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TCI: Oxygen Generator System installation starts this week

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#TurksandCaicos, March 8, 2021 – InterHealth Canada-Turks and Caicos Islands Hospital in partnership with the Turks and Caicos Islands Government, continues to monitor and manage various critical resources that can affect the hospital’s capacity during the COVID-19 national response. These include the availability of hospital beds, personal protective equipment (PPE), human resources, and oxygen.

The installation of an oxygen generator system at the Turks and Caicos Islands Hospital is scheduled to commence this week. The project seeks to provide the hospital with the equipment to independently produce medical-grade oxygen and reduce the reliance on overseas suppliers.

The system design and layout process are underway, and the overall project is expected to span 10 to 12 weeks.

8 March International women’s day illustration

A duplex MDOCS 200 VSA oxygen generation system will be installed at both the Cheshire Hall Medical Centre on Providenciales and Cockburn Town Medical Centre on Grand Turk. During the installation process, the hospital can utilize an emergency provision to rapidly install an oxygen generator module if there are supply-chain difficulties encountered with the shipment of oxygen cylinders.

COVID-19 is a respiratory virus, and due to the nature of the disease, the virus can affect the lungs and impair a patient’s ability to intake sufficient oxygen. Therefore, oxygen is the mainstay of clinical therapy for patients admitted with severe COVID-19 disease, and for these reasons, piped oxygen demands are naturally higher during the pandemic.

The supply and consumption rate of oxygen is actively monitored in conjunction with the patient admission and discharge trends. Oxygen supply levels can fluctuate daily based on patient care needs and the length of inpatient stay for COVID-19 patients. Oxygen cylinders are ordered on a rotation cycle, and approximately 100 or more cylinders arrive from overseas every week to bolster supply levels. Liquid oxygen cylinders are also used, which provides the health care facility with an even higher storage capacity.

The project is government-funded, and InterHealth Canada, the hospital’s private health care management company, is specifically responsible for the coordination and logistics onsite. A robust phase of quality assurance checks was completed to ensure the requisite standards and technical specifications were met before the installation contract.

Deputy Premier and Minister of Health, Agriculture and Human Services, Honorable Erwin Jay Saunders, stated: “The Ministry of Health (MOH) has been working closely with TCI Hospital since the start of the COVID-19 pandemic to ensure that capacity was built at the hospitals to respond to this public health emergency, being the only secondary care facilities in the TCI. A joint plan of work was undertaken and funded by the TCIG and included the uplift of additional beds at both sites, including furniture, procurement of biomedical equipment and consumables for these beds, procurement of personal protective equipment (PPE), facilitating additional clinical staffing from Cuba as well as the development of a capacity to generate oxygen within the TCI for the first time.

Previously, the TCI has relied on the importation of medical-grade oxygen for use in the hospital and clinics. The oxygen generators were purchased and are in-country, and works are underway to install and commission these generators.

This initiative will be sustainable in allowing the hospitals to generate oxygen in the country during the pandemic and beyond and no longer rely on external sources. We are excited about this development and the partnership which has led to this point and look forward to the implementation of these devices as a part of the ongoing COVID-19 response.”

Chief Executive Officer at TCI Hospital, Dr. Denise Braithwaite-Tennant, stated: “This represents a tremendous achievement in our pandemic and disaster resiliency. The genesis of this project came about as a result of a task force commissioned in the early months of the pandemic.

The task force was led by PS Desiree Lewis, supported by specialist advisors from the UK and members of the hospital and team health. During the ensuing months, we conducted robust data analysis and scenario planning, and the outcomes are the hospital and system developments that are progressively being implemented by various project leads. It was also important that the oxygen generating capacity be present at both the Providenciales and Grand Turk facilities, which seek to build redundancy and resiliency. This is especially important when one considers that each facility for periods has to operate without the support of its sister facility during a disaster.

The project leads for the oxygen generator implementation are Ms. Florinda Talbot, MOH Contract Manager, and Martín Dawtry, our facilities General Manager and strongly supported by the AG Chambers. The project leads have all worked passionately with both the hospital and MOH teams to bring this new and potentially life-saving technology to the Islands and continue to do so as the contractor progresses the installation. It is through a collaborative and visionary relationship with the Turks and Caicos Islands Government that great successes are achieved for the community.” 

Chief of Medical Services at TCI Hospital, Dr. Dawn Perry-Ewing, stated: “The upscaling of TCI Hospital’s capacity to deliver care to patients during this pandemic makes the nation’s healthcare system even more resilient. This project is the result of a collaboration between the TCI Government and TCI Hospital. The welcomed arrival of the generators gives our operating team a wider margin of comfort as we can consistently provide a higher standard of care to our patients.”

Contract Manager at the TCI Government Contract Management Unit, Florinda Talbot, stated: “Hospitals all over the world realize that onsite oxygen generation provides a highly reliable and economical solution for their oxygen requirement. This includes directly supplying oxygen to the hospital’s in-house supply lines, filling cylinders to provide backup or supply for over-peak demands. I am elated to see that the TCI Hospital has arrived at this stage.”

General Manager of Facilities at TCI Hospital, Martin Dawtry, stated: “This is a great partnership initiative, which allows the health care facility to generate its medical grade oxygen, not only for this current pandemic but for future resilience. We will also have the ability to produce medical-grade oxygen to fill our cylinders to support oxygen needs for community clinics across the islands. The installation works will add to our existing long list of resources implemented at TCI hospital to improve patient care during this pandemic and support additional capacity.” 

Health

Measles Alert, Ministry of Health concerned about Patients

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The Ministry of Health and Human Services is asking all clients seen at the Cheshire Hall Medical Center Emergency Department on April 21, 2024, April 22, 2024, and May 3, 2024, to remain vigilant for any signs and symptoms of Measles. Any signs and symptoms noted must be reported immediately to your doctor.

As a reminder, the signs and symptoms of measles are:

  • Fever
  • Red rash (starts behind the ear and then spreads to the head and neck then body)
  • Coryza (runny nose)
  • Cough
  • Conjunctivitis (red eyes)
  • Body aches

Small greyish-white spots with a bluish-white center inside the mouth, cheek, and throat.

Measles is highly infectious and can be spread quickly in persons who are unvaccinated. If you think that you have been in contact with someone with symptoms of measles, please do not hesitate to see your doctor. For more information please call (649) 338-5469. For further information please visit the Ministry of Health and Human Services Facebook page at https://www.facebook.com/tciministryofhealth/.

 

 

 

 

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Caribbean News

Belize, Jamaica and St. Vincent and the Grenadines eliminate mother-to-child transmission of HIV and Syphilis 

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Belize, Jamaica, and St. Vincent and the Grenadines are the latest countries in the Americas to receive certification from the World Health Organization (WHO) for eliminating the mother-to-child transmission of HIV and syphilis (EMTCT). The milestone was marked today at a commemorative event organized by the Pan American Health Organization (PAHO) in Kingston, Jamaica, with support from UNICEF and UNAIDS and with the participation of health ministers from the three countries.

 

“This achievement is a testament to years of dedication, hard work, and collaboration among governments, health professionals, and communities”, PAHO Director Dr. Jarbas Barbosa said at the event. Dr. Barbosa also acknowledged the “remarkable resilience” displayed by the three countries, ensuring the adaptation and continuation of essential services despite the challenges posed by the COVID-19 pandemic. “I trust that the celebration today will inspire other countries to reinvigorate their commitments” towards a generation free of HIV and congenital syphilis.

 

In 2010, countries of the Americas committed to the elimination of mother-to-child transmission of HIV and syphilis and endorsed the regional strategy, which was updated in 2016 under the PAHO Plan of Action for the Prevention and Control of HIV and Sexually Transmitted Infections.

 

To meet elimination targets, countries focused on strengthening prevention and treatment services within primary health care and in maternal and child health, updating guidelines, ensuring the effective screening of pregnant women, monitoring cases and following-up with HIV and syphilis exposed infants.

 

In a video message, WHO Director-General Dr. Tedros Adhanom Ghebreyesus, praised Belize for integrating primary disease prevention and treatment into maternal and child health services. He also commended Jamaica for its civil society organizations’ commitment to human rights and lauded St. Vincent and the Grenadines for investing in robust national laboratory structures. “While validation is a tremendous accomplishment, maintaining it requires sustained efforts to prevent new infections,” he said. “WHO and partners will continue to support all countries in the Americas to strengthen health systems, provide comprehensive services, and ensure the involvement of women in planning and service delivery.”

 

Globally, 19 countries and territories have now been certified for eliminating mother-to-child transmission of HIV and/or syphilis, with 11 of them located in the Americas. In 2015, Cuba made history by becoming the first country in the world to achieve the dual elimination of HIV and syphilis. This was followed by Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands and Montserrat and St. Kitts and Nevis in 2017, and Dominica in 2020.

 

“The end of AIDS is an opportunity for a uniquely powerful legacy for today’s leaders. We are again celebrating a great public health milestone today as Caribbean countries show global leadership in the elimination agenda to achieve an HIV free generation,” Christine Stegling, UNAIDS Deputy Executive Director, said.

 

New HIV infections among children in the Caribbean decreased by 25% between 2010 and 2022. During that period, annual notified cases declined from 2,000 to 1,500. Reported cases of congenital syphilis in the English-speaking Caribbean now stand at 36 cases per 100,000 newborns, below the goal of no more than 50 cases per 100,000 newborns.

 

“UNICEF welcomes the commitment of Belize, Jamaica and Saint Vincent and the Grenadines for achieving the double elimination of vertical transmission for HIV and Syphilis”, Garry Conille, UNICEF Regional Director for Latin America and the Caribbean, said. “We are confident that this milestone will be a catalyst for other countries in the region to pursue the Elimination of Mother-to-Child Transmission Agenda toward the 2030 target: No child left behind in the progress to end AIDS,” Conille added.

 

WHO awards this certification to countries which have brought the mother-to-child HIV transmission rate to under 5%; provided antenatal care and antiretroviral treatment to more than 90% of pregnant women; reported fewer than 50 new cases of congenital syphilis per 100,000 newborns, and achieved an HIV case rate of fewer than 500 per 100,000 live births.

 

Elimination Initiative

 

The PAHO Elimination Initiative seeks to put an end to more than 30 communicable diseases, including the mother-to-child transmission of HIV and syphilis, in Latin America and the Caribbean by 2030.

 

The initiative was relaunched during the Organization’s 60th Directing Council and seeks to harness the lessons learned from the COVID-19 pandemic, as well as from previous elimination experiences to accelerate disease elimination in the Region.

 

Quotes from Ministers of Health

 

Kevin Bernard, Minister of Health and Wellness of Belize: “Eliminating mother to child transmission of HIV and syphilis is an extremely significant accomplishment for the people and the country of Belize. The activities leading up to this momentous goal were not always easy, however with the commitment and motivation of our health care workers, in all areas of health, this has become a reality. We continue to work towards achieving public health goals for a healthier and more productive Belize.”

 

Dr. Christopher Tufton, Minister of Health and Wellness of Jamaica: “The elimination of mother-to-child transmission of HIV and syphilis is a win that underscores protecting the health of all. It is also exemplary of the extraordinary progress being made in our maternal health care. What’s more, it is vitally important that we consolidate the gains made from this achievement, especially through continued community engagement and partnership in the public health interest of all.”

 

St. Clair Jimmy Prince, Minister of Health, Wellness and the Environment of St Vincent and the Grenadines: “I commend the dedication and commitment of healthcare workers on achieving certification by the World Health Organization (WHO) of the dual elimination of mother to child transmission (EMTCT) of HIV and syphilis. This achievement signals to the world that ending paediatric HIV and congenital syphilis through the elimination of mother to child transmission of HIV and syphilis is achievable. The Ministry will continue to work towards ending AIDS as a public health threat by 2030.”

 

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Health

Ministry of Health and Human Services Confirm Two Measles Cases 

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Grand Turk, Turks and Caicos Islands – 11th May 2024: On Thursday, 9th May 2024, results of testing for two suspected measles cases were received from the Caribbean Public Health Agency, confirming that both cases were positive for measles. These represent the first cases of measles in the TCI since 1991.

The public health team has been responding since initial reports of the suspected cases, carrying out contact tracing, isolation, public education and outreach in anticipation of yesterday’s results. No additional suspected cases have been identified at this time. All unvaccinated contacts of the confirmed cases have been vaccinated. Additional vaccination efforts will be conducted throughout the TCI.

The public health team has been receiving technical support from its key stakeholders including the Caribbean Public Health Agency (CARPHA), UK Health Security Agency (UKHSA) and Pan American Health Organisation (PAHO).

Measles is a highly infectious disease caused by a virus that spreads easily between people. Symptoms typically start between 10 and 12 days after catching the infection. The signs and symptoms of measles are:

  • A high fever
  • Runny or blocked nose
  • Cough
  • Red, sore, watery eyes

Small greyish-white spots with a bluish-white center inside the mouth, cheek, and throat may appear a few days later. A rash usually appears 2-4 days after the cold-like symptoms start. The rash starts on the face and behind the ears before spreading to the rest of the body.

Measles is spread through close contact with someone with measles. This could be through droplets in the air which are generated by the coughs and sneezes of infected persons or by touching things that someone with measles has coughed or sneezed on.

Measles spreads easily within households and in other places where people mix closely together. Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected. The period when a person is infectious and can spread the virus is within 7 to 10 days of exposure but can be up to 14 days.

Most measles-related deaths are caused by complications associated with the disease and serious complications are more common in children under the age of 5, or adults over the age of 30 and individuals whose immune systems have been weakened. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. Women infected while pregnant are also at risk of severe complications, and the pregnancy may end in miscarriage or preterm delivery. People who recover from measles are immune for the rest of their lives.

Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.

No specific antiviral treatment exists for measles virus.
Severe complications from measles can be avoided through supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhoea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.

A number of measles outbreaks have been detected globally and regionally. While the TCI has high vaccination coverage in the measles, mumps and rubella vaccine (MMR) (>95%), unvaccinated persons can still acquire measles through contact with an infectious person.

Having the MMR vaccine is the best way to prevent measles. The vaccine is safe and effective in providing long term protection against measles, mumps and rubella. Vaccines are offered free of cost to all children at government-operated primary care facilities across the TCI.

The Ministry of Health and Human Services encourages parents to ensure that their children’s vaccines are up to date.  If you are unsure if you or your child has had 2 doses of the MMR vaccine, please visit your health care provider. If you have missed a dose, you can still be vaccinated at any age.

The public is being advised to remain vigilant and report any fever with rash or fever followed by rash to their doctor/health care provider as soon as possible.

The Ministry of Health and Human Services is grateful for the support of its stakeholders, including CARPHA, who provided the results of testing in such a prompt manner.
The Ministry of Health and Human Services will continue heightened surveillance for fever and rash and take necessary actions to mitigate against further cases.

For additional information please call 649-338-5469 or visit the Ministry of Health and Human Services Facebook page at https://www.facebook.com/tciministryofhealth/.

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