- Saint Lucia has noted 11 new cases of Leprosy which represents a 120% increase from 2020 to 2023;
- Eight cases of leptospirosis;
- Cancers account for about 1 in every 5 deaths (20%) in 2020. Men- prostate cancer & Women-Breast Cancer;
- Three new cases of Tuberculosis were reported in 2023;
- Twenty-six new cases of HIV diagnosed in 2023 which represents a 32% decrease from 2022; 65% of the cases were male; 992 persons living with HIV in Saint Lucia of which 57% are male.
By Caribbean News Global contributor
CASTRIES, St Lucia, (CNG Health) – The General Health Summary 2023, by the Ministry of Health (MOH) January 2024, states “during the year 2023, the health system managed many health programs and diseases,” adding “this ranged from new less virulent variants of COVID-19 to our regular infectious diseases and chronic non-communicable diseases,” hitherto, warrants an autopsy.
The General Health Summary 2023 ‘medical writings’ at the level of the MOH, wedged attention, in the first instance, proceeding three disclosures.
- The Public Health Board notes the increased number of unregulated food establishments on island.
- One severe malaria case was imported. A total of 8 cases of leptospirosis, all male were reported in 2023. This represents a 14 percent increase over last year.
- Saint Lucia has noted 11 new cases of Leprosy which represents a 120 percent increase from 2020 to 2023.
Relevant to the Public Health Board, the MOH mission reads: “To provide leadership and direction in the creation of environment in which institutions and individuals can be created, empowered, guided and nurtured for provision of holistic health and social services to the entire population of Saint Lucia.” The vision says: “The Bureau of Health Education / Promotion be a catalyst for influencing health public policy, coordinating and collaborating all health promotion activities for facilitating healthy lifestyle choices.”
The question reverberates: Is St Lucia Health Board practising ‘willful blindness’?
In 2023, “eight cases of leptospirosis” [‘a bacterial disease that affects humans and animals’] and “eleven new cases of Leprosy” [‘a chronic infectious disease caused by Mycobacterium leprae, affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract and the eyes,]” should warrant secondary inquiry.
The MOH report, continued: “A national action plan has been drafted towards the elimination of Leprosy on island. This includes an educational public health campaign, intensive contact tracing in the affected communities, re-training of health care workers towards early detection and diagnosis, increased in-country testing and more aggressive and consistent treatment.”
On the wisdom of stating that: “The Public Health Board notes the increased number of unregulated food establishments on island,” Caribbean News Global (CNG) pursued the expert advice of a regional physician/consultant, with knowledge of the domestic substructure and practice.
“ What MOH speaks to here is as a result of a poorly performing economy, people need to survive and so food establishments are sprouting up all over the place without the requisite permits and quality control mechanisms. This is a major source of a public health nightmare in the making. And where the food stalls are located is usually of low and mediocre input, with continued bad outcomes.”
In addition, the Government of Saint Lucia (GOSL) and MOH, collectively and/or individually, “has no perspective, no clear and target-driven policy agenda.”
In furtherance of this, the effectiveness of public health certification, environmental officers and food certification programmes, policy and implementation among others, should be driven to accountability.
“For decades,” said the regional physician/consultant: “The MOH has been making the same diagnoses over and over, failing to bridge the gaps that will deliver improved public outcomes; consequently, healthcare continues to worsen on a rapid downward spiral,” adding: “A fundamental reason why our healthcare KPI [Key Performance Indicator or metric is a well-defined performance measure that is used to observe, analyze, optimize, and transform a healthcare process to increase satisfaction for both patients and healthcare providers alike] continues to worsen is because of the growing lack of – and diminishing mutual public trust.”
“Successive governments are unable to mobilize citizens to a healthy lifestyle for better outcomes. Currently, the GOSL is like a bad parent, unable to excite and engage, lead and implement. Therefore, the overall health of the country is not good,” the physician diagnosed. “The GOSL is not solution and action-driven.”
The other observation from the General Health Summary 2023, relates to bed shortages.
It is a common secret that all of the island’s medical facilities suffer the fate of bed shortages. Patients wait in hospital hallways and waiting rooms for access to services and care. Unfortunately, very few patients survive the much-needed care, while others die in the hallways of our hospitals.
Historical analysis
One of the most important reminders navigating unprecedented times keeps pouring in. “St Lucia’s PM favour horses before hospitals, says opposition leader,” November 2, 2019:
“The governance of a country is not about entertainment; it is not a sport… not even for Kings. Governance is about the serious business of managing issues of life and death,” said, then opposition leader Philip J. Pierre, “Therefore calls upon all good citizens of this island to join the movement in protesting and halting, the foolishness, the callousness, and misguided priorities of this Chastanet-led government.”
Moreover, prioritizing Saint Lucia’s well-being can be tough to navigate upon revision that, “St Lucia opposition exposes government’s reckless approach to healthcare,” March 15, 2019:
Moses Jn Baptiste, the then, SLP spokesman on health, agriculture, fisheries and food production, in a presentation entitled ‘Recent government decision on healthcare intensify suffering,’ said:
“For nearly three years the government of the United Workers Party (UWP) has, through its actions, deliberately caused patients, medical staff and other professional staff of the St Jude hospital to endure additional, avoidable suffering and frustration.
“The Saint Lucia Labour Party interprets the government’s actions as careless and without due regard, to the people who are suffering most’ and ‘suggest that the UWP administration is not interested in completing the St Jude hospital and continue to hold the people of Saint Lucia in contempt.”
The General Health Summary 2023, conceded that:
“Record health facility closures and diversions for care due to environmental air quality issues were noted in 2023. We are working to determine the causes and address these issues to reduce the breaks in service access and provide healthy and safe environments for staff and patients. Twelve SMART health facilities are scheduled to be set up during 2024.
“The opening of the Castries Urban Polyclinic will address and improve access to care in the north and central zone of the island and reduce the utilization of the Owen King European Union (OKEU), hospital for non-emergency services. The recent opening of the Secondary Care facility at the old Victoria hospital should address the bed shortage issues at OKEU.”
Instructively, help is on the way. Prime Minister Philip J. Pierre, New Year’s address, reads: “We will continue work on the construction of St Jude hospital to deliver a well-equipped hospital to the public. Work on four buildings is expected to be completed by June 2024. Work on the other buildings will commence shortly after.”
Respiratory Syncytial Virus (RSV)
The virus is still circulating globally and Saint Lucia is not immune as a destination island, banking on the travel and tourism industry.
“The year 2023 saw a drastic reduction in the number of confirmed cases of COVID-19. This may be attributed to the reduced number of persons presenting for testing, the reduction in physician testing post declaration of the end of public health emergency of international concern, home testing and the overall relaxation of measures and protocols. […] An increase in cases of RSV was noted in the pediatric population,” says MOH.
Dengue fever
“The MOH noted a significant increase in Dengue Fever in 2023 compared to 2022 however outbreak levels were not attained. This increase in cases was consistent with that observed in the neighbouring island of Martinique. The majority of the cases were diagnosed in the south of the island, particularly Vieux-Fort.”
The MOH has work to do. “Dengue (or dengue fever) is a disease spread to humans by mosquito bites, and is caused by one of four types of dengue viruses. Dengue can result in shock, internal bleeding, and even death.”
Crime and motor vehicular accidents
“The increasing impact of violence and injuries due to crime and motor vehicular accidents on the hospital system and blood bank resources remains of serious concern,” noted the MOH. While, “chronic non-communicable diseases continue to be a significant source of mortality in Saint Lucia, with cancers, cerebrovascular disease/stroke, heart disease and Diabetes Mellitus dominating as the top four causes of death respectively for the last 10 years. Males accounted for 56 percent of all deaths in 2020.
Trends
According to the MOH report, trends noted over the last five years and the data from the Behavior Risk Factor Survey carried out in 2019, primary care/preventative health strengthening remains a major focus for the MOH.
“We continue to note low levels of health screening, increases in obesity, low fruit and vegetable intake and limited physical activity among our population. Given the increases in chronic obstructive pulmonary disease especially in the young male population, the MOH will be launching smoking preventive campaigns and working with event planners and other stakeholders to reduce the exposure to smoking.
“Programs to improve on preventative strategies such as the adoption of healthy lifestyles, early detection and screening will be further strengthened. The strengthening of the referral process between primary and secondary care is also urgently needed to manage patients between services and reduce loss to follow-up.
“The Universal Health Coverage (UHC) strategy, Results-Based Financing Project and Health Systems Strengthening Project will support the implementation of these programs in 2024. “The quality initiative is one of the priorities for the MOH for 2024 and with the implementation, it is anticipated that general quality of care and service utilization will improve moving forward.
CNG diagnostics
Contributing wisdom, and providing more public good that is conducive to constructive participation in resolving health and wellness, and policy implementation are actively remote.
The hypothesis, sense of purpose, security, development interests and UHC for an enabling environment are currently non-existent towards solutions for our health problems.
The route to the many General Health Summary 2023 as prescribed is ‘certainly not delivering patient satisfaction through improved outcomes.’The result is conspicuous evidence of the impulse – “I die dead” – to reproduce a former politician’s verbosity.
