The State of St Lucian Healthcare, In-Depth

[dropcap]T[/dropcap]he end of one year and start of a new one always brings with it new resolutions and plans. To many people in business, common new year goals for the growth of a company or progression in one’s career are often accompanied by very personal ones, like the desire for greater health and happiness in the year ahead. Ultimately, health and happiness will always be tied together, and the ability to have the latter will always be informed by the former. But it’s a reality that for much of the past year, observers would have found plenty to be unhappy about when it comes to the state of healthcare in Saint Lucia. Then, news of a new beginning arrived in the later months of the year. So what is the state of Saint Lucia’s healthcare at the end of 2018? And what can we expect for the sector in the year ahead? Let’s look now in-depth.

Saint Lucians in 2019

Saint Lucians will be cheered to know that this island’s residents are living longer. Life expectancy has grown in recent years. Any Saint Lucian boy born in 2018 who has a life of good health can expect to see his 73rd birthday. Any girl can expect to see beyond that, with a life expectancy of 78 years. While the longer lifespan is certainly good news, the commendable work done by authorities in tackling Saint Lucians’ national health issues surrounding infectious diseases has been replaced by a rise in chronic non-communicable diseases such as heart disease and diabetes. These trends are mirrored among many nations worldwide but treatment for these diseases locally is reliant upon this nation’s healthcare sector exclusively. And within the healthcare sector, where there are literal battles between life and death, it’s been a tough year.

The Road of Recent History

Early to mid-2018 saw the state of Saint Lucian healthcare publicly criticised by the Saint Lucia Nurses Association, the Vieux  Fort Concerned Citizens Coalition for Change (VF4Cs), the Saint Lucia Medical and Dental Association (SLMDA) and the Civil Service Association (CSA). Criticisms were broad and diverse but poor infrastructure and resource allocation — where resources were available — was common. The apparent waiting time of up to four days for a hospital bed proved a lightning rod for critique. The November openings of three upgraded healthcare facilities across the island — in Mon Repos, Desruisseaux and Belle Vue — can be seen as a clear step forward. Nonetheless, these recent months show that the efforts in earlier years to improve administrative healthcare processes nationwide —by decentralising management, integrating multi-level care, and greater collection of data to be used in evidence-based policy-making — ultimately need a new examination, given the breadth of criticism levelled.

In late September the World Bank announced it would approve US$20 million towards the improvement of Saint Lucia’s public healthcare sector. The provision of funds via the International Development Association was put forward with the specific targets of improving efficiency, accessibility and responsiveness among the nation’s key healthcare services. How this proceeds in the new year will be interesting to observe; also the plans of the Chastanet government for the construction of a new wing at the existing St. Jude hospital complex in Vieux Fort. Expectations of rapid-fire improvements via new infrastructure alone would be short-sighted, but no fair mind can be blind to the simple maths that more beds should equal more care.

Local and Global Benefits

Improvements to the healthcare sector will not only be beneficial to Saint Lucians at home, but also for Saint Lucia’s brand abroad. While Saint Lucia is not alone as a nation that has battled with the notorious Zika and Chikungunya viruses, even one report of an isolated case can cause reputational (and economic) havoc, as would-be travellers to our tourism-dependent nation might fear an island-wide outbreak is imminent. In reality, one report does not necessaruly mean that the whole island is affected, but the upgrading of Saint Lucian healthcare offers a two-part benefit. Firstly it provides a path for the more immediate treatment of any cases that arise locally; secondly it projects to the world that the nation’s healthcare sector can be quickly mobilised to rapidly treat any malady encountered while travelling.

Artificial and Actual: The Limitations of Future Tech in Health

Going into 2019 and beyond, global healthcare will continue to advance through the greater use of technology. Around the world, many hospitals and healthcare sectors have already began to incorporate emerging technologies into their operations. There is the Artificial Intelligence (A.I.) partnership between University College London Hospitals and the Alan Turing Institute in the United Kingdom, and the Eastern European nation Estonia’s use of blockchain for its e-health national database of medical records. As the capability of tech increases, so too can the expectation that it will play a great role in efficient healthcare services.

This notwithstanding, healthcare remains at something of a distance from the immediate benefits that emerging tech offers. Undoubtedly, A.I., blockchain, and similar phenomena can aid in more efficient administration and basic service delivery, but the need for face-to-face interaction between a medical professional and their patient will remain central. This should not deride the good work of technologists, nor dismiss the benefits of future tech, but this sector is one where reliance on advances of tomorrow to address the problems of today would be especially unfortunate. Certainly, looking ahead is always productive but the only certain fix for the problems of here and now is the work done to address them here and now.

A Clean Bill of Health

Identifying the right path between improvement of processes and upgrade of infrastructure will be essential, especially with a recognition of the limitations of tech. Those hoping for the medical field to be ‘hacked’ and get a disruptor like Uber or airbnb to come along will likely be waiting a very long time. Like the human body, Saint Lucia’s healthcare sector is complex. Like any other in the world, it has its share of issues and idiosyncrasies. Yet when so many stakeholders level such high criticism, as seen in 2018, it’s clear that many will not lament saying goodbye to 2018, and will welcome an opportunity to begin afresh in 2019 — with a hope that local healthcare will obtain greater fitness.