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Treatment Abroad in JEOPARDY; regional hospitals out of ICU space

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#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.

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Ministry of Health and Human Services Encourages Citizens to Take Precautions to Reduce Cancer Risks  

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PRESS RELEASE

 

FROM THE MINISTRY OF HEALTH AND HUMAN SERVICES

 

 

Providenciales Turks and Caicos Islands, 8th February 2025 – As we celebrate World Cancer Day on February 4th, the Ministry of Health and Human Services joins the global movement to raise awareness about cancer and promote preventive measures. This year’s theme, “United by Unique,” underscores the importance of putting individuals at the centre of care by sharing their stories and supporting their journey in the fight against cancer.

 Cancer affects not only those diagnosed but also their families and communities. The Ministry emphasizes a people-cantered approach to care that addresses each person’s unique needs, fostering compassion and understanding to achieve better health outcomes.

 Cancer remains a significant global health challenge, with an estimated 19.3 million new cases reported worldwide in 2020. Breast cancer is the most frequently diagnosed cancer, with approximately 2.3 million new cases in 2022. In the Caribbean, it ranks as the second most prevalent cancer in both incidence and mortality, affecting nearly 15,000 individuals and causing almost 6,000 deaths annually.

 Several factors can increase the risk of developing cancer, including:

  • Lifestyle Choices: Poor diet, physical inactivity, and excessive alcohol consumption.
  • Environmental Exposures: Long-term contact with toxic chemicals and pollutants.
  • Genetic Factors: Family history of certain cancers.
  • Infectious Agents: Viruses and bacteria linked to cancer, such as human papillomavirus (HPV) and hepatitis B virus (HBV).

 Recognizing the need for a structured approach to cancer prevention and care, the Ministry of Health and Human Services is actively developing a National Cancer Plan and creating a population-based cancer registry. These initiatives aim to guide prevention, screening, diagnosis, and treatment strategies in the Turks and Caicos Islands, ensuring comprehensive and data-driven responses.

 Additionally, the Ministry is enhancing its focus on screening for non-communicable diseases (NCDs), with cervical cancer and prostate cancer screening services readily available at Primary Health Care clinics across the islands.

 The Ministry encourages all residents to adopt healthy habits and participate in regular health screenings. Recommended preventive measures include:

  1. Nutritious Diet: Incorporate fruits, vegetables, and whole grains into daily meals.
  2. Physical Activity: Aim for at least 150 minutes of moderate exercise per week.
  3. Limit Alcohol Consumption: Reduce alcohol intake to lower cancer risk.
  4. Avoid Tobacco: Stop smoking and minimize exposure to second-hand smoke.
  5. Vaccination: Protect against HPV and HBV. The HPV vaccine is available free of charge to males and females starting at age nine.
  6. Regular Screenings: Attend cancer screenings, such as mammograms and pap smears, to enable early detection and timely treatment.

 Self-screening and self-awareness are vital tools in cancer prevention and early detection. Simple methods like breast self-exams, testicular exams, and skin checks can help identify changes early when treatment options are most effective.

 The Ministry urges everyone to make self-awareness part of their regular health routine. Knowing your body and recognizing changes can lead to earlier diagnoses and better health outcomes.

 Permanent Secretary of Health, Mrs. Desiree Lewis, emphasized: “Self-screening and self-awareness are key components of cancer prevention. By being attuned to our bodies and recognizing any changes, we give ourselves the best chance to catch cancer early.”

 Dr. Nadia Astwood, Chief Medical Officer, added: “Early detection saves lives. Whether it’s a simple self-exam or attending a screening, taking the time to check on your health can make a significant difference. We encourage everyone to take an active role in their health and seek medical advice if they notice anything unusual.”

 On this World Cancer Day, the Ministry of Health and Human Services urges everyone to come together to reduce the burden of cancer in our community. By understanding the risks, adopting preventive measures, and supporting one another, we can make meaningful progress in the fight against cancer.

 World Cancer Day serves as a reminder that through awareness, vigilance, and timely treatment, cancer prevention and improved outcomes are possible. Everyone is at risk, but through collective action, we can make a difference.

 For more information please visit the Ministry of Health’s Facebook page at https://www.facebook.com/tciministryofhealth/.

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PDM Leader responds to National Debate question on Healthcare

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Deandrea Hamilton

Editor

 

Turks and Caicos, February 3, 2025 – The PDM, if elected government, will create a treatment policy which focuses on getting residents the best possible care and ensure proper funding for treatment abroad travel, said Edwin Astwood during the live-streamed National Debate on Thursday January 30.

“On day one, I will bring a treatment abroad policy to Cabinet, to reverse what is there now.  We will ensure wherever you can get the top treatment you will be sent to.  Whether it is the USA, whether it is Canada, we will not say that you can only go into the Caribbean region.  We want the best for our people, we will put the money there in the treatment abroad policy that we can send you to places where we believe and where the data shows you can get the best treatment possible for you to fully recover and fully be healed, that is what the PDM is about.”

Astwood, who has led the PDM since 2021 and is a former Minister of Health for the TCI said medical centers will not be selected based on a limited budget and a common complaint will be no more.

“We will not send people abroad without having money in their pocket.  We will not send people abroad to be put out of hotels. We will not send people abroad to be put out of hospitals.  We will ensure that whatever allowance you need, you will get that before you go.”

In July 2022, a National Insurance Board Appeals Tribunal was established to field concerns and respond directly to contributor’s complaints, however, in the years following its set up little has been said about the effectiveness or impact of that body.

Additionally, Astwood addressed the quality of healthcare generally in the islands.

“Our people were healthier 15 years ago.  The records can show that; if you look at the birth rate compared to the death rate you will see that that ratio is higher now in ‘23-’24 than what it was in 2017, in 2015 and before.  On day one, I myself is going to push through the Cabinet a bill to ensure that primary health care is rejuvenated in all of our communities.

We know that in order to keep our people healthy, we have to look at prevention. Prevention is always better than cure, the honourable premier’s style is always to put the bandaid on the bleed.  But we (PDM) always want to go in there and stop the bleeding so that you don’t need the bandaid.  So that is what we are going to do, we are going address healthcare at its root cause and put the primary health care clinics back in every community.

He said the goal is for there to be early detection through early screenings.  Astwood said the country’s profits in recent years meant it could afford to set up an Intensive Care Unit.

“They also messed up the entire NHIP system.  Now our people cannot even get an air ambulance to come to the Turks and Caicos islands because they bankrupted the NHIP.  They made it where people are at a critical state.”

The PDM leaders shared that during a recent House of Assembly sitting, members approved $10 million dollars to pay outstanding medical bills.

Also on the PDM agenda is attention to oncology and all aspects of neonatal care due to a raised standard at the Cheshire Hall and Cockburn Town Medical Centers.

“We will get those health professionals in the hospitals.  No more will you see persons googling, to find out what your diagnosis is, we will get the proper machines for scanning.  No longer will you have those misdiagnosis and wrong diagnosis like under the honourable premier and no more will you be sent to places without money.”

He said the PDM has all of the plans to fix healthcare in the Turks and Caicos.

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Health

Premier addresses Healthcare during National Debate

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Deandrea Hamilton

Editor

 

 

Turks and Caicos, February 3, 2025 – The Progressive National Party established  the National Health Insurance Board and the TCI Hospitals, so if there is something wrong with either of them, the PNP will fix it, explained Washington Misick during the Thursday January 30 National Debate, viewed by 38,000 people.

“We have a good infrastructure, yes we have some management issues and we are in the process of establishing a National Health Authority to deal with the whole healthcare system.  Including building poly-clinics within the various communities to take the strain off the hospitals.  We will be opening up to 10 beds in Providenciales at the hospital here, and putting in two ICU units.  We will be expanding the facilities in Grand Turk.”

April 2025 will mark 15 years since the hospitals were opened in Providenciales and Grand Turk with clinical care managed by InterHealth Canada on a contract to the tune of nearly $5 million per month.

A recent report posted on the hospital’s website explains, “Patient volumes for certain services have reached peaks 17 years earlier than expected. For example, the number of outpatient visits recorded in 2015 has surpassed the volume projected at 2033 by nearly 15,000 visits. This means a large number of persons are accessing the services far beyond what was predicted.”

Government in December informed the public that, “Under the original contract, the services delivered were to be best in class. However, for some time there have been concerns that TCIG was not receiving good value for money or the quality services it was paying for.

The Turks and Caicos Islands Government (TCIG) has redoubled efforts to hold IHC to account, including the retention of specialist PPP advisers. As a result, TCIG believes it has established areas of non-compliance that could result in TCIG being able to pursue various remedies under the contract. Whilst IHC have disputed this, the last few months have seen greater dialogue in which a settlement of outstanding issues was sought.”

The Premier was adamant that his government is a caring one and would iron out the myriad of issues, which have been well publicised, on the state of health care in the country.  That includes being more supportive of terminally ill patients, building medical professionals capacity at home and making adjustments at the NIB.

Here’s what he said during the debate:

“And we will build for those persons who need palliative care because they are terminally ill and staying in hospitals beds, restrictive visiting ability; to build a hospice first in Providenciales so that they can live out the rest of their lives in comfort with palliative medication where their relatives can visit them and spend time with them.”

Another plan was laid out.

“We will be focusing on developing expertise and competency in the country so that the level of referral abroad will be reduced and we wouldn’t be sending our patients in future to just any place, we will be sending them to centres of excellence and that doesn’t mean they will be going necessarily to the United States because there are centers of excellence all over the world some of them in our own region, so we have thought this thing through.”

Premier Washington Misick, who is leader of the Progressive National Party (PNP) and Minister of Finance, Investment and Trade said there is reform on the horizon for the National Health Insurance Plan.

“That program is being reformed so that we get value for money, “ he added, “ We are building a healthcare system where we can reduce the number of patients that are referred abroad.  We need to upskill our medical professionals here, to develop specialties and the level of referrals abroad will then come down.”

But that could take years and currently he NHIP is falling short on funding regularly, as the medical needs of contributors surge well ahead of projections, as pointed out in the TCI Hospitals report online.

“Whatever is wrong with NHIP; we are fully cognizant of it.  We have a full team working on transitioning the Hospital to the system to the public Health authority and fixing the NHIB.  Yes, we have issues with the NHIB, we established it, we appreciate that the healthcare of people is important to us so we fixed it and we will fix it again. That’s what we do.”

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