Staff Writer

August 2, 2023 – As diabetes continues to be an ongoing issue globally, the British Virgin Islands Ministry of Health and Social Development is on the move to standardize the care and treatment of people with the non- communicable disease with the launching of guidelines for the management of the disease.

Introduced by the Caribbean Public Health Agency (CARPHA), the guidelines are designed to make sure that diabetic people receive the same standard of care despite the healthcare facility they seek. This is according to Ronald Georges, Chief Medical Officer.

He emphasized that the guidelines will enhance the results as well as the lives diabetic people.

“At the Territory level, this will improve outcomes for patients, reduce complications and improve their quality of life while reducing costs and improving health care,” he said.

“We are very excited for the possibilities of this programme,” he later added.

The Ministry will not just stop at launching the guidelines. Georges highlighted that to fortify the guidelines, they will have ceaseless education in the form of Continuing Medical Education, and this will address standardized assessment, care, and treatment for diabetic people.

“We want these guidelines to be seamlessly implemented within our healthcare system.  To do this, our focus will be on offering continuous education sessions, building collaborations with the Diabetes Association and clinicians as well as empowering patients to be more proactive and vested in their own care,” he informed.

The vision going forward, as expressed by Georges, is to reach a point where clinical audits are conducted to ensure that the guidelines are being put into practice and more education and training is being provided where needed to guarantee sustainability.

The Launch of the CARPHA Guidelines for the Management of Diabetes in Primary Care in the Caribbean will take place on Thursday, July 20th at 5:30 p.m. and the venue will be the Dr. D. Orlando Smith Hospital.

According to CARPHA, “in the Americas, diabetes was recorded as the fourth leading cause of death and disability in 2019. According to the IDF Diabetes Atlas, North America and the Caribbean are ranked 4th in the world, with an age-adjusted comparative diabetes prevalence in adults 20-79 years of age of 11.1%. Projected prevalence in 2030 and 2045 are 12.3% and 13.0%, respectively.”

Additionally, CARPHA described the disease as the “leading silent but most preventable killer in the Caribbean,” and considering this, the soon to be launched guidelines will be a driving force in lowering the death rate of diabetics as well as contributing to the reduction of its prevalence throughout the British Virgin Islands. This can potentially encourage more countries in the region and globally to take further action against the disease.

Staff Writer

#TrinidadandTobago, July 17, 2023 – It is an unfortunate reality for Trinidad and Tobago as they have now recorded the first case of the Monkeypox Virus.

The infected individual according to the Ministry of Health, is a middle aged male with travel related history.

He was tested on Tuesday July 11th, and the sample sent to the Caribbean Public Health Agency’s (CARPHA) laboratory through the Trinidad Public Health Lab.

Taking action, the Ministry said the County Medical Officer of Health (CMOH) has started the local public health response, which includes contact tracing.

Trinidad and Tobago now joins the global community that has had MonkeyPox cases as expressed by the World Health Organisation’s update as of July 4th, 2023, that 88,144 Mpox cases have been detected globally amongst 112 countries. Also, there have been a total of 149 deaths.

The Ministry reminded the public that the virus is spreading worldwide as we speak, and that it is important to maintain good hygiene practices such as hand washing or sanitising where appropriate.

The vaccine is currently available in Trinidad and Tobago but will, at this time, be used for positive cases only.

The Ministry expressed that it will continue to provide updates to the public as necessary.

Staff Writer 

#TurksandCaicos, June 18, 2023 – Following confirmation that the strain of cholera which can cause outbreaks is in the Turks and Caicos Islands, a team from the United Kingdom will be coming into the country to help the TCI Ministry of Health shore up local defenses.

The report came from the Ministry on Thursday (June 15th) morning. They had sent the suspected cholera sample to Trinidad to be tested by the Caribbean Public Health Agency (CARPHA) and promised residents would be updated when results were available.

Test results were received on June 11; on Thursday June 15 the Ministry, in a press release conveyed: “CARPHA confirmed that the sample contained Vibrio Cholera 01, Biotype “El Tor,” and Serotype “Ogawa.” This is of concern as it is a toxigenic strain and can cause outbreaks.”

This week a team from the United Kingdom Health Security Agency UKHSA will arrive in the Turks and Caicos Islands, which is a British Overseas Territory with the aim of working alongside local medical professionals to provide the technical support the islands need to strengthen both preparedness and response.

Despite no evidence of further infection, other than the case which occurred in a traveller who recently visited cholera-stricken Haiti, the Ministry says it remains vigilant ‘in light of the ongoing outbreak in Hispaniola, with which the TCI has close trade and travel links.’

The Ministry also reiterated that following the confirmation, the National Public Health Laboratory (NPHL) is actively developing additional capacity to provide in-country confirmation of cholera cases.

In the meantime residents are urged to protect themselves thoroughly against the disease in ways including:

• Taking proper precautions when traveling to areas with confirmed cases of cholera
•  Drinking water from a safe source
•  Washing hands often with soap and clean water, especially before you eat or prepare food and after using the bathroom. If no water and soap are available, use an alcohol-based hand sanitizer with at least 60% alcohol
• Using clean water to wash dishes, brush teeth, wash and prepare food, and make ice
•  Eating foods that are packaged or freshly cooked and served hot
•  Not eating raw or undercooked meats, seafood, or raw or undercooked fruits and vegetables unless peeled
• Disposing of feces in a sanitary manner to prevent contamination of water and food sources

Cholera occurs when a human ingests the bacteria that causes the disease, this can be caused when infected persons’ feces contaminate a water source, and that water is ingested or used to cook food or make ice.

Cholera is treatable with correct medical care.

If left untreated, it has a 25-50% mortality rate; the UK National Institute of Health says treatment reduces this to less than 1%.

Staff Writer 

#TurksandCaicos, June 12, 2023 – After recording one case the Ministry of Health says it is working to be able to check for cholera locally.

“As a result of this case, the Ministry of Health and Human Services is rapidly developing its capacity to provide confirmatory testing within the country.  As the Caribbean Public Health Agency (CARPHA) is still the regional body with oversight for the Turks and Caicos Islands, and as such, samples will continue to be sent for oversight to ensure that regional actions can be taken.”

The update was shared in a June 7th press release which this time correctly referred to the bacteria which caused the disease, Vibrio cholera.

The correction followed a scathing rebuke by PDM Opposition leader and former health minster, Edwin Astwood who called the error in labelling cholera a viral disease, “academically shameful.”

The Minister opted not to respond to Astwood’s criticisms, instead informing in a second media statement that a sample from the lone patient was sent off to Trinidad and Tobago immediately and arrived in that country on Tuesday.

The public will learn of updates once they are available, said the ministry.

In the meantime Shaun Malcolm, Minister of Health and Human Services, said having testing capacity locally was “essential to safeguard our local population by providing information to inform early response from the public health team to facilitate interventions aimed at preventing further disease spread.”

He also encouraged residents to always be vigilant in practicing proper hygiene.

Staff Writer 

#TurksandCaicos, June 5, 2023 – The Turks and Caicos has recorded its first case of cholera.  The update came from the Ministry of Health and Human Services on Monday June 5th.

The positive result came from a stool sample sent from the Cheshire Hall Medical Centre.

The case appears to be an imported one as the individual had recently travelled to Haiti which is struggling to deal with a major outbreak of the disease.

Beset with vomiting, diarrhea and dehydration, the person was tested for the viral illness.

Cholera is spread through contact with the feces of an infected person.  This can occur when sewage isn’t treated properly and comes in contact with drinking water, or where sources of water are not properly treated.  Drinking or eating food prepared with contaminated water can cause the disease to spread.

The US National Library of Medicine says If left untreated, cholera has a 25-50% mortality rate.  Treatment reduces this dramatically to less than 1%.

Minister of Immigration Arlington Musgrove had told Magnetic Media that the Department of Immigration had implemented a new system to check for cholera infections which had also been in use for any irregular migrants from Haiti.

The National Security Council, NSC had also instructed the Ministry of Health to secure a cache of cholera vaccines for the country’s protection should they become necessary.

Shaun Malcolm, Minister of Health and Human Services today said, “The TCI’s National Cholera Preparedness and Response Plan was updated with stakeholder involvement in 2022 and a number of training sessions were undertaken for frontline workers on Infection Prevention.”

There was no mention, however, of whether the Turks and Caicos Islands was able to secure the vaccines recommended for stockpiling by the NSC.

What was asked of residents is that they “seek medical treatment immediately if they suspect they or their family members are infected.”

The patient is now in stable condition and responding to treatment, informed the Health notice.

The government has sent the sample off to the Caribbean Public Health Agency, CARPHA to determine which strain of the virus is present.

#TheBahamas, May 5, 2023 – A pledge to close the growing immunization gaps was signed by Caribbean country leaders during the staging of the 29th Special Meeting of the Council for Human and Social Development (COHSOD) held last week  in Nassau Bahamas; it’s being called:   The Declaration of Nassau.

“We commit ourselves to the pursuit of initiatives and targets to be implemented to achieve an improved health status of our populations within the next five years, emphasizing leadership, strategic planning, management, implementation and resource mobilisation in the context of health sector reform processes that are underway,” says Article 1 of the Declaration.

There are seven articles in all.

The Declaration of Nassau devotes Governments to make efforts to fortify the national immunization programs with evidence-informed interventions, which includes prioritizing immunity gaps among children (which was worsened by COVID-19), elderly people, pregnant women, persons with pre-existing conditions, health workers and those living in situations that makes them vulnerable to contracting certain illnesses.

Additionally, it calls on and encourages countries to keep strong the regional targets for the control and elimination of measles, polio, Hepatitis B, rubella, tetanus, bacterial meningitis and cervical cancer, and proffers the development of policies and strategies to address vaccine hesitancy and infodemics (misinformation and false information).

The Governments under the Declaration, signed on Thursday April 27th, 2023, are committed to ensuring that Immunization is paramount on the health policy agendas in the political eye and for long-term sustainable financing.

These actions are evidently necessary for the region as pointed out by Dr. Jarbas Barbosa, PAHO Director in his address at the meeting.

He said, there is “great risk” of the re-emergence of diseases which had already been eliminated from our region,” due to the decline in “Immunization coverage,” as further expressed by Dr. Karen Broome, Immunization Advisor for the Caribbean Subregion at PAHO.

To support the initiatives outlined on the Declaration, Barbosa referred to a collaboration between PAHO and the Caribbean Public Health Agency (CARPHA), to use refunds from COVAX ( the vaccines pillar of the Access to COVID-19 Tools [ACT] Accelerator,  a global collaboration to accelerate the development, production and equitable access to COVID19 tests, treatments and vaccines), to support routine vaccination for Member States.

Held in partnership with the Government of the Bahamas, through the Ministry of Health and Wellness, delegates to the longest-running health research conference in Latin America and the Caribbean region will explore the theme, “Caribbean Health and Tourism: Pathways to Recovery and Resilience”, at the popular Atlantis Paradise Island Resort.

Travel and tourism are crucial to the sustainability and resilience of Caribbean economies as they drive revenue, employment and foreign exchange. But the sector can also be a catalyst for the introduction and spread of disease, as was the case during the COVID-19 pandemic, which negatively impacted Caribbean health security.

The Bahamas conference aims to highlight all the ways that the region is working toward addressing concerns, challenges, lessons learned, and innovations in the health and tourism arenas.

Dr. Joy St. John, Executive Director of CARPHA, stated: “The Caribbean is known for its desirable tourism product and as a fabulous tourism destination. The Bahamas is one of the most sought-after spots and the Caribbean is one of the most tourism-dependent regions in this world. CARPHA therefore sees the partnership with the Ministry of Health and Wellness in co-hosting the appropriately themed ‘Caribbean Health and Tourism: Pathway to Recovery and Resilience’ Annual Health Research Conference, as a serendipitous collaboration,” she said.

The goal of the conference is to facilitate and promote communication and the sharing of scientific outputs among health scientists, policymakers, and related professionals in the wider Caribbean region.

On April 24, before the start of the conference, CARPHA will stage its third Regional Tourism and Health Steering Committee and Stakeholders Meeting at the Atlantis. The one-day event is the regional initiative for enhancing health, safety and security as well as the economic recovery and resilience of Caribbean tourism, especially as the emergency phase of the COVID-19 pandemic has elapsed.

At this meeting, regional and international health, tourism and development stakeholders, will seek to cultivate sustainable practices related to CARPHA’s innovative Tourism and Health Programme (THP), strengthen health and tourism partnerships for the THP, and advocate and promote for THP implementation and its multifold impacts.

The THP is a multifaceted program that addresses the health, food safety and environmental sanitation solutions to the related threats which impact sustainable tourism development.

In a statement commemorating the occasion, Dr. Joy St John, Executive Director, CARPHA noted that, “We take this opportunity, at this stage of the COVID-19 pandemic, to create a renewed vision and re-commit to the practices and policies that we know support the health and wellbeing of our Caribbean people.”

Built spaces and urban planning laws can significantly impact the level of movement in society and is a crucial element in ensuring a healthier Caribbean.

“The commitment of governments towards the implementation of intersectoral public policies and programs so that all neighbourhoods have basic services, safe public transportation, areas where we can socialise, safe streets, places to walk and green spaces, is so important.” PAHO Director, Dr. Carissa F. Etienne said. “I want to recognize the efforts of many municipalities in the region that are working on making their municipalities healthy, responding to the needs of people, and facilitating strategies that improve the conditions of places where they are born, work, study and have fun,” she added.

Another issue to be addressed during the “Reimagine Healthy Spaces” campaign is the negative impact that cigarettes have on both public health and the environment.

Dr. St John noted that, “Millions of trees are cut down annually to produce the number of cigarettes that the industry demands to maintain profits, while cigarette butts and packaging can contribute to environmental pollution.” She asserted that, “This reimagining of a smoke-free Caribbean, that limits the negative impact of the tobacco industry on our health and our environment is necessary, not just for our own health but for the health of the next generation.”

Sir Trevor Hassell, President, Healthy Caribbean Coalition noted that “Healthy Schools are a cornerstone of our neighbourhoods and a building block of a productive society.  A Healthy school is smoke-free, promotes inclusive physical activity and is protected by healthy school policies.” He elaborated, “These policies would limit the sale and marketing of foods full of sugar, fats and salt both in and around schools, while increasing the availability of healthy foods and drinking water.”  In keeping with this, the recently launched digital campaign, ‘#ActOnFacts – The Food in Schools Matters’, encourages public and policymaker support for the introduction of policies that puts the health of our children at the centre.

PHOTOS CAPTION:  Graceway Supermarkets marked Caribbean Wellness Day in the Turks and Caicos Islands with a ten percent discount on its produce items.  The grocery store conglomerate, with four stores across Providenciales and Grand Turk partnered with the TCI Ministry of Health and Human Services to also offer free health checks to shoppers.

Staff Writer

July 25, 2022 – An altered version of the smallpox vaccine which is effective against Monkeypox is being offered in countries around the world to protect the most vulnerable as cases rise and the World Health Organization declares the event a Public Health Emergency of International Concern.

The vaccine is called Imvanex in the UK and Europe, Jynneos in the US and Imvamune in Canada but the vaccine is the same in every case and is made by the same company.  The vaccine is effective before and even after contact with an infected person.  But for persons who may already be infected, it works best within four days of contact with an infected individual.

Unfortunately because Monkeypox has never broken out on this scale, demand is outstripping supply across the globe.  The UK at present is only offering one dose to the most vulnerable populations.  These include healthcare workers who are caring for and who are due to start caring for a patient with confirmed Monkeypox.

Gay, bisexual and other men who have sex with men (GBMSM) is at the highest risk of exposure and  people who have already had close contact with a patient with confirmed Monkeypox.

In terms of supply for the Turks and Caicos there has been no mention yet of providing overseas territories with the vaccine.

In fact the UK is firm on their stance that those at most risk will be considered first with every new batch that becomes available.  Not even healthcare workers “who work in non-specialist wards or clinics, even those in frontline services and Accident and Emergency” will get a vaccine if they do not meet the criteria.

The Caribbean Public Health Agency CARPHA has also not made any mention of procuring the vaccine as yet.  In the agency’s latest communication on July 18th it warned countries to be vigilant and Dr. Joy St. John, Executive Director said, “Personnel are prepared to respond in country to assist in the investigation and control of an outbreak, should the need arise.”

The Pan American Health Organization (PAHO) said vaccination should be done on a case by case basis but stressed, “Mass vaccination is not required nor recommended for Monkeypox at this time.”

Anyone can get Monkeypox through prolonged close contact with a positive individual, touching rashes or materials that have been in contact with an infected individual’s open lesions.

Staff Writer

#TurksandCaicos, July 25, 2022 – The Turks and Caicos is still waiting for confirmation on that first suspected case of MonkeyPox, what we do know is the suspected case is from a resident with a history of travel to the UK, this is according to Dr. Nadia Astwood, Chief Medical Officer at the Ministry of Health & Human Services in response to Magnetic Media questions about the case.

Apparently samples cannot be shipped to CARPHA with the courier services operating out of the TCI because the disease is classified as a ‘Category A’ pathogen.

The National Institute of Allergy and Infectious Diseases says, “Category A pathogens are those organisms/biological agents that pose the highest risk to national security and public health because they

• Might cause public panic and social disruption

OR

• Require special action for public health preparedness.   Among other reasons.

As a result TCI health officials say they are “diligently working on developing local capacity for testing utilizing equipment acquired by the NPHL during the COVID-19 pandemic.”

The individual is in isolation and is apparently recovering well.

Health officials say the person turned up to a healthcare provider, not the ER, and they are now  carrying out contact tracing.  Local testing should be up soon to confirm the presence of the virus.

If the virus is confirmed to be on island, the Ministry of Health and Human Services says they will make a formal announcement and healthcare providers are already on alert.   Anyone presenting with the signs and symptoms of MonkeyPox to any healthcare provider will trigger an immediate response including testing contact tracing and isolation.

“The MOHHS has requested that all health care providers have a high index of suspicion due to the unprecedented global spread of this disease which has been confirmed in countries with close travel ties to the TCI as well as recent confirmation of cases in the Caribbean region,” Astwood said.

While she did not give a concrete turnaround time for testing and she did not reveal which island reported the suspected case, Dr. Astwood said results will come as soon as is practical.   Additionally, isolation for positive individuals will be observed at home due to the mild nature of the disease and can last up to 21 days.

To stay protected the MOHHS said to residents, “It is important that the public stays informed and takes precautions to protect their health and that of those around them as the pandemic is ongoing and there is the added threat of MonkeyPox.  The same hygienic measures are recommended for both illnesses inclusive of mask wearing.”

Almost all of the TCIs major travel partners including the US,UK, Canada, Dominican Republic and Jamaica have recorded cases.