Dear Editor,
The Caribbean Heart Institute (CHI), Guyana’s top cardiac center based in the Georgetown Public Hospital Corporation complex, has pioneered heart procedures since 2007 and provided life-saving care to hundreds of patients, although its mission and work are not widely known locally.
Founded in 2005 by Guyanese-born Dr. Gary Stephens—Chief Medical Officer at “One Brooklyn Health System,” Brooklyn and attending a cardiac surgeon at Maimonides Hospital Brooklyn—CHI aims to serve Guyanese and Caribbean patients with affordable cardiac procedures, as many island nations lack resources for dedicated cardiac units.
Although CHI has already treated some Caribbean patients, it seeks to attract more in the future.
CHI continues to advance with innovative technology. It recently implemented Extracorporeal Membrane Oxygenation (ECMO), a life support system for patients with severe heart or lung issues. In August 2024, CHI achieved another milestone by performing the first Optical Coherence Tomography (OCT) in the Eastern Caribbean—enabling doctors to examine the inside of blood vessels without interference from blood flow.
Heart issues are linked to diabetes and diet. Diabetes is more common among West Indians (including Guyanese) than Europeans, partly due to dietary habits and genetics; for instance, Indians in the UK have higher diabetes rates than native Britons. Dr. Stephens, CEO of CHI, observes that Afro-Guyanese migrants in the US develop proportionately more coronary problems due to dietary changes after migration. He estimates that 15-16% of Guyana’s resident population have diabetes, with 600 patients currently on dialysis.
Before CHI was established, cardiac patients had to seek advanced treatment abroad, with open-heart surgery costing about US$50,000—placing a significant strain on the nation’s finances and in the context of the country which had a staggering public debt of $(US) 1.5 billion. The concept for CHI originated in December 2004 when Dr. Stephens presented his vision to former President Dr. Bharrat Jagdeo at a New York forum of faith leaders at which President Jagdeo was a guest.
Four weeks after the December 2004 meeting, Dr Stephens met with President Jagdeo in Guyana to discuss the CHI project. He received the green light to proceed and traveled across the Caribbean for insights on establishing CHI. The Caribbean Heart Institute opened in 2005, performed its first open heart surgery in 2007, and completed three pediatric surgeries by 2010, funded by the George Subraj Foundation.
From 2005 to 2012, there has been just one resident certified cardiologist in Guyana, Dr Pratik Soni and he returned to India in 2011. The lack of trained cardiologists during this period, had forced Dr Stephens to recruit US cardiologists to work pro bono at specified periods, covering only travel and accommodation costs, while Caribbean recruits were paid.
The CHI needed a resident cardiologist to stabilize the situation. Dr Stephens invited Guyanese-born Dr Mahendra Carpen from Boston in 2012 to join CHI as Interventionist Cardiologist and Electrophysiologist. Dr Carpen accepted, leading to ongoing growth for CHI. He was the first trained Guyanese cardiologist resident in Guyana. In addition to his role at CHI, Dr Carpen currently serves as Senior Advisor to President Dr Irfaan Ali on the healthcare sector.
From a cost perspective alone, the impact of CHI has been substantial. In Guyana at CHI, Coronary artery bypass surgery costs $(US)8,000 and heart valve replacement $(US)10,000, compared to about $(US) 30,000 for these procedures in Barbados and Trinidad and Tobago. The CHI has saved Guyanese substantial sums of money in healthcare expenses. Cardiac procedures at CHI are free for patients referred by government hospitals/medical centers, with the government covering all costs. Private patients, however, may need to use insurance to cover cost for cardiac procedures and pay for medication if their hospital stay exceeds 10 days.
Dr. Gary Stephens’s team at CHI performs about 100 heart procedures yearly, with 200 patients currently on the waiting list. Cardiac procedures carry risks; mortality rate is 2% in the US and 3.5% in Guyana; the difference due mostly to earlier diagnoses in the US. Guyana’s free healthcare and the 12 new hospitals aim to promote early detection and lower advanced rate of health problems.
Thanks to Dr. Mahendra Carpen’s leadership and the presence of several resident and practicing cardiologists in Guyana, CHI’s workload has recently become more manageable. The government is actively working to resolve the shortage of nursing staff. We also wish to recognise Dr. Gary Stephens for his outstanding contributions to healthcare and commend his forward-thinking leadership, which truly deserves national recognition.