TCI News
Overview of Diagnostic Imaging Services Post 2017 Hurricanes
#Providenciales, February 7, 2019 – Turks and Caicos – Similar to other major service providers across the country, InterHealth Canada – Turks and Caicos Islands Hospital received significant damages during the hurricanes in September 2017. These included latent damages to the electrical circuitry of medical equipment that only became apparent over time. The total cost of repairing the damages to the hospital’s infrastructure and medical equipment is estimated to be USD$16 million.
The majority of the equipment in the hospital is highly sophisticated and extremely sensitive. The environment of CT, MRI and Mammography machines require tight control over temperature and humidity. An independent 
review of the Diagnostic Imaging infrastructure at Cheshire Hall Medical Centre was conducted by XRCT Limited, a physics consulting company based in Ontario.
The report stated: “In the wake of the storms, the lack of air conditioning lead to ambient air temperature and humidity conditions within the facility that were outside of the manufacturer requirements. This created a severely hazardous environment for electronic components. In addition, the restoration of power to the island created multiple daily power outages, surges and brownouts. All of these conditions, when combined have led to premature component failure, significant increase in downtime and potentially shortened the expected lifecycle of the diagnostic imaging equipment.”
INTERIM CORRECTIVE MEASURES
Biomedical Engineers employed at the facility assisted by overseas specialists worked assiduously to resolve any emerging technical issues. To date, all diagnostic imaging machines are fully operational. The intermittent downtime experienced in previous months with CT and Mammography machines were minimal. The MRI machine was operational, but with limitations on the type of radiological scans that could be performed at the time.
“Despite the high temperatures and lack of humidity control present in the facility, the records show the hospital continued to make every effort to operate the equipment under these extreme conditions in the interest of providing vital and medically necessary patient care,” stated XRCT Consultants in an official report. These efforts sought to ensure the continuity of high-quality care and to minimize the number of patients who require treatment abroad. Patients were categorized based on clinical priority and the equipment up-times were maximized by increasing the volume of radiological scans performed per day.
THE MAINTENANCE PROCESS
CT, MRI and Mammography machines generate significant heat while in use and at rest. Therefore, operating temperatures within these areas are closely monitored, checked and reviewed regularly to ensure temperature and humidity is within the guidelines established by the manufacturer. Any changes in these precise specifications can create the risk of overheating and damage to internal components. Monitoring the relative humidity of MRI rooms is also crucial to avoid the risk of moisture damage to very delicate electronic components such as electronic expansion boards, cables, and connectors.
XRCT Limited also performed an extensive review of the service records for the Diagnostic Imaging department and stated: “Over the months/years preceding the storms in 2017, the service history for all the equipment was excellent. In fact, with the exception of a few random downtime events and planned maintenance, the uptime of all clinical systems was quite good, in excess of 99%.” Based on these expert findings, the technical issues experienced over previous months were evidently not attributed to inefficiencies in the maintenance or management processes established by InterHealth Canada, but were connected to acts of nature, beyond human control.
THE COMMUNICATION PROCESS
InterHealth Canada has continued to abide by the terms of the Project Agreement and meet the extensive reporting and service standards detailed in the contract. As partners in health care, InterHealth Canada is contractually mandated to submit monthly reports to the Turks and Caicos Islands Government (TCIG) related to over 48 clinical key performance indicators, including Diagnostic Imaging services. These key performance indicators seek to demonstrate how effectively the management company is achieving pre-established targets. InterHealth Canada fully supports and complies with these accountability mechanisms.
The TCI Government via the Contract Management Unit has been kept informed, at all times, where services have required expansion or, where challenges such as the 2017 hurricanes have caused damage to equipment, resulting in some delays to services. Representatives of TCI Government’s Contract Management Unit and Fortis TCI also conducted a physical inspection of the UPS and surge protectors in the Diagnostic Imaging Department.
THE LIFE CYCLE PROGRAM
Managing the lifecycle of medical equipment from planning to purchase, installation, operation all the way through decommissioning and disposal helps medical institutions improve operational efficiency, enhance quality and reduce service-related cost.
The purchase of capital equipment is covered under a life-cycle program, which is a reserve fund established under the contract between TCI Government and InterHealth Canada for equipment replacement. The decision to purchase equipment involves several key considerations. These include: Equipment Specifications and Suitability, Procurement and Logistics, Available Financial Resources, Prospects for Maintenance, Repair and Life expectancy.
InterHealth Canada has filed a short term and long-term recovery plan with TCI Government and are actively considering replacement possibilities for key modalities in diagnostic imaging. Negotiations are also underway with the insurance companies relative to the damages ensued.
Release: InterHealth Canada
South Side Jet-ski Buoy
Providenciales, Tuesday 30 April, 2024 – The Department of Environment and Coastsal Resources (DECR) would like to make all jetski operators, jetski owners, jetski users, watersports operators, tour guides, and the public aware of ‘No jetski’ buoys that have been installed within the Princess Alexandra Land and Sea National Park and Nature Reserve.
Additional buoys will continue to be deployed and are strategically positioned along the perimeter of protected areas, serving as a clear boundary beyond which jet skis are not permitted. All jet ski users are to heed that jet skis are strictly prohibited within all protected areas in the Turks and Caicos Islands, in accordance with the National Park Ordinance (11 of 1975):
Section 3(1) Prohibitions and permitted activities within all National Parks
(g) Jet skis and hovercraft
Section 3(2) Prohibitions and permitted activities within all Nature Reserves
(f) Water skiing, jet skis or hovercraft
Section 3(3) Prohibitions and permitted activities within all Sanctuaries
- Water skiing, jet skis or hovercraft
Emerald Point Buoy
Section 3(4) Prohibitions and permitted activities within all Areas of Historical Interest
(g) Water skiing, jet skis or hovercraft
A person contravening these regulations commits an offense and is liable on summary conviction to a fine of between $5,000 and $50,000 or a term of imprisonment, or both, as per Section 13 of the National Park Ordinance.
The accompanying map delineates the protected areas (highlighted in red) and indicates the placement of the buoys. It should be emphasized that the regions shaded in red signify areas where jet skis are not prohibited.
Should you require further clarity, please contact the DECR at (649)338-4170 or email environment@gov.tc
PRESS RELEASE
MINISTRY OF HEALTH & HUMAN SERVICES
Providenciales, Turks and Caicos Islands, 25 April 2024 – The Ministry of Health and Human Services is issuing a public advisory regarding a recent increase in chicken pox cases, particularly within school communities in the regions of Grand Turk and Providenciales. The Ministry is actively monitoring the situation and is working closely with affected schools to provide support and education aimed at preventing further spread of the virus.
Chicken pox, caused by the varicella-zoster virus, is a highly contagious infection characterized by a distinctive rash of itchy red spots or blisters. Transmission occurs via droplets, aerosols, or direct contact with respiratory secretions, and almost always produces clinical disease in susceptible individuals. While mostly a mild disorder in childhood, varicella tends to be more severe in adults. It may be fatal, especially in neonates and in immunocompromised persons. The Ministry urges parents, teachers, and the general public to remain vigilant and familiarize themselves with the signs and symptoms of chicken pox, which may include:
- Rash: The primary symptom of chicken pox is a rash that typically begins as small red spots, which then develop into fluid-filled blisters over several days.
- Fever: Children with chicken pox may experience a mild to moderate fever, often preceding the appearance of the rash.
- Fatigue: Some individuals may feel generally unwell, tired, or lethargic.
- Loss of Appetite: A decreased desire to eat may accompany other symptoms of chicken pox.
Management aims to relieve symptoms and reduce the risk of complications and may include:
- drinking plenty of fluid (try popsicles if your child is not drinking) to avoid dehydration.
- taking paracetamol to help with pain and discomfort.
- cut your child’s fingernails and put socks on their hands at night to stop them scratching.
- use cooling creams or gels e.g. Calamine lotion
- speak to your health care provider about using antihistamine medicine to help itching.
- bathe in cool water and pat the skin dry (do not rub)
- dress in loose clothes.
- do not use ibuprofen unless advised to do so by a doctor, as it may cause serious skin infections.
- do not give aspirin to children under 16.
- do not go near newborn babies, or anyone who is pregnant or has a weakened immune system, as chickenpox can be dangerous for them.
- do not scratch the spots, as scratching can cause scarring.
To mitigate the spread of chicken pox within schools and communities, the Ministry emphasizes the importance of practicing good hygiene habits, including frequent handwashing with soap and water, covering coughs and sneezes with a tissue or elbow, and avoiding close contact with infected individuals.
In the event that a child exhibits symptoms of chicken pox, parents and caregivers are advised to keep them at home and seek medical attention promptly. A sick leave for a period of 14 days is usually given. After the 14 day sick leave period, the individual must return to the physician or the public health nurse at one of the primary care clinics to obtain a fit for work or school certificate allowing them re-entry back into school or work. Anyone returning earlier than this time or without this certificate should not be allowed in school so as to prevent spread to other children. Additionally, it is crucial to inform school authorities to prevent further transmission among classmates and staff.
The Ministry of Health and Human Services is committed to ensuring the health and well-being of all citizens, and will continue to work diligently to address this current situation. For further information and guidance on chicken pox prevention and management, please visit Turks and Caicos Islands Ministry of Health and Human Services Facebook page at https://www.facebook.com/tciministryofhealth/.
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