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Shortage in nurses, lack in respiratory therapy specialty

By Ashley Skinner

In Guyana, specialties in almost every other area of the medical field can be found in the hospitals, except respiratory therapy.

The lack in the specialty stems from two major areas: a nursing shortage and the absence of the curriculum at the university level, according to Sheik Amir, the director of medical and professional services at Georgetown Public Hospital Complex.

During a training day at Georgetown Public Hospital, Sharon Armstead speaks to a group of nursing assistant students about the importance of respiratory care.

“Getting respiratory care to Guyana rests on the arms of the Ministry of Public Health,” Amir said. “It has to start at the university level.”

The University of Guyana is responsible for introducing students to the curriculum specialties. Once the students go to nursing school, they are taught basic respiratory care techniques.

However, the experience the students receive in the hospitals is mostly the traditional duties of a nurse like taking blood, checking temperatures, cleaning up the patients and all about the body, according to nurse Natasha Cameron at the Linden Hospital Complex.

“Since we don’t have the specialty, we do check the ventilators and listen to the patient’s lungs,” Cameron said. “But we weren’t really taught to do much else. In school, I learned the respiratory tract and what causes lung diseases, but the rest I am still learning as we get new patients who need different treatments.”

Through a series of collaborations with universities around the world, the most prominent including the U.S., Canada and China, the country has been introduced to and adapted many specialties like neurology, radiology and mental health.

Yet, while a Canadian university is collaborating with some hospitals in the country, few have specific respiratory care units. Linden Hospital Complex is an exception.

“We recently got a spirometry unit to help diagnose asthma,” Gerald Thompson said, general practitioner and spirometry unit assistant. “We really need respiratory therapy in the country though, especially this mining town because bauxite produces a lot of contaminating things.”

Bauxite is a sedimentary rock that is used in making aluminum, as it has iron oxide in it. While the rock itself is not toxic the red mud that is created when the bauxite is being mined for is very harmful. The dust that is made from the dried red mud can cause chronic illnesses and asthma, a driving force in Linden.

After a press conference at Georgetown Public Hospital, Sharon Armstead exchanges contact information with Emanuel Cummings, the Dean of Health Science at the University of Guyana.

“Respiratory therapy is a specialty for a reason: because putting our job on nurses in its totality is overwhelming,” Sharon Armstead said, respiratory therapist and Professor at Texas State University. “You have to know causes for the illnesses in your area and everything there is to know about them and the machines that go with them. If a human cannot function without lungs, why would you let a hospital function without respiratory therapist?”

Armstead also said the country needs to look into curriculum for the specialty and installing spirometry units in all of the hospitals.

However, the nurse retention problem must be solved before the curriculum can be instated to the university.

“We don’t have shortage in people who want to be a nurse,” Amir said. “We have a shortage of nurses coming back to the country once they’ve left for training.”

Once nurses become certified, some are given the opportunity to do their training abroad. Many of the nurses do not come back to the developing country once they have been in a more developed one.

“It’s not unusual that they never come back,” Amir said. “The top neurosurgeons in Jamaica are Guyanese. There is not just a need for specialist in this country, there is a need for employees since some leave and never come back.”

Many of the doctors in the country are from other places around the world. Between Georgetown and Linden, 10 doctors are from China alone. Other major specialists include doctors and nurses from Cuba, Brazil, the U.S., Canada and Japan.

Elizabeth Gonsalves, deputy CEO of the Georgetown hospital, said she is aware there is room for improvement in the curriculum, nurse retention rate and the hospital overall.

“I want our hospital to be first-world-like,” Gonsalves said. “We are doing pretty good with what we have but I know we can do better once we get these issues solved. We definitely need to improve the education of our nurses because they don’t get all the attention they deserve.”

Cleopatra Barkoye, principal of the Georgetown School of Nursing, said in press release on the University of Guyana’s website that the system has failed the nurses who are in training. This statement is in regards to the 2016 Professional Nurses State Final Examinations, where the school has a 90 percent fail rate.

“We don’t have enough lecturers in the classroom, in none of the schools,” Barkoye said. “We don’t have enough materials. The curriculum specifies that you must have a clinical instructor, we don’t have any clinical instructors in Georgetown and New Amsterdam, what we have are clinical supervisors.”

The professional system requires one tutor for every 20 nursing students. In the Georgetown School of Nursing alone, there are 343 students, but only seven tutors.

“Due to the shortage of tutors across the three nursing schools – the Georgetown School of Nursing, the Charles Roza School of Nursing in Linden and the New Amsterdam School of Nursing – there is no room for specialization.”


Photos by Ashley Skinner/Global News Team


The adventures of storytelling in a different country

By Ashley Skinner

I was the editor-in-chief of my high school newspaper.

I wrote for my local, hometown paper for three years.

I won State in the news competition my senior year in high school.

I was a reporter and news editor of the Texas State newspaper, the University Star.

Through all that, the hardest thing I’ve had to do regarding journalism was travel to a different country and gather information to write stories weeks later.

At McKenzie High School in Linden, Guyana, we were able to talk with students of all ages. One student, Sharisee, asked me about my field of journalism, and told me she wanted to go into broadcast journalism. Talking with these kids made me realize how they make good out of unideal situations.

Journalists love new experiences and a change of scenery. Going to Guyana, I knew I would get a change of scenery, a new perspective on life and a new experience with storytelling.

However, weeks later, I did not know I would long to tell more of the Guyanese peoples’ stories.

While our team was in Guyana for 11 days, we spent our time listening. We didn’t go through the hospital each day looking for sources; we went through the hospital listening deeply to the community members of Georgetown and Linden, looking for a niche where we could fit to best tell their stories to our communities back in the states.

As we were leaving the high school, I saw a group of kids practicing basketball. Their coach was helping them learn how to work as a team and shoot the ball. I could help but reminisce on my days of playing basketball, wanting to go out there and teach these kids as much as I could.

The hardest part was listening to their voices, so full of passion and pride for their country, and being the person designated to transfer that same passion into a story for others to read.

Like I said, I’ve done this before in my high school community and in the Texas State/San Marcos community. But this, this was so different.

I was dealing with a completely different country that doesn’t really matter to people in the United States, honestly. People here are interested in what we as a team did, not necessarily the content in our stories.

Listening to the people of Guyana broke my heart in some ways. They have gone through so much, but they are strong. They endure life in such a different way than we do and have so many stories to tell about it.

All they needed was a bunch of kids from Texas to listen to them for a few days. In that time we managed to do everything a journalist should do:

We told people’s stories in a way that others can relate.

We showed people how others live; we made them see how good their lives are here in the U.S.

We gave people a reason to take action on things they feel passionate about.

We informed people.

We helped people.

We inspired people.

We are journalists.

The ways I’ve changed

When I left for my study abroad trip in January, I did not think that I was a journalist. I was afraid that my skills would not stack up against the other students that I was headed there with. I had never been off of my own continent and I was just afraid of being away from the safety and security of my own bubble.

When I left for my study abroad trip, I did not think that I would grow to care so much about the group of people that I was with. Strangers at the start of the year and, now, people that I hope to keep in touch with even after the semester has ended. We learned something from each other, and that is what has changed me.

Skyler, a journalism student, that faced her fears and left her comfort of home just as I did. She is brave and can survive any bug bite that she is faced with (at least with an EpiPen in tow). She showed me that I wasn’t alone in my fear and discomfort and that I would be okay, just like she was.

Alana, a fellow Public Relations major, showed me what it means to truly care about and have a passion for the field that you are going into. She is passionate about museums, latinx history, art and photography. From her, I learned to find something that I love and never stop chasing that.

Katie, the sassiest and most outspoken of the group, is so involved in reporting news and writing the best stories that she can. She taught me what it really means to be a journalist and helped me gain skills that I didn’t know I had–like interviewing, gathering sources and being confident in what you are writing about.

Ashley, the inspiring and resilient nineteen year old, really showed me that even if you have been in the trenches at points in your life, you can rise above and come out on top. We shared our stories of childhood and found many points that we could relate on. She is a strong woman who has set her mind to whatever she wants, and I know that she can achieve her dreams. I wish that I had been more like her when I started off as a student–determined, passionate and hard-working.

Last, but certainly not least, Holly Lynn Wise. The most inspiring woman that I have met in my college career. Holly pushed me and convinced me to go on the study abroad trip two days before the application was due. I learned how to use my writing skills, thanks to her, and for that I am very grateful. Journalism aside, I am now passionate about finding my place in the world and using my skills to add to it. Holly showed me what it means to be career-driven and to take your life and run with it. She is caring, kind, compassionate, and I am excited to watch how the next chapter of her life unfolds. I hope she knows how much she means to me and that I would not trade the experiences that I had because of her for anything.

I will not view my life in the same way I did before I left on my study abroad trip. I have determination and the drive to use my skills and have an effect on the world around me.

Featured photo by Alana Zamora/Global News Team

Curious, caring, compassionate: three characteristics of an aspiring respiratory therapy student

By Ashley Skinner

Death: a fact of life Texas State University senior respiratory therapy student Jacki Brewer is becoming familiar with as she takes on her career goals of becoming a respiratory therapist.

Brewer calculates the right dosage of medicine to give to a young patient in the emergency room at Georgetown Public Hospital. Too much medicine can cause complications, such as more difficulty breathing.                                                           Photo by Ashley Skinner/Global News Team.

“Of course I get scared and worried when things start to go wrong,” Brewer said. “You’re always going to worry about your patient, but the best way to put those bad thoughts aside is focusing on how to make the patient stable. You can’t worry about your feelings or yourself.”

When a patient’s family decides to take him or her off life support, a respiratory therapist is the one who disconnects the patient from the machines. For Brewer, this comes at a cost.

“Personally I step aside and get some fresh air,” Brewer said. “I’ll go pray and take a few deep breaths to clear my head. You can’t let it affect the rest of your day or you because you have other patients too. Your patients are your priorities; you can deal with yourself later.”

Brewer came to Texas State in 2014 from Carrollton, Texas. She chose Texas State because of the location between San Antonio and Austin, and because she felt like she immediately fit in on the campus.

Upon entering college, she did not know exactly what she wanted to do. However, once she realized there was a respiratory therapy program, her search for a major was over.

“In high school I was a home health aide and I took care of this really sweet, elderly lady,” Brewer said. “That experience paired with my asthma history is why I wanted to get into the field. I did my research once I heard about the profession at Texas State and I decided I wanted to be a part of that profession.”

Sharon Armstead, clinical assistant professor for respiratory therapy at Texas State, said Brewer is meant to be a respiratory therapist.

“She’s not scared to ask questions,” Armstead said. “She’s curious and shows initiative, and she isn’t afraid to take control of tough situations. That’s what a respiratory therapist needs to be.”

In January, Brewer went on a study abroad trip with Armstead to Guyana, South America, where she worked on patients with breathing issues in Georgetown Public

Brewer works alongside a doctor at Georgetown Public Hospital, attempting to stabilize a patient in the CICU.
Photo by Ashley Skinner/Global News Team

Hospital . Within 10 minutes of Brewer entering the cardiac intensive care unit (CICU), a patient began to show signs of being hypoxic: a condition in which the parts or regions of the body are deprived of adequate oxygen supply.

“I was really scared, this being my first time in their hospital with their equipment that I wasn’t familiar with,” Brewer said. “Once I got into it, I wasn’t scared and I think I handled it well. We got his stats back up and that’s all that matters.”

Armstead said at first she was worried about having Brewer in the CICU alone, but was impressed with how well she handled the patient with such urgency and care.

“She noticed the settings on the ventilator and that the patient was hypoxic immediately,” Armstead. “She bagged the patient. She suggested what changes should be made. She took control and she cares. That’s what I like about Jacki.”

Stephanie Kelley, senior respiratory therapy student at Texas State, went on the trip to Guyana and worked closely with Brewer while they were in the hospitals. Kelley also noticed how caring Brewer is with her patients.

“I don’t think anyone else is as observant as Jacki,” said Kelley. “She cares about her patients and people in general, and that’s one of her best characteristics.”

Listening to a person’s breathing before a treatment versus after, Brewer said, is a very rewarding feeling, as is being able to take a healthy person off of a ventilator.

“Their lungs go from sounding wet and crackly to sounding dry and clear and that’s proof of the work you’re doing,” Brewer said. “When someone is on a vent and is able to extubated, you get to take that tube out of their throat.  The first thing they say is ‘oh my goodness that feels so much better, thank you’ and hearing those words is the most rewarding part of my job.”

Above is a video of Brewer helping a doctor draw blood from a patient to test the level of gases in his blood.

This video is of Brewer aiding a nurse during a hospital-wide oxygen shut down. 

Videos by Ashley Skinner/Global News Team. 

Family as a Foundation: Bridges Global Medical Missions

By Lindsey Blisard

Dr. Claudette Heyliger-Thomas founded Bridges Global Medical Missions in 2008 with the sole purpose of giving back to the country that she is from–Guyana.

Her team of volunteer medical professionals ranges from nurses and social workers to doctors of different specialties, such as endocrinologists, gynecologists and cardiologists.

Food For the Poor, an organization in the United States that helps to provide donated items, meals, and healthcare to poor areas, has been one of her greatest supporters. They supported her in the beginning of her mission work and continue to support Bridges Global Medical Missions by donating shoes, clothing and toiletry items for her to distribute in the country.

When Heyliger-Thomas started Bridges, she knew in the beginning it would be challenging to help the entire country, so she decided to start near where her mother grew up – West Coast Berbice and Parika.

On her first medical mission in 2008 to Guyana, Heyliger-Thomas brought along with her a team consisting of her cousin (a cardiologist), her daughter (a surgical resident), her childhood friend (a pharmacist), and her husband’s cousin (a nurse).

“It was family. Family, family, family,” she said. “I talked with them… they jumped on board, and we did it.”

Heyliger-Thomas left Guyana when she was 18 to attend university in Montreal, knowing that when she left, she wanted to be a physician. After going to UMDNJ Robert Wood Johnson Medical School in New Jersey, she became a pediatrician and has been doing private practice in Atlanta, Georgia.

In addition to her medical outreach, Heyliger-Thomas has also started a Continuing Medical Education program in Guyana. Since 2009, she and her medical team give lectures at the hospitals that they rotate at, but in the beginning, they felt they were leaving much of the country out and that not enough people were getting chances for expanding their education.

In 2017, as a  collaboration with the University of Guyana, they put out ads in the newspaper to invite nurses, physicians, and allied health professionals to the Continuing Medical Education program. Diversity was important to her in order to get as many people to come to the conference as possible.

The number of people who showed up was something Heyliger-Thomas was not expecting.

“We catered for 100 people and 350 showed up,” she said. “I walked into the room and we were absolutely blown away.”

Sharon Armstead, a respiratory therapist, has been a part of the group since 2015. She is also from Guyana and, with Bridges, was able to return home for the first time since she was a child. She has gone with Bridges back to Guyana in order to help expand the respiratory therapy knowledge in the country.

Armstead said she appreciates Heyliger-Thomas because of the amount of passion she has for her profession and her country.

“She gets people from all over the world and all over the country to come and volunteer their time for free,” she said. “And they come because of Claudette.”

Heyliger-Thomas has several future projects she is working on.

Currently, she is trying to get a grant to help provide support for maternal health and prevent maternal death nationwide. She is also working with the University of Guyana to offer a respiratory therapy program within the school.  

Bridges has worked with the Ministry of Public Health to provide care in the country. During a press conference in January of 2018 at Georgetown Public Hospital, Volda Lawrence, the minister of public health, and Dr. Karen Cummings, the minister within the ministry, explained how important the work that Bridges is doing for the country.

“We do not offer a first-world health service, but I can assure you that we are working towards that,” Lawrence said. “And we will reach our goals.”

Since she is close to retiring from being a physician, Heyliger-Thomas will make Bridges Global Medical Missions her primary focus. She hopes to work toward providing care to many other countries. Originally, her organization was just called Bridges Medical Missions, but after starting her missions and realizing that she wanted to go to places other than Guyana she added Global to expand her mission.

“My focus is not only Guyana,” she said. “My focus is to go to other places in the world.”

Featured image by Nigel Durrant