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New WHA resolution to accelerate efforts on food micronutrient fortification

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May 30, 2023 – The delegates at the Seventy-sixth World Health Assembly adopted the resolution on accelerating efforts to prevent micronutrient deficiencies through safe and effective food fortification. The resolution urges Member States to make decisions on food fortification with micronutrients and/or supplementation and to consider ways of strengthening financing and monitoring mechanisms.

Deficiencies in vitamin and mineral status, particularly of folate, iron, vitamin A, and zinc, affect 50% of all preschool aged children and 67% of all women of reproductive age (WRA) worldwide. Micronutrient deficiencies can have serious consequences, including spina bifida and other neural tube defects. These preventable deficiencies are also associated with a higher risk of blindness, fragile immune systems, diminished  exercise and physical capacity. Mothers with low micronutrient can have babies prematurely or with low birth weight. Iodine deficiency, still prevalent in many countries, impairs brain development in children, undermining their ability to learn and their eventual productivity.

Large scale food fortification (LSFF) is part of the solution. By adding essential vitamins and minerals to staple foods and condiments, such as wheat and maize flours, rice, cooking oil, and salt in accordance with national consumption patterns and deficiencies, countries can correct and further prevent a demonstrated micronutrient deficiency.

Fortification is an evidence-informed intervention that contributes to the prevention, reduction and control of micronutrient deficiencies. It can be used to correct a demonstrated micronutrient deficiency in the general population (mass or large-scale fortification) or in specific population groups (targeted fortification) such as children, pregnant women and the beneficiaries of social protection programmes.

WHO has been working in food fortification for decades and collaborates with different networks for fortification at the regional, country and community levels. WHO recommends large scale food fortification as a powerful evidence-informed and cost-effective intervention to fight the consequences of vitamin and mineral deficiencies, including iodine deficiency disorders, anaemia and iron deficiency, and neural tube defects among others.

The resolution was put forward by Australia, Brazil, Canada, Chile, Colombia, Ecuador, European Union and its 27 Member States, Israel, Malaysia and Paraguay.

The resolution received a wide support from the civil society, with over 50 organizations calling on WHO to accelerate efforts on micronutrient fortification of food through a jointly signed letter. The organizations underlined in their letter that micronutrient deficiency is a crisis that affects all communities globally, low-income or high-income, and that there is still a large unfinished agenda on food fortification, calling on WHO to double the efforts to improve the reach and quality of food fortification programs, which have big potential to combat these preventable deficiencies and protect health.

The resolution was adopted under the umbrella of the United Nations Decade of Action on Nutrition (2016-2025) report. The Nutrition Decade aims to accelerate the implementation of the Second International Conference on Nutrition (ICN2) commitments, achieve the global nutrition and diet-related noncommunicable disease (NCD) targets by 2025, and contribute to the realization of the Sustainable Development Goals by 2030. Reflection on global progress and challenges encountered and on a way forward after the ending of the UN Decade of Action on Nutrition (2016 – 2025) is encouraged.

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

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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/.

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Dengue cases rising in Region 

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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

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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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