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MOH emergency response to fire victims and their families

The Ministry of Health (MOH) became aware at about midnight Sunday, May 21 into Monday, May 22 morning that a catastrophic event was taking place in Mahdia (Pataro-Siparuni), Region Eight with a fire that had engulfed the whole Female Dormitory at the Mahdia Secondary School.

The Health Emergency Protocols were activated immediately. A team of doctors and other public health officials from both Georgetown Public Hospital Corporation (GPHC) and the Ministry of Health (MOH), headed by a Burns Specialist and Plastic Surgeon, Dr Shilindra Rajkumar, together with necessary medical supplies were assembled and departed the Eugene F. Correia International Airport at about 1.45 am, May 22. Earlier departure was impeded by inclement weather resulting in the team arriving at 2:50 am.

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By that time, the local health team, led by Regional Health Officer (RHO), Dr Johnaton Dudhnath at the Mahdia District Hospital had already been responding to the crisis and had already prepared three patients for a medivac to the GPHC, with one person’s condition listed as critical. They arrived at Ogle and were immediately transferred to GPHC at around 4.15 am. Subsequently, two other medivacs brought in six additional patients. By the afternoon of Monday, May 22 five of those patients were stabilised and admitted into the Intensive Care Unit (ICU). Another underwent surgery and was admitted into the Burns Care Unit (BCU) and three others were admitted into the Pediatric High Dependency Unit (PHDU).

On Tuesday, May 23, 10 more patients were medivac to the GPHC. Their condition was listed as stable. Only three of these ten children were still patients at the Mahdia District Hospital at the time of Medivac. The other seven were housed at the hospital because it was the most convenient accommodation at the time.

The MOH, out of an abundance of caution, decided to medivac the ten children for further general, medical and psychiatric examination at GPHC. Upon arrival in Georgetown, during the afternoon of Tuesday, May 23rd, the three children who were hospitalised at Mahdia Hospital were assessed and admitted into the PHDU, while the other seven were admitted for further observation and subsequently discharged into the care of the Ministry of Education, Ministry of Human and Social Services and Ministry of Amerindian Affairs.

UPDATE AS OF THURSDAY, MAY 25 AT 10:00 AM

Currently, there is no child from the dorm still admitted to the Mahdia District Hospital. Twelve girls, however, remained patients at the GPHC. There are three (out of twelve children) admitted to the ICU at GPHC, and nine in the PHDU. While two are still critical in the ICU, the others are listed as stable. Their conditions are improving and discharges for some are possible in the shortest possible time.

In addition, after arriving in Mahdia, the President requested that 11 children who had gone home without seeing a doctor be medically assessed. These children arrived in Georgetown at about 3.00 pm on Wednesday, May 24th. They are presently being assessed by the special team in the ER of GPHC assigned to see all the children from Mahdia.

Presently, there is an enhanced medical team present in Mahdia. The Ministry’s Director of Primary and Family Health Care, Dr Ertenisa Hamilton is on the ground coordinating the medical response in Mahdia and the Region 8 villages affected. She is being supported in the coordination by Mr Michael Gouveia, the Hinterland Health Coordinator from the Regional Health Services Department of the MOH. Dr Veronica Griffith, the Deputy Director of Regional Health Services is coordinating interventions from the Ministry of Health while Dr Vishwa Mahadeo, the Director General, is providing overall oversight of the medical response in Mahdia and the Region. Dr Mahadeo is ensuring that the enhanced medical team present since the early morning of May 22nd remain in place at Mahdia for follow-up in the next three months. At the end of the three months, a review will be conducted to ensure an enhanced capacity continues in Mahdia.

The GPHC Emergency Team and Specialist Departments, including the Emergency Room (ER), the ICU, the BCU, the PHDU, etc. are fully on alert, emergency and heightened mode. All the senior administrative and medical management teams, including Mr Robbie Rambarran, the Chief Executive Officer (ag), Dr David Samaroo, the Director of Medical and Professional Services (ag), Nr Leslyn Holder, Director of Nursing, Dr Zulfikar Bux, Director of Emergency Medical Services, and Dr Shilindra Rajkumar, Head of the Burns and Plastic Surgery Department, were fully mobilised and has been on the ground at GPHC on 24-hours alert.

The GPHC teams have assessed and treated twenty -nine (29) children and are presently still caring for nine (9) admitted children. Of the nine (9) hospitalised, two remain patients in the Intensive Care Unit (ICU).

The GPHC Teams will continue on the alert and emergency mode as long as the medical emergency persists. The GPHC is on standby for further inputs from its medical staff should the need arise for the team to be dispatched to Mahdia.

Of the twenty (20) discharged patients, there are currently in private accommodation in Georgetown while in Mahdia there are medical teams that are on call to visit.

From early Monday morning (May 22), mental health teams were assembled. Dr Triston Griffith, a Psychiatrist at the GPHC, headed the teams working with children, parents and others who arrived in Georgetown. Dr Hamilton coordinated the teams that were sent out to Mahdia to work. The dedicated teams have been working at GPHC with children and parents and at the facilities (hotels) where parents and children have been housed. Four teams have been active in Mahdia and Region 8 communities, working with children, families, teachers, and other staff.

Mental Health Response

Under the coordination of the Director of Non-Communicable Diseases, Dr Lachmie Lall, mental health teams were dispatched to Mahdia comprising one child psychiatrist, one child psychologist, three adult psychiatrists, two general psychologists, six social workers, mental health assistants, and two mental health trained family physicians. This team from day one prioritized all children that were in the dorms at the time of the fire, including parents, guardians and teachers. They were all evaluated and offered psychosocial support. On day two, the fourteen children who were hospitalized in Madhia and their parents were evaluated, including the parents of the children who died in the fire. Auxiliary staff in direct contact with the fire, and first responders, which were inclusive of teachers, police officers and other support staff were also assessed and given psychosocial support. Students who were not hospitalized but were in direct contact with the incident and students that were not in direct contact with the incident but were affected were also assessed and provided psychosocial support.

Thus far, in Mahdia and Region 8 villages, the Ministry’s Mental Health Teams have worked with 260 persons, including 126 children. The teams will continue to work in Mahdia and Region 8 villages continuously over the next three months. We will review the response at the end of three months and maintain a strong mental health team in the region permanently.

All the parents and children are under continuous support from the Mental Health Team including the psychiatrist, psychologist, counsellors and social workers.

Pathology Update

A pathology team led by Dr Nehaul Singh was part of the initial medical team that flew into Mahdia. The pathology team completed six post-mortems in Mahdia. Thirteen bodies which could not be positively identified were transported to Georgetown and stored at a private mortuary. The police services arranged for an RSS specialist pathologist to come into the country to assist with DNA identification. The Pathologist from Barbados arrived in the country by noon on Tuesday, May 23. He completed the post-mortem on the remaining bodies and DNA samples were collected.

The DNA samples were transported through a charter aircraft jointly organised by Mount Sinai and Hess Corporation. The samples arrived before midnight on Wednesday, May 24. We expect rapid results for identification purposes between 48 and 72 hours.

We are grateful for the significant support the Government of Guyana (GoG) and the Ministry of Health have received from international partners. Already on Monday, the MOH received medications for critically-ill patients from Mount Sinai. Both Mount Sinai and

PAHO/WHO provided kits for burn patients. We received some of these kits today and more will be arriving tomorrow. Also, the world-famous Cornell Burns Department has been consulting with the Ministry of Health and the GPHC and is providing both guidance and supplies.

We are grateful for the support the Ministry of Health has received from the GDF, and the Police Force in their coordinating role to obtain the support of the RSS. Through this collaboration, the Ministry of Health obtained the services of a forensic specialist pathologist from Barbados who completed the sampling from the deceased for DNA analyses.

The Ministry’s Emergency Protocol has been effectively mobilized under the leadership of Minister Frank Anthony who has been working feverishly with the international communities to ensure the medical response is of the highest international standard.

The Ministry of Health is grateful to the many health care providers at different levels that have ensured that the highest quality health care has been and will be delivered to all the affected children and their families.

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