The Shame of Guyana: A Depraved Indifference to Human Life
On September 16, 2015, the Guyana Chronicle reported that Ronald Walcott, a patient of the Georgetown Public Hospital Corporation (GPHC), died after being denied meals by hospital staff for over one week. According to the article, after Ronald’s admission to the hospital for a surgical procedure, things went so terribly wrong that he attempted to end his life by suicide on two occasions. After his second failed attempt, he reportedly threw himself on the ground and vented about the lack of treatment and care he was receiving at the hospital:
Ah want a gun; a want a knife…A wan’ dead!…Is six days ah deh in dis place and can get a tablet to drink. I ain’t getting no treatment so I want dead.
Because of his suicidal ideations, Ronald was restrained by being bound to his bed. However, no provision was apparently made by the hospital for a nurse to feed him, so even though food was sometimes left in a container, his restraints prevented him from consuming it. His fellow patients and a reporter from the state-owned newspaper expressed concern about his plight, but no one in authority listened to their pleas. As a result, Ronald slowly starved to death, in plain sight.
The cruel and inhumane treatment that Ronald was subjected to was witnessed and documented in detail by a Guyana Chronicle reporter, who stated:
[The nurse] walked around the ward, deliberately avoiding…[Ronald]…even though his eyes began dancing with excitement at the thought of getting a box of food. This reporter asked her whether the patient was on special diet since she had not given him anything to eat. She replied affirmatively and went outside and brought a Styrofoam cup with something in it. She chucked it onto the cupboard and walked away. This reporter also asked her how was he going to get it since he was bound hand and feet and was prostrate on the bed and could not reach the cupboard. The nurse replied that it was her time to come off duty, adding that the incoming nurse would look after him. It was then that the other patients in the ward, disappointed and out of compassion, disclosed to this newspaper: “Dat man deh in hay over a week now and never get anything to eat.” He was dehydrated and kept crying out for help. Needless to say, he was never fed what was brought for him in the cup and it had to be thrown out the following day.
The first time I heard this story, I desperately wanted to believe that there were extenuating circumstances and important facts that were omitted from the article. I wanted to be reassured that we, the Guyanese population, could still return from the precipice, and learn to treat our brothers and sisters with dignity and respect. However, with each passing day, the continued silence of the GPHC, the Ministry of Public Health, and almost all other stakeholders, suggests that there is little room for hope. Indeed, their silence has been deafening, and tells a thousand stories about the low value we ascribe to human life in Guyana — particularly those of vulnerable individuals.
The sad truth is that Ronald was a drug addict, who struggled to eke out a living transporting items for vendors in the Bourda Market. His addiction, and social status, condemned him to being viewed as an “unwanted” member of society, who faced significant hurdles accessing social services and support that he desperately needed. In the streets where he spent most of his days, the odds were heavily stacked against him. Yet, it is shocking that at the largest hospital in Guyana, where he should have been provided with quality healthcare by trained professionals, he was treated like a menace, and starved to death in a manner that suggested his life had no value.
As a mental health and healthcare lawyer who has worked on multiple disciplinary hearings of healthcare professionals in New York state, this is by far the most egregious and inhumane treatment of a patient by hospital staff that I am aware of. Moreover, while the reported facts suggest that the nurses in question breached their non-delegable duty of care towards Ronald, their conduct also demonstrated such a depraved indifference to human life that it would have risen to the level of murder had it occurred in New York.
This concept was explained by a New York court as follows:
Depraved indifference is best understood as an utter disregard for the value of human life — a willingness to act not because one intends harm, but because one simply doesn’t care whether grievous harm results or not. Reflecting wickedness, evil or inhumanity, as manifested by brutal, heinous and despicable acts, depraved indifference is embodied in conduct that is so wanton, so deficient in a moral sense of concern, so devoid of regard of the life or lives of others, and so blameworthy as to render the actor as culpable as one whose conscious objective is to kill. People v. Suarez, 6 NY3d 202, 205 (2005).
One of the fact patterns that establish depraved indifference murder is where a defendant intends neither to seriously injure, nor to kill, but nevertheless abandons a helpless and vulnerable victim in circumstances where the victim is highly likely to die. That is what appears to have happened in this case. By bounding Ronald to his bed, failing to put measures in place to ensure he is fed, and failing to adequately supervise the level of care provided to him, the hospital abandoned him in circumstances that led to this death.
One would have expected that the utter callousness of the hospital staff towards Ronald’s plight would have been career-ending for every staff member involved, and also resulted in significant jail time. I am advised that under the laws of Guyana, there may be sufficient grounds for charges of murder in the second degree, or manslaughter. However, I will not hold my breath in the expectation that any of the hospital staff involved will face the full force of the law because there is growing evidence that all human lives are equal in Guyana except for the poor, the vulnerable, and those without connections to people in power.
I am extremely worried, therefore, that we will continue to see similar incidents like this one in the future, and that the staff who were culpable in Ronald’s death will remain unsanctioned, and in the healthcare system. If that proves true, the public distrust and lack of confidence in public healthcare facilities like the GPHC will continue to grow, with significantly negative ripple effects.
That will be unfair to the institution, because it has made significant improvements over the years in terms of services offered and quality of care. It will be unjust to those hard-working, decent, compassionate members of the medical and nursing profession who give so much to serve the people of Guyana at great personal expense. And most of all, it will be devastating to vulnerable groups who have no choice but to rely on the public healthcare system in Guyana for all their health needs.
As such, it is crucial that the Ministry of Public Health finds its voice and immediately articulate its plans to ensure that no other Guyanese will ever be subjected to the mistreatment that Ronald faced. It must also immediately ensure that all steps are taken to weed out those nurses and doctors from the healthcare system who are a disgrace to this country. Nothing less will suffice to reassure the Guyanese public that the healthcare sector hasn’t spiraled into utter chaos and lawlessness.
Let us remember the words of Peter Marin, a writer, who stated that our vulnerable populations are “the sum total of our dreams, policies, intentions, errors, omissions [and] cruelties.” This is the shame of Guyana. It will only change if people take action.
