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TCI: Governor’s Address – First Covid Anniversary

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#TurksandCaicos, March 24, 2021 – Good afternoon.  I have been invited to provide some personal reflections from the last year so I hope to explain what I think my long-term memories will be when, perhaps, I look back on this period in five years’ time.  In other words the bigger picture.

I’ll start with what I believe will be my strongest positive and my strongest negative memory of the last twelve months, then talk about some of the big lessons I think I’ll remember, and end with my darkest potential fear and greatest possible hope for the year ahead.

The strongest positive will be about our people.  Everyone in the Islands ended up on the front-line during COVID and the vast majority were magnificent throughout, and continue to be so.  True – a very small number – failed the integrity test I described at the very start of the pandemic, putting others at risk while they sought either profit or momentary gratification – but compared to the rest of the world these individuals were a very small percentage of our number. I’m immensely proud of the people of TCI.

Beyond the population there are people who we have all relied on, many in front of me today, and many of us owe you more than we will ever know, such as Desiree Lewis (the Permanent Secretary of Health) and Denise Braithwaite (the CEO of the Hospitals) and those in support or alongside them, who have spent the full year working relentlessly – 15 hour days or more – often seven days a week.

I include in this list, because I saw it close up, the last Premier whose work ethic over the last year, and the attention to detail she paid to health, should be recognised today as we reflect back on where we were and where we got to.  Health is after all a devolved issue. I should say I see all the same characteristics in the new Government who will now steward us towards the second anniversary next year. If the last 12 months was about a successful defence, the next 12 months is all about our counter-attack and how completely we all throw ourselves into regaining the initiative and retaking control of our future. More on this later.

When I think about the people who got us through this I include people across every profession and with any, and every, job title, in both the public and private sector, who adjusted and innovated and delivered in a way that has not only kept these Islands safe, but also kept us functioning in relative normality, compared to the rest of the region and indeed the world. You know who you are – so if you recognise in yourself the contribution you made – I can only thank you on behalf of us all. 

And so to the overpowering negative. There is one thought that overshadows and that is the loss of our people to this wretched virus with – perversely-numbers of deaths now increasing, even as the vaccine is available on the Islands for those that wish it; a theme I will return to at the end.

Those lives shortened, and the sorrow it brings to those left behind, will be the abiding memory of this year. Attending a young Police Officers funeral service to mourn a further Police Officer, struck down not in the direct line of duty but through the impact of COVID, are memories that I will hold, but wish I didn’t have to. 

Having lost my own father to Covid my family isn’t left untouched by this year’s events and when all other memories have gone, this is the one that will of course abide. There will be others listening who know exactly how this feels, and will also know that none of us want others memory of this period to be attached to this type of direct personal grief.

There are of course other consequences of this year that have hit families in other ways. For some this will have been the toughest year of their lives economically. When tourism stops the economy here stops.  The obvious lesson from this year must be about diversification but it surely must also be about starting on the journey of having a proper safety net in place, that can catch the most vulnerable and most deserving, quickly, when unexpected calamity occurs.

And on that point, another memory I will hold is the magnificent NGO’s, in these Islands, who managed to achieve so much with so little. While we didn’t say so at the time Mandy – my wife – spent time working alongside them, regularly packing up food parcels – so our family had a very good and very regular insight into just how much good, these very good people in the TCI did, on behalf of the poorest of our Residents.

Quite probably the longest term consequence is that, as we acknowledge a year of COVID, we must also acknowledge a year that the schools have been closed. I’m personally delighted they are now on a planned course to full reopening. Education has been disrupted globally this year and what the longer term impact of that will be, no one yet knows, but there has to be an impact and every Government must plan for it, which I know ours is.

So as I think about this year I will think about the children of these Islands, what they were asked to sacrifice and how they managed, brilliantly, the challenges that none of us would have wished to face, at their age, particularly the disruption to friendships, fun and childhood freedoms as well as lessons.    

Looking back, I will recall we started the pandemic without the means to fight it. We had little high dependency care capability, we had no Intensive Care Unit. We had little PPE. We had no testing capacity on the Islands. We had no closed ventilators. We had modern hospitals, but with very limited bed capacity, and those risked being overwhelmed extremely quickly. We had insufficient staff in our hospital. We had, and we continue to have, a health system built on treatment of our most serious cases outside our shores and when we were most in need, the region was closing down to us.  All this, underpinned by a National Health Insurance Program that going forward cannot sustain, over the long term, the sort of costs that the pandemic has imposed but also modern medicine will bring.

The extremely tough and well observed lockdown – the use of emergency powers – the closure of the international borders and the stopping of our economy – not least because the rest of the world stopped travelling – saved us from the first wave of the pandemic and gave us just enough breathing space to build up capacity to give ourselves a fighting chance, although that capacity has recently been sorely tested. 

So, in the future, I will reflect that at the end of the first year we were in an immeasurably better place than when this pandemic started.  The extraordinary amount of hard work and grind by so many people who made that possible is a memory I will also hold of this year, for some time.

Another positive memory I will hold is the role the UK played. They stepped up.  Facing a crisis alone is not a place you want to be – particularly when you were as ill-prepared as we were, and while it’s probably more appropriate for others to talk of the UK’s practical, comprehensive and rapid delivery of the stores, equipment and expertise we needed, I will personally remember a group of UK colleagues, here and in London, who fought for TCI as if their very lives depended on it.

If I believe we made the right decision locking the country down quickly, another memory will be the belief that the elected Government took a brave decision – and I use that word in its most positive sense – to open our international borders in July, and then keep them open. I pay tribute to the then Government for having the courage to do this, and then hold that position. That decision has positioned us in the region as, presently, the standout tourism destination.

What we and the industry have learned over the last eight months, while others have stayed shut or oscillated in their position, is how to deliver a safe tourism experience and our top end visitors know it, admire it, and will remember it as will the wider industry. 

We also now have the data – because of testing prior to departure of our visitors – to tell us that not only are tourists not bringing the virus with them (because of our pre-testing model) they are also staying extremely safe while here – and I attribute much of that to the protocols the hotels and villas are observing, but also the excellent take up of vaccine we have seen in their front-line staff.  Our main industry has done an excellent job.

There is a good dictum that you should never let a good crisis go to waste and beyond burnishing our tourism reputation I believe in the future we will look back on this period and see it as the moment that a consensus emerged amongst politicians, senior officials and across the medical profession, that Healthcare on the Islands requires a root and branch review.  I know the Premier has this in his sights.

The pandemic put Heath under just the right amount of strain that it hasn’t (yet anyway) been broken but it has given us a forensic insight into its weaknesses.  Our hospitals need greater capacity and capability. Our partnerships across public and private medicine have to be strengthened. The affordability of our treatment abroad programme has to be examined. Our past lack of investment in public health and mental health provision needs to be questioned.

And the good news is that necessity, being the mother of invention, means progress is already underway. Our overall health system and the relationships between medical practitioners and officials are immeasurably stronger in March 2021 than they were in March 2020; that is a welcome foundation on which to build. While there is ongoing and complex arbitration between the Government and the Hospital, the working relationships between the CEO and the PS are outstanding. Public Health England, who have been magnificent partners to us throughout this year, stand ready to help if and when that help is needed but there is a huge amount of experience and local knowledge now accumulating that can be released when required.

But now we turn to the most important points I wish to make, my greatest fear and greatest hope, because these look to the 2021 rather than reflecting on 2020. We cannot change the past but we can all influence the future and what I’m about to say places exactly the same amount of power, to influence that future, in each and every residents hands. It is the great equaliser of this year. Rich or poor, old or young, whatever your ethnicity, you, the population, not the Government, through your own personal decisions will decide whether 2021 is an opportunity seized or an opportunity squandered.

I believe the end of this first year does start to mark a hinge moment, a moment when we have to start to look towards individual responsibility for our protection rather than government imposed restrictions to govern our collective behaviours around our personal health. The later got us through the last year but the former will not only get us through 2021, but reignite our economy and return our personal liberties.

What all of us here in this hospital know, but what we need the whole Territory to understand, is that the COVID virus is not going to give up and go away. Quite the opposite, it is mutating, it is getting stronger, it is becoming more deadly, it is being transmitted at a faster rate. We don’t need epidemiologists or the World Health Organisation to tell us this, we can see it with our own eyes here in TCI. People are getting sicker, faster and getting sicker with more deadly results. If we include residents we have sent overseas for treatment in just the last 7 days, four from TCI have died. All of these deaths occurred after the vaccine was available – which would have prevented their death.

I confidently predict more deaths, there is no reason to think any other way. The restrictive measures we have in place clearly are reducing contagion, but not eliminating it, and those catching the virus are becoming more likely to die. Sat behind this, the Hospital has on several occasions’ risked being overwhelmed. The Government could of course return us – on a regular cycle – to a lockdown and stop the Islands economy, or keep ramping up and down restrictions, forever, but why should we now need to do that? There is no action Government can now take – in terms of restricting your behaviours or closing down parts of the economy that offers the protection that an individual can now take, themselves, by taking the vaccine.

I promised to be straight and clear in my inauguration speech. The issue for me, as Governor, is that rather than the uptake of the vaccine increasing week-on-week, as more and more evidence accumulates that this is the life-saving remedy, the uptake of the vaccine is starting to flatten off.  We had an extraordinary roll out – efficiently delivered and administered – but momentum is seemingly cooling.

This coincides with news that the Pfizer vaccine may well become in short supply in the UK and while the UK will send us as much vaccine as the TCI population can use – in terms of full transparency – we cannot in all conscious ask for more to be sent if the clinicians and medical officials on the Islands are uncertain if future deliveries will be used before their expiry date.  We cannot have vaccines being thrown away here when there are those in the UK who want the vaccine but have yet to receive it.

Having attended a forum with Premiers and Ministers from across the Caribbean last week, where a cry from the independent Caribbean was for easy access to vaccines as they look enviously on at us, the one memory I do not want to hold from this anniversary is that this month marks the moment the vaccine program to TCI started to falter because the demand for it was not there.  

For TCI to miss this opportunity, the opportunity to prevent loss of life, the opportunity to prevent our hospitals being overwhelmed, for us to choose to rely on curfews and restrictions and masks – indefinitely – when the door to normality has been opened and the route clearly signposted would, along with the deaths already mentioned, be the darkest of memories for me – a once in a century opportunity offered and then missed.

So on this anniversary what we must do in Team Health and Government is redouble our collective efforts at public education, answer the publics concerns respectfully and diligently, continue to deliver the vaccine – as we all have – efficiently and safely to all those who want it.  As of 21 March – 12,935 persons have been vaccinated, without any incident, which is 34% of our population. That’s a good start, but only a start.

So we must also explain to those who have yet to be vaccinated that at some future point the program – as constructed – will be closed, the supply will have halted, and the country will have to move on – indeed the world will have to move on – with some – hopefully most of the population safe – and some of it at risk – and at risk through personal choice.

I use this opportunity again to say, when you take the vaccine you are taking it for yourself, your family, all those you come into contact with, for their health, for their future prosperity and for their future liberty. You are doing it – literally – for your country and your TCI brothers and sisters.

In strong contrast the memory I want to hold – the memory I believe I will hold – is that together we all created the safest destination and home in the Caribbean for ourselves and our visitors alike, and that our reputation for this secured us an unbelievably positive future for these Turks and Caicos Islands as a world and regional leader.

This future is ours to have if we have the collective courage to seize it.  Please (please) register for the vaccine and more than that encourage those you care about to do so to. This is a moment for all of us to be leaders and recognise that the power of one, the power of individual decision making, has the power to change these Islands future.

And with that, may God Bless these Turks and Caicos Islands.

Bahamas News

CARPHA Team undertakes Assessment of Guyana’s National Surveillance System for Non-communicable Diseases

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October 14, 2021 – The Caribbean Public Health Agency (CARPHA) conducted a technical mission to Guyana from September 22nd – 25th, 2021 to undertake site visits as a part of an ongoing assessment of six (6) Member States’ systems for the national surveillance of non-communicable diseases (NCDs) and their risk factors. This activity was implemented in collaboration with the Ministry of Health Guyana through an Agence Française de Développement (AFD) – funded project.

The aim of the assessment s to provide evidence in support of the development of a Regional Surveillance System for NCDs, a priority under the regional health framework Caribbean Cooperation in Health IV (2016-2025).

During the mission, the CARPHA technical team reviewed the capacity of existing surveillance mechanisms in Guyana to collect, analyse and report on the NCDs and risk factor indicators proposed for the regional surveillance system. These indicators were recommended by a multi-stakeholder meeting series convened in 2020 under the AFD project, which reviewed global, regional, and sub-regional mandates, targets and practices in surveillance for the prevention and control of NCDs.

The CARPHA Team along with senior officials from the Ministry of Health conducted visits to two (2) health centres, the National Cancer Registry, Ministry of Health Surveillance, and Statistics Unit.  The results from the overall assessment will be presented to the Ministry of Health Guyana and will also be reviewed alongside results from similar assessments in Anguilla, Aruba, Jamaica, St. Vincent and the Grenadines, and Suriname to inform the finalisation of the regional surveillance system design through a regional stakeholder meeting.

The regional NCDs surveillance system would facilitate the reporting and availability of data to inform policy development, planning, and tracking of progress towards meeting for targets NCDs at Regional and National levels.

Through funding from the Agence Française de Développement (AFD), CARPHA is leading the Region in Strengthening Strategic Intelligence and Partnership Approaches to prevent and control NCDs and Strengthen Regional Health Security in the Caribbean. This project, signed in 2019 with a value of €1,500,000.00, demonstrates the commitment of the Government of France and the French people to supporting the public health priorities of the Caribbean Community through CARPHA.

More information on the Project can be found at: https://www.carpha.org/Projects/Ongoing-Projects/Strengthening-Strategic-Intelligence-and-Partnership-Approaches-To-Prevent-and-Control-NCDs-and-Strengthen-Regional-Health-Security-In-The-Caribbean

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Bahamas News

World Sight Day: Love Your Eyes

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Port of Spain, Trinidad and Tobago.  14 October, 2021.  In the Caribbean, the leading causes of blindness are glaucoma, cataract and diabetic retinopathy (a complication of diabetes).  According to the Vision Atlas, 6.2 million persons in the Caribbean were reported to have vision loss, with an estimated 260,000 persons reported to be blind in 2020.

Information gathered from eighteen (18) Caribbean countries (Antigua and Barbuda, Bahamas, Barbados, Bermuda, Belize, Cuba, Dominica, Dominican Republic, Grenada, Guyana, Haiti, Jamaica, Puerto Rico, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Suriname and Trinidad and Tobago) with a population of 44 million, showed that the crude prevalence of blindness was 0.60%, and the prevalence of all vision loss was 13.20%. Many of the persons affected were females at 52%.

Global statistics reveal that for 2020, a total of 596 million persons had distance vision impairment worldwide, of this number 43 million were blind.  Projections for 2050, indicate that an estimated 885 million persons may be affected by distance vision impairment with 61 million expected to experience  blindness.

CARPHA’s vision for the Caribbean is a region where the health and wellness of the people are promoted and protected from disease, injury and disability, thereby enabling human development in keeping with the belief that the health of the Region is the wealth of the Region.

Although there are no projects that directly address vision impairment, CARPHA in collaboration with its public health partners is implementing initiatives to address risk factors such as unhealthy diets, use of harmful substances and poor physical activities. This in turn, will help reduce the risk of disability due to complications associated with poor blood sugar and blood pressure management.

Efforts to improve the standards of care for diabetes through the implementation of the CARPHA Guidelines on the Management of Diabetes in Primary Care in the Caribbean, and training of health care workers from the CARPHA Member States will also contribute to the prevention of vision impairment and blindness due to diabetes.

Access to eye care services can reduce visual impairment.  CARPHA urges Member States to strengthen health systems to improve eye health services with emphasis on reaching the vulnerable and those most in need.  Governments should commit to integrating eye care into the universal health care system.

World Sight Day is celebrated annually on the second Thursday in October.  The focus of the day is to bring awareness to blindness and vision impairment as a major public health issue and blindness prevention.

The 2021 commemoration observed on 14th October, seeks to encourage persons to think about the ‘importance of their own eye health.’

Our eyes are working hard during the COVID-19 pandemic. We have been indoors, in front of our screens, and probably missed our eye test appointments. Now more than ever, we need to protect and prioritize our eyesight. There are simple things you can do for yourself to prevent the development of serious eye issues:

  • Take screen breaks for at least five minutes every hour
  • Spend time outside.  Increased outdoor time can reduce the risk of myopia (near-sightedness)[3]
  • Get an eye test. A complete eye exam can detect eye conditions such as glaucoma before it has an effect on your sight. The earlier an eye condition is identified, the easier it is to treat.
  • Eat a healthy balanced diet and engage in physical activity. These are crucial steps in maintaining a healthy weight, controlling obesity, and preventing diseases such as diabetes, all of which can impact eye health.
  • If you have diabetes, you should have your eyes checked every year

Your sight cannot be taken for granted.  It is time to LOVE YOUR EYES!

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Bahamas News

TCI Premier and Tourism Minister lead delegation  at NABHOOD Summit

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#TurksandCaicos, October 13, 2021 – The Hon. Premier, Charles Washington Missick and Hon. Josephine Connolly Minister for tourism attended the 8th Annual International Multicultural & Heritage Tourism Summit and Trade Show. This summit was held at the Miami Marriott Biscayne Bay Hotel from October 8th to 10th. The theme of this year’s Summit was ‘Gaining Economic Powers Through Multicultural Tourism’. The summit was held by the National Association of Black Hotel Owners, Operators & Developers (NABHOOD)

Both the Hon. Premier and Minister for tourism were key panelist at the summit. The Premier sat with interviewer Vincent Vanderpool Wallace, former Minister of Tourism & Aviation of the Bahamas on a one on one interview entitled A conversation on The Turks and Caicos Islands. This discussion was extremely well received and allowed for the Premier to discuss factors attributing to the success of the Tourism industry in the islands and his vision for the sector.

Hon. Connolly joined a high caliber panel with three other industry experts on Saturday morning. Their discussion centered around Diversity in Tourism and the impact to the Destination. The Minister expanded on where Turks and Caicos’ industry was heading post pandemic, how it performed over the past months and insight into the future of Tourism in the Turks and Caicos Islands including the setting up of a Regulatory Authority and a Destination Management Organization.

Among others participating from the Turks and Caicos Islands were students and a chaperone from the Turks and Caicos Islands Community College Hospitality Program. The students had the opportunity to network with other US and Caribbean students at the summit.

It is clear that the growth of the Tourism sector in the TCI and the fact that we continue to perform well despite the challenges of COVID 19, is of interest to many. Also of note is the vision articulated by the Premier as he noted; ‘it is imperative that we provide opportunities within the Tourism sector for the growth of investment and local ownership. Turks and Caicos Islanders must benefit directly from the growth of this sector’. The Premier noted that much of his efforts will be to promote investment and ownership by Turks and Caicos Islanders as much as possible.

The Hon. Minister of Tourism stated her pride in representing the country and sector at this summit; ‘This is the first opportunity I have had to present our island on a panel for some time. This year despite COVID 19, we saw arrival numbers that even exceeded pre-COVID 19 during the summer months. I can say that our protocols, our partnerships, our pre-screening program and our COVID 19 marketing strategy all contributed to this success.’

 

 

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