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TCI Hospitals Building Business Cases for ICU, Ophthalmology & Vascular; early estimates is over $10 Million needed



By Dana Malcolm

Staff Writer


#TurksandCaicos, June 30, 2022 – An Intensive Care Unit is under active consideration for the Turks and Caicos however it will be a long and expensive process with an at least $10 million dollar price tag attached; the good news is the space is available and the Health Minister wants to cut the cheque.

“In our 2021-2024 strategic plan and with the group that we have through our contract management unit and our collaborations with NHIP; these are some of the services that we are looking at over the next three years to build a business case based on our data and their data to present to government with a proposal. Now we recognize that we have to take our time in presenting all of these proposals to Government because they are the ones funding it.”

Dr. Denise Braithwaite Tennant, CEO of InterHealth Canada explained the extreme complexity of planning and building an ICU in this British overseas territory.

“There are different levels to the ICU, there are ICUs that focus on medical, trauma, and high complexities such as open-heart surgeries and ecmo. So we recognize we have to have a starting point and we are building the business case for that and it’s the most complex one we’ve ever had to build… our aim is to start with a medical ICU so that we can reduce the number of persons going abroad for surgeries that we do here.”

The medical ICU is especially important because what has happened in the past and continues today is that residents with certain comorbidities are sent overseas for surgeries offered on the island.  While the surgery expertise exists in-country, post-surgery ICU care is not.

“Because of their patient complexity we’ve decided that it’s not safe to do it in the absence of an ICU,” Braithwaite-Tennant explained

Building a business case for an ICU is intricate and demands that planners identify the requisite staff, consider the infrastructural needs and introduce the proper operations program and many other factors.  These boxes must be checked even before the Government then weighs in on the proposal which they must agree to fund from the public purse.

Jamell Robinson, the TCI Minister of Health in that Tuesday press conference offered a simple, “Long time” when asked if he would be willing to support putting the money behind the development of an ICU and other areas itemized as priorities by the hospitals CEO.

Dr. Braithwaite-Tennant says there are two other high volume procedures putting a strain on taxpayers and Turks and Caicos should begin immediate work on addressing the deficiency in these clinical services.

“As a unit they may not be very expensive but because of the critical volumes that they generate they still end up causing NHIP a lot of money.”

These high volume services were named as surgical and medical Ophthalmology or eye care, which she describes as a “key driver in terms of volume” and vascular which is climbing in demand as the number of dialysis patients in the TCI is on the rise.

Despite the difficulties in crafting these plans, TCI Hospitals’ executives are assertively pushing for the in country services in ophthalmology, vascular and an ICU and have confirmed that by year end, the businesses cases will be handed over to Government for review.

“Thereafter it’s going to be a back and forth communication about it, group meetings explaining so they can fully understand and then comes the part of funding it.”

One good thing is that the physical building space already exists as the government had built the hospitals with expansion capacity.

“The ICU buildup is complex — thankfully the government of the Turks and Caicos Islands had the foresight to build expansion spaces. All it is now is a shell and we currently use it for storage but it has the fixtures in the walls to come forward.” she said.

Dr. Braithwaite-Tenant explained they were moving on these medical services proposals aggressively because they recognized that the current system is not sustainable.

“The project agreement did not necessarily envision it being used with an ICU component– but COVID forced that because there were times in the very beginning that no one wanted patients who had Covid-19.  No one.”

Which meant TCI islanders who tested positive for the virus prior to being medially evacuated, were denied medical care.  It placed Islanders in life threatening situations.

The idea that in five months, Turks and Caicos Islands Government could be holding the plan to build an Intensive Care Unit and to add specialists in eye and vascular care is heartening.  Residents have long been calling for the extension and the country is in a fantastic place, fiscally, to action and approve these significant upgrades.

The 40,000 residents and two million visitors will be able to rest easier with the assurance that specialized care is only minutes away; giving patients more precious life saving time which could mean the difference between life and death.


Women 30x more likely for UTIs; Learn More



By Dana Malcolm 

Staff Writer 



January 25, 2023 – Itchy, uncomfortable and often painful Urinary Tract Infections affects millions of people yearly, the vast majority of them women. In fact ‘UTIs will likely affect almost half the female population at least once in their lives and women get UTIs up to 30 times more often than men do. Also, as many as 4 in 10 women who get a UTI will get at least one more within six months’ the US Office on Women’s Health explains.

Caused by germs that get into the bladder, UTIs can happen in any part of the large urinary system including the kidneys; ureters; bladder; and urethra, but are most common in the bladder. They are easy to cure with proper antibiotics but can be serious if left untreated. Knowing how to identify a UTI and getting quick and effective treatment can save women and girls a lot of pain. The UK National Health Agency lists the symptoms as

  • pain or a burning sensation when peeing (dysuria)
  • needing to pee more often than usual during the night (nocturia)
  • pee that looks cloudy, dark or has a strong smell
  • needing to pee suddenly or more urgently than usual
  • needing to pee more often than usual
  • blood in your pee
  • lower tummy pain or pain in your back, just under the ribs
  • a high temperature, or feeling hot and shivery
  • a very low temperature below 36C

What many people may not know is that these painful symptoms can affect young children as well, if your baby is generally unwell, has a high temperature, wets the bed or themselves and refuses to eat you may want to ask your doctor to take a look as these are symptoms of UTIs in children.

A quick visit to your doctor and a round of antibiotics will usually clear up the infection and any recurring ones but avoiding UTIs completely may be the best bet for all. UTIs are caused when bacteria often from the skin or rectum, enter the urethra, and infect the urinary tract the CDC says. The agency also lists a myriad risk factors that can cause this including poor hygiene in older adults with catheters or young children who are potty training causing bacteria to spread. Other risk factors include: Sexual activity; Changes in the bacteria that live inside the vagina, or vaginal flora. (For example, menopause or the use of spermicides can cause these bacterial changes.); Pregnancy; and Structural problems in the urinary tract, such as an enlarged prostate.

There’s nothing to be embarrassed about in having the common medical condition a UTI, while painful, is easy to treat, make use of the treatment options available to you and don’t ignore the symptoms in the hope that they will disappear as this could make the problem worse.

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Caribbean News

Haiti’s death toll from cholera continues to climb; Cases shoot past 21,000



By Sherrica Thompson

Staff Writer



#Haiti, January 25, 2023 – The cholera situation in Haiti has worsened, with the country recording 496 deaths in nearly four months after the resurgence of cholera was reported on October 2 of last year.

In a statement released on Thursday, January 19, the Ministry of Public Health and Population (MSPP) Department of Epidemiology revealed that the country has already registered 25,182 suspected cases and 21,407 hospitalized cases, 73 of which are new.

The Ministry noted that the average age of those infected is 19 years and the most affected age group is 1 to 4 years old, with 374 confirmed cases of 5005 suspected cases.

In addition, the department in the west, where Port-au-Prince is located and where more than one-third of the population lives, was pointed highlighted as the most affected area, with 1,155 confirmed cases for 16,408 suspected cases.

The World Health Organization (WHO) recently warned that the world is suffering unprecedented cholera outbreaks in countries affected by climate disasters and other crises.

Vaccines to prevent the disease have also become “extremely scarce.”

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US to consider annual COVID vaccination



By Dana Malcolm

Staff Writer



#USA, January 25, 2023 – In a matter of days, the United States is going to make a decision on whether or not they will make Covid-19 vaccinations an annual recommendation.

In an effort to reduce vaccine mistakes and increase compliance from the public the best way to administer COVID shots going forward is via a single vaccine shot for primary and booster doses according to a proposal from the US Food and Drug Administration (FDA).

The FDA said despite the fact that the fact that bivalent vaccines were proven to work, getting shots into arms was proving difficult with the agency citing “implementation complexities”.

In addition healthcare workers have made mistakes administering the vaccine owing to the number of different vial presentations and booster uptake is low all these issues are expected to be fixed or improved with the simplification of the vaccine composition.

The vaccine will have to be periodically updated to handle new variants but if the FDA gets its way gone will be the era of multiple boosters. In fact the COVID shot will be more like the flu shot in how it is administered. Regulators will also vote on whether all shots should target the same variants. Of this is approved regulators would decide the most concerning variant in summer giving vaccine makers a chance to change the formulation in time for winter.

“Review of the totality of the available evidence on prior exposure to and vaccination against SARS-CoV-2 suggests that, moving forward, most individuals may only need to receive one dose of an approved or authorized COVID-19 vaccine to restore protective immunity for a period of time. Two doses of an approved or authorized COVID-19 vaccine may be needed to induce the expected protective immunity”

The Agency explained that though it was not completely the same the data observed in long term effectiveness of COVID shots was similar to that observed with annual influenza vaccination cementing their proposal.

The proposal will be considered this Thursday at the Vaccines and Related Biological Products Advisory Committee.

Even as yearly shots are considered, the US is holding fast to its vaccine mandate for entry.

This is despite most other countries relaxing the rules months prior. The vax rule came into effect during the initial onset of Omicron in November 2021. Prior to that only a negative test was needed. The measure was set to expire on January 9th but was quickly extended to April 10 this year.

The WHO has advised that travel bans and restrictions “do not provide added value and continue to contribute to the economic and social stress and safety measures such as masking, testing, isolation/quarantine, and vaccination should be based on risk assessments.

The country lengthened their vax mandate and activated more stringent entry measures, particularly for travellers from the China region, as new and elusive COVID sub-variants are emerging and infection rates are increasing.

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