June 8, 2007 — Health-care spending is increasing within the territory and other Caribbean islands, but challenges such as a lack of manpower and resources are keeping the region's medical systems from fully meeting patients' demands, experts said Friday.
The observations came at a two-day health-care conference that began Friday on St. Thomas. Funded through a grant by the V.I. Legislature, the conference pulled local health officials together with a diverse group of medical professionals from neighboring locales such as Haiti, Grenada and the Cayman Islands. The event was designed to highlight the region's many health-care challenges and give participants the opportunity to start brainstorming solutions, according to Delegate Donna M. Christensen.
As the conference's keynote speaker, Christensen set the tone for the event by making comparisons to the mainland. Minority populations in the Caribbean, much like their U.S. counterparts, are often impacted by a variety of socioeconomic factors that have a negative impact on the delivery of local health-care services. Dealing with chronic problems such as poverty or the lack of preventative health-care education is the first step toward increasing awareness and shaping a healthier community, she said.
The health-care challenges cited by Christensen came as no surprise to conference participants. Major topics emphasized during previous conferences include an increase in diabetes, major diseases such as cancer, HIV/AIDS, hypertension and a jump in adolescent and adult obesity levels.
Some of the statistics Christensen provided did catch a few in the audience off guard, however — especially data related to the levels of HIV/AIDS cases in the region.
In addition to having the second-highest rate of HIV infection in the world, the Caribbean also experienced 24,000 AIDS-related deaths at the end of 2005, as opposed to the 17,000 deaths recorded on the U.S. mainland, Christensen said. Nearly half a million individuals — many between the ages of 15-24 — are also living with the disease, she said.
Women account for more than half of the territory's AIDS population, Christensen said, noting that major risk factors include the injection of drugs, heterosexual sex and blood transfusions. A large percent of the infected female population "does not know" how they picked up the disease, she added.
"We need to understand that it is some of our habits and behaviors that keep us from wrapping our arms around this epidemic," Christensen said, describing risk factors such as having multiple sexual partners or an unwillingness to use condoms.
Christensen also included another risk factor for HIV/AIDS entitled "men on the down low," which she described as married men having sex with other men, then passing the disease onto their wives or female partners.
In terms of the region's health-care infrastructure, a shortage of professionals (such as doctors and nurses) and financial resources keep Caribbean medical facilities from meeting the needs of all patients, Christensen said. While explaining that several national initiatives designed to bolster the Caribbean's health-care systems will soon make their way through Congress, Christensen also said the road to improvement lies in preventative health care, the creation of a stronger health-care network and the elimination of negative socioeconomic elements.
The collection of more accurate and widespread medical data would increase the region's access to federal funds, and would give medical professionals a better idea of what the bigger challenges are, Christensen said.
According to Jill S. Doran, another speaker, the territory is already on the way to creating an electronic database designed to store medical records and data for patients within the community. The database will start with a patient's medical provider or health-care professional and would link to local pharmacies, hospitals and laboratories.
While the E-Health initiative is expected to go live in August, Internet connectivity and financing still pose some major problems, Doran said. "Still, a lot of the reasons we don't have what we need in the Virgin Islands is because we simply don't have the data," she added. "So this network would enhance the ability of providers to exchange electronic data, and allow our health system to accurately report public health information for Virgin Islanders."
While the need for more accurate medical data was a major concern for other islands represented at the conference, many speakers also discussed problems unique to their own communities.
In Haiti, for example, health-care professionals are trying to bridge the gap between traditional and Western medicine. According to Dr. Georges Michel, head of radiology at three of the country's hospitals, Haiti still has a population of traditional doctors who use plants, witchcraft or voodoo. "They say that the practice of medicine at home is less expensive — that the first step is to take charge of your own health," he said.
While the phenomenon known as the "brain drain" is not uncommon to many Caribbean countries, Haiti's young medical caregiver population is being diminished by recruiting efforts in Canada, Michel added.
"Canada is playing an irresponsible and negative role by offering immigrant visas to young Haitian doctors much needed within the country," he said. "Canada has not invested a single dollar to train these individuals — they are making us lose a very valuable professional element within our society."
To combat some of Haiti's challenges, Michel said, incentives must first be provided to encourage young professionals to stay and work within the country's hospitals. In addition, a public-health policy must be drafted, along with the expansion of health-care coverage to patients, he added.
Traditional practitioners can also be trained in basic health-care skills and integrated into the country's more modern health-care facilities, Michel explained.
Another solution emphasized by many speakers on Friday centered around balancing a community's medical needs with its available financial resources — in short, budgeting to fit medical priorities.
"There needs to be a balance between needs and supply," said Dr. Tamer Tadros, medical director of the Health Services Authority in the Cayman Islands. "For the future, we need to think about establishing what we need and whether we can supply it our not. In terms of human resources and materials, we need to put it in the context of, 'What do we need and can we afford it?' Because in any business, the name of the game is, 'We can't have it all.'"
Looking ahead to future health conferences, Tadros added that the islands should look at collaboration, cooperation and consolidation — making a move toward comprehensive regional policies that maximize the Caribbean's resources.
The 2007 Caribbean Health Care Conference, planned in collaboration with the Cleveland Clinic Florida, continues at 9 a.m. Saturday at Marriot Frenchman's Reef Resort.
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