I Should be Looking at the Finish Line, But....

One Week Left

I know my trip is a little shorter than my usual and it seems to have been busier than usual.  Yes, the self-inflicted travels to Mabaruma and Lethem were way too enjoyable and informative to regret except from the workaholic side of my personality ..... and my retired self is trying hard not to have that side re-emerge.   This week my easy-going-contented side seems to have lost the battle.

The Final Exams for the First Class of Graduating Psychiatry Residents   
Usually everything happens slowly - really slowly - in Guyana; the Master's Degree in Psychiatry is really an exception.  It was a dream in 2015... and now it is a reality.

Drs. Elizabeth, Veneta and Stefon

Three doctors, Elizabeth Nickram, Veneta Gangaram and Stefon Henry have written their final exams... and with more than two-thirds of the marks in they have been exceptionally successful.. I wish my marks had been as good in graduate school!  There is only one section [the dreaded 200 Multiple Choice Questions] left to be graded.   I have had the privilege to be the "External Faculty Member" for these exams.   Yes, I have had to grade the Oral Exams and the Answers to the Short Questions part, and my main official duties were to take the sealed envelope from the University of Guyana Invigilator and open it and hand it back.  I accomplished this academic feat without incident three times.   I didn't have to suffer through the hours of sitting there watching the residents write.

During the oral exams each resident had to assess a person whom they had not seen before.   I found their interviews to be organized, strategic and competent.  And as it is my custom not to do anything by the book, I asked each person being assessed how they would grade their resident.   Really, the person who came for help is a most important evaluator and they all responded positively with quite specific comments.   Then, Drs. Bhiro Harry (Chief Psychiatrist, Guyana) and Odalys Mirabal Benitez (Cuban Psychiatrist assigned to the Psychiatry programme for several years now) and I questioned each resident and then proceeded to grade each one.

At exam time, we had to take a taxi to the other side of the
hospital  because the flood-water was way over our shoes.  It did
take their minds off  the exam.

The Short Answers section had 10 questions, one submitted by each person who had taught them over the years. The same group, with the additions of Drs. Pedro Pons Brovet, a Senior Neurologist and Geriatrician, and Zenia Lopez Mompel, another Cuban Psychiatrist who had worked in the Guyana clinic for many years, met for a couple of hours to grade the exams individually and then establish a consensus mark.  I don't know why I was surprised, but I was the easiest marker ..... at least with the questions that I understood.     I enjoyed a stimulating academic debate.

We still have to wait for the results from the last section, but no matter:  I am proud to have been a part of history.  And besides from the local staff there have been other volunteers who have spent many hours visiting and on line, sharing their wisdom.   These include (and if I have forgotten someone, please excuse me):

• The pioneer Dr. Tony Carr, a British-trained Internist and Psychiatrist, who has been involved since 2007 and is responsible for me being involved in Psychiatry.   Without his enthusiasm and commitment I doubt this degree would have been possible.   The Residents still bow their heads when his name is mentioned.

Sujay, Brenna, Peter and Ram

• Dr. Peter Kuhnert, a Family Medicine Doctor and Lutheran Pastor,  who called me almost a decade ago because he thought I was a Psychiatrist and even after he found out I wasn't, has still stayed involved.   It was his vision and energy that brought the first exploratory team to Guyana to explore how a small group of volunteers (Dr. Sujay Patel, Psychiatrist; Ms. Brenna Christian, Teacher; and, Rev. Ram Kalap, Chaplain) came to Guyana in 2013 ......  And from that small visit, this group has gone on to create an impressive legacy.   A Canadian NGO "Mental Health Without  Borders" is functioning strongly to support Mental Health issues in Guyana  and elsewhere. For example they have contributed funds that make it possible for my nursing students to travel to the National Psychiatric Hospital.

Sujay and Shrenik with the 2018 MHWB Team

• They are also in the final stages of formalizing their academic relationship with the Master's Programme through the International Health Science Educational Institute at Georgetown Public Hospital with a Memorandum of Understanding.  This is an enormous undertaking for a volunteer group; They will need  your prayers and financial support.

• This initial group, under the leadership  of Dr. Kuhnert, has brought yearly teams of professionals to teach and work in Mental Health and the Residency in Psychiatry.   Peter has also been the driving inspiration behind the Guyana NGO, Institute for the Development of Psychiatric and Mental Health Resources in Guyana.  They have raised enough funds to bring the three senior residents to the Grand River Hospital in Kitchener, Ontario for a one month's Medical Observership - amazing.

• Dr. Shrenik Parekh, Child Psychiatry Residency, including several trips with MHWB and Peter's teams.  He has been the online educator, taking over from Dr. Carr.   As well, he has been responsible for arranging and scoring the 200 multiple choice questions for their final exam.  

Sorry: My pictures of Shrenik must have been transferred 

to my external drive in Ayr, so you 

will just have to imagine a really cool South Asian male.

I know he is in the group one above, but he deserved his own.

I knew I was going to forget someone important:  Dr Erv Janssen.  He is a Child Psychiatrist from Oklahoma who had been coming here for more than a decade before I first came.   He organized his church, Fellowship Lutheran Church, to take Mission seriously.  He brought down health teams, music teams and construction teams yearly.  He has left his imprint on the  success of the Master's programme...

And I can't even find my old black and white picture of Erv

so I'll include a picture of his wife, who is ..... like ..... way cuter.

Sometimes when you are always there...

Last but never least, my friend and colleague, Dr. Bhiro Harry.  He is definitely the Father of Psychiatry in Guyana.  (He should be the Grandfather of Psychiatry but his children aren't obliging him.)   For many years , he was the only Psychiatrist working with the public in Guyana.

There is almost no one in Georgetown who has not heard of Bhiro.  It is usual if we go out for a beer that one or two people just want to chat with him and thank him - or ask for some money!  (To be clear it is not seldom that we go out for a beer .....)

In my life there have been a few people who have been just like me, even though we are seemingly nothing alike in personality or background.  Bhiro is a pastoral shrink and I may be a secular pastor ..... so in a way we are similar.

Bhiro has supported every effort to strengthen psychiatry and all the Canadians who have come to assist.  You can count on him and therefore, may not notice his contribution.   I can say without a doubt that without his welcoming support of all of us, there would have been no changes to Psychiatric services in Guyana.

Thanks, brother!

And thanks to you for reading so far .....
More to come .....
I have more to write about after I am back home.
John
 

Four Down - Two to Go...

Time is flying by... and once again I am reminded of my own fallibilities of body and mind.  It is a good thing the problem is familiar; I seem to have done it every year.  " I am going to do ....." this that and the other thing.   As usual, I will get less than half done...  including not writing a Pulitzer Prize- winning blog... You will have to settle for "good enough".

Visit to Lethem

For the second weekend in a row, I was given the privilege of flying (this time  to Lethem on the Brazilian Border) as an impostor psychiatrist. You can go by minivan on a potholed dirt road,  overnight for 18 hours; I declined that experience.

This time it was Dr. Stefon Henry who did all the work, while  I played tourist. Actually, he is a hometown boy from there who made good.   I mean that everyone knew him.

I started with the commercial district ... a mistake, as it is a strip mall of Chinese Discount Stores who seemed to sell the same "junk" to a never ending line of Brazilians who were looking for bargains.  Henry made up for that over the next two days.   

 

After he finished his clinic he was the radio guest at the local station (Radio Lethe 95.1).   He was the bonafide expert on how to increase your mental health.  I was sitting inside with them during the broadcast... He talked about 10 things people can do to help their mental health.    I was impressed with his ease of conversation, and so were other people who stopped us later, saying they had heard him.

Brazil Here I Come.

"Wait! I have to go back and get my passport."

"No you won't need one... Have a beer!"

(I was wondering what the inside of a Brazilian prison looked like.)

Our car approached the Guyana Immigration stop .... and the man just looked at us and waved us on.  I thought of similar times when I was with my Customs Officer brother at the border between Vermont and Quebec, and people would just honk and he'd wave ..... they were going for gas or bingo.

Now we approached the Brazilian border stop ..... and there were rifles.  I knew this was an official stop as our driver put the open beer between his legs.   The officer looked at us and knew Troy and Stefon, so waved us on.

We were going for wine and liquor and beer... and some household goods for Stefon's large family.  We did the same thing on Sunday morning because they realized the three gallons of wine was not enough!  And a few beers for the road .....

Churrascaria Everywhere

I remember when there was only one in Georgetown... In Lethem they are everywhere and certainly the most popular... Clearly not the place for vegetarians.   However, I loved it.   Here it is served on a pre-made skewer:  Churrasco but it sounds like Shohas.

KUMU Falls

I love waterfalls, so Stefon arranged that we go ....   I imagined that we would just get a taxi, drive up to the Falls and go for a swim.  Not exactly!   We had to get a minibus because we made several stops all over Lethem to pick up some of Stefon's brothers and sisters and nephews and nieces...  and then we headed out...

We were on the Rupununi Plains... red dirt roads with lots of pot holes. They also have an amazing way to repair roads.  They simply create new ones to the left or to the right of the bad one.   So sometimes there are three or four alternate roads .....

Water in the old road?   Just start one on the right .....

We arrived and the gate was locked ..... No problem for the locals:  we would go around the back way... However, the back way had a road and bridge that was muddy, wet and a little weakish looking.    We could go back, but in John Wayne's famous words, "Men never retreat."  Instead, we should have chosen "Discretion is the better part of valour."  We got stuck in the mud .....  No problem ..... Out came the ropes and the beer.

We did finally get the van onto the bridge; then it occurred to us, with the wisdom that only beer can bring.  "We will need to leave."   And if it rains we will never leave.  Right now I was thinking that the Brazilian prison was looking good.   Again no problem.  The driver would just get a running start off the bridge and get back up the hill .....  and sure enough, soon the bus was safe on high ground.















Now to the waterfall.   I remember asking more than once "Are we there yet?"  This really doesn't look like a trail."   As the kids bounced over rocks and streams, I actually needed someone's hand to steady myself ..... A true sign I am old!  I should be embarrassed to write this but alas, it is true.

Of course, you can't go anywhere without cold beer.

 //

And yes, Caroline, Izzy and Sydney this is just before the current
took me ass-over-teakettle downstream ..... muttering
"My mind is younger than my body."

Stefon playing King of the Falls.  My mind is not that young!

Once Again

I have rambled on and not gotten to other more important reasons for me being in Guyana ..... students in nursing and psychiatry.  I'll have to save them for another blog ..... I must finish this with a tribute to

Stefon's Family

Over the three days I was in Lethem, Stefon's brothers and sisters and parents welcomed me into their homes and lives; they drove us around when Stefon forgot to book a ride,  and they constantly made do ..... when one brother's car was available but could not get to Brazil and back, we changed cars to get us there ....  I will no doubt forget their names, but never their kindness to me.

 

 

I would like to write more but I have lots still to do today, including reading for Problem Based Learning -- oh, and a lunch and a dinner.   Life is good.

Here is a link to more pictures from Lethem.... for the truly dedicated!  Just pics, no commentary .....  If you have a question, I'll respond.

wonderful and random Lethem pictures



Thanks for reading.

Abbreviated Blog

This is Amerindian Month
So in honor of this wonderful heritage and the fact that I was tired out by the travelling...  an exciting video.   The dancer are acting out all the steps they  need to go through to change Bitter Cassava which is poisonous into the main food staple of the Indigenous People of Guyana.

https://youtu.be/xRnusVIupog

If either guilt or energy or a combination of both, I will get a "real" blog out later this week.

Thanks,
John