Sharon-Flax Brutus, a resident of Virgin Gorda, vividly remembers lying on a boat and travelling to Tortola for emergency medical help while going through a miscarriage and thinking, “I hope I make it.”
Thirty years later, she said, her 27-year-old son also had to travel across the waters for an emergency, holding onto a gurney and praying for his life.
Their stories are indicative of a longstanding problem that the sister islands have faced when it comes to emergency medical services.
“It is very real that not enough progress has been made,” said Ms. Flax-Brutus.
Her sentiments are shared by many other residents and have been documented in a recent report by the Sister Islands Unit run by the Office of the Deputy Governor.
Compiled by Sister Islands Programme Coordinator Sasha Flax, the Jan. 3 report outlines how healthcare and emergency response on the islands of Jost Van Dyke, Anegada and Virgin Gorda are severely lacking and in need of major improvements.
The report — which was leaked to the Beacon but has not been made public through official channels — includes analysis of information collected last year based on interviews with numerous residents, department heads, and district officers, who complained of several issues across their respective organisations and departments.
‘Skeleton staff’
According to the report, all the government entities that the Sister Islands Unit interviewed pointed out a need for more adequate staffing.
“Some departments are working with less than a skeleton staff and are not being given the support they need to carry out their duties,” the report stated.
Government entities also reported a lack of supplies and equipment, citing the need to wait months for critical supplies just to carry out their duties. The report pointed out that Jost Van Dyke had no ambulance despite its high elderly population and high influx of tourists.
Anegada, meanwhile, has a high influx of tourists and an elderly population — as well as a high prevalence of residents with diabetes and hypertension — but it didn’t have a doctor stationed on the island at all times, the report found.
Additionally, establishing a consistent system for emergency evacuations by helicopter or boat was an “urgent priority,” the report added.
“There is no established process or course of action for emergency response on the sister islands of Jost Van Dyke and Anegada,” the report stated. “While there is a process for Virgin Gorda, the process is flawed and filled with operational challenges that must be remedied.”
Statistics unavailable
The report also noted that statistics were not available for the number of emergency hospital transfers from the sister islands carried out in 2022 or the number of ambulance calls that were received.
“Additionally, most residents opt to use their own connections and resources to get loved ones transported to the main island of Tortola,” the report stated. “This poses to be quite stressful for residents and should be established within the ministry and shared with communities. There have been several noted [incidents] that have taken place over the course of the year that have had ill or damaged residents waiting hours for medical evacuation.”
The report also noted the lack of barracks for Fire and Rescue Services on each sister island except Anegada.
According to Ms. Flax-Brutus, business owners with water trucks are encouraged to make their trucks available for emergency response.
“When there is a fire on Virgin Gorda, the private businesses tend to respond to help fight the fire,” she explained.
The report also highlighted findings from interviews with members of Virgin Islands Search and Rescue — a volunteer-run non-profit organisation that responds primarily to marine emergencies across the territory’s waters.
‘Haphazard’ responses
VISAR noted that emergencies are often “dealt with haphazardly” on the sister islands and that VISAR has had to address emergency calls on land because other emergency services were short-staffed or not able to assist, according to the report.
The organisation also pointed out a need for training, noting that the staff at sister island clinics tend to be general practitioners who are not trained to handle emergencies.
Members from VISAR also said it is imperative to have lifeguards at The Baths in Virgin Gorda, joint task forces on each sister island, and an ambulance boat, the report noted.
Additionally, the BVI Health Services Authority on Tortola has been reported to break news over the phone to bereaved family members on sister islands because there is no one on the sister islands to do so, according to the report.
‘Inhumane and crass’
VISAR members also reportedly said that post-mortem reports can take hours to arrive to the sister islands.
“The way loss of life is dealt with currently can be described as inhumane and crass,” the report stated. “Family members are not informed in a timely manner of the process and what one can expect.”
Businesses’ input
The report also shared information collected from businesses and community members who highlighted a lack of trust in the system, a lack of awareness and information, and overall neglect of the sister islands.
According to the interviews, residents often seek medical attention outside of the territory where possible.
Virgin Gorda is the only sister island with a doctor who provides healthcare daily — and even there, a doctor is only on call during normal working hours, the report stated.
For emergencies outside those hours, the doctor must be called, and response times vary, the report added.
Furthermore, the newly refurbished clinic in North Sound is not open daily, according to the report.
On Jost Van Dyke, a doctor visits once a week or once every two weeks; on Anegada, a doctor comes “occasionally,” according to the report.
“Residents of the sister islands deserve around-the-clock medical care, which includes doctors permanently stationed at facilities,” the report states.
Improper treatment
Residents on the sister islands have reported instances of improper care due to a lack of resources.
Virgin Gorda resident Greg George recalled a recent instance when his relative received emergency medical treatment. While he had “no complaints” for the treatment administered between Virgin Gorda in transit to Road Town, he noted that there was a long wait for the ambulance once his relative reached Beef Island.
He was surprised to see his relative transported off a gurney, onto the dock, and onto another gurney.
“They said they don’t want this gurney going up to Virgin Gorda because they don’t keep their equipment up to par,” he said. “I was a little disturbed by that.”
That issue seemed “unnecessary” to Mr. George.
“I think that’s an area where we can improve: getting similar standard gurneys across the [VI],” he added.
Anegada
In Anegada, a resident who wished to remain anonymous for fear of victimisation expressed concern at the lack of medical supplies on the island.
“There is no pharmacy on the island,” he stated. “People have to wait until the prescription gets to Tortola and the medicine to be sent back to Anegada.”
Another Anegada resident, Darvin Potter, told 284 Media in a March 2022 interview that he witnessed a slow and unsatisfactory medical response when his wife suffered a stroke days earlier.
Mr. Potter said he didn’t feel comfortable putting his wife on a ferry to Road Town for medical treatment, so he requested airlift. Authorities arranged a helicopter from St. Thomas for his wife after telling Mr. Potter that accessing airlift from Beef Island wasn’t possible, he said.
His wife suffered a stroke at 6 a.m. but the helicopter didn’t arrive until late afternoon, he said.
“There is a formula in place to service all the outer islands if something like this takes place again,” he said. “It had no right to come to this juncture. … We should’ve had this thing rectified many, many years ago.”
The Ministry of Health and Social Development referred the Beacon’s queries to the Deputy Governor’s Office, which didn’t respond to requests for comment.
SOLUTIONS PROPOSED
The “Medical and Emergency Response on the Sister Islands Report” produced by the Sister Islands Unit proposes various solutions to bolster healthcare on the sister islands. They include the following.
1) Stakeholder sessions that include the BVI Health Services Authority and representatives on each island from agencies including the Fire and Rescue Service, the Royal Virgin Islands Police Force, and VI Search and Rescue, as well as other community members;
2) Establishment of protocols to outline the roles of VISAR, the Fire and Rescue Service, and a chain of command in emergencies;
3) Emergency training for doctors at all clinics, the Fire and Rescue Service and the RVIPF;
4) Establishment of medical evacuation processes on each sister island;
5) Budget for staffing, an ambulance boat, barracks and an ambulance;
6) Development of quicker requisitioning for requested items; and
7) Community awareness sessions