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Problems in Health Care Delivery



#TurksandCaicos, September 1, 2022 – I am very concerned about the lack of clinical services being made available to our citizens at both the Cockburn Town hospital, Grand Turk, and the Cheshire Hall Hospital, Providenciales. And when I investigated what clinical services are accessible in Grand Turk, it is extremely far less than being offered at Cheshire Hall.

A number of patients have brought to my attention the difficulty in getting an appointment to be seen, and many have expressed the feeling of being neglected. And as we all know that with health matters timing is everything. Early detection and early interventions almost always save lives and prevent future life-threatening complications.

During my time as Health Services Manager and before that as Laboratory Director, it had always been the target to have both Health Services locations properly equipped and staffed to tackle the citizens’ health needs. Both locations had identical equipment, and identical complement of staff, with a few variations in numbers. Grand Turk Location handled Salt Cay and South Caicos, and Providenciales location handled North and Middle Caicos.

When I was the Minister of Health, much progress was being made in the reestablishing of old community clinics, e.g.; the town clinic location in Grand Turk, and also returning Myrtle Rigby Health Complex location back to a health care facility for our people. The goal was, and still is, to have regular weekly specialist clinics with other needed services for all islands. Additionally, to have all community clinics equipped with basic laboratory testing abilities and imaging capabilities, i.e., blood electrolytes, red and white blood cell counts, glucose and cholesterol testing, blood nitrogen levels, urinalysis, and are equipped with portable x-ray abilities.  These technologies reveal extremely important and timely information on a person’s health status.

We all have to demand more from our health services providers, demand more accessibility, demand more diagnostic competency, demand more high dependency units, demand the availability of Intensive care capability (ICU), demand more attracting and retaining highly skilled personnel, demand increasing salaries of our health personnel. Hence, our people need to demand a high-performing health care system, “A Good Health System.”

A Peoples’ Democratic Movement government will recommence the work of enhancing our Health system to one that we all can be truly proud of, one which we have the most trust and assurance in.

So, what is the “good” health system that the PDM wants to develop for our people? A good system will be one that is organized in a way to ensure timely access to the highest attainable standard of care to all its citizens; one that has the right programs managed by competent well-paid professionals; one in which clinics provide constant preventive and curative care for the most common conditions, and primary health care in facilities or in the community where people live. A good health system under a PDM Government would ensure that our on-island hospitals deliver high-quality secondary or tertiary levels of care to increase the likelihood of desired health outcomes.

A PDM government is committed to continuing the work we started of ensuring our health services are:

  • Effective – providing evidence-based healthcare services to those who need them;
  • Safe – avoiding harm to people for whom the care is intended; and
  • People-centred – providing care that responds to individual preferences, needs and values.

To realize the benefits of quality health care, a PDM Government will also ensure that our health services are:

  • Timely – reducing waiting times and sometimes harmful delays;
  • Equitable – providing care that does not vary in quality on account of constituency/Island location, and socio-economic status, ethnicity;
  • Integrated – providing care that makes available the full range of health services throughout the life course, i.e. from newborn to old age.
  • Efficient – maximizing the benefit of available resources and avoiding waste.

From many personal testimonies from our citizens, it can be concluded that current health system is not serving our people well. We the PDM are confident that we can deliver the health care system that our citizens need and deserve.


Hon Edwin A. Astwood 

Leader of The Opposition


Ministry of Health and Human Services Conducts Emergency Vehicle Operators Course for Emergency Medical Services Personnel



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

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Dengue cases rising in Region 



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.

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31 Turks & Caicos Medical Professionals, Trained in Trauma care



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.

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