Woe betide you should you be diagnosed with a serious illness in a island devoid of the most basic of medical resources or where treatment is available but beyond your means. Saint Lucia is one such place. The majority of the population has little choice but to depend on bush remedies prepared at home, often with dire consequences. Here, kidney disease is rampant. According to recent reports, some 120 Saint Lucians are undergoing dialysis treatment. As many are on a list waiting for treatment. But at the islands two hospitals there are only 17 dialysis machines.
This week the health minister, Senator Mary Isaac, told the nation what already it was well aware of: that the options available to sufferers of kidney disease on the island were extremely limited. She offered little comfort. She told reporters: “For a short time we will continue to maintain the machines at Victoria Hospital and then we’ll see what happens from there.” While acknowledging “diabetes is a real priority for us in Saint Lucia,” she also seemed to be saying many would die before there is any serious change in the existing circumstances. The St. Lucia Diabetes and Hypertensive Association, the Blind Welfare Association too, are especially worried. Renal failure, a consequence of untreated diabetes, is fast becoming commonplace. As if further to underscore the deadly situation, Senator Isaac this week advised regular residents to take better care of themselves. “We have to look at tackling that from a holistic standpoint from birth,” she said. “People must change their lifestyles, eating habits and everything else.” She also underscored the need to get to the root of the matter and to determine the causes for the escalating cases of diabetes on the island. “We want to put things in place so that people can start looking at their lifestyle, people can start embracing the whole health notion that because I am healthy today does not mean that tomorrow I am going to be healthy.” Last month, this newspaper, published an interview with the then Director of the St Lucia Diabetes and Hypertensive Association George Eugene, and Kevin Hanville, Partner at Tenacia Global, an international association concerned with reducing the high cost of treating diabetes.
At the time, Hanville had been doing the necessary groundwork for a pilot project that would target the diabetes epidemic in the Caribbean. After a determination from the American Diabetes Association (ADA) that 70 percent of the cost of diabetes is due to the mismanagement and non-compliance of patients, plans were underway to launch an initiative that would approach the health crisis on the community level, and aid in bringing technologies and products to Saint Lucia as part of a large-scale pilot project to be rolled out on the island early next year. The American Diabetes Association is a partner on the project, and according to Hanville was “extremely excited to be working with us because nobody has tackled the diabetes problem in this fashion.”
Additionally: “It is necessary to tackle it at the community level because you cannot do it in the current infrastructure. The doctors and nurses are all overworked. You can’t pull them out of what they’re doing and get them touching the customer six times a year, four times a year, however much, they just can’t do it. Neither can you afford to pay a doctor or a nurse to go do that. But by certifying home health-care workers to do that, to do the blood tests, simple measurements and that kind of stuff, you have a much less expensive asset you can use. You’ll also be creating jobs.” Hanville said the solution for Saint Lucia and other Caribbean islands had much to do with community involvement. He talked about training people with disabilities caused by related illnesses, people who could help change perspectives and even dispel myths that discourage people from seeking treatment in the first place. “If there’s somebody who has an amputation for example and can’t work, let’s figure out a way to plug them in here,” he said. “Let’s put them behind a desk in their local community, as a patient advocate. Let that person do data entry, for instance, so we can show that you can be productive even though the disease has devastated you. You can still be a productive member of society, regardless. If such people are first to talk to diabetic patients, they will realize they are not alone. The patient might think, I better change my habits or I’m going to wind up like this. If I don’t do anything this is the outcome. It’s all kinds of layers and motivations that get people to change their behavior. We know what the outcome will be if we don’t do this. And it’s not good.”
Where preventative health-care measures and fighting the diabetes epidemic is concerned, Hanville added “nothing is impossible. It takes people with vision and a positive attitude to go, ‘oh yeah, that is the solution,’ instead of going, ‘no that isn’t going to work.’ We’ve got solutions; we just need the ability to execute. The problem is that the current system does not allow for that type of execution because it would be too expensive.”
Research conducted here by Geneva-based W Science, in 2015 indicated that some 25 percent of the population suffered, often on their own, from diabetes. While foreign aid was available for the treatment of communicable diseases, not so with diabetes.