Hurricane Irma showed the territory’s health sector to be “largely resilient,” according to Petrona Davies, the permanent secretary in the Ministry of Health and Social Development.
Ms. Davies gave this assurance last Thursday while speaking at a stakeholder meeting that addressed the Irma recovery plan as it relates to the health services sector.
Over the next five years, she explained, the plan calls for better health and social services under a strengthened National Health Insurance system.
The estimated cost is $80.1 million for the health sector alone, with a mixture of public and private financing.
The PS began by addressing the health facilities that suffered damage in the hurricane.
“We are focusing on conducting repairs to the facilities that were badly damaged, and we have conducted assessments for the clinics that are closed,” she said. “We are working to have those facilities restored.”
At the moment, repairs are being conducted on Jost Van Dyke, and soon insurance payments will begin covering repairs to Peebles Hospital.
“Other facilities are a greater challenge because the damage is to the community centres, but in the absence of those facilities the [BVI Health Services] Authority has been able to provide services through mobile operations,” she said, adding, “We are hoping to procure a mobile clinic that will help us to better serve the northwestern sides of the island, given that the Cappoons Bay and Cane Garden Bay clinics are offline at the moment.”
Officials also have been discussing the need to establish larger, better-equipped clinics across the territory, according to the PS, who reminded attendees that the Virgin Gorda medical facility is under construction.
“We want to make sure our health facilities meet smart standards so that they are safe and green, tying into the wider plans for the recovery,” she said.
Ms. Davies also said that emergency call handling has now become a responsibility of her ministry.
“We now have a new call handling centre in the hospital annex, and given that the fire station suffered extensive damage to [its] 911 services, we purchased a [satellite] phone package,” she said.
The PS added that police and fire officers will take charge of the system and that it will be commissioned Feb. 1. Calls are currently being monitored at the hospital.
Ms. Davies also expressed a need to consider how to expand access to specialised health services, possibly to people outside the territory.
“Just recently I was approached about partnering with the [United States Virgin Islands],” she said. “A lot of neighbouring territories have been affected by the storms, and people see that there’s opportunity to provide care to populations beyond our borders. We’ve also been having ongoing discussions with partners that are willing to provide specialised care.”
Recently, progress has been made toward providing more cardiology services here, she explained.
“We are continuing with the investment in the health information systems; the accreditation of health facilities — and also, just to mention, the improving emergency medical services, from ambulance service to medevac,” she said.
The PS also addressed the issue of paying for all of the recovery initiatives.
“Certainly we are happy to see that the [NHI] system has shown resilience,” she said. “There was concern — rightfully so when we saw the devastating impact that Irma had on the workforce and saw what that could mean in terms of the viability and sustainability on NHI.”
However, the arrival of the storms provided an opportunity to reexamine how the health system is financed, both for “NHI as a payer; but also out-of-pocket spending and how we can make it as consistent as possible,” she explained. “In addition to an actuary review, there will be need for a comprehensive view to health financing in general.”
The PS also gave an update on ongoing needs assessments. In the immediate aftermath of the storm, she said, the ministry collaborated with the Caribbean Disaster Emergency Management Agency to conduct more than 3,000 home visits.
“We were able to identify those with urgent needs and target the assessment to them immediately and enter them into a database,” she said.
The assessments will continue.
“This year we were supposed to be launching our country assessment of living conditions, but with Irma it was pushed back,” she said. “That is where we will go into the communities … and get more information into exactly how people are doing.”
BVIHSA CEO Paula Chester-Cumberbatch and Director of Nursing Gretchen Hodge-Penn agreed at the meeting that one of the main issues facing health services after Irma has been a shortage of staffing.
“The [recovery] plan is fine, but staffing it is going to be a major, major problem,” said Ms. Hodge-Penn. “We don’t have a nursing programme here in Tortola that should feed health services, so we rely on recruiting nurses from around the Caribbean. The amount of time it takes to get one nurse is around four months.”
She added that Irma has increased that amount of time significantly, saying that many nurses have declined the job due to the cost of living.
“We don’t have residences to supply to them,” she said. “So why should they leave their country to come to ours?”
Chief Medical Officer Dr. Irad Potter said that another issue with the plan may be immigration policy.
“Let’s be mindful that our population is only 30,000,” he said. “The way in which we assimilate people into our community is a major hindrance. Every time we’ve [revised immigration policy], we’ve made it worse.”
At the meeting, Premier’s Office Permanent Secretary Broderick Penn said the government has addressed some concerns about immigration, including establishing a multi-year entry permit announced Jan. 8.
“You see changes to immigration laws that allow people to stay after they’ve been here a long time without having to leave with their children,” he said. “So I think various bits and pieces are coming in place. Within the plan, we have to look more holistically and make sure that we have all the linkages for the professional staff in the VI.”