Long before COVID there was our nation’s premier killer: Diabetes!

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

Estrada’s lawyers had challenged Juffali’s defense, in the process dumping our tiny island 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 U.S. dollars.

Online reports about the case had been in circulation over a week when the day’s leader of the opposition United Workers Party, Allen Chastanet, took to the airwaves to demand the government account for the 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 greedy shark lurked. Many speculated openly about what they saw as yet another surreptitious official pay-for-play arrangement. Others choked on silent embarrassment!

As I’ve elsewhere underscored, back in 2016 the doomed prime minister had decided Chastanet’s questions unworthy of reasonable response. Typically, he hit back with an ill-considered non sequitur: While on a private visit aboard his luxury yacht Walid Juffali had somehow tracked him down to express sincere love and admiration for our incomparably beautiful island and to offer salvation to its neglected diabetes-plagued population.

As earlier mentioned, most of what the prime minister delivered from the steps of his favorite Castries perch was hastily invented hyperbole. We the people were left to speculate without official assistance about the IMO appointment: did the visiting billionaire sheik proffer his special services? Was it he who 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 Walid Juffali was near death by cancer. He never attended a single meeting of the organization. And even if he had been in a position to attend, he was wholly inexperienced in maritime matters and absolutely unqualified for his position—facts that had not escaped Justice Hayden.

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

Shortly after Juffali’s passing in July 2016 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 only recently has 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 also was 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. (It turns out Juffali never visited Saint Lucia, not by luxury yacht, not by private jet and conceivably must’ve lost his Saudi heart to Helen’s admittedly irresistible brochure pictures.)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 and CMO Dr. Stephen King—which left me wondering why he remained silent on Juffali while others played muddy political football with the philanthropist billionaire’s reputation. In all events, and as I mentioned in an earlier report, the study revealed some shocking statistics that speak volumes about the history of healthcare in Saint Lucia: “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 acknowledged its continuing use of “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. [See side bar.] 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 W Science report states what already most of us have known from the heyday of long deceased health minister Romanus Lansiquot: 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.” That of course depends on the local definition of “soon.”

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.” A planned fifth wing to the hospital remains unbuilt, reportedly 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 existing 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 had led to the majority of diagnoses being made when patients present themselves to healthcare 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, the report 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 of 2015: “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 is 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 plants; 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 investigating committee observed in its report, “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 healthcare.” But all of that was before the Juffali waters had been turned into a political cesspool by self-serving election candidates, by Prime Minister Kenny Anthony especially.

The distressing report from which I’ve quoted so liberally has never been made public, thanks to obscurantist politicians that pay lip service to healthcare in Saint Lucia—with scant regard for the afflicted hundreds of thousands!

This article first appeared in the February 2021 edition of the STAR Monthly Review. Be sure to get your printed copy on newsstands or view it here: https://issuu.com/starbusinessweek/docs/star_monthly_review_february_2021