13/08/24
CHU: the CDPS – Local Hospitals pole is also preparing

The delocalized prevention and care centers have begun their transformation, notably with the creation of the three local hospitals of Maripasoula, Grand-Santi and Saint-Georges. As the creation of the CHU of Guyana looms in the first quarter of 2025, they are strengthening to extend their care to other specialties, offer more tele-expertise and participate in research and public health work. In Saint-Georges, a Franco-Brazilian health cooperation center will open at the end of the year.

It is sometimes forgotten that the CDPS – Local Hospitals hub is the fourth pillar of the future CHU of Guyana, alongside the three public hospitals of Cayenne, Kourou and Saint-Laurent du Maroni. In the same way as the forty or so care sectors identified in Guyana, they contributed to the medical-care project. The document defines the objectives and organization of the hub.

Numerous hospitalizations

These projects are taking place in a context of transformation of the delocalized prevention and care centers, with the creation of the three hospitals of Maripasoula, Grand-Santi and Saint-Georges, the upcoming reopening of the CDPS of Saint-Elie and the consultation room project in Apagui (read the Pro Letter of July 16). “After six months of operation, the local hospitals are enjoying some success,” rejoices Dr. Cyril Rousseau, coordinating physician of the CDPS center at the Cayenne hospital. “Short-term hospitalizations are numerous” and avoid as many medical evacuations to the coast.

The main reasons for consultation are infectious diseases, skin diseases and abdominal and gastric problems. “When no specific examination is required at coastal hospitals, this allows patients to be sent home. We feel like we are providing a service, with accommodation that meets hospital standards,” continues Dr. Rousseau. Local hospitals also allow patients who are waiting for a stay in a coastal hospital but face the difficulties of air transport to be accommodated. The chartering of an aircraft dedicated to health is one of the projects linked to the CHU. It will make it easier to transport health professionals to their place of practice and patients who need to return to the town or reach a coastal hospital.

Starlink deployed in all CDPS

The three local hospitals are now equipped with imaging tools. This also avoids transfers to the coast. To facilitate the work of professionals, to be able to organize teleconsultations and tele-expertise, and to speed up the transmission of images to coastal specialists, Starlink will be deployed in all CDPS. “We will thus have a backup network where the current network suffers frequent interruptions. And it will be the main network where there is none. This will make our work easier and will contribute to improving care for the population of the municipalities,” rejoices Dr. Rousseau.

Maripasoula dental chair operational in September

Care is also experiencing “significant improvements”. The local hospital in Saint-Georges has had a dental chair for two years; the one in Grand-Santi, for a year; in Maripasoula, the chair will be operational in September. In addition, the hospital in Cayenne now has a mobile chair to go to more isolated sites (read the Pro Letter of January 19). For ophthalmology, the CDPS – local hospitals center relies on specialists from the region but also on the Rothschild Foundation and private practitioners from outside Guyana who regularly come to carry out missions.

Local perinatal centers in 2025

Regarding maternal and child health, local perinatal centres will be established in 2025. “In mainland France, these are often the successors to small maternity wards that were closing,” explains Dr Rousseau. “In Guyana, they will be new creations.” These centres will “take care of all maternal and child health issues except childbirth.” Fifteen midwives now work within the centre. “They provide pregnancy monitoring and prevention, visit pregnant women, and organise sexual and reproductive health sessions in secondary schools,” explains the coordinating doctor.

Greater use of specialists

In other specialties, the hub’s logic is to “interact with all the territorial sectors that are being structured, while respecting patients’ choices. We have significantly increased the use of specialists so that they come to CDPS and local hospitals,” continues Dr. Rousseau. Gynecologists, urologists, diabetologists, pediatricians, infectious disease specialists, dermatologists, etc. are carrying out more and more missions. “In the three local hospitals, we have added around 200 m2 of premises. These are consultation rooms that prevent professionals from competing for available space.”

The arrival of stable and quality internet will make it possible to offer more telemedicine starting next year. “The need for specialists is immense even if our general practitioners already do a lot of things. Dermatologists and emergency doctors do it regularly. This makes it easier to assess a situation,” the doctor emphasizes.

Developing research and public health

The CDPS – Local Hospitals hub is also developing a public health and research program. The goal is to strengthen the mobile public health teams in municipalities (Emspec) and their mission of reaching out, to consolidate the place of health mediation and to participate in research projects that are being set up in the area, particularly on the subjects of primary care and mediation. Dr. Rousseau also hopes to see the Public Health France Barometer deployed in isolated municipalities. “This would allow us to have data not only on those who come to see us but also on residents who do not come to the CDPS.” Research projects could be funded with the deployment of the “Guyane Santé 2030” research program. Finally, the hub would like to obtain more approvals for internship sites for specialist interns who will potentially write their thesis on subjects specific to isolated municipalities.

A Franco-Brazilian health cooperation center financed by the ARS at the end of the year

Cooperation, which is part of the missions of the university hospitals, has not been forgotten. At the end of the year, a Franco-Brazilian health cooperation operational center will be created in Saint-Georges. It will facilitate the post-hospitalization of Brazilian patients hospitalized in Cayenne in their country of origin, and draw up joint protocols with the hospitals of Oiapoque. “This allows us to redirect certain Brazilian patients or women whose pregnancy is normal and who are not intended to give birth in France if they have no material interest in doing so into the Brazilian health system. Over the past year, we have also carried out several transfers of patients from the CHC to the Brazilian health system for the continuation of their hospitalization. Since the beginning of the year, we have done this a little over ten times. “These cooperation issues will once again be at the heart of discussions this week, during a visit by Dimitri Grygowski, Director General of the ARS, to Saint-Georges and Oiapoque.