May 30, 2023 – Tobacco use remains a major public health concern in the Caribbean Region. There is no safe level of exposure to tobacco smoke. The use of tobacco products in any form harms nearly every organ of the body, irrespective of whether it is smoked, smokeless, or electronic.  Of all the forms of tobacco use, most common in the Caribbean region is cigarette smoking.   Cigarette smoking is the number one risk factor for lung cancer. Using other tobacco products such as cigars or pipes also increases the risk for this disease.

Second-hand smoke exposure causes stroke, lung cancer, and coronary heart disease in adults; and acute respiratory infections and severe asthma in children. It is a preventable risk factor for non-communicable diseases (NCDs), which are the leading cause of death, disease and disability among Caribbean people.

This year, World No Tobacco Day focuses on Grow Food, Not Tobacco. This campaign advocates for ending tobacco cultivation and switching to more sustainable crops that improve food security and nutrition. The campaign observed annually on 31 May, also informs the public on the dangers of direct use, and exposure to tobacco.

In the Caribbean Region, non-communicable diseases (NCDs) are the leading cause of death and disability – 76.8% of the total deaths (non-Latin Caribbean, excluding Haiti) were due to NCDs in 2016. Cardiovascular diseases 30.8% and cancer 17.2% are the leading causes of death due to NCD, both linked to tobacco use. Many of these persons die in the prime of their lives before the age of 70 years old. The prevalence of smokers for overall tobacco products ranged from 57.2% prevalence (95%CI 48.4 to 65.4%) to 16.2% (95%CI 11.2 to 23.0%). According to the Report on Tobacco Control in the Region of the Americas (2018) Caribbean countries have the highest levels of tobacco experimentation before the age of 10.^[1]

Dr. Joy St. John, Executive Director at the Caribbean Public Health Agency (CARPHA) “Smokeless does not mean harmless.  Nicotine in e-cigarettes is a highly addictive drug and can damage children’s developing brains.  Children and adolescents who use e-cigarettes at least double their chance of smoking cigarettes later in life.  Preventing tobacco product use among youth is therefore critical.  It is important that we educate children and adolescents about the harms of nicotine and tobacco product use. We must work to prevent future generations from seeing such products as “normal”.”

In 2008, the Caribbean Community (CARICOM) endorsed the recommendation to ban smoking in public spaces.  Later, in 2012, CARICOM regulated a standard for labelling retail packages of tobacco products with health warnings. Caribbean civil society organisations (CSOs), working in collaboration with local governments and international partners, have led the charge in fighting for significant gains in tobacco control in the Caribbean region.

Dr. Heather Armstrong, Head, Chronic Disease and Injury: “At CARPHA, we believe that reducing the harm caused by tobacco use requires a collective approach, where government, civil society, and the individual play a critical role. CARPHA promotes the prevention of tobacco use in all forms and commitment to the WHO FCTC. The focus on tobacco control deals with the youth of the Region.   Children and adolescents who use e-cigarettes at least double their chance of smoking cigarettes later in life.”

The Chronic Diseases and Injury Department of CARPHA provides leadership, strategic direction, coordinates and implements technical cooperation activities directed towards the prevention and control of NCDs in CARPHA Member States. CARPHA’s message for prevention of tobacco product use has spread across its Member States.

In 2018, CARPHA in partnership with the University of the West Indies (UWI), Global Health Diplomacy Program at the University of Toronto, the Pan American Health Organization (PAHO), and the Healthy Caribbean Coalition evaluated the Port of Spain Declaration to learn which mandates helped to prevent and control NCDs. Taxation, smoke-free public places mandate, and mandatory labelling of tobacco products are some of the leading policies making the biggest impact on reduction of tobacco use in the Caribbean regions.

CARPHA urges Member States to work together to prevent and reduce the use of all forms of tobacco products, and scale-up efforts to implement their commitments under the WHO Framework Convention on Tobacco Control (FCTC).  By doing so, the negative impact of smoking and its consequences on the health of our people, especially the younger generation, and the tremendous burden on the economies of the countries in our Region, will greatly be reduced.

By Dana Malcolm

Staff Writer 

#TurksandCaicos, May 30, 2023 – The Health Ministry has hit the majority of its initiatives only two years into its term according to Shaun Malcolm, Minister of Health and Human Services, who also revealed how he will spend the $86 Million dollars allotted to his portfolio for 2023-2024 spending.

“In the Ministry of Health we have nine deliverables and we’ve already done seven and a half,” said the minister, referencing the PNP Citizen’s Contract. Those deliverables as listed in the contract are:

• 1.Strengthen and improve the delivery of health care through the integrated health services delivery network (IHSDN)
• 2. Upgrade the Grand Turk Primary Health Care (PHC) Clinic.
• 3. Build a new central PHC in the Cheshire Hall community
• 4. Build/upgrade the Public Health Laboratory
• 5. Complete Phase II of the Wellness Center
• 6. Build a Long-Term Hospice Care facility
• 7. Build a Home to care for persons with mental health issues
• 8. Expand Secondary and Tertiary care services within the hospitals to serve both the local and medical tourism population and reduce the need for treatment abroad
• 9. Restructure the medical treatment abroad program to procure more cost-effective care

Stressing the theme “Embracing Service Integration; Building a Resilient Health System” Malcolm detailed how the Ministry would be spending the massive allotment, the third highest ministerial budget in the country.

While most of the money goes to the Treatment Abroad Program, also Included in the budget is:

$1.3 million for new ambulances

$1.6 million for Ambulance bays in Providenciales and Grand Turk

$200 000 for upgrades to the Eliza Basden Aged care center

$100,000 for the procurement of a wheelchair accessible van for the Centres

$600,000 for the establishment of an all new aged care center in the twin islands

$50,000 for Mental Health Facilities

Also slated for completion this year is the South Caicos Morgue and a new incinerator purchase to dispose of increasing levels of medical waste.

Armed with a new 3-year National Health Sector Strategy Plan, Minister Malcolm says his ministry will continue to move toward the advancement of Healthcare in the Turks and Caicos.

By Dana Malcolm 

Staff Writer 

#TurksandCaicos, May 30, 2023 – An internal investigation has begun at the TCI Hospitals into how photos of a victim who lost her foot in a “reported Shark Attack” last week surfaced on social media as the possibility of legal action looms.

“The Turks and Caicos Islands Hospital is extremely concerned about the photos being circulated and have commenced an immediate investigation into the source of the photos,” they said in a statement to Magnetic Media.

The investigation will determine whether graphic photos of the injured woman came from within the TCI Hospital, it’s a slip up that if confirmed, could lead to a possible lawsuit.

Reports from official agencies confirmed that on Wednesday May 24th the young woman was carried from the waters of Grace Bay, where she was attacked.  Medics were awaiting the trauma patient at the Leeward Marina; those aiding the American tourist inform she was taken straight to shore and picked up in minutes by emergency workers. She was then taken swiftly to the Cheshire Hall Medical Centre before being airlifted some hours later.

Within hours, photos of the recent Yale University graduate who completely lost her foot, surfaced all over social media. The images were not only of her severed foot but the bloody stump appeared online.

It is believed a Caribbean Reef Shark mistook the young woman for prey and bit her as she snorkeled a popular reef near Providenciales.

However it is the behavior of people on land drawing concern about how much is too much and possible breaches in confidentiality.

In those photos, viewers can see several things:

• An arm with blue gloves on holding the young woman’s severed foot over what appears to be a medical container of ice
• Two sets of arms holding the severed body part while another photo is taken from a different angle and;
• The young woman’s mutilated leg as hands reach to wrap in it medical gauze

Based on the photographs they had to have been taken with the knowledge of at least three people present, in addition at least one had to have been taken while the young woman lay bleeding on a gurney.  It’s not clear yet whether the confidentiality breach happened inside the medical centre.

Hospital officials are well aware of the gravity of the situation, when we questioned them on whether it was normal to take photos of patient;’ injuries they said

“This investigation is still ongoing.  There are times when it is appropriate for health and forensic professionals to take photos for plan of care and injury documentation, however, such photos are subject to strict professional ethics and patient confidentiality standards.”

Those professional standards likely do not include sharing images via social media or outside the hospital at all.  The photos have now been spread via whatsapp and posted on Facebook.

The young woman was medically evacuated to the US late on Wednesday night, we are told by the TCI Hospitals.

It is less clear if doctors abroad were able to reattach her foot.