By Lakhram Bhagirat
Nurse Olive Sinclair has been in the medical profession for over 32 years now, and over the years, she has worked in almost every aspect of the hospital system. She has vast knowledge of the inner workings of the system as well as the needs of patients.
It was that knowledge of the needs of patients that moved Nurse Sinclair to establish Biomed Energy Enterprise Dialysis Clinic in December of 2015. She saw a void in providing quality care for kidney failure patients and sought to fill that gap.
Sinclair – a Registered Nurse – joined the health-care sector almost immediately after she left school and worked in the Laboratory, X-Ray and Pharmaceutical Departments at two hospitals. However, she soon felt as though those positions did not present her with a challenge so in 1991, she applied for the Nursing Programme.
In 1994, she graduated from the Programme as a Registered Nurse and was attached to the New Amsterdam Hospital in Berbice.
During her years as an RN, Sinclair worked in almost every department of the hospital, but was originally trained as an Operating Room (OR) Nurse. After a few years of working at the New Amsterdam Hospital, she took the bold step to move to Georgetown and took up a post at the Georgetown Public Hospital.
“At the Georgetown Hospital, I was placed in the OR again and literally I wrote a letter asking to be removed and I was sent to [Intensive Care Unit] ICU. I worked the regular ICU, the Cardiac ICU,” she recounted.
However, something was still missing for her and she felt that a bigger challenge was needed. She took up employment with a private clinic, but that did not work out, so she went back to the Georgetown Public Hospital. In 2011, she got a challenge when she was recommended as a nurse to work in the Doobay Dialysis Centre on the East Coast of Demerara.
She was interviewed and appointed to serve as the Registered Nurse/Administrator at the Centre. There she was further trained and worked for four years. However, circumstances would cause her to part ways with the Centre and in 2015, when she decided to start her own dialysis unit, she already had experience in the field.
She had co-founded Biomed Energy Enterprise back in 2013 and was setting up dialysis units, water systems, and machines as well as servicing and maintaining them. She played a part in setting up the Doobay and GPHC Units as well as some private institutions.
“I was financially stable to start (my own Unit) and we started with one machine and as the months went by, I saw the need to have at least two more and Biomed Energy Enterprise grew from there. Presently, I have two locations: one at Woodlands (Hospital in Georgetown) with 14 machines and one at Anamayah (Memorial Hospital in Berbice) with four machines,” Nurse Sinclair said.
Now she would travel to Berbice three days per week and the other four would be spent in Georgetown performing dialysis on patients.
For a dialysis centre to become operational, it requires far more planning and execution than just having patients. It needs to have a water system: the reverse osmosis water system, then you need special pipes for that water to go to the dialysis machine. You would need the dialysis machines, and operators for them. Technical personnel are also required to ensure that the machines are calibrated correctly, serviced, and maintained for optimal functioning.
Sinclair and her Canadian business partner serve as a dynamic duo, since he has over 40 years of experience in the dialysis arena and is responsible for all the technical work while she takes care of the clinical aspects of the operations.
Dialysis is one line of treatment for persons whose kidneys have failed. A person can have acute renal failure which starts within one to seven days, it happens within a short period of time and then the kidneys kick back in within three months to a year.
In chronic renal failure, the kidneys have lost their function and for that affected individual to survive, he or she needs hemodialysis. The process of hemodialysis starts when the blood is removed from the patient, it is then passed through a machine, through a filter or dialyser which performs some of the functions of the kidneys and then that clean blood is returned to the patient.
For that procedure to happen, the patient must have some medical intervention that provides access to the blood that flows around in that individual. There are three types of access. There is the AV Fistula where an artery is connected to a vein and then allowed to heal for six weeks to three months before it can be used. There is the option where a graft is surgically inserted between an artery and a vein, and the other type of access is the catheter.
Catheters are widely used in Guyana because most patients are diagnosed with renal failure when they show all the signs and symptoms – that is retention of fluid, bad taste in their mouths, smelly breath and low blood count. The disadvantage of catheters is that they are infection prone.
Nurse Sinclair has been conducting her own research to determine the needs of every administrative region in Guyana concerning access to dialysis care. Thus far, she has found that there are about 175 or more kidney failure patients in Guyana, with most dialysis centres located in the city.
She had, under the previous Administration, submitted proposals for the setting up of dialysis units – through a public-private partnership – in six of the 10 administrative regions, but that never materialised. She said that there were plans in the pipeline for expansion to other regions, but noted that she preferred to set those units up within the regional hospital system for a number of reasons.
“One of the advantages of having a dialysis unit within a hospital environment is that it takes away a lot of literal supervisory burden from you when it comes to the medical waste disposal. (In the hospital setting) The blood work can be readily done. If there is an emergency, there are always doctors within the hospital, access to the ICU is very easy, medication is readily available within the hospital setting. The hospital also does like the laundry, the attendants will move the patients from point A to point B and there are always cleaners available to keep the environment clean. It also takes away a financial burden to some extent even though you pay for that within your rent and utilities fees,” she explained.
Another one of the driving forces for her decision to set up dialysis units in the hospital setting is the fact that there is always power available. The Guyana Power and Light (GPL) is notorious for its blackouts so it is critical that her units have a steady power supply.
Nurse Sinclair’s research has found the need for a dialysis unit in Region Three (Essequibo Islands-West Demerara), since she has patients travelling from as far as the Essequibo Coast to access dialysis services in Georgetown. She is hoping that she will be able to meet them halfway with a unit in Region Three so that it cuts their commute as well as brings some financial relief, since dialysis sessions are in themselves a huge financial burden.
Sinclair said that if she was given permission to set up dialysis units at the regional hospitals, she could have them up and running in 14 days, noting that it has been over a year now since the Linden Hospital Complex was supposed to have a unit set up by another firm and it was yet to happen.
Over the past five years, she has interacted with a number of persons and had the chance to hear of their burdens in terms of accessing care for their kidney failure. She said that the common complaint was access to transportation, and its cost.
“Some patients can go to work after dialysis. I have patients who start dialysis at 5:30am, they leave at 9:30am and then they go to work. But then there are some patients after dialysis that need to relax, to go home and relax for an hour, have something to eat before they can get around to do their regular daily chores. So, it is very fatiguing on the patient’s body travelling those long distances, and then cost for travelling is also a burden,” the experienced nurse said.
She is also advocating for more preventative testing to be done for those with diabetes and hypertension so that there may be early intervention for potential kidney failure patients. This, she said, will result in early acceptance of the condition and treatment as well.
Sinclair is hopeful that she will see dialysis accessible in every region, access to medication, and most importantly, more inspections of dialysis units. The Biomed Energy Enterprise Dialysis Unit has a qualified Nephrologist on staff along with ancillary staff qualified in various fields of functioning.
