Submitted: IS4H team rebuts statements by former minister Ramadhin: “Measurable results versus political talk”

 The IS4H team of the Ministry of Public Health, Welfare and Labour firmly rejects the repeated statements by former minister Amar Ramadhin about the national digital health programme. In contrast, the team presents verifiable results: a positive report by the Inter-American Development Bank (IDB) following a mission in October 2026, and three international awards at the 5th regional PH4H Connectathon in Panama in July 2026. The team calls on the former minister to correct his statements immediately.

“We are speaking out as a technical team, not as a political party. Denying established results affects not only us, but also the doctors, nurses and administrative staff who work with these systems daily.” – IS4H team

What the IDB establishes

In its accompanying letter to the report of the technical mission from October 21 to 23, 2026, the IDB acknowledges the “enormous progress” the ministry has made in the digital transformation of healthcare. The bank praises the enthusiasm, commitment and growing capacity of the IS4H team, as well as the strong national ownership of this agenda.

The IDB explicitly cites the following results:

• Electronic health record: GNU Health has been installed in 22 of the 43 RGD (Regional Health Service) clinics, 18 of which are fully operational. The clinic in Moengo, which the IDB visited, operates approximately 90% digitally.
• National exchange platform: the HIEP was delivered in March 2026 and the ministry is working towards operational exchange between the EHRs, the national platform and the Patient Portal.
• National capacity and ownership: the IS4H team independently manages, adapts and expands the platforms using open-source technology. This reduces dependence on external suppliers and eliminates licensing costs. Local servers ensure that clinics continue operating during internet outages.
• International standards and regulations: Suriname has incorporated the international classifications ICPC-2, ICD-11 and ATC into its systems. Since 2025, an EHR has also been a licensing requirement for general practitioners.
• Innovative solutions: together with PAHO, Suriname has developed a digital death certificate, which will become available as a digital public good through the Pan-American Highway for Digital Health (PH4H). Automated reporting through the EHR systems reduces manual administrative work.
• Regional leadership: Suriname completed all test tracks at the PH4H Regional Connectathon 2026, which, according to the IDB, underscores the country’s growing technical capacity.

The IDB congratulates the ministry and its technical teams on this progress and states that it is proud to have supported these results. The IDB Health Services Improvement project (SU-L1054), worth US$ 20 million, reached its final disbursement in October 2026.

In figures

The facts at a glance

1. National direction and in-house expertise

The ministry owns the system and sets policy and national standards. An IS4H focal point and a technical team within the ministry independently manage the platforms, based on open-source technology. This eliminates licensing costs and means Suriname is no longer dependent on a single external supplier. Local servers ensure that clinics continue operating when the internet goes down. The IDB explicitly identifies this built-up national capacity as one of the programme’s main results.

2. Electronic health record (EHR) at the RGD

The GNU Health EHR system has been installed in 22 of the 43 RGD clinics. Of these, 18 are fully operational, with more than 80 workstations in total. Due to the long-standing absence of infrastructure work at the RGD clinics, the system still needs to be installed in the remaining clinics. In Moengo, approximately 90% of processes now take place digitally, from registration to prescription. The system has been adapted based on feedback from healthcare staff and has a Dutch-language interface. The IDB established this first-hand on site on October 21, 2026.

In his statements, the former minister refers to a report by the former consultant on the GNU Health pilot in Moengo. That report was never handed over: neither to the ministry nor to the IDB. Moengo itself does not have it either, despite repeated requests.

At the time, the former consultant stated that the system was unworkable and difficult to use – remarkably, a system he himself had recommended. His advice was to deploy his own private systems for the RGD clinics as well. The IDB opposed this proposal.

The former minister is therefore relying on a report that no one has been able to review. He is apparently not properly informed and is thus spreading misinformation. The facts speak for themselves: with the same GNU Health system, approximately 90% of processes in Moengo now take place digitally, as the IDB established on site.

3. National exchange platform (HIEP – Health Information Exchange Platform)

The claim that the national exchange platform (HIEP), worth US$ 450,000, was delivered but is not being used, is incorrect.

The HIEP was delivered in March 2026 within the IDB-funded project. The platform already processes patient registration, demographic data, allergies, laboratory results, prescriptions, appointments, vaccinations and clinical documents, in accordance with the international HL7 standard. The systems use the international codes ICPC-2, ICD-11, LOINC, SNOMED and ATC.

The GNU Health installations in the RGD clinics are currently not yet able to communicate fully with the HIEP. The necessary technical adjustments are being made in both the EHR and the HIEP. The aim is for the clinics to eventually send their messages to the HIEP; in the event of an internet outage, those messages are stored locally and sent automatically once the connection has been restored.

Work is also under way on the further development of the Patient Portal. This component was initially not defined as a separate functionality within the HIEP and is therefore still in the development phase.

The current phase is a controlled pilot with secure access, registered systems and full logging. Additional safeguards are needed for the full production phase: the Personal Data Protection and Privacy Act, which is now before De Nationale Assemblée (Suriname’s parliament), and agreements with each affiliated institution. Careful handling of patient data is not stagnation. The experience with the death certificate shows precisely why that care is necessary.

The team regrets that progress widely reported in the media is repeatedly ignored, while the IS4H team is personally attacked. The team refers to the IDB report.

4. Digital death certificate

The system delivered by the previous consultant did not function properly. Data quality was poor and there were even cases in which hospitals were running on a test server, where test data were mixed with real patient data. Those data were on the consultant’s own company server and have not been handed over to this day. The IS4H team restored the system; it is now in use. Together with PAHO, it is being made available as a digital public good for the region. The next step is integration with the BOG and the CBB and connection to the HIEP.

5. General practitioners

This did not concern “support”, but a contract that the then minister signed with two suppliers of digital systems. One of those suppliers was also the consultant engaged for the project. Approximately 90% of the systems now installed at private general practitioners originate from this former consultant. The contract stipulated that the ministry would pay the licensing costs for one year.

When the contract expired, the new policy did not renew it for two reasons: first because of the conflict of interest, and second because the ministry still needs to hold follow-up discussions with the VMS. The team makes no statements about the ongoing court case.

Since 2025, an EHR has been a licensing requirement for general practitioners by ministerial order. The fact remains that all systems must comply with national standards. General practitioners can choose: continue with their own system, or indicate that they want to use the ministry’s system. In both cases, the systems must be interoperable and connected to the HIEP.

6. HEARTS

No functioning solution for duplicate registration was discontinued, because one never existed. Under the previous minister, only an assessment was conducted into duplicate registration. That assessment was paid for from the IDB loan, but did not produce usable results.

The team is surprised that the former minister now presents this differently. It concerned an assessment from his own period; he should be familiar with its outcome.

The structural solution to duplicate data entry is interoperability. Once the EHRs of general practitioners and the RGD exchange data through the HIEP, doctors will no longer have to register separately in a HEARTS application. Maintenance and further development are handled by the IS4H team itself and are therefore not dependent on external licences or an individual consultant.

7. International recognition

At the 5th regional PH4H Connectathon in Panama, Suriname completed 100% of the required test tracks and received special recognition for the EHR rollout at the RGD. In October 2026, Suriname hosted the first pre-connectathon mission in the Caribbean. The programme is funded through the IDB project SU-L1054, worth US$ 20 million, with the final disbursement taking place in October 2026.

Call for correction

The IS4H team calls on former minister Ramadhin to stop spreading incorrect information about the programme and the team, and to correct his statements immediately. The team deliberately does not mention the names of staff members because they have repeatedly been personally attacked in recent times.

“The former minister writes that criticism is not sabotage. We agree with that. But repeatedly spreading incorrect information about documented results, and personally attacking our team, is no longer criticism.” – IS4H team

The IS4H team therefore strongly asks the former minister to correct his statements. If he does not do so, the team will be compelled to take appropriate steps.

The work continues

Meanwhile, the IS4H team continues the rollout unabated. “Our goal remains unchanged: one patient, one record, securely available where care is needed.” – IS4H team