Addressing the 36th Caribbean Cardiac Society Conference last month in Kingston, Jamaica, Dr. Binoy Chattuparambil, Senior Consultant, Cardiovascular & Thoracic Surgery and Clinical Director at Health City Cayman Islands, highlighted the life-saving ECMO or extracorporeal membrane oxygenation process, a form of life support for patients, successfully and consecutively performed at the Caymanian facility.

“There is no reason for patients with reversible cardiac diseases (to) die because you can put them on ECMO and the technology is very good and our understanding (of it also) is very good,” Dr. Binoy told his peers, explaining that ECMO provides time for the body to rest and recover by doing the work of the heart and lungs.

Having saved countless lives with this technology at the Cayman Islands hospital, the respected surgeon cited a case of a child who is doing well following treatment with ECMO and transfer to the United States for a heart transplant: “Whether it is reversible pulmonary reasons or cardiac reasons, just put them on ECMO and the recovery is usually very good and we can save lives.”

In 2017, the hospital became the Caribbean’s first regional center to provide the advanced form of life support (ECMO). The hospital also installs artificial hearts or left ventricle assist devices (LVAD) for chronic or advanced heart failure patients for whom a transplant is unlikely to be readily available in the mainland United States. Health City anticipates that transplant services will be available in the Cayman Islands in the near future following the establishment of transplant laws and regulations.

The theme of the Kingston conference was “Serving and Saving the Hearts of our People Today, Tomorrow and Beyond!” and Dr. Binoy presented on “Enhancing Cardiac Surgery in the Region – Updates and Perspectives”.

The surgeon expressed his joy at seeing greater collaboration between cardiac surgeons and cardiologists throughout the region. “Now I see my cardiologists more often in our hybrid cath lab rather than outside,” said Dr. Binoy, who established the adult and pediatric cardiac programs at Health City Cayman Islands in 2014 and has overseen thousands of successful cardiac surgeries and procedures at the tertiary care hospital.

He revealed that there were no deaths or reinterventions from elective Coronary Bypass Surgery at Health City Cayman Islands and minimally invasive surgery has been successfully completed for most mitral valve defects. Additionally, aortic valve surgery has evolved over the past two decades from an open incision with a large scar to that of no incision and no scar.

Pulmonary thromboendarterectomy to treat chronic pulmonary thromboembolism is also another achievement at the Joint Commission International (JCI)-accredited institution. This procedure has been more frequently performed since the COVID-19 pandemic where patients often present with acute pulmonary embolism which can later present as chronic thromboembolic pulmonary hypertension.

In the specialized areas of pediatric and neonatal surgery, a variety of life-saving surgeries to correct defects in the heart, in collaboration with a pediatric interventional cardiologist, have been achieved at Health City Cayman Islands. Children from over 25 countries have been treated, including those families who have insufficient funds and are supported by various charities.

A broad spectrum of vascular surgery options with successful outcomes are also provided, including repair of major arteries in the chest and abdomen to treat aneurysms, and replacement of major arteries in the chest through minimally invasive or no-incision procedures.

Dr. Binoy concluded that Healthy City has “significantly contributed to the enhancement of the scope and landscape of cardiovascular surgery in the region”, and commended the Health City team for the excellent service that they have provided over the past nine years.

Photo Captions

Header: Dr. Binoy Chattuparambil addressing the cardiac conference in Jamaica.

Insert: Health City’s team at the conference included (from left): Sales and Marketing Specialist Ingrid Harris, Dr. Binoy and Rebekah Anne Brooks, Head of Marketing & Sales.

About Health City Cayman Islands

Health City Cayman Islands is a medically advanced tertiary hospital located near High Rock in the district of East End in Grand Cayman. The brainchild of internationally renowned heart surgeon and humanitarian Dr. Devi Shetty, it features a unique model of health care, built with a focus on the patient and rooted in innovative business models that allow the delivery of high-quality, affordable care. It is the largest hospital in the Caribbean to have earned the prestigious Gold Seal of Approval from Joint Commission International (JCI), the worldwide leader in accrediting the quality of health care. For more information visit www.healthcitycaymanislands.com.

Staff Writer

#St.KittsandNevis, August 5, 2023 – Kidney transplant surgeries will soon be offered in St. Kitts and Nevis as announced by Prime Minister Terrance Drew.

This development is a big one for the country’s health system and so it will provide kidney transplant services to citizens who are unable to travel overseas to acquire said services.  This was emphasized by Drew during the announcement at the Freedom FM’s Issues program held on Wednesday July 26th, 2023.

“These people are dying sooner than they should because they don’t have access to transplants.  I cannot allow our people to die when we have an opportunity to save their lives,” he highlighted.

Additionally, despite the country’s efforts to enhance health services for kidney patients, he urged residents to make better choices and take better care of their bodies adopting healthier habits such as frequent exercise, having balanced diets, maintaining blood pressure  and sugar levels etc.

But for those who fail to do so and fall victim to kidney ailments, he expressed that the aim is to have a something in place to help them.

“We want to make sure that they have an option for renal transplant and we are going to launch the renal transplant program.”

The kidney transplant surgeries will be provided at the country’s principal healthcare facility, the Joseph N France General Hospital.

In continuation, Drew further spoke to a team which will at some point in the near future, visit St. Kitts and Nevis from Canada to provide specialized training to the Haemodialysis Unit’s staff, to up the use of the recently acquired dialysis machines, further strengthening the nation’s fight against kidney diseases.

The equipment was procured through the New Variant Assessment Platform, led by United Kingdom Health Security Agency (UKHSA).  This marks another milestone in CARPHA’s mission to strengthen its systems to better detect and respond to emerging diseases in the Caribbean region.

The items received are two liquid handling instruments namely, the Mosquito® HV, and the Dragonfly Discovery.

Dr. Joy St. John, Executive Director of CARPHA.  “Our overall collaboration with UKHSA has been very supportive to our work with our Member States. These devices have ensured further strengthening of CARPHA’s  gene sequencing capabilities, maintaining the cutting-edge array of laboratory services we provide to our Member States.”

“The acquisition of the instruments will serve to advance our laboratory productivity, shorten turnaround times, and reduce costs per sample.  Overall, the instruments will improve sample processing accuracy,” stated Dr. Michelle Hamilton, Head, Laboratory Services and Networks.

The Mosquito® HV is a highly accurate and precise multichannel pipetting system.  The Dragonfly Discovery enables innovative, low volume liquid dispensing that is compatible with a wide range of applications including molecular biology and genomics, and biochemical assays.

“Both devices will be used together to increase sequencing capacity by automating some of the preparation steps. These instruments will allow CARPHA to carry out multiple sample runs,  and switch between applications with minimal setup required,” explained Ms. SueMin Nathaniel, Manager of Laboratory Services at CARPHA.

The acquisition also included a supply of consumables. Laboratory staff at the CMML will receive training in the use of the instruments.

During the first half of 2023, CARPHA signed a Memorandum of Understanding with the UKHSA.  The agreement builds on a long-term collaboration to improve regional health security across the Caribbean. The MoU includes commitments to define strategies for combatting  infectious disease threats, non-communicable diseases, strengthening outbreak response, building laboratory and workforce capacity, and improving healthy safer tourism. There is specific emphasis on genomic surveillance of high priority pathogens which emerged as a new service during the COVID-19 pandemic.

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.

August 1, 2023 – Schools are open, masks are off for many, and residents are hugging instead of bumping elbows; it is a stark contrast to the tentative uber-cautious reopening seen in 2022, following historic worldwide lockdowns because of COVID-19. Back then, masks were a strict requirement for many, social distancing was in effect and sanitizers were a must for entering any public building.

The message from the World Health Organization is that while Covid-19 is no longer a Public Health Emergency of International Concern, it’s still present and still deadly. Exacerbating that is the fact that the vaccines, which gave so many the confidence to interact freely with others, are known to wane and the waning effect of vaccines was of serious concern for Health professionals, and internationally, regionally and locally, the intake of boosters was heavily encouraged as a way to protect lives by lessening the severity of infection if it occurred. But booster uptake to strengthen vaccination has been extremely poor across the Caribbean region and generally low elsewhere, leaving residents vulnerable to infection.

The New York Times Vaccine Tracker says 72.2 percent of the world’s population was fully vaccinated but less than half that number had an additional dose (booster 1), and the number of people who progressed to the second booster is even lower.

Despite these obvious points of concern, there is evidence that residents at all levels are less restricted in 2023. In an absence of new variants of concern that are not offshoots of Omicron, many protocols have melted away and with them the rigid sense of vigilance against touching and interacting with others. This is despite the fact that many residents are technically barely protected against severe disease. Governments across the world have loosened COVID era rules for travel and spacing, from earlier countries like Jamaica and the Dominican Republic, to the more cautious and restriction heavy areas like China.

Also concerning is that as residents and governments have become more relaxed and data sources are disappearing. The White House Covid team in the US has been ended, Covid-19 charts in the Turks and Caicos are less frequent than before and authorities like the WHO are warning that residents are testing less and less. It means reporting is not as accurate as it was in the height of the pandemic.

While authorities still urge caution, it’s no longer enforced, rather encouraged. Cases globally are on the decline the WHO says but they also say “currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally.

Staff Writer

July 31, 2023 – Dengue is on the rise and the region of the Americas is most affected according to the World Health Organization (WHO) with nearly THREE million suspected and confirmed cases this year.

In an update on July 19th, the WHO described the outbreaks as of ‘significant magnitude’ have been recorded regionally. The numbers seen in the first seven months already eclipse the entire year of 2022 which saw 2.8 million cases. Of the cases this year, 45 percent were lab confirmed.

The number is dangerously close to the highest year on record (2019), which saw 3.1 million cases.

Thankfully, the number of severe cases are extremely low with only 0.13 percent classified as severe dengue. The death rate is also low, recorded at 0.04 percent or 1,302 deaths. The worst affected areas remain in South America, specifically Brazil, Peru and Bolivia.

The WHO is warning however, that the regional risk of outbreak is high because of the high prevalence of the mosquitos (especially Aedes Aegypti) which are carriers.

The Turks and Caicos has already completed one round of mosquito fogging exercises this summer in an attempt to control the vectors that spread dengue fever throughout the population.

Dengue, also called break-bone fever, spreads from mosquitoes to people. The WHO says most people who get dengue won’t have symptoms. But for those that do, the most common symptoms are high fever, headache, body aches, nausea and rash.

In order to lower your risk of dengue, you must avoid mosquito bites.

Effective ways include sleeping under mosquito nets, using mosquito repellents and preventing mosquito breeding by getting rid of garbage that can facilitate standing water collection and caring for drains properly so they don’t clog.

“United Way TCI is ramping up our Literacy Campaign, and this collaboration between us (Youth Help Foundation, Learn & Lead and TCI Hospital) is a testament of our commitment to improving our country’s literacy rate. “Lit from Birth” will make a powerful impact. We are here as a united force to help and happy to make a difference. On behalf of the Board of Directors, I would like to thank our partners and look forward to more collaborations.”

Photo Caption:

Header: L-R (Dr. Stuart Ewing, President Youth Help Foundation, Midwife and RN Asha Haynes-Trumpet, MoH RN Savita Ramkellowan and Chief of Clinical Services Mikette Been)

 1st insert: L-R (Dr. Stuart Ewing, President Youth Help Foundation, Midwife and RN Asha Haynes- Trumpet)

2nd insert: L-R (Dr. Stuart Ewing President, Youth Help Foundation, Midwife and RN Asha Haynes-Trumpet and Chief of Clinical Services Mikette Been)

Staff Writer

#BArbados, July 27, 2023 – COVID-19 continues to move through the Caribbean infecting and claiming lives as Barbados recorded eight deaths between July 8 and July 21, 2023.

Eight hundred and twenty-one tests were conducted and from that 227 cases were found, giving a positivity rate of 27.65.

Now, the death toll for the country in relation to the virus is at 620.

This comes just a month after an outbreak on ward at Geriatric Hospital on the outskirts of the capital.

The Pan American Organization continues to inform countries on the importance of continuing public awareness on hand hygiene, cough and sneeze etiquette, and the importance of social distancing, despite the fact that we have nearly, if not entirely gone back to living life as it was before covid.

COVID-19 is still at large and so we must continue to be vigilant.

Social media content on the importance of eliminating mosquito breeding sites.

year – the vast majority in travelers coming from countries where malaria commonly spreads.

The United States is a popular destination for many Turks and Caicos Islanders, especially Florida, additionally, it is also one of the major gateway ports for tourists to enter the TCI. Though the risk of transmission is still extremely low, the Ministry of Health and Human Services along with the Environmental Health Department is encouraging all residents to take extra precautions this summer, more so if traveling to one of the states mentioned above. 

Although the mosquito which spreads malaria is not present in the TCI, the Aedes Ageypti mosquito is present and can spread dengue, chikungunya and Zika.

You can protect yourself and your communities from mosquito-borne diseases by doing the following:

Personal Protection

• Wear suitable clothing such as long pants and shirts with long sleeves when venturing into areas where mosquitoes are known to be present.
• Apply mosquito repellent to exposed skin. Effective repellents are those that contain ingredients DEET, oil of lemon eucalyptus, picaridin, para menthane-diol, 2-undecanone, or IR3535.
• Ensure that screens in windows and doors are in good repair to deny mosquitoes access to your home.

Prevention of Mosquito Breeding

• Remove all debris and containers that can potentially collect water from around your property e.g., old tires, bottles, cans, pots, coolers and old appliances.
• Drain or treat any standing water that may exist around your property. Pet water bowls should be emptied and cleaned at least once a week. Water drums and other water-holding vessels that are not to be used for consumption purposes can be treated with cooking oil or any other environmentally friendly oil. Report standing water that cannot be self-treated to the Environmental Health Department.
• Tightly cover water-holding containers like drums and kiddy pools to prevent mosquito access.
• Cover boats, vehicles and tires with tarps to prevent water accumulation.

The MOH and EHD will continue to closely monitor the situation and update the public accordingly. For further information or assistance please contact the Ministry of Health and Human Services at tel. 1-649-338-3055/5263 or the Environmental Health Department at Tel. 1-649-338-2143/2144.

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.