05/24/24
In Guyana, an endometriosis sector is being set up
On May 30, the first general assembly of the association which will coordinate the treatment of endometriosis in the region is held. It will allow Guyana to benefit from funding, but also to create a care pathway, offer training, and create a directory of health professionals. Dr Alphonse Louis, gynecologist-obstetrician at Cayenne hospital, invites health professionals to join her.
In France, the prevalence of endometriosis is estimated at 10% of women of childbearing age. In Guyana, at least 7,000 women are affected by this chronic gynecological disease. In 2022, the General Directorate for Healthcare Supply released an instruction aimed at organizing patient care pathways in connection with the structuring of a graduated offer within dedicated sectors, within the framework of the National Strategy to Combat Endometriosis. This sector is in the process of being structured in Guyana. The association which will coordinate it will hold its first general meeting on Thursday, at 7 p.m., at Cayenne hospital. It is still possible to join for free by joining online.
“The treatment of endometriosis has existed for several years in Guyana,” underlines Dr Alphonse Louis, gynecologist-obstetrician at the Cayenne Hospital Center. But we were not organized into a sector and this prevented us from claiming existing funding. We met Dr Jane Poincenot (medical advisor to the Regional Health Agency). Thanks to the support of the ARS and with Sabine Trébaol (CPTS coordinator), member of EndoFrance, we started working on this sector a few months ago. »
“A lot of diagnostic wandering”
“The work of the association will mainly be awareness-raising and training of health professionals,” continues Dr. Louis. Many women are still told: “You are in pain; it’s normal ! » A few years ago, there were no courses on endometriosis during medical school. There is therefore still a lot of diagnostic error. »
In its instruction, the DGOS underlines that “the absence of structuring of a graduated care offer constitutes a loss of opportunity in the patient journey by limiting the early diagnosis – currently seven years on average – leaving time for the disease to progress even though there is currently no curative treatment. Early access to quality multidisciplinary care is essential given the complexity of diagnosis and treatment linked to the different dimensions of the disease. The structuring of sectors is therefore a priority supported by the National Strategy to combat endometriosis to ensure patients receive appropriate, quality care throughout the country. In a logic of interprofessional collaboration, the sectors must organize the diagnosis and secure care by improving the relevance of complementary explorations, medical treatment and surgical procedures. »
Offer training, raise awareness among health professionals
The structuring of this sector will also make it possible to offer training. A post-graduate course (EPU) on the subject was held at the end of March, in Cayenne, with specialists from Cochin hospital, on whom the Cayenne hospital relies for the most complex cases. “This is multiple and changing care,” emphasizes Dr. Poincenot. At one time, we did a lot of surgery” whereas today, recommendations are to operate on fewer than 10% of women with endometriosis.
“We need to raise awareness among health professionals, to be able to pass on the recommendations to them,” concludes Dr. Louis. General practitioners, midwives, gynecologists, algologists, nurse anesthetists have already joined the association. We need supportive care professionals: masseurs-physiotherapists, hypnotherapists, osteopaths, etc. The interest of the association will be to know who to refer to, to provide training in diagnosis and first treatments. »
A specialized consultation at the CHC
Cayenne hospital offers a specialized consultation for endometriosis. “These are long consultations, lasting an hour,” explains Dr. Alphonse Louis. Some community doctors provide consultations, but endometriosis requires pain management, a consultation with a psychologist, and another with a sexologist. This consultation allows us to see whether surgery will be necessary or not. »
Dr. Louis hopes to “save slots for this consultation. Having a specialist consultation sometimes allows other problems to be detected. We also try to include the subject of menstrual hygiene,” whose World Day takes place on Tuesday.
“In the city, some professionals continue to send their patients to France for consultations,” notes the gynecologist. They can direct them to us. We relied on establishments in France for the most complex care. We are in the process of structuring RCPs (multidisciplinary consultation meetings) with the Cochin hospital, with whom we have been working for many years. »
