Down the Back Stretch

One Last Week Ahead

I use the horse racing analogy not because of any fierce speed on my part; it is the time that is racing...  "Do not go gentle onto that good plane..."   or so said the non-guitar playing Dylan.   I am running as fast as I can to complete all I set out to do, but I fear I'll have a "DNF" posted.   This is probably how I feel every year. (And if I listened to what I tell my students, I'd go back and read my old blogs to see.)   Almost none of the uncompleted stuffs are related to needing more money. I realized a long time ago that I would never ever be able to give enough even with my small focus of the nursing school and St. Ann's -- things like the outdoor playground for the girls at St. Ann's.  The new basketball backboard is up and the girls really enjoy it and we have balls... However, it is really hard to change routine.  When I was at St. Ann's Thursday afternoon, it took over 30 minutes to find the key for the locked playground.   The girls had not used it since we left on Sunday. It is not that the sisters and matrons don't want them to play; it is not thought about, as it hasn't been done before .....  changing behaviours is slow work .....   I really would hate to see it sit locked for months .....  Dennis and I will be back to St. Ann's a few more times and keep kicking the can, but even if I stayed till Christmas some stuff would still not be changed .....  The good news is that if I get back next year, I will know where to start as the same problems may still be there!

Mental Health and Psychiatry

Last week the Graduate Academic Committee of the Graduate School of University Guyana approved the offering of the degree Master in Medicine, Psychiatry.    This was the last big hurdle before there will be an official Psychiatry Residency Programme in Guyana.   There is a more formal committee for the university but they almost always accept the working committee's recommendations.   A few of my colleagues deserve the credit for pushing this through - Drs. Bhiro Harry and Jorge Balseiro who did  all the research and document preparation for several long months.   It also had the support of the Dean of Health Science, Dr. Emanuel Cummings, and the Dean of the Medical School, Dr. Madan Rambaran, all of whose experience with University Committees were essential.   I had the privilege of attending the meeting as a "Visiting Expert"... I really think I was there to just add some colour.

Guyana is still number one in the world by population for suicides ..... and as you know if you read the papers online or even my blog, the events that scream the need for better mental health in the Guyanese community are the daily occurrences of spousal abuse, violence, etc.  There is now a concrete though long term approach to treating the most difficult mental illnesses.    Four general practice doctors will begin the three-year programme in the new year.    It is uncanny how one positive development can have the power to dispel the darkness.

This is probably from Confucius.   However, is also
the saying of a group from Maryknoll that I joined in 1964.  (Dennis as well.)

As much as I love psychiatrists and think they do wonderful things, I know that the new programme is only a tiny part of improving the mental health needs of the country and the delivery of services to the sufferers from mental illness.    There are other initiatives both by government and private groups, including faith groups.

Last Sunday, I was invited by the Youth Group of Holy Rosary to talk about suicide prevention and mental health.   Mental health needs are being brought to the forefront of public discussion over the last two years.    I am optimistic there are much better times coming in these areas.

More Mental Health

The new Minister of Public Health, Dr. George Norton, liked the idea of a National Mental Health Institute -- a separate place that would be the focal point for all Mental Health Services in Guyana, much like the Caribbean Heart Institute.  Recently, they have purchased two buildings near the hospital that will house the psychiatry outpatients, provide teaching classrooms for the residents' and medical students' rotations in psychiatry, a community reference library and meeting rooms, and the main office for the Mental Health Unit of the Ministry of Public Health.

Setting for the National Mental Health Institute (in progress)
on Quamina Street.

Leslyn Holder,
the new National Mental Health Coordinator.

We have a new National Mental Health Coordinator, Leslyn Holder, who is getting organized and presenting the first ever budget for Mental Health.  A costing accountant has detailed the costs of implementing the National Mental Health Action Plan 2015-2020.

Lots more good stuff is happening, including the third trip to Guyana of the Canadian Mental Health Team whom you an find on FB at:  Transforming Guyana's Mental Health System. Old timers Peter Kuhnert and Ram Kalap will be joined by first timers Lance Morgan and Shrenik Parekh.  They are here to finalize goals for the next 3 to 5 years.

Peter last year

Ram and John last year

Your Tablets and their Stories

The generosity of those who have little amazes me again and again.   When I was getting organized to come down, I had asked Elsie Asabere, the Director of the Nursing School if she could identify all the new first year students who had a device that could access the internet.   She wrote me back that there were only ten who did not have a tablet, laptop or phone; so I bought 20 tablets with donated funds.

However, when I got here there were 15 who did not have anything and a few more whose units were not really very good.   So I said that as I had planned to give five as photography contest winners to girls at St Ann's, could they decide among themselves which 15 students would get a tablet?  I was willing to just have two photo prizes if they needed more than the 15.   When I returned there were only 15 in total who needed a tablet ..... because, they told me,  the girls at St Ann's needed them more.  More?  I was amazed at their cooperation and generosity towards others.  

Well, I have run out of time to do the photo contest ..... so I decided to see which first year students really needed a tablet right now.  I knew two second year students had had their tablets from last year give up the ghost and they had no money to get another tablet ..... but the first year were my priority, so I asked who really needed a tablet.  (Some had little phones that could access the net, but I couldn't read them even with my glasses.  So I said that I had four extra ones now (I knew someone who really needed one in second year) and we would draw lots for who got them.      The next day I brought in some blank sheets to do the draw... And the class had decided that there were only really three students who needed the tablets and I could use the other for someone who needed it more.  More?

Another first year student came to tell me that a quiet student needed the last one... So I said, Fine send her in.   She arrived at my room and told me she had a phone but the charger was broken and was waiting for some family to come at Christmas to bring her a new charger ..... and in the meantime, she would use a batchmate's on class days.    She did not need it.   And she did know of one second year student who needed it more.  More?

I do not want them to sound like Mother Theresa - or else I couldn't yell at them when they gave a stupid answer (yes, I know there are no stupid questions, but there are some incredible answers) -- imagine yelling at Mother Theresa!   However, they are gracious, kind and generous... amazingly generous.   Next year, I will get everyone a good tablet - with your help of course...  I might even roll the donations to my beer fund into it as well.   I do know what more is...

The National Flower is Becoming Endangered

The government has banned the sale and use of styrofoam at the start of 2016.  The white food boxes have littered the landscape from ocean and canals to trees.   An amazing move!  And as usual, I have been ahead of my time:  I have been having my meals here in plastic reusable containers since Maria Kidner and Jane Greiling made me, back in 2003 (and as Kristin did many years ago in Dundas). Actually, they shamed me into it and -- and then they never came back to check .....   And today I have the same ones ..... though they have gotten stained over the years so the kitchen staff always ask me, "Have you cleaned these recently?"

Dennis is getting ready to leave the day before me, but not before packing his parachute and one more pink umbrella drink at Frenzy's Bar on a Saturday Morning...   He tells me that those umbrellas are nothing to laugh at as they are big chick magnets ..... Anyhow, the "chicks" get their laugh for the day....  All kidding aside, I will miss him.

Dennis will write next week's blog and I will probably finish up the following week.. Thanks for sharing our adventure - John, Dennis and Emilee.