Health
Treatment Abroad in JEOPARDY; regional hospitals out of ICU space
#TurksandCaicos, August 27, 2021 – Air Ambulance teams can show up to take you to a medical destination of choice, the TCI Hospitals can have you prepped and ready to go, but it is wholly out of the control of these providers and government to find Turks and Caicos residents a bed and a medical facility able to render life-saving medical care in the midst of the worst spell of the ongoing coronavirus pandemic.
The situation is dire at home, but is especially bleak abroad and even though miles separate Turks and Caicos residents from the overwhelming statistics for cases and burdens on hospitals in nearby nations, their capacity woes are very much our own.
The Turks and Caicos Minister of Health was direct when he explained.
“Presently the TCI Hospitals does not have ICU capacity. It only has HDU which is High Dependency Unit capacity. If you conditions turn to the worst, particularly with Covid-19 we have to fly you out. The reality is there are only a certain amount of facilities that are accepting our patients,” said Jamell Robinson, the Minister of Health for Turks and Caicos during a press conference held Wednesday August 25.
Patients cannot be flown into Jamaica, The Bahamas or Florida due to their strained health care systems in this latest surge. Colombia and the Dominican Republic are all that it left open for TCI medical evacuations and if the patient dies of COVID in these countries, the body will be cremated within 24-hours of death.
The details were among the shocking reveals coming Wednesday night when the Minister of Health, Jamell Robinson led a press conference and update on the coronavirus situation.
“We were also informed that the ICU beds in Florida were full at the time of asking, in particular Broward Health is required to prioritize public local patients over international private patients. Consequently it is expected that as long as Florida is experiencing low ICU availability due to the surge in COVID cases, access to service will be impacted.”
The High Dependency Unit of the TCI Hospitals can function like an ICU until medical evacuation arrives but at this time, Turks and Caicos does not have sufficient staff or sufficiently qualified staff to offer the round the clock care and intense monitoring required when two or more organs are failing.
“In the month of July, in the beginning of this current surge we had only two patients but both of those patients, admitted to our Providenciales facility, had to flown out to ICU care and had to be placed on our pre ventilator status. That is when their condition is so bad that we have to apply the ventilator to care for them and to help them to breathe,” said Dr. Baithwaite-Tenant, CEO of the TCI Hospitals in an overview presentation of the past two months.
“We admitted 10 patients so far in our Providenciales facility, the majority of those patients are females, 70 per cent; 30 per cent are males. Seventy per cent of those patients have chronic, non-communicable diseases of which the most common being hypertension or high blood pressure, diabetes Type 2, high cholesterol and heart disease. One patient was detected asymptomatic as a part of our screening,” the TCI Hospitals CEO added, “Sixty per cent of our patients are below the age of 60 years.”
Dr. Braithwaite-Tenant said Turks and Caicos would need several different types of specialist doctors and nurses to comprise a proper ICU team. The Cheshire Hall Medical and Cockburn Town Medical centers are smaller acute secondary care facilities and that’s it, at least for now.
The hospitals strategic plan, which is taken in consultation with the Ministry of Health, includes the addition of an ICU in the future and not having the ICU, said Dr. Braithwaite Tenant is an identified risk, especially given the current global health crisis.
Hon Robinson, made the only plea he could, given the circumstances and the urgency.
“While this is a fluid situation yes, do you want to chance not having any options for having ICU help abroad. Do not take that risk.”
His advice: Take the Covid-19 Vaccine.
Turks and Caicos currently administers the Pfizer/BioNtech brand, which on Monday August 23 moved from being emergency-use approved to being commercially-ready approved by the US Food and Drug Administration.
Dana Malcolm
Staff Writer
In a first for the Turks and Caicos and one that some would describe as particularly important, over three dozen healthcare professionals were upskilled in emergency trauma care via Advanced Trauma Life Support (ATLS) certification.
Trauma Care in emergency medicine usually refers to treating patients who are critically ill or have severe injuries and need to be quickly stabilized like gunshot wounds, damaged limbs, crush injuries, and stab wounds.
In 1976 following a plane crash involving a surgeon and his children who experienced substandard trauma care, the first ATLS course was created. It attempts to provide basic training for medical professionals when dealing with acute trauma cases where there is little staff on hand. In fact ATLS is supposed to work with as little as a single doctor and nurse team working together to stop the most critical injuries first, ensuring a better chance of survival.
This is particularly useful for the Turks and Caicos with its small hospitals and limited staff. Health officials admitted this, highlighting what they describe as ‘the pressing need for such training, particularly due to physician shortage, isolated communities in family islands and other barriers to accessing this critical training.’
Recognizing the need, the Hamilton Education Foundation jumped into action, and in collaboration with Massachusetts General Hospital and the American College of Surgeons conducted a Hybrid Advanced Trauma Life Support (ATLS) Demo for 31 doctors in the Turks and Caicos Islands on May 22nd and 23rd, 2024.
Led by Professor Susan Briggs,the foundation describes the course as historic in that it’s the first-ever done outside the United States and says it is;“Crucial for enhancing the quality of healthcare delivery and saving lives in the face of increasing intentional and unintentional injuries.”
With the rise in gunshot injuries in the country, seen through police data since 2020 many residents might be inclined to agree.
While admitting it was difficult to measure if ATLS reduced mortality, a 2016 article published in the National Library of Medicine describes the courses as “very useful from an educational point of view. It significantly increased knowledge, and improved practical skills and the critical decision making process in managing multiple trauma patients”
Rufus Ewing, Former Premier and Executive Chairman of the Hamilton Education Foundation, said, “This initiative aligns with our mission to enhance medical education and improve access to quality healthcare services in the Turks and Caicos Islands.”
The training received broad brush support from the Ministry of Health, TCI Hospital and private sector.
Rashaed Esson
Staff Writer
#Argentina, April 15, 2024 – Argentina is currently facing a shortage in mosquito repellents, a severely unfortunate development for the nation as it is now fighting a surge in dengue cases, in-line with PAHO predictions that the region will face its worst dengue season on record.
The mosquito repellent shortage was reportedly noticed in March 2024 and Argentina, according to the Ministry of Health, recorded over 163,000 cases with deaths in all age groups, more common for those over 80 years old.
The situation is widespread across Argentina as indicated by supermarkets putting on display “no repellent” signs.
Places where repellents are still available, online spaces especially, are selling them at high prices.
As to the reason behind the shortage, BBC reports that it was told by one of the production companies (for repellents), that a forecast error was at fault and that manufacturing took months. Additionally, mirroring this, Mario Russo reports a supply and demand problem.
The Government is making efforts to have this sorted as soon as possible, but Argentinians, reports say, are not so hopeful as hundreds of thousands have already been infected.
Preventative measures such as repellents are crucial for Argeniniand who reply heavily on them, as they await the dengue vaccine which is already developed, but still In its early stages of distribution.
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