|Volume No. 1 Issue No. 34 - Monday, December 30, 2002
| The Health Situation
by Samuel J Christian, MD
"When it comes to primary care, Dominica is at the head of the line." This is according to our psychiatrist Dr. Griffin Benjamin, in my calls to the ministry of health.
While there are serious needs to be addressed, let us begin realistically and give our homeland kudos for the sustained accomplishments over a series of administrations.
As we survey the health situation from a global perspective, we can take some degree of satisfaction that from immunizations to access to clinics, Dominica actually is not doing too badly. Having said that I attach a proposal directly from physicians at home as to pressing needs in our homeland.
"We gwayaying (i.e. suffering)," is a frequent response to the question of how are things at home. The cost of living is high, opportunities for advancement are limited, nepotism is prevalent and overall the stresses of life are more acute.
Mental health has been neglected, robbing the nation of a measurable segment of manpower resources.
The Acute Psychiatric Unit is already in a sad state of disrepair, badly in need of a fresh coat of paint. 37 inpatients and about that many for regular outpatients depend on the unit for recovery. Yet there are zero trained mental health nurses, occupational therapists or drug counselors.
Concrete amenities for harnessing the productivity of the broad spectrum of handicapped is conspicuously lacking for a nation, which has otherwise produced an enviable cadre of professional powerhouses.
Dominicans are most often transferred overseas for diagnosis, radiation and complex orthopedic and burn surgery. Even in the United States, it makes sense to transfer certain critically ill patients to large University Hospitals.
Transfer arrangements can be refined, addressing language and cash-up-front complaints in certain destinations.
Recent availability of a CT scan has been a major addition to the diagnostic armamentarium of local physicians.
The Cleveland Clinic in Ohio, Sloan Kettering Memorial Cancer Center in Manhattan, The Mayo Clinic in Minnesota and the M.D. Anderson Hospital in Houston, all see a significant proportion of wealthy foreign patients.
The income generated significantly impacts the local economy. When princes and potentates come over for extended treatment stays, they may often rent a whole hotel for their entourage. Since September 11 some of these destinations are hurting for obvious reasons.
While it is impossible to compete on that level, the principle is instructive. Numerous travel destinations offer retreats and spas for certain niche customers. It is all in the marketing.
With the steady inflation in the US healthcare industry and continued improvements in travel, it may be conceivable that certain elective (non-urgent) surgeries such as hysterectomies, gallbladder and gastric bypass could be done more cost efficiently in Dominica.
We are told that fresh water will be an even more valuable resource in this new century. The western world has growing appetite for organic foods and herbal medicines. The Internet offers new marketing opportunities.
Thanks to Ma Pampo, longevity is a crown that Dominica can rightfully claim at this time. With the demise of bananas, we must certainly strategize to market our resources and products to increasingly savvy consumers.
Indigenous producers like Blow's Tea Factory, Sister Nats Banana Universe and John Robin's Benjo's Seamoss are some examples of Dominican enterprise, which can lead us out of the bind of underdevelopment. The Diaspora can help the local producers make it.
Dominican overseas Doctors (D.O.D.) shall commit to return home every 3 to 5 years to relieve and augment the pressing medical manpower situation in Dominica. This lends itself to our sense of tithing in the universe.
It would not be construed as an imposition. While people hate to be made to feel obligated, commitment is therapeutic.
All the great thinkers talk about that sense of belonging. Call it is angst, separation or existential anxiety. Naturalized Americans tend to live in a gray zone between two worlds, uncertain whether to cheer or mourn events like September 11th.
It is only as we identify ourselves fully with our adopted home that we free ourselves to act effectually to assist our native land.
In 1979 I brought down a Cadillac hearse to replace the World War II vintage vehicle that would often stall during funeral processions.
At that time I brought down a chill-box which preserved bodies, giving overseas relatives time enough to make travel arrangements.
I credit missionary assistance in that project. In 1994, on a family vacation, I brought down equipment and worked with Dr. Paul to perform the first laparoscopic cholecystectomy on the island.
If as D.O.Ds, we commit ourselves to a flexible schedule, published on our web site, we can coordinate our vacations with local practicing doctors to avoid burnout.
Every family has certain travel goals when the kids are growing up. That might be Disney, or Statue of Liberty, a cruise, visiting another major travel destination such as Canada, Europe or Hawaii.
All of that is very good. What we are saying is put Dominica in there somewhere. You want to be able to go back and honestly say I involved the kids in helping the cause in this way or that.
Jews around the world go to Israeli Kibbutz at least once growing up. Muslims are required to go to Mecca once in their lifetime.
We are quite aware of what this level of commitment can do. If Dominicans can commit themselves to take their children to Dominica while still at an impressionable age, we can avoid loss of the second generation to prevalent self-consumed, lackadaisical attitude prevalent among youth today.
They need that opportunity to see how fortunate they are. This is fundamental to our family and professional health and sense of belonging.
I do believe a Dominica Health Science Foundation would be a robust non-profit platform to attain our goal of a healthy and health literate population.
It would bridge the gap between our homeland and the Diaspora and create the different income generating and technical assistance means to ensure our success in the 21st Century.
Editor's Note: Dr. Samuel Christian was born in Goodwill, Dominica in 1956. He is a graduate of the Dominica Grammar School and former President of the United Students Council, National Youth Council, and Dominica Mental Health Association. A graduate of Shorter College and Howard University Medical School, he is co-founder, with Dr. June Henry-Christian, of the Heartland Nutrition Institute.
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