Dana Malcolm 

Staff Writer 

#TurksandCaicos, September 29, 2023 – A suite of actions that constitute misconduct for medical professionals in the Turks and Caicos has been laid out by the Government, along with a process outlined for recourse for residents who think they have been wronged via proposed amendments to the Health Professions Ordinance.

Section VIII of the ordinance which dealt with disciplinary actions has been repealed and replaced; included in that replacement is a list of 12 actions that will land medical professionals in hot water.

Drinking on the job, abandoning patients, faking certificates for vaccines and even sharing profits are actions that TCIG is warning against. The full list outlines the misconduct of a health professional as:

• If he personally abuses or misuses alcohol or other substances such that it affects or impairs the performance of his duties, or during the performance of his duties;
• If he abuses or misuses his position as a health professional;
• If he conducts himself in an indecent or violent behavior;
• For misconduct in research endeavors;
• If he willfully betrays a professional confidence;
• If he abandons a patient in danger without sufficient cause, and without giving him an opportunity to retain the services of another health professional;
• Knowingly gives a false certificate respecting birth, death, notice of disease, state of health, vaccination or disinfection or respecting any matter relating to life, health, or accident insurance;
• Divides with another person, who is not a partner, any fees or profits resulting from consultations or surgical operations, without the patient’s knowledge and consent;
• Impersonates another health professional;
• Employs in connection with his professional practice an assistant who is not registered or licensed under this Ordinance, or permits a person who is not registered or licensed under this Ordinance to attend or treat patients
• Directly or indirectly holds himself out to the public as a specialist or as being specially qualified in any particular branch of medicine and who has not taken a special course in such branch and received a certificate of specialty therein which is recognized by a council;
• Does or fails to do any act or thing, the doing of which or the failure to do which a council considers to be unprofessional or discreditable

If a resident alleges malpractice or makes a complaint against a medical health professional, the proposed amendments now require that person to provide in writing an affidavit detailing the alleged offense and his reasons for believing it true.

The authorities then have to decide whether the complaint is genuine and then proceed to censure, reprimand the health professional, suspend their license, or strike them from the register of licensed registered health professionals via hearing.

Rashaed Esson

Staff Writer

#Jamaica, September 29, 2023 – As Jamaica battles a dengue outbreak, the Ministry of Local Government and Community Development is taking steps to fortify the country’s resilience to the mosquito borne disease.

The Department announced it will be providing funds for the emergency response to contain the dengue outbreak, according to Desmond McKenzie, Minister of Local Government, as reported by JIS.

McKenzie was in talks with Journalists at the Spanish Court Hotel in Kingston this past Wednesday, September 27th when he revealed that the resources will come from the National Solid Waste Management Authority (NSWMA).

In fact, work, he expressed, is already being done as he informed that discussions have started with Jamaica’s Minister of Health and Wellness to see to the roll out of clean-up programmes to ensure communities do not morph into breeding grounds for mosquitoes.

It was reported that: “International health authorities have reported elevated dengue fever activity across multiple areas in Jamaica, with more than 560 suspected cases (78 confirmed) reported Jan. 1-Sept. 22. This is compared to the 59 cases reported over a similar period in 2022. Majority of the confirmed cases were reported in Kingston, Saint Andrew, Saint Catherine, and Saint Thomas.  The Jamaican Ministry of Health & Wellness has deployed vector control workers across the island to high-risk communities.  This report represents the most complete data available as of Sept. 29.”

These clean up initiatives, the minister points out, will be in operation in the days to come and they will commence in areas identified by the Ministry of Health; the plan is to later extend the efforts other communities.

In continuation, Audley Gordon, Executive Director of the NSWMA, spoke of vulnerable areas which he termed the “problematic sites”, informing that they are scheduled for action, including the removal of bulky waste by his teams, adding that the “NSWMA is fully ready to play its part in what we are asked to do, starting this weekend”.

Not only will the programmes clean the respective areas, they will call community members to practice proper garbage disposal, as people often fail to acknowledge the importance of these hygienic habits.

How weather can affect your blood sugar  

We often look forward to a change of seasons and warmer temperatures. But if you have diabetes, you may be especially sensitive to the hot weather of summer.

Extreme heat can affect your blood sugar control. If you use insulin or your blood sugars aren’t effectively controlled, you could be at higher risk during the summer months. Worsening blood sugar control is often the main concern, and depending on your level of activity, developing low blood sugars may also be a concern.

If you’ve had complications from diabetes that have damaged the nerves to sweat glands, you may be unable to sweat properly. This can become serious as outdoor temperatures rise, leading to heat exhaustion and heat stroke.

Extreme temperatures can also damage your medications and testing equipment, says Dr. Marwan Hamaty, endocrinologist at Cleveland Clinic, Ohio. “I always remind my patients to take precautions to protect themselves and their supplies during both winter and summer.”

He says it’s important to get a handle on your blood sugar control before you engage in summer fun. “If your blood sugars are mostly higher than 250 mg/dl, I recommend improving your blood sugar control before engaging in heavy physical activity — regardless of the climate and the temperature, as recommended by the American Diabetes Association.”

Dr. Hamaty also advises that the extreme heat of summer affects blood sugar levels. How the heat affects your levels depends on what you’ve eaten, whether you’re well-hydrated and your activity level.

If the heat and your activity make you sweat a lot, you may become dehydrated, leading to a rise in glucose levels. “If you become dehydrated, your blood glucose levels will rise. This can lead to frequent urination, which then leads to further dehydration and even higher blood sugar levels — a kind of vicious cycle,” he says.

Things can become even worse if the treatment includes insulin: “Dehydration reduces blood supply to your skin and, therefore, the ability of your body to absorb the insulin you’ve injected is reduced,” he says.

Most types of insulin can tolerate temperatures up to 93-95 degrees Fahrenheit. Exposing your supply to anything higher than this will make the medication quickly break down. Be careful and pay attention to any insulin you’re carrying with you in the heat.

While it’s fine to store insulin and glucagon in the refrigerator, hot temperatures (as well as freezing temperatures) will cause the medications to degrade, making them ineffective and unusable. High temperatures can have a negative effect on other medications and diabetes management supplies too. Don’t forget about the weather’s effect on things like test strips and monitoring devices. When the mercury begins to rise, these items can change in their effectiveness.

Physical activity usually causes blood sugar levels to decrease, reducing your need for insulin. The sudden addition of exercise may put you at an increased risk for low blood sugars.

Therefore, if you’re active in extreme heat, know that you’re at high risk for both low and high blood sugars. This means you should take extra precautions and monitor your sugar levels before exercising.

“I advise my patients to maintain warm skin and adjust insulin dosage prior to engaging in physical activity because insulin adjustment could vary significantly,” says Dr. Hamaty. “But don’t allow the heat to keep you indoors. It’s OK to participate in outdoor activities and enjoy all types of weather as long as you take a few precautions.”

Dr. Hamaty also suggests seeking input from your doctor regardless of the temperature before adding physical activity to your routine.

Follow these tips to help manage your diabetes while enjoying the outdoors:

1. Drink plenty of water.Staying hydrated is important for everyone during physical activity, and it’s especially critical if you have diabetes.
2. Avoid becoming dehydrated.Carry small bottles of water or low-calorie electrolyte-replenishing sports drinks in a backpack or on a belt while you’re hiking or playing sports.
3. Adjust your insulin as needed.Ask your provider or diabetes educator how you should adjust your insulin (and sometimes eating extra carbohydrates) before exercising. Typically, your first few doctor’s visits focus on urgent issues, such as getting diabetes under control. Ask about how to adjust your insulin so you can prepare to be physically active.
4. Test your blood sugar levels frequently.Since hot temperatures can cause blood sugar levels to fluctuate, it’s a good idea to test more often. That way, you can take appropriate and immediate action to keep your levels stable. You should continue frequent monitoring for several hours after you’re done with your workout or other activity. That’s because the effects of activities on blood sugars usually last for a longer period of time.
5. Keep items to treat low blood sugar with you. This includes glucose tabs or glucose gel. If you’re at high risk for very low blood sugar (if you have frequent low blood sugar or had very low blood sugar previously), you should also have a glucagon kit available.
6. Take some snacks with you.Some snacks can serve as a meal replacement while others help prevent low blood sugar. Discuss possible options with your dietitian.
7. Protect your medication and supplies. Take proactive steps to protect your insulin, glucagon kit and other supplies before you head outdoors, regardless of the temperature. Consider a car cooler that plugs into a 12-volt car adapter to keep your supplies at the proper temperature. This will keep the temperature stable for some time. If you’re going away from your car for an extended period, you’ll need to take your supplies along with you. If you are on insulin pump, be sure to protect your insulin pump from high temperatures. Depending on the situation and how long your activity will be, you might simply need to monitor your glucose more often. In certain circumstances (if it’s extremely hot or you’re out for an extended amount of time) consider using a long-acting insulin temporarily along with meal insulin injection instead of an insulin pump.
8. Avoid sunburn. You can get sunburned while skiing on the slopes or while hiking in the summer. Sunburn stresses your body and can raise blood sugar levels. Use a broad-spectrum sunscreen and wear protective eye gear.
9. Finally, limit how much time you spend outside in extreme temperatures. “While I advise staying active during the peak winter or summer months, I also tell my patients to try to take advantage of outdoors activities when temperatures aren’t too extreme,” says Dr. Hamaty. By taking a few precautions, you can enjoy an active, healthy lifestyle in most any weather.