St. John’s, Antigua and Barbuda. April 17^th  2024. The Caribbean Public Health Agency (CARPHA) is conducting an integrated mission to Antigua and Barbuda (ANU) during April 15-19^th  to build capacity in surveillance, early warning and response systems, laboratory capacity, competence in health and food safety, and prepare for the launch of  the CARPHA Regional Tourism and Health Program (THP), ahead of the 4^th International Conference of Small Developing Island States (SIDS), Sailing Week, the ICC Men’s T20 World Cup, and other major upcoming mass gathering(MG) events.

The CARPHA mission, led by Dr. Lisa Indar, Director, Surveillance, Disease Prevention and Control Division (SDPC), comprises  persons from several CARPHA departments: Dr. Laura-Lee Boodram, Head, Caribbean Regional Field Epidemiology and Laboratory Training Programme, Dr. Michelle Hamilton, Head of Laboratory Services and Networks (LSN), Dr. Jarelle Branford and Ms Sheena DeSilva  from  Health Information Communicable Diseases and Emergency Response (HCE), Ms Neeta Oudit (LSN), Mr. Keston Daniel and Dr. Anushka Bissoon-Pustam  of the Regional Tourism and Health Program (THP), and Mr Mohammed Elsherbiny, Senior Technical Advisor to the THP from the UKHSA.

Dr. Kamaria De Castro, Acting Chief Medical Officer, remarked “The partnership is timely as it helps to improve capacity as it assists in developing a sustainable future. We want to protect our local population as well as our visitors and let them know that we are aware of public health threats and we are preparing, building capacity, training and procuring resources that will be put in place to effectively prevent major spread of diseases. She extended her gratitude to CARPHA for the continued support and partnership.”

Dr. Lisa Indar indicated, “It is important to prevent public health threats to stop them from becoming emergencies as visitors are coming in from many different countries for Cricket World Cup, SIDS, Sailing Week and we want to make sure our visitors as well as our people are safe. We want to put systems in place and strengthen existing systems to be able to identify risks early and begin immediate and more timely responses to mitigate the potential spread of diseases.”

Key outcomes and activities of this mission include:

• High level endorsements for the capacity building missions from the Ministers of Health, and Tourism
• Formation of an Antigua and Barbuda THP Steering Committee for promoting healthier safer tourism
• Communicable Diseases Surveillance workshop for Health Workers across the health sector to understand case definitions and timely reporting to the central level.
• National Risk Assessment for mass gatherings, using the WHO/PAHO Mass Gathering Risk Assessment Tool, the results of which will be used to guide preparation and response for the upcoming MGs.
• Desktop simulation exercises with doctors, public health nurses, Emergency Medical Services, law enforcement, National Office of Disaster Services, Red Cross and laboratory workers to assess how participants will respond  to  multiple public health  scenarios during mass gathering events and identify gaps/challenges of the same.
• Rapid response training for public health professionals, including persons from the security/defense force and  the National Office of Disaster Services and partners. The training will review scenarios that  necessitate  mounting a response to a public health emergency by rapidly dispatching a multidisciplinary team to investigate and implement mitigating measures to contain the situation.
• Mass gatherings surveillance training for surveillance team, public health nurses and other members within the health sector. An all-hands-on-deck approach will be taken to emphasize the need for daily and real-time reporting, monitoring, response, coordination, and communication. CARPHA’s regional mass gathering syndromic surveillance system (MGSS) is detailed,  including  national surveillance, tourism-based surveillance and the new module developed for mass gatherings . Doctors, nurses, and surveillance officers to be present at the health stations for the 4^th UN SIDS Conference will also be trained and registered on MGSS.
• Engagement with the health, tourism, and port authority teams to discuss ways to bolster disease surveillance of cruise ships for Antigua and Barbuda as a large number of the transient population for the country is through cruises, especially as Antigua and Barbuda is a homeport for many cruise ships.
• Conduct field visits to major hotels (including the ones hosting the players and officials for the T20 games) to get them registered on the confidential early warning THiS system.
• Training on Food and Environmental Health safety during mass gatherings for food handlers and restaurants, including those who will be providing the catering services for the SIDS Conference. The training focuses on ensuring all food handlers are equipped with the appropriate knowledge and tools to prepare, cook, store and serve food to guests at the establishments and in a Mass Gathering setting.
• Training in Prevention and Control of Infectious Diseases, for the hospitality sector with an additional focus on Mass Gatherings. The session aims to build capacity to quickly identify and respond to cases of infectious diseases and will include participants from the hotel, food and beverage sectors some of which will be working closely with the SIDS Conference and will be working with the upcoming Cricket World Cup.
• Assessments of the laboratory network of Antigua and Barbuda for optimization of laboratory services available in-country. Training in testing for priority pathogens during an emergency response and/or mass gathering will be conducted.

As a highly tourism-dependent country, Antigua welcomes as much as 20,000 visitors daily, further highlighting the need for robust visitor-based surveillance. These workshops will provide instruments in identifying and addressing various challenges of Antigua and Barbuda in preparing for mass gatherings. This joint mission aims to strengthen Antigua and Barbuda’s surveillance and response capacity and preparedness to effectively anticipate and manage potential challenges, ensuring a seamless and secure SIDS conference, T20 CWC tournament, Sailing Week and Carnival experience for all.

CARPHA and Antigua and Barbuda continue to work toward supporting Antigua and Barbuda’s preparation for these large-scale mass gathering events and for the large number of tourists visiting the islands on a daily and weekly basis. CARPHA stands ready to continue supporting Antigua and Barbuda.

Ministry of Health and Human Services successfully conducted Emergency Vehicle Operator Training for Emergency Medical Services Department in March 2024.

The Ministry of Health and Human Services has reaffirmed its commitment to ensuring the safety and efficiency of emergency services across the Turks and Caicos Islands with the successful completion of an Emergency Vehicle Operator Course. Hosted for all members of the Emergency Medical Services (EMS) Department, this course marks a significant step in the ongoing efforts to provide high quality emergency response services.

Tailored specifically for ambulance operators, the course featured a comprehensive curriculum blending theoretical knowledge with practical skills. Participants underwent rigorous training encompassing critical safety practices essential for effective emergency responses. The amalgamation of didactic instruction and hands-on training enabled operators to navigate emergency situations with precision and confidence, fostering a culture of safety paramount for preserving lives.

In times of crisis, the EMS Department emphasizes the importance of well-trained and composed responders. Equipped with the skills acquired through this specialized course, EMS personnel are better prepared to address emergencies promptly and effectively, ensuring timely assistance to individuals in need.

The course, conducted by esteemed expert Mike Massaro, President of Trilogy Emergency Medical Solutions, ran from March 19th to March 22nd, 2024, across all islands. Mr. Massaro commended the EMS Department members for their enthusiasm and dedication to learning, acknowledging their pivotal role in enhancing community safety.

Participants lauded the interactive teaching approach employed throughout the course, noting its effectiveness in making lessons both engaging and informative. Their positive feedback underscores the value of practical, hands-on training in bolstering emergency response capabilities.

Minister of Health and Human Services, Honorable Shaun D Malcolm commented that “I am confident that the principles instilled during this course will significantly contribute to the safety and well-being of individuals accessing emergency services. By investing in continuous training and development, the Ministry remains steadfast in its mission to deliver safe, efficient and reliable emergency care to the people of the Turks and Caicos Islands.”

For more information, please visit the Turks and Caicos Islands Ministry of Health and Human Services Facebook pagE at https://www.facebook.com/tciministryofhealth/.

Dana Malcolm 
Staff Writer 

As of March 26, 2024, over 3.5 million cases of dengue and more than 1,000 deaths have been reported in the region, now, both the US Centres for Disease Control (CDC) and the Pan-American Health Organization (PAHO), are ringing alarm bells about the outbreak as cases swell to record highs.

PAHO on March 28 called for collective action in the region to fight back the growing wave of infections.

“This is cause for concern, as it represents three times more cases than those reported for the same period in 2023, a record year with more than 4.5 million cases reported in the region,” Jarbas Barbosa, PAHO Director said during a press briefing.

For now cases are concentrated in three main countries: Brazil, Paraguay and Argentina which account for nearly all of them, around 92 percent, but infections are on the rise regionally.

According to Barbosa, Caribbean countries must still be vigilant as data is beginning to show increases in areas like Barbados. That is paired with concerns from PAHO that some countries may not be equipped to handle the surge.

Nearly $500,000 was allocated in the 2023 2024 budget to the environmental health department under The Turks and Caicos Ministry of Health and Human Services to help with dengue which had been listed as a public nuisance.

Last year in the Turks and Caicos Islands, only a few rounds of fogging were completed. According to data from the Appropriations Committee around 10% of communities were fogged on schedule. Explaining the low number, representatives of the Environmental Health Department (EHD) maintained that fogging was not the primary defense against mosquito breeding locally.

”Fogging should actually be a last resort, there are preventative measures such as the treatment of swamps, and inspection of residential areas and communities for breeding sites.”

Representatives admitted though that they were still hampered by a lack of resources.

The country declared an outbreak in late 2024. Now there is an ongoing public education campaign to make residents aware of what they need to do to keep their homes safe and free from mosquitoes in addition

The Turks and Caicos Islands EHD also says they have been provided with money to help with garbage disposal in their battle against the vector borne disease.

The Ministry has also contracted entomologists to research what kind of mosquitoes live in the country and how to tackle them.