Will New Government Embrace Project Juffali?

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It remains altogether conjectural why our recently reassigned former prime minister—if he truly believed all he said about Walid Juffali last November—allowed, if not encouraged, many among us to believe that under his Good Samaritan costume the multi-billionaire Saudi was just another scheming low-rent scumbag. Less than half a dozen Saint Lucians had heard of him before his widely publicized imbroglio over money with his third wife, an American former calendar pinup named Christina Estrada, and sought refuge behind the immunity afforded him by his position as this country’s representative on the board of the International Maritime Organization.

Estrada’s lawyers had challenged Juffali’s defense, in the process dumping Saint Lucia smack dab in the middle of a miasma of negative publicity that reverberated around the world—especially after a UK court had effectively declared Juffali’s appointment a sham, a papier mache shield against his former wife’s petition for a divorce settlement totaling multi-millions of dollars.

Dr. Stephen King (right) was one of the honored guests at the naming of the hospital in honor of his deceased father. He was also on a special advisory committee to a visiting team of experts from W Science, chaired then by Walid Juffali.

Online reports about the case had been in circulation over a week when the then leader of the opposition United Workers Party, Allen Chastanet, took to the airwaves to demand that the day’s government account for the year-old no longer secret marriage of convenience. It being the season of elections, it was hardly surprising that at least half the country concurred with Justice Hayden’s conclusion: that Juffali’s maritime appointment reeked of shellfish and sardines; that in the murky details a shark lurked. Many speculated openly about what they saw as yet another official pay-for-play arrangement. Others choked on embarrassment!

As I underscored last week, the doomed prime minister decided Chastanet’s questions unworthy of a reasonable response. Typically, he hit back with an ill-considered non sequitur: while on a private visit aboard his luxury yacht Dr. Wallid Juffali had somehow tracked him down to express sincere love and admiration for our incomparably beautiful island and to offer salvation to its neglected sick and dying population.

As I underscored last Saturday, most of what the prime minister delivered from the steps of his favorite Castries perch was hastily calculated hyperbole. We the people were left to speculate about the IMO appointment: did the visiting billionaire sheik proffer his special services? Was it he made an offer at once prestigious and timely? As by now the whole world knows, at the time of his appointment as Saint Lucia’s IMO representative Dr. Juffali was only months away from death by cancer. He never attended a single meeting of the organization. And even if he could’ve attended, he proved wholly inexperience in maritime matters and absolutely unqualified for his position—hence Justice Hayden’s unsurprising determination.

What Wallid Juffali knew a lot about was W Science. A private company that he founded for the stated purpose of establishing medical and scientific partnerships. Dr Juffali was its chairman until his death last month. By reliable account, Ernest Hilaire (recently elected MP for Castries South) was introduced to the billionaire when he was still Saint Lucia’s high commissioner in London. Their several postprandial discussions over several months had led to Juffali’s company agreeing to undertake a study of diabetes in Saint Lucia.

Shortly after Juffali’s passing Hilaire informed reporters that a $2million fund existed for the purpose of setting up a diabetes research center here but it all depended on the present government’s attitude to the project. Doubtless, he was cognizant of the fact that Juffali had been permitted to become a political football at election time; that something good may have been allowed to go bad on the altar of selfish political motives. In all events, the feasibility study was undertaken in 2015—another secret that has only now come to light. The expectation was that the study would allow W Science to gather perspectives and explore the interest and capacity for a collaboration with Saint Lucia and the Caribbean community and learn how the company could work with the people to have a positive and meaningful impact on their well being.

“It was also hoped there would be opportunities to develop sustainable partnerships and programs centered on the special needs of people with diabetes in Saint Lucia.”

Medical and research teams put together by W Science visited the island between 2 and 5 September 2015. They were allowed “unprecedented access to private and public hospitals, universities and technical schools, non-profit associations, health-care professionals and diabetes patients.” With the endorsement of the health ministry a core committee was assigned responsibility to interface with the visitors. Among leading figures on the committee were former senator Dr. Stephen King—which left me wondering why he remained silent on Juffali while others played muddy political football with his reputation.

In all events, and I mentioned this last week, the study revealed some shocking statistics that speak volumes about healthcare in Saint Lucia. To quote directly from the W Science report: “The commonly cited Graven study from 2007 that indicated Saint Lucia has the highest prevalence of diabetes in the world was flawed and discredited by all stakeholders questioned. However, members of the public still believe what the study claims is true.” W Science concluded that setting the record straight had either not been attempted or has been unsuccessful.

The health ministry, meanwhile, had acknowleged it continues to use “the discredited statistics as a means to promote improvements in diabetes healthcare. Regardless, public awareness of the nature of the diabetes problem and the social burden of the disease appeared quite low. At the same time, people with diabetes are reluctant to disclose their condition for fear of discrimination and are unaware of its seriousness, impacting negatively on management of their disease.”

Additionally: “It is impossible to say exactly what the burden of diabetes in Saint Lucia is, due to a paucity of reliable information. There is no reason to suspect that any less than approximately 9% of the population have diabetes.”

The report states what already most of us have known from the hey day of long deceased health minister Romanus Lansiquot; that both Victoria Hospital and St Jude “are old and in poor repair.” However, there was the silver lining that “the new Owen King EU Hospital is soon to replace Victoria Hospital.” Of course we know, too, that “soon” has not yet arrived.

At the time of the study—early September 2015—the Owen King Hospital (built with EUR54M assistance from the European Union) was “in its final stage of fit-out prior to opening.” Nearly a year later a planned fifth wing to the hospital remains unbuilt, for lack of funds. (Nevertheless, shortly before the June 6 elections the government staged a much ballyhooed ceremony to name the hospital, with scores of invited overseas and local guests, at a cost of well over $100,000.)

The W Science report also warned that with the opening of the new hospital “healthcare costs will increase.” As for the island’s 33 clinics, “they are over-run and often suffer shortages of medications and supplies and poorly skilled workers without routine supervision.”

Of great concern, the study revealed a shortfall of screening and public awareness has led to the majority of diagnoses being made when patients present themselves to health-care staff with established complications of diabetes (end-care renal, cardiovascular and other diseases.) “Some clinicians suggested that a shocking 90% of all diagnoses occur at this stage, with foot ulceration being the most frequent presenting complaint.”

Also significant, opportunities to prevent the devastating complications of diabetes are routinely missed or wrong diagnoses made”—with dire consequences both to patients and to the nation.

The island does not have a national diabetes registry, it was revealed. Individual hospitals and community primary care clinics have had to develop their own registries. Victoria Hospital received five computers that were still boxed at the time W Science visited. They were donated by Morehouse School of Medicine to pilot the establishment of a diabetes registry.

Again quoting from the W Science study: “There are eleven dialysis machines at Victoria Hospital, ten at St. Jude Hospital and five at Tapion—private and more expensive. The machines are fifteen years old but working well, since the staff are well familiar with the machines’ idiosyncrasies. No home dialysis is performed, due to risk of infection. No kidney transplants are performed on Saint Lucia: patients must travel to Trinidad, Martinique or Barbados.”

Additionally: The reluctance of a significant proportion of patients to seek help for diabetes is noteworthy. Many believe in the health properties of local herbs and plans; also that there are poisons in modern medicine which cause unpleasant side effects and so they need to cleanse their body of the poisons. The use of alternative medicine is rampant.

Poverty is another major contributor to non-compliance. Limited supplies force many patients to obtain medication via other sources that are not free, or go without. “Even if medication is available,” the scientists observed, “some people don’t have access to a refrigerator to properly store their medication . . . People buy food they can afford, not what the dietician tells them to.”

Of special interest is the following, taken from the study: Despite the political inertia and the practice of deliberately preventing the facts or full details from becoming known, “the country acknowledges many of the problems regarding diabetes healthcare and is ready for change and to collaborate with W Science to improve the management and care of people with diabetes in a sustainable and ultimately self-financeable fashion, linked to active research programs. Political will and support was received at the highest level—and most specifically the returning high commissioner to the UK, Mr. Ernest Hilaire.”

Moreover, “the government of Saint Lucia is open and supportive of international partnership to improve diabetes health care.”

But that was before the Juffali waters had been turned into a political cesspool by self-serving election candidates. What will be the impact since the Saudi billionaire’s death and the change of government are all-important questions at this time unanswered. Indeed, the distressing report from which I’ve quoted so liberally will probably never be made public, thanks to obscurantist politicians that pay lip service to health care in Saint Lucia—with scant regard for the afflicted hundreds of thousands!