With emotion audible in her voice, Charlene Henderson spoke slowly in short sentences that commanded the room’s attention.
“Bucky was dying. He could hardly breathe. He was breathing through his nostrils. And his lungs were probably closing up on him,” Ms. Henderson said, describing the Aug. 30 medical emergency that took the life of Revovion “Bucky” Sprauve on Virgin Gorda.
The nearly 100 residents gathered at St. Mary’s Episcopal Church on Saturday evening for a meeting with Virgin Islands health officials likely had already heard the story of Mr. Sprauve’s death. It occurred after he sought treatment at the Nurse Iris O’Neal Medical Centre in Spanish Town only to find it closed.
There were no after-hours emergency numbers listed on the door and no medical personnel present. A security guard directed Mr. Sprauve and his friend Wally, who had accompanied him, to the Virgin Gorda Police Station, Ms. Henderson said.
“They got there, and the police said, ‘Why they send you here? What are we to do?’” she recounted during the Saturday meeting on Virgin Gorda.
Then she asked officials in attendance for more accountability for VG healthcare, drawing loud applause from the audience.
“That is our brother,” she said. “We are all brothers and sisters.”
Throughout the three-and-a-half-hour meeting, dozens of VG residents raised many concerns about Mr. Sprauve’s death and the state of medical care available on the island, particularly in the case of emergencies.
Dr. June Samuel, the acting CEO of the BVI Health Services Authority, assured Ms. Henderson that actions to address such issues were already under way.
“As it relates to the incident, we hear you. We also made sure to make some corrections,” she said. “You mentioned the fact that the guard wasn’t trained, which means that no clinical person was there. That has been corrected. You mentioned the emergency number, so I went through that earlier in terms of ensuring that everyone is aware of the emergency number and all persons respond to the emergency number when it is called.”
Tasha Bertie, the permanent secretary in the Ministry of Health and Social Development, told attendees that the intent of the meeting was to listen to their concerns and solicit ideas about how to improve the island’s healthcare. On hand were about a dozen officials from the BVIHSA, including Chairman Ron Potter, and the ministry, including HSD Minister Vincent Wheatley, who is also the Ninth District representative.

Evacuation problems
Residents gave them plenty to consider, describing panicked attempts during emergencies to contact the Georges family who run Speedy’s Ferry to get patients to Tortola in the middle of the night.
“The outer islands, we’re all going through the same thing. You all sit in Tortola; you don’t know what we’re going through,” Ms. Henderson told the health officials. “You go home, you get sick, you get a stroke at night, you can call an ambulance. We have to rely on the Georges family to get us out.”
Coy Levons, an Anegada resident, spoke similarly, arguing that the BVIHSA and the ministry have “dropped the ball.” Emergency evacuations, he complained, can be long, costly and uncomfortable.
“You can’t put an individual on a boat and cross at least 15 miles of rough water in a December month,” he said.
Some residents questioned why evacuations from Virgin Gorda usually drop off patients at Trellis Bay instead of Road Harbour. Landing at Beef Island requires a transfer to an ambulance and an approximately half-hour ride to the hospital, but Dr. Samuel said that route offers a “quicker turnaround” than Road Harbour.
Mr. Wheatley said his team has been considering all options to improve emergency evacuations, including the use of a dedicated emergency vessel or even a helicopter.
Government currently relies on a vessel owner for VG evacuations, and that craft could be outfitted for medical care, but this would require a contract and negotiations with the owner, the minister said.
Other issues
Many attendees spoke of other healthcare shortcomings they have experienced on VG, such as dead batteries in defibrillators, dentists with inadequate tools, keys locked in ambulances, and gurneys that wouldn’t fit in vehicles.
Such concerns are not new. Early last year, a scathing report urged the government to staff the Nurse Iris O’Neal Medical Centre and the North Sound Clinic with doctors 24 hours a day. The report stated that while Virgin Gorda regularly had a doctor available around the clock — and was the only sister island with this service — response times to reach that doctor in the case of emergencies outside of working hours varied.
Dr. Samuel, the BVIHSA CEO, acknowledged residents’ concerns and said that the recent passage of Tropical Storm Ernesto made matters worse at the already short-staffed Nurse Iris O’Neal Medical Centre. The clinic had been operating 24/7 before Ernesto, but it sustained damage in the storm and closed temporarily before reopening with reduced hours two days before Mr. Sprauve’s death.
“Currently, the clinic does have some challenges as it relates to the recent storm they had, and it damaged our air-conditioning system. That is being repaired. The staff continue to provide services,” Dr. Samuel said. “Most of the services are back up and running. So your lab services, your X-ray services are in the building and functioning, as well as physicians and nurses, all of your primary care providers as previously. In addition to that, there is a clinical person, a nurse, on the campus around the clock to deal with any issues that may come up after 4:30 p.m.”
Dr. Samuel said that in the future the authority aims to have “comprehensive services” provided from the medical centre, adding, “Anegada is a part of this discussion.”
Getting there, however, will require millions of dollars.

Needed changes
Dr. Shana-Kay Fraser, the BVIHSA’s lead clinician at the medical centre, noted that the facility is currently understaffed, with only five doctors and eight nurses covering all of Virgin Gorda and Anegada. Ten doctors and 16 nurses would be considered full staffing to maintain a 24/7 operation at the clinic, according to Dr. Natasha Frett, the BVIHSA’s director of primary healthcare.
The same five doctors are responsible for emergency care, urgent care, primary care and extended community medicine, Dr. Fraser said, adding that all of them work more than 40 hours a week. That arrangement, she explained, leads to gaps in coverage at the clinic.
“Our scheduling has to cover 8:30 a.m. to 4:30 p.m. regular primary care; that was way before the new facility,” she said. “We saw the need that that had to be extended, so we went to 7 p.m. and then further to 10 p.m. With changes in staff numbers, we try our best not to have one physician on any shift, but more than one”.
Dr. Samuel said that recruiting for medical staff is “ongoing” but a difficult endeavour, in part because jobs on Virgin Gorda often require more experienced clinicians and there’s a need to provide them housing. The clinics have residential quarters, but they have been damaged over the years by storms, she added.
Attendees suggested working with the Ministry of Education, Youth Affairs and Sports to identify promising students to steer into medical careers and to recruit Virgin Islanders abroad to return home.
Mr. Potter, the BVIHSA chair, said that H. Lavity Stoutt Community College is working on starting a nursing school next year. He added that the BVIHSA is also in discussions with a medical school, which he did not name, to supply doctors to the territory.
North Sound Clinic
Staffing challenges also plague the North Sound Clinic, which Mr. Potter acknowledged “has been operating sporadically” since the 2017 hurricanes, “with it being closed most of the time.”
Mr. Wheatley said, though, that the clinic and its associated staff quarters were refurbished last year.
Mr. Potter added, “The intention is to have this clinic operating a few times a week in the very near future.”
Capital improvements are also planned for the Nurse Iris O’Neal Medical Centre, which opened in 2020 but was never fully outfitted as planned.
“Unfortunately, services meant for two floors were consolidated onto one floor, and over time the integrity of the roof was compromised and has been leaking for a few years,” Mr. Potter explained.
Then the radiator for the clinic’s backup generator failed and a spare part had to be special-ordered. That issue is now fixed, he said.
Dr. Frett said that a “fully functional” Nurse Iris O’Neal Medical Centre would include staffing for eight-to-12-hour shifts of primary health care as well as 24/7 emergency services and laboratory, radiological and pharmacy services; a dental suite; physical therapy; and mental health care. Mr. Potter said such a clinic would require an investment of at least $5 million to finish the outfitting and around $5 million annually to run. The BVIHSA, however, doesn’t currently have a separate budget for the medical centre, Dr. Samuel said earlier in the meeting.
Mr. Wheatley said that the House of Assembly, which for three months has been largely preoccupied with Commission of Inquiry reforms, will soon consider a $100 million loan for capital projects that will include $4 million for the BVIHSA to spend across the territory.
‘Baloney’
Early during Saturday’s meeting, Ingrid Sprauve, Mr. Sprauve’s sister, asked officials why it took a death for them to meet with residents.
Ms. Bertie, the permanent secretary, disputed that characterisation.
“I wouldn’t say it’s because of this event that’s why we’re here,” she said.
Ms. Sprauve replied, “Baloney. Don’t come with that tonight, please.”
She added that government officials outside of the BVIHSA haven’t approached her about her brother’s death.
Mr. Wheatley said the Social Development Department and BVI Social Security Board will assist with Mr. Sprauve’s burial costs by paying a total of around $5,500. The minister,
who is a VG resident, also mourned Mr. Sprauve’s loss.
“Don’t forget I also live here. This pain is as real for me as it is for anybody else,” he said, promising not to “kick the can down the road” when it comes to health care.
Still, many residents’ frustrations appeared evident. Nearly two hours into the meeting, Barbara Stevens-Creque asked officials to come back to Virgin Gorda soon with a timeline of scheduled improvements with actionable dates.
“It’s not rocket science, people,” she said. “We can do this. We here on Virgin Gorda have been patient for too long. And, unfortunately, the sleeping bear has been poked. And tonight we are not asking nicely. We are demanding that we get our fair share. It is long overdue.”
Petition
Sharon Flax-Brutus told the audience that she had started a petition on MoveOn.org titled “Urgent Request for Enhanced Health Care on Virgin Gorda.” It asks for 24/7 staff coverage at Nurse Iris O’Neal Medical Centre, a reopening of the North Sound Clinic, and further exploration of the ambulance boat proposal, among other requests.
As of Tuesday evening, it had already gathered more than 650 signatures.
“Unless it is sometimes you’re embarrassed into action, nothing meaningful happens,” Ms. Flax-Brutus said, to vigorous applause.