009, the PCV 9 and PCV 13 vaccines were introduced and in 2010 the rotavirus vaccine was introduced. The Hon. Dr. Ramsammy did say, “We will introduce the Human papillomavirus (HPV) vaccine with the aim of arresting potential impact on women contracting cervical cancer and other STDs, first to girls and then to boys. This vaccine was launched on 11th January at the East La Penitence Health Centre.
There are serious issues with regards to this vaccine and the vaccination campaign. Some are of the opinion that this vaccine, which is very expensive, is unnecessary and can be dangerous to life and are openly opposed to the use of it in Guyana. They say that the Ministry of Health is better advised to promote preventative measures that take into account nutrition, social and economic conditions and lifestyle. There has been picketing exercises and petitions to the Ministry of Health to halt the campaign. As a matter of fact, it was no other than Dr. Barnett of the Pan American Health Organization (PAHO) who said that most Human papillomaviruses are benign and will go away without treatment. According to the Journal of American Medical Association, in the USA where the prevalence of HPV infection is significantly higher than in Guyana, only 3.4% of all these viruses result in cancer. Since this campaign is by far the most ambitious and costly campaign the Ministry of Health has ever embarked on, according to the Hon. Minister, one begs the question: if the so many other pressing public health issues such as mental illness, alcohol and drug abuse, child abuse, maternal mortality, diabetes and domestic violence, abuse of women, would these not make better choices for investment and action?  
Others are concerned that there is no proof of a casual relationship between the HPV and cervical cancer. The campaign continues despite the protest. And what is the Hon. Minister calling the group of concerned women, sisters and wives? “Naysayers, political fringe groups masquerading as at NGOs” And he is challenging them to come to him with their facts and qualifications.  Dr. Janice Woolford form the Ministry of Health said that the programme is voluntary and started since 2001. There was information sharing and discussions with parents and guardians of the targeted schools. But the question is asked, and we can ask ourselves, what kind of information has been provided? Has prior and informed consent been sought?
When and where were public discussions held? This Women Group is asking the Hon. Minister to meet with them on national television so that pertinent questions can be answered about the adverse effect of this vaccine that may not manifest itself until years later. Many are of the opinion after diligent research that the dangers of this vaccine by far outweigh the pros. They are saying that concerns are not limited to the actual introduction of the vaccine, but rather the manner in which the Ministry is handling it. Parents must be allowed to make an individual informed consent, a choice to accept or reject the vaccine rather than being subjected to an imposed decision. Answer the question.
I personally ask around the Georgetown Public Hospital who of the doctors and nurses knows of the HPV vaccine? Hardly any did know. Where was this information disseminated? Lack of proper medical education about this vaccine could cause persons to believe that this vaccine protects them from other STDs and they will not protect themselves or take the necessary safeguards.
The entire worlds and Guyana in particular has become very sensitive to many issues that no longer will be taken for granted. Gone are the days when persons would quietly and obediently line up for a vaccine without questioning those in authority about the pros and cons of these vaccines granted that not all medical information published online have been completely validated.
We read of large numbers of persons falling ill. Only last month in New York 12 girls fell ill after the vaccination, suffering from Chronic Fatigue Syndrome.
This vaccine was introduced to eleven-year olds girls at the school in La Penitence, a community that was described by the Hon. Minister in his budget speech two years ago as being the poorer level of the economic scale, he said, “living in home overcrowded with children”. Was that why the Hon. Minister invited all the little girls who took the shot to an appreciation lunch for the show of bravery? When this is added to the fact that we here this vaccine is approved by the United States Food and Drug Administration (US FDA) and is supported by the Pan American health Organisation/World Health Organisation (PAHO/WHO) and of the Medicine Healthcare Regulatory Agency and about all the adverse effects we cannot but help remembering that Tuskegee Syphilis Study. For those who do not know what it was, it was an infamous clinical study in Tuskegee by the US Public Health Service on the natural progression of untreated syphilis in poor black men who were made to believe they were receiving free medical help. It was as sensitive as that. It has become so sensitive. You have to be careful!
We insist, and I am saying this to you, that sufficient information must be made available to the Guyanese public by the Ministry so that we can weigh the risks and benefits associated with the vaccine. That is what we are saying.
It is sufficient that this information must be made available to the Guyanese public by the Ministry. This must be done, even if it means taking up the offer made by Dr. Chowdhury, the Dean of the Green Heart Medical Facility here in Georgetown who has offered to help the Ministry in educating the nation about this vaccine. Thank you very much Mr. Speaker. [Applause]

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Designation: Minister of Social Cohesion
Profession: Ophthalmologist and Physician
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