The Week After and The Week Before

Departures and Arrivals

Emilee Flynn has left and is back hard at work and Dennis LeBlanc is in the air going the wrong way from Boston to get here, but he said it was quicker.    So this week has lacked a little panache... Good but average... and for most of the week I forgot that I had my camera in my pocket... Must be my age or my biorhythms are off.   Anyhow, a colleague in Nova Scotia wrote me: "I guess the scary part is that neither Julie nor I found this last two weeks boring at all, even though this letter is about as mundane and ordinary as you can imagine. So either I am not much of a writer, or we are just getting more and more ordinary."   And I remembered a quote from Malcolm Muggeridge [1998:p 112] wrote, with much wisdom, that "the true wonder of life is indeed its ordinariness."   Sounds okay to me for a week, but I hope next week will be unordinary... at least a little.

Saying farewell and
Maggie looks happy?

Dennis will be joining me for the third time, so he is an old pro... And he has set out an ambitious agenda for the three weeks he is here.  I hope that I can keep up with him; I should, as he is older than I am.

 World Mental Health Day  

As you may remember, Guyana is Number One in the world in the number of suicides per 100,000; the WHO suggests that it is 44 per year.  The average in neighbouring countries is about 7 and in the world about 11.   So the Guyana numbers are really worrisome.   And to their credit the previous government and the present government have been trying to address the problem directly.    Today, the Ministry of Public Health hosted an awareness information session at the National Public Library (I may be wrong I think it is the only public library in Guyana. Yes or No?).

My friend Bhiro 

William Adu-Krow, Leslyn Holder,
Mosa Hudson, Morris Edwards

In typical Guyana fashion the 9:00 sharp start time became somewhere after 9:30 and the introductory greetings ran long, so the workshops were somewhat shortened.  However, this year's event was better attended than last.  I was talking about "Helping people who have suffered a loss by suicide".  I was actually quite busy with questions about almost everything in the Mental Health field other than the topic.    Actually, a medical student was there and we had a great conversation about coping with the special griefs surrounding a suicide.   She is a bright, young, engaging doctor and will be waiting for the Master in Psychiatry programme to get going at University Guyana, so she can begin her residency training.  And did I mention she thinks I am smart?  

The usual cast of characters filled out the speakers and presenters.   Bhiro Harry, Jorge Balseiro, Indhira Harry, Maria a Cuban psychiatrist, several psychologists, including Mosa Hutson who has been working now for over a year in Mental Health.   There were representatives from the Ministry of Public Health and William Adu-Krow, the head of PAHO in Guyana, and the Acting Chief Medical Officer Morris Edwards.    There is a National Coordinator of Mental Health, Leslyn Holder - a first for Guyana.  She is Guyanese and trained as an RN in England; she has returned to give something back to Guyana.   Her position is a vital step in the organization and growth of Mental Health Services.   I am starting to get tempted to believe that mental health services will improve and improve quickly .....  Mind you,  I have been wrong about married priests and just about everything else I have prophesied .....  But (just like the lottery ticket I just bought):  this one I have a good feeling about!

Leslyn Holder addressing the "Crowd".

Miss World Guyana was there with her entourage. She has
been dedicating her year to talk about youth suicide prevention. 

If you have read the following on FB you can stop.

Lunch with Kavita and Dolly

As I wrote on FB: I was honoured today by some old friends: Kavita Karran Sookhoo and her  husband Naresh, and Dolly (her mom) and the wonderful grandchild Kadesh. They celebrated a meal after church and it was the first time that they had a sit down meal since Kavita's father Kampta died several years ago. Dolly had made a special snapper meal; it was delicious.

I had to think for a while about what to get Kadesh to annoy his parents. A cricket bat, wicket and ball - just the answer as Kadesh started playing right away in the house. 

And as it is all over the world, especially since Robert Frost wrote a poem about it, there was  disagreement about where the fence should go.  It wasn't settled when I left...  It is somewhat comforting to know people are the same all over the world.

Have a good week, readers.  John

"Light Dawns in a Weary World"

This post is written by Peter Kuhnert, a Lutheran pastor and medical doctor and Guyanese colleague.    He was a leader with both the 2013 exploratory mission and the 2014 Mental Health Team which worked in Guyana for ten days in October-November.  [They have a wonderful FaceBook page, "Transforming Guyana's Mental Health System".  Peter's message serves as an excellent reflection on giving flesh to the incarnating Christian Christmas message.   

Peter bends low to listen to a girl at St. Ann's 

********************************************

Three years ago, shortly after my first ever visit to Guyana, I was contacted by John.  He asked me if I thought we might do any kind of work together in Guyana.  I told John, emphatically, that I did not think there was any opportunity to do any work in Guyana.  There was no will, no energy, no finances, and no manpower.  There was no Spirit.  I suggested perhaps we talk again in one year.

Two years ago, a dimly burning wick began to splutter to life.  Perhaps a opportunity did exist for some partnership work to strengthen and support existing mental health services in Guyana.  John was now living locally in Ayr.  I had started working at Freeport Hospital.  We had met a couple of local psychiatrists who wanted to explore international mental health care in a culturally and religiously diverse context.  Perhaps this opportunity might bridge the partnership and development work of the ELCiC with that of mental health services, for the betterment of life for the whole people of Guyana.  Perhaps.  Certainly, there was enough enthusiasm to plan a needs assessment visit and begin some relationship development.

One year ago, October 2013, Ram and Brenna and Sujay and I joined John in Guyana for a week of site visits and meetings and discernment. We were graciously received by Dr. Bhiro Harry (Georgetown) and Dr. Mayda ( New Amsterdam), and by the minister of health, Dr. Ramsarran. We saw much and heard much and clearly saw the need for a sustained mental health initiative to support good people and hard work already being done with absolutely minimal resources.  Few in-patient beds.  Few trained staff.  No budgets.  Limited medications with only variable availability.   The needs seemed overwhelming. Yet the Spirit began to blow.  The candle burned brighter.  We knew we would come back.

The past year has been a year of planning and preparation.  An excellent slide show about our 2013 trip, courtesy of Sujay and Brenna, began to peak interest in this initiative amongst the local mental health staff at Grand River hospital, Homewood health centre, and the Kitchener Downtown CHC. Who would have expected that when we called a planning meeting, in March,  for those interested in a self-funded mental health trip to Guyana in October 2014, over 40 people would attend!  And over 20 would commit to this 10 day project!

The Canadian Mental Health Team at the Farewell reception
hosted by the Minister of Health

The project itself was a huge success.  19 individuals divided into two teams, working in both Georgetown and New Amsterdam.  The number of initiatives for  this 10 day trip was astounding. The re-introduction of life-saving ECT technology to the New Amsterdam hospital.  Clinical visits to community hospitals in Linden and Suddie ( including an awesome speedboat ride across the Essequibo river).   Opportunities to teach physicians and nursing staff at both Georgetown and New Amsterdam.  Community education initiatives about mental health during each of our community tours.  Relationship building opportunities with the ministry of health, the University of Guyana medical school, and the schools of nursing in both Georgetown and New Amsterdam.

Dr Bhiro Harry continued with his
on the ground leadership for our team.

Dr. Bheri Ramsaran, the Minister of Health provided
excellent direction and support for our team.

Perhaps most impressive, has been the high level work that John has participated in, to help create a national mental health strategy for Guyana.  This is coupled with an ambitious strategy for the creation of a bilateral university partnership to bring bring post-graduate psychiatric training to Guyana.  This would be a first step to creating a national human resources strategy for mental health that might eventually include nurses, social workers, occupational therapists, and chaplains.  The wheels of future possibility have already begun to turn.

Chaplain Ram Kalap was a leader
on both the 2013 and 2014 teams.

Sujay Patel and Peter celebrate the fulfilment
of all their hard work over the last two years.

What a difference a couple of years has made!  Initially, there was no hope.  There was no kairotic time- no time for illumination and transformation.  But slowly, ever so slowly,  light has dawned.  A dimly burning wick has begun to burn brightly.  Hope is being reborn and a spirit of possibility  is beginning to take hold. What began with the question of one, " What can we do in  Guyana?" has been echoed by the voices of 19 others and the possibility of systemic change is becoming real.  Systemic change for the betterment of care for the whole

people of Guyana.

What is more Christmas?

...than bringing Joy to children.

Thanks, John, for risking asking the initial  question.  Thanks, John, for nurturing hope in your own unique manner.  You have helped open our eyes to the possible.  You have inspired us.  We are grateful.

John amazing the Cuban Psychiatrists
 with his command of Spanish.

Thanks for being a blessing. Looking forward to being your partner into the future.

Peter Kuhnert MD MDiv 

***********************************************

Thanks, Peter.  I am humbled by your kind words.

PS: I have a few more themes for this blog, but I have returned from Guyana to develop my usual cough and cold. I am feeling better today.  I especially want to post the pictures and stories from the "2nd  Annual Father John's Photo Contest.'

Have a Blessed Christmas and let you light shine...

A Few Goodbyes ... But Not Mine Yet.

Class Visit to the National Psychiatric Hospital

Sometimes (I was going to say "almost always", but I am a teacher and would feel too threatened)
the best teachers are not the ones called teachers.   This is true on the visit to the people who are patients at the hospital.

  Psychiatrist Sujay Patel and Family Doc/professional entertainer Upe Mehan met us at the hospital and provided a rich commentary and insight about who these people are and their behaviours.  Again your best teacher about the experience may not be the professional teacher - rather, a learner:

The Class and Nurse Trin.  she has worked at the NPH for 20 years
and still continues to learn something from her patients

Visit to the Psych Hospital (Berbice - 2014) by Natalie Persaud- Singh

 The tour was indeed interesting. I was shocked, for this is my first experience with mental patients. I see this facility as somewhere that gives patients a chance to better themselves with the help of the health team available there. However I think the hospital need renovation, proper facility to house these patients and more nurses onboard. As it’s said, for a patient to get better they must feel comfortable in their environment. This is just a suggestion from what I've seen. The surrounding needs cleaning. The odor of the hospital was obnoxious. 

Something needs to be done about this.

This is not the present  hospital; it is the old Berbice Asylum.
I just like my photograph .....
and it reminds me of Thoreau's 'vivacious lilacs'.

I've had the chance to speak with some of the patients and I must say I was heartbroken by some of their stories. Some of their family took them there and didn't even look back to them. They are human beings, no matter what sickness they have physically, mentally, emotionally, etc.  Everyone needs love. Someone to talk to, someone to be there just to listen, all of which can brighten their day.

I feel the need for there to be more educational programs readily available to them. One patient told me she wants a book to read (story book) or a book to write. Writing helps one to express their emotions. So if they don’t feel comfortable discussing their problems with a nurse they can at least write about how they feel.  If more emphasis can be place in bettering the facility I see this hospital as successful, not that they are not but they would be able to offer much more to these patients.

Rev, I hope this is good enough!!   Thanks for having us share this experience with you!!

Yup, more than good enough... She and other students had some brilliant reflections...  I was impressed and mad at the same time, because I have had to read some of their other research and exams! L Oh well, as Martin Luther said, "Simultaneous Smart and Stoopid"..... or something close.   The Canadian Mental Health Team had a major focus: "To reduce the stigma surrounding mental illness.." and after the visit to the Berbice Mad House my students know ..... People are People, including doctors. [See karaoke pictures.]

Another Focus: ECT

If you read last week's blog [and who hasn't, eh?], you heard the horror story of the ECT Team... Well, I am happy to report that despite several more minor heebie-jeebies, like finding the machine packed up and ready to ship back to Canada with the Team .....  they were able to train more than enough Guyanese professionals, and under the leadership of Dr. Maida, Psychiatrist at the National Psychiatric, Guyana will have re-activated a forgotten service.   I am sure when Peter Kuhnert writes his guest blog [hint]  he will tell you all about it.  I want to just show you a picture of one man who had a ECT treatment earlier that same day.  When I asked him how he was feeling, he said he was "Never better...  I might even be happy."

All Work and no Play Makes...

If you can believe it, the Team said they were too tired to go out to dinner, just wanted to have a quiet beer and something to eat at the Sleep-Inn.  So Sylvia and I went over to join them.  Dennis had to prepare his class for the following day (talk about "no play"!).   However, once they got down to the bar and the karaoke started - a second wind, I guess.

The Highlight of the Night!  The guys were singing American Pie and I wasn't lip-synching.
It was supposed to be Macho Man, but got censored by the politically correct Guyanese.

We are the Champions...Yes, you are!

The "Women" trying their best
to imitate the guys.

And a Bollywood  melody
from the surprising Zahir.      



The "Originals" celebrate a successful Mission.

And then there was the Final Final dinner hosted by the Minister of Health.  It too was at the Sleep-Inn and earlier than  planned as the Team was out that night at 2AM... Lots of congratulatory words for all involved.

Minister Bheri Ramsaran expresses his gratitude
to the whole Canadian Mental Health Team 

Peter and Sujay express their thanks to
Chief Psychiatrist Bhiro Harry.

The Parting Shot

Dennis is Off and Home Safely

And speaking of 2 am, Dennis, my university friend, left on Friday night for his home in Greenfield, Massachusetts via Trinidad, Toronto and Boston!   Just a mere 21 hours door to door...  He too is going to write a guest blog (Subtle Reminder) so I won't steal his words, but he did say that he has never met a more knowledgeable, competent, humble, etc., person than me.  Thanks Dennis.   

It is strange and wonderful for me to have someone other than family who has known me for 50 years ..... and to find, as the saying goes, "You get together with a friend after years of absence and you continue chatting as if you saw each other yesterday.

Elsie presented Dennis with one of her famous
African shirts to wear when he gets chased
out of Greenfield for wearing it.

Dennis is here explaining Sex and Relationships
to the students. If you can't see the immediate
connection, read his blog, coming "Just now."

 Enough - More or Less

 I had my last Boys, Bodies, Beliefs and Boundaries Class at St. Ann's.  They were sad it was over and even sadder when I gave them an evaluation sheet -- which they told me they wanted to fill in during the week and not in class as I had planned ..... So much for the evaluation. However, the judging of the 2nd Annual Father John's Photography Contest is this Thursday AND if I don't get their evaluations before the contest, they cannot win a prize!  Oh, the benefits of a bribe!  I have learned some things in Guyana.  Not fair!! they screamed ..... and they were right ..... and it is my contest, eh?

I have arranged for the four Mercy Volunteers to come and judge the pictures in the five categories: Girls Playing, Girls Working or Studying, Action Shots, Happy Face and Unusual or Abstract.   I had way over 2,000 pictures that the girls had taken since September... I want to get it down to 10 finalists in each category, but had to settle for 15!   There will be five Ipod Shuffle MP3 Players, one for each of the category winners.   They were donated by the Sunday School kids at Church at Stony Hill, Medina, Ohio...

John being presented with the Shuffles

Pastor Shannon making an important homiletic intervention

There will be a surprise of two Grand Prizes ..... One of them will be a special one donated by Jerry Bacchus of Jerries' All Nite Restaurant.

Well, I have finished a whole pot of coffee and a big roll of cookies for breakfast as the cafeteria is closed on Sundays.  I can't wait to get home and have my healthier breakfasts of a whole frozen Pizza or a Hungry Man Dinner.... or my Sunday Morning Special Onion and Cheese Omelette at Bucky's of Ayr with the old guys.

So make sure if you are in Georgetown, Guyana, or Ayr, Ontario --- visit our sponsors ..... and maybe I'll get a free meal!

Thanks for reading... John

Same as Before and Just as Hot

This Week's Star at Mercy

Mark Joseph Harry Low

 

Mark is a true Mercy Hospital person as he was born at the hospital some forty years ago, when (I think) Sister Sheila Walsh was the CEO here, and his family lived just around the corner on Duke St. He did move to the East Coast for a while, as he had to live with his grandparent in Annandale and went to Buxton Community High School.    His grandfather and father were Hindu Pandits, but he didn't follow in their footsteps.  However, as he said his grandfather said, "The Lord is One."

He started his Mercy Career as a Maintenance volunteer for 6 months and then in 2006 began is present position as  a Ward Attendant.   His job takes him all over the hospital - delivering oxygen or a patient or waste.   This allows him to serve as a greeter to staff and visitors alike.  I would think it was unusual if you came to Mercy and he was working that you didn't see him and get a friendly hello.

He says the best part about working at Mercy is his job description ..... a little of everything and everywhere.   "So Mark, you like your job?" "No Rev, I love it."   He has little routine and is constantly learning new things.  In fact, he has been going back to school for several years trying to upgrade his education and is now in the pre-CXC programme at a local Adult Education School four nights a week.   As he says, "I am slow academically, but that doesn't stop me."

When asked about what would he tell my vast readership about Guyana, he sounded just like a travel brochure outlining all the interesting sites here, the Amazon Jungle, Kaieteur.  I think he named something interesting in all ten regions.

Asked about his piece of wisdom for my readers: "If you want something, then go after it. You just can't sit down.   It is not easy.  You need to believe in yourself.  You need to have the mind to do it and with prayer."

So in 2014 what will you be doing, Mark?   "So many plans.  And with God's grace I'll pass Maths and English CXC's.  I would love to be a Nurse Aid"  And of course at Mercy Hospital!

I Should Listen to Myself

Whenever I evaluate what I am doing here, I am content to say my goals are small: I come and work really hard for 12 weeks with my 20 or so students.   I do this because it is way too frustrating to do anything larger societally.  Clear focus; no problem .....


I don't know what happens to me.  It started innocently enough in July. My friend, Bhiro Harry asked, "John, would you help us edit Guyana's new Mental Health Action Plan?"  Sure; sounds easy; how much trouble and stress could an editor get into?


When I finally got a copy of the detailed Action Plan, I think there were almost an many blank pages  "To Be Completed", as there were pages with content.  And then it went downhill...  Bhiro would rather see 20 psychotic patients off their meds than read one paragraph; and the other collaborator, Jorge, is a Cuban psychiatrist whose English, while much better than my Spanish, does make me look like a grammarian.   I had asked for some financial data and other statistics and Guyana's "just now's"... permeated the correspondence.   A week or so before I left Canada, I rewrote the places where we needed actual data, using realism.



So in place of "the budget for 2015 will be so many dollars", I wrote, "The actual budget contribution of the government will be determined after the legislative passage of specific lines of action."  

Anyhow, there was the  roll-out of the plan on Friday (while the actual plan is still being printed);   there were the press and tv ..... a set of powerpoint slides, a few discreet questions -- and it was mercifully over.

Dr Bhiro Harry sharing the overview of the "Shaping Guyana
Mental Health Through 2020.
[R] Minister of Health Bheri Ramsaran
providing strong support
for the  New Plan

 

Before that we -- the unholy trinity of Bhiro, Jorge and me -- were invited to talk about the Mental Health Plan at the UN Headquarters.  I was going there to just look cute and give some moral support. Well, the head of the staff there got up to introduce us and proudly announced that it was her great pleasure to have us talk about Balancing our Work and Home Lives.   I started to slouch down in my chair .....  It reminded me of once presenting to a nurses' group in Toronto on "Developing Organ Donor Protocols" and as I was sitting to be introduced, someone handed me the programme where it was clearly displayed that I would be talking about the "Spiritual Needs of the Elderly".  And there was no place to run .....  So:  "The spiritual needs of the elderly in their distilled form parallel the development of donor organ transplant procedures ....."



I am so full of BS!  I had no trouble addressing their topics, but first I had to point out the obvious:  "Here you have three professionals volunteering on a late Friday afternoon to do this session.  I really think you should distrust anything we may say about balancing your lives."  In the end, I had fun; and they want us back for an advanced session.   I suggested they schedule it for December, as I leave in late November .....



And then today at 6:00am there was to be another march for Suicide Awareness -- and Breast Cancer?  The march was to end at the Fair site, the plaza of the Revolution with the famous Cuffy statue of 1783.   There at     9 am, I was to man a booth that dealt with "Counseling Adolescents" -- another surprise.



When I got here maybe forty police officers were there listening to Bhiro.    And as I was dropping my backpack, I hear, "Now Rev John will share his thoughts on mental illness and policing."   (I swear I am not making this stuff up.)   So I talked about resisting the urge to settle a mental illness standoff with violence.   They needed to be in touch with their fears and prejudices about the mentally ill, and very few ever resort to violence against others, and a few other gems .....

Dr Tony, a new Cuban, psychologist got put to work
early with the police attendees.
[R] I started with "Counseling Adolescents"
and then scratched out Adolescents... and finally ended
up with my last sign, so Bhiro came over! 

And in the spirit of "I bet you can't eat just one".   I will be helping another person Tabitha Mallampati conduct a full review of the Nursing School at Mercy -- right after I design it.   Sylvia invited me as consultant to the Family Life Commission of the RC Diocese here in Guyana... and I somehow left there with my used-to-be friend Sylvia, saying that I would lead a small workshop for all the leaders of the local GT congregational groups on desensitizing the stigma of Mental Illness.

It is a good thing Dennis LeBlanc is coming, I think he is an expert in that area!   He might not be too willing after he sees all the changes that have been happening to his new bedroom.  Below is this morning's picture.-

Sylvia and I did move the table.  Now there is an  avant guard
open concept bedroom complete with invisible furniture. 

Old Friends and A Swim

It has not been all work.  I have invited several old friends out for a meal and a few beers to catch up on their lives.  

 David Yahn was the Chairman of the Board at St Joseph Mercy Hospital.   And in our usual tradition we solved the world's and our own problems over a few beers.    David's family have a long history here in the life of Guyana and some great stories.  His dad grew up right around the corner from Forbes Burnham, a former President of Guyana.






Then, I caught up with Raymond Jagessar.  Ray is a Chemistry Professor at University Guyana who specializes in the medicinal qualities of many Amazon Jungle plants.  He did his Ph.D in the States but came back to help out his country.  AND he is a Lutheran from Skeldon and that is how I first got to know him.   We met at our usual hangout outside the university and he had a couple of Maltas - and I had -hmmm - what was it - oh yes, a few beers.    Raymond is still single, so any eligible women out there, write me and I'll give you his contact information.



I still have to catch up with a few more old friends like the Scarboro Sisters  Donna and Bev. Also, and my fault,  I didn't remember to take a picture of Shawn Rampersaud when we went out.  Shawn was a previous Treasurer here at Mercy for many years.   In many ways, he is still supporting Mercy as he works with Demerara Tobacco Company.   

Swim at the Grand Coastal
This is really about an old friend too, but Ian MacKay wasn't here this time. He is back in Canada recovering from a total hip replacement.  Tony Carr and I first met him here many years ago as he has been the consultant for the renovation of the hotel.  So I ride on his coattails and go for a swim and a few beers and dinner without getting a room.    This Eid holiday, Sylvia and I spent a very cool afternoon poolside.  Thanks, Ian.

Thanks for reading this week and to all my Canadian friends and family -- and all those Americans who wish they were Canadian:

                  HAPPY THANKSGIVING!