The Interview: August - October 2016

OCT 2016 CORPORATE NEWSLETTER

THE

OCT 2016

INTER-VIEW

EVOLUTION OF HEALTHCARE IN TCI: A WALK DOWN MEMORY LANE Welcome to the October 2016 edition of Turks and Caicos Islands Hospital newsletter, which features stories from across the healthcare organization. A new edition will be published every two months.

Inside the Issue

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Nurse Cindy Durham

“Nurses dispense comfort, compassion, and caring without even a prescription. When you’re a nurse you know that every day you will touch a life or a life will touch yours.”

-Val Saintsbury

One of the oldest nurses at TCI Hospital reflect on healthcare in the past, working at the old Blue Hills Clinic in the 1980’s.

TCI Hospital attends the World Medical Tourism Congress -- one of the largest conferences in the Medical Tourism sector.

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Med Tech Lessonjulle Lyon-Dobney becomes a published researcher following findings on Antimicrobial Resistance in TCI.

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Unsung Heroes: Behind the scenes of the Medical Device Reprocessing Department and a look at the meticulous tasks involved.

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Breast Cancer Survivor, Dr. Denise Braithwaite-Tennant shares how her battle with cancer shaped her style of patient care.

NEWSLETTER

FEATURE: Senior persons in the community are natural historians having witnessed dramatic changes in our way of life including access to healthcare.

“All the necessities or conveniences we take for granted were not available back then,” remarked Nurse Cindy Durham as she recollects the challenging crossover from a hospital setting in the United Kingdom to the old Blue Hills Clinic in the 1980’s where she worked as a Staff Nurse/Midwife. The miniature building contained two small rooms, a bathroom and small reception area with an outside porch.

Imagine working in a tiny clinic with no running water or telephone, limited supplies, no ambulance or modern equipment available?

Fortunately, there was electricity in those days as opposed to the 70’s where nurses used oil lanterns to deliver babies and coal stoves to sterilize instruments. Nurse Durham describes the contrast between health care in her days and healthcare in the present as the difference between night and day. “…A person was hired to fetch water from the well, which thankfully was located on the clinic compound. Later on a tank was built to catch the rain- water and then this would be pumped through the pipes. All linens like sheets and pillow-cases etc. had to be hand washed

Nurse Cindy Durham in the 80’s wearing her nursing uniform and badges. The government owned mini Dihatsu car was used to transport patients.

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and this was a big challenge without running water. There was a person hired to do this and to clean the compound.

All instruments had to be sterilized in the clinic by boiling and with so few instruments available, we found ourselves waiting patiently for this process to finish so we can use the instruments,” said Nurse Durham.

Essentials such as medication, bandages, antiseptic solutions, materials for dressing wounds, sutures, disposable sterile syringes and needles were ordered and brought in from Grand Turk hospital by the visiting doctor in limited amounts. Nursing on

Providenciales and the Caicos Islands in the olden days were very laborious since Grand Turk was the main hub for healthcare.

In-order to contact a doctor in Grand Turk or contact the airport to secure arrangements to fly a critically ill patient out to the capital island, nurses had to commute to the Police Station located on old Airport Road to use the telephone. Making the journey was never an easy ride.

There were no paved roads, and the sandy paths were rocky and clustered with potholes. “…We did not have an ambulance on island so I had to transport the patient in the government’s vehicle which I was allowed to use. I could not drive any faster than 15 to 20 miles/hour… it took forever to get from Blue Hills to the airport or any other part of the island.

Never the less, my patients survived the ride and so did the vehicle!”

Motorized transportation was even limited in the 70’s. We understand from senior residents that persons such as Anna Borne, a Voluntary Services Overseas Nurse from the United Kingdom, would commute to various settlements via bicycle to administer care.

Patients were required to pay 50 cents to access government

NEWSLETTER

The Old Blue Hills Clinic underwent multiple changes over the past few decades. The above photo was taken in the mid 90’s after renovations.

“...All the necessities or conveniences we take for granted were not available back then.” clinical services. Since there were no resident government doctors on Providenciales in the 80’s. The doctor from Grand Turk visited once a week and stayed only for a day. These clinics were conducted by Nurse Durham, a clinical nurse and the visiting doctor at the Provo Health and Medical Clinic (PHMC) building located on Airport Road, which is now the old post office.

TCI Native, Doctor Hugh Malcolm was among the first batch of persons to graduate from the University of the West Indies in Jamaica. Dr. Malcolm also visited Providenciales once a week.

The then estimated 700-800 residents from the three settlements of Blue Hills, Five Cays, and the Bight could easily access PHMC due to itscentralized location. This facility was more modern than the Old Blue Hills Clinic. Trained

Public Health Nurses would also conduct frequent visits to carry-out immunization programs.

In the late 80’s, Nurse Durham left the Government service to work part time at Menzies Medical Private Practice for a few years. By then, Providenciales was beginning to see improvements in infrastructure, an increase in visitors and eventually the Myrtle Rigby Health Complex was constructed.

After a hiatus from her nursing career to raise her children, she re-entered healthcare in 2013 at Cheshire Hall Medical Centre where she has a unique appreciation for the availability of modern technology and a secondary-acute healthcare system. “…this makes my nursing job easier, less time consuming and I was able to learn about modern

medicine and upgrade my training.

However, the basicnursingcareandsome techniques have not changed. It was very easy for me to adjust to the modern medical setting once I got into my nursing uniform (even though I missed my nursing cap which we wore in the old days.” “…My goal now, in this the latter part of my life is to see the patient as a person and to take time away from the state of the art medicine to talk, laugh and build a relationship as in the days gone by at the old Blue Hills Clinic.”

A brief timeline on the evolution of healthcare in TCI is provided on the next page (4).

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NEWSLETTER

IN THE SPOTLIGHT: DR. DENISE BRAITHWAITE-TENNANT BREAST CANCER SURVIVOR Doctors dedicate their lives to caring for others, but even they often find themselves in need of intense medical treatment.

TCI Hospital Chief of Medical Services, Dr. Denise BraithwaiteTennant vividly remembers the moment doctors delivered the shocking news that she had Breast Cancer back in April 2013.

a definitive diagnosis. As a married, mother of three young children she was shocked, but determined to beat it through faith and determination.

Luckily, she was able to detect the cancer at an early, She noticed abnormalities treatable stage. She underwent in one of her breasts during chemotherapy treatment a routine self-assessment at at Turks and Caicos Islands home. A mammogram and tissue Hospital and radiography sampling conducted at Cheshire treatment in the Bahamas for Hall Medical Centre returned at-least 9 months.

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...“HOW CANCER SHAPED MY STYLE OF PATIENT CARE” Treatment Schedule:

Dr. Braithwaite believes cancer treatment plans should be tailored to the patient’s lifestyle (wherever possible) to maintain some sense of normalcy and provide minimal disruptions to their life. Her chemotherapy sessions were scheduled at the end of the week, which allowed her to report to work as normal instead of staying at home. She utilized the weekend to recover from any side effects of the therapy.

Deeper Empathy

Even as a doctor, she was shocked by her cancer diagnosis. Fear of the unknown grabs people mentally. She is now a firm believer of giving patients bad news in smaller, manageable chunks to allow them to process the information.

Family Support System

She encourages patients to embrace supportive family members, which was extremely helpful in her case. Her family made her days much easier and would even prepare her meals at home.

Patients are sometimes reluctant to share their diagnosis with relatives for a number of reasons.

Cancer has a stigma, and being surrounded by positive people is important. Her employer was also very supportive during her 6-9 month battle.

Trusting Local Doctors

The competency of regional doctors is sometimes underestimated, however, she trusted every member of her medical care team with her life. Having been trained in the region, she knows the vast amount of talent and their capabilities. As a cancer patient with the medical expertise to critique a doctor’s every move, she was satisfied with the quality of care rendered by teams in both Turks and Caicos and Bahamas.

Financial Safety Net

Chemotherapy is an extremely expensive treatment. Dr. Braithwaite was grateful for the National Health Insurance Plan and the financial support it gives to persons with chronic illness that require extensive time off from work. Such treatments can leave families in a financial black hole. Thankfully, this was the least of her worries, and her mental energy was primarily focused on remission.

Perception of Chemotherapy

Some patients misunderstand the benefits of Chemotherapy due to lack of information.

Breast Cancer has been heavily studied. There are many treatment modalities in existence.

Following her cancer battle, she is now able to better inform patients using first hand experience, instead of patients rejecting the treatment due to fear. “He who feels it, knows.”

Every October, Dr. Braithwaite reflects on her difficult journey and how blessed and fortunate she is to have won a battle that so many people have sadly lost. While awareness-raising initiatives focus on the negative impact of cancer, she provided insight into her life-changing brush with the deadly disease and how it has positively transformed her outlook on life, forever.

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NEWSLETTER

MINISTRY OF HEALTH CLINIC REDUCES WAITING TIME Waiting times at Cheshire Hall Medical Centre reduced significantly following the launch of an extended hours clinic on-site by the Ministry of Health, Agriculture and Human Services in July.

A DAY IN THE LIFE OF A MEDICAL DEVICE REPROCESSING SPECIALIST A patient recovering from a trauma surgery is unlikely to think about the people behind the scenes who are central players in their healthcare.

Medical Device Reprocessing Professionals are one of the unsung heroes of every hospital operation due to their critical role in the sterilization and decontamination of reusable patient care items, medical and surgical instruments.

More than 3,000 instruments are centralized and reprocessed every month

by MDR Specialists inside the Cheshire Hall Medical Centre through a strict organized process. The detailed-eyes of these individuals coupled with the latest sterilization methodologies reduce the risk of patients acquiring healthcare associated infections.

The new working hours are: Mondays – Fridays 8:00 am 9:00 pm, and Saturdays 9:00am - 1:00pm.

ED Physicians at CHMC have since referred hundreds of level 4 and 5 patients with non-emergency medical conditions to the MOH section for primary health care services, which declutters the ED and increases efficiency.

This has ultimately enhanced the patient experience.

It’s more than soap and water.

MDR technicians are well-versed in the powerful antiseptics and hightech devices that thoroughly clear equipment of all living microorganisms.

These specialists follow an exhaustive list of protocols for Infection Prevention and Control wearing mandatory Personal Protective Equipment.

Each stage of the process is critical and cannot be fast-tracked or skipped. These stages include Usage, Disinfection, and Transport to Central MDR Department, Sorting & Cleaning, Reassessment, Packaging and then Sterilization.

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Similar to a Laundromat, powerful Steris double-chamber washers are used to disinfect each medical instrument. A special device is tossed into the machine to gauge the efficacy of the cycle and ensure instruments are cleared of all blood remnants.

Medical instruments are washed for 1 hour, disinfected at nearly 90°c and then dried at 100 °c. They are then removed from the washer, reassessed using magnifying glasses and special light, carefully packaged and then sterilized. The sterilization cycle takes about 1 hour and 30 minutes in Steam Autoclave Machines at a temperature of 134 °c.

NEWSLETTER

Certain types of instruments must undergo a slightly different procedure. For example, complex medical devices with mechanical or electrical components cannot be fully immersed due to sensitivities to water, chemicals and high temperatures, and therefore require special manual cleaning techniques. Other complex devices contain numerous tiny components and must be dismantled, cleaned, reassembled and made ready for patient contact.

Every medical device must be manually double wrapped using non-woven fabric, special tape, and a specific packaging technique. Imagine wrapping hundreds of Christmas gifts in a single day with perfectly folded edges and no room for peek-a-boos?

Without these special technicians, doctors would not be able to carry out medical procedures and patients would not be able to receive certain treatments. These unsung heroes monitor their inventory of reprocessed devices, and are always on-call in the event their services are needed to save the day, as they do, everyday.

GROOMING THE NEXT GUARDIANS OF HEALTHCARE TCI Native Coral Pratt, 20, studies Medicine at Bristol University in the United Kingdom. Pratt concluded her two-week mentorship at TCI Hospital in late August. She gained invaluable firsthand exposure to internal healthcare operations. Pratt is now eager to crossover into her second year of university.

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NEWSLETTER

FROM MEDICAL TECHNOLOGIST TO STAR RESEARCHER: Abstracts from a groundbreaking research conducted by a TCI Hospital Medical Technologist on ‘Antimicrobial Resistance in the Turks and Caicos Islands’ has been published in a supplement of the West Indian Medical Journal.

Lessonjulle Lyons-Dobney presented her findings at the CARPA Conference this past June after being advised by one of the main facilitators at the 2014 Antimicrobial Resistance Regional Conference in Trinidad that TCI indeed had publishable data.

The research examined antibiotic resistance data from 1,343 anonymous swabs from wound infections processed between Jan 2013 and November 2015 at Cheshire Hall Medical Centre. The most frequently isolated organisms along with the antibiotic resistance patterns were documented.

Frequently classified among the group of “flesheating bacteria” is Methicillin resistant Staphylococcus aureus (MRSA), which accounted for 9% of the 1687 isolates recovered from wound infections over the period. Other frequently isolated organisms included non-MRSA, Pseudomonas, E coli and Acinetobacter species.

Although overall antibiotic resistance rates were below 50%, individual isolates exhibited much higher resistance rates when exposed to some antibiotics. The research also revealed that antibiotic resistance patterns differ from region to region. According to the World Health Organization, patients with infections caused by multi drug-resistant species are generally at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with the same bacteria that are less resistant. Patients are treated at TCI Hospital using laboratory analysis performed by Medical technologists to ensure the best clinical outcomes.

The rapid development of antibiotic resistance by bacteria may be a significant cause of the major

drought and disinterest in the discovery of new antibiotics by Pharmaceutical companies worldwide.

There are high economic and other costs associated with the research and development of new drugs.

Some bacteria have developed resistance within one year of a counter-antibiotic being introduced. The problem is so significant that the UK’s Chief Medical Officer, Sally Davies placed antibiotic resistance on the government’s national risk register, alongside terrorist attacks and pandemic flu.

Colistin, frequently called “the last-resort antibiotic” has been toppled by some strains of bacteria such as E coli and Salmonella species.

Top officials from Centers for Disease Control and Prevention have expressed serious concerns about these “super bugs”. Some mainstream news outlets have even referred to these strains as “Nightmare bacteria”. Fortunately, these strains have not been isolated in the Turks and Caicos Islands.

POISED TO BECOME ONE OF TCI’S FIRST RADIOGRAPHERS

Mentee Adresha Gardiner on rotation CHMC.

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Andresha Gardiner and Latavia Ingham study Diagnostic Imaging (Radiography) at University of the West Indies in Jamaica, while Paul Lewis is pursuing his degree at the University of Guyana.

The three students are poised to become one of few certified local Radiographers in the near future. Each mentee spent at least two full weeks at Cheshire Hall Medical Centre.

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Multiple change enquiries submitted by Interhealth Canada (TCI) Ltd were recently approved in principle by Cabinet, pending confirmation that funds are available in the Ministry of Health budget. Each enquiry was supported by detailed clinical data and research to justify a sustainable service model. Below is an overview.

A request has been made for the National Blood bank to be managed by TCI Hospital for a period of two years. The National Blood Service is currently managed by the Government in accordance with the Project Agreement. TCI Hospital draws blood units from the bank in order to comply with requirements for on-site blood bank storage for the delivery of care. The hospital operates a full service accredited laboratory.

A second proposal has been made to introduce cost-effective technology such as Tele-radiology services to cater to the increasing demand for diagnostic imaging, which is presently covered by a single Consultant Radiologist at TCI Hospital. Tele-radiology improves patient care by allowing radiologists to provide services without actually having to be at the location of the patient. Tele-radiology also allows for trained specialists to be available 24/7.

Patient images such as radiographs (X-rays), CT’s, and MRI’s will be transferred via a secure system to a remote company of radiologists and physicians for professional analysis.

The implementation of hysteroscope technology at the Turks and Caicos Islands Hospital is also being sought. This will allow specialists to evaluate the cavity of the uterus in female patients using a thin tube-like telescope with a built-in video camera giving doctors a

“Keeping pace with technology and increases in patient volume.” more direct visual of the uterus prior to removing any tissue, as opposed to D&C where the tissue is removed without direct visualization. The technology not only enhances the diagnosis and management process, but also supports service delivery that aligns with advancements in technology and minimally invasive approaches to care. Both D&C and hysteroscope are outpatient procedures where the patient usually does not require admission to hospital upon completion.

A fourth proposal has been made for additional equipment in the Dialysis Unit along with a full-time Nephrologist due to an increase in Dialysis patients at both TCI Hospital sites. TCI

Hospital presently employs a General Internist who is a cross-trained Nephrologist. A Consultant Nephrologist also visits the hospital every three months. While the number of machines have remained the same since commencement of clinical operations (CTMC – 3 machines, CHMC – 6 machines), the number of patients on dialysis machines for Grand Turk has increased by 50% and Providenciales by 65% since 2010. The inclusion of a full-time Nephrologist will enable care to be managed more proactively with an emphasis on preventing the progression into kidney failure.

A fifth proposal has been made for the procurement of special blood screening

equipment which will reduce the cost of oversees screening and allow for swifter results.

In accordance with recommendations issued by the Food and Drug Administration (FDA), TCI Hospital screens donated blood for Zika virus using an overseas reference laboratory. TCI Hospital will continue to ensure the safe delivery of appropriately screened blood to patients in light of confirmed local transmission of the virus with the procurement of a Polymerase Chain Reactor Machine and Associated Equipment for Human Pathogen Detection.

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NEWSLETTER

A E L I SM HILE W Dr. Roxanne Allen Emergency Department Physician

Dr. Monifa Wilson Obstetrician & Gynaecologist

TCI HOSPITAL ATTENDS WORLD MEDICAL TOURISM CONGRESS A delegation from Turks and Caicos Islands Hospital attended the 9th World Medical Tourism & Global Healthcare Congress in Washington D.C. at the Gaylord National Resort & Convention Centre from September 25-28th, 2016.

The congress is one of the most comprehensive international healthcare conference and trade show in the medical tourism industry and attracts up to 3,000 participants, 400 qualified buyers of healthcare along with industry forums and executive summits.

TCI Hospital Chief Executive Officer, Daniel Carriere and Chief of Medical Services, Dr. Denise Braithwaite-Tennant participated in the 2016 Global Medical Directors Summit (Invitation Only Summit) and the Caribbean Round-table Forum. Both forums encouraged countries to collaborate, network, and discuss emerging ideas, share best practices and obstacles related to the medical tourism sector.

Other members of TCI Hospital delegation were Marketing and Public Relations Manager, Nikira John and Visiting Consultant Coordinator, Kay Vanes-Williams.

Attendees participated in a series educational break-out sessions and presentations from global innovators in medical tourism and healthcare.

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WMTC Delegation (L to R): Dr. Terese Maitland - TCIG National Epidemiologist, TCIH Chief Executive Officer - Daniel Carriere, TCIH Chief of Medical Services - Dr. Denise BraithwaiteTennant, Premier and Minister of Health - Honorable Dr. Rufus Ewing, TCIH PR/Marketing Manager - Nikira John, TCIH Visiting Consultant Coordinator - Kay Vanes-Williams.

The TCI Hospital delegation met with TCI Minister of Health and Premier, Hon. Dr. Rufus Ewing and other government stakeholders during the congress.

According to a recent report issued by VISA and Oxford Economics, the Medical Tourism industry was valued at USD 439 billion, with a projected growth rate of up to 25% year-over-year for the next 10 years.

The report forecasts an estimated three to four percent of the world’s population will travel internationally for healthcare and health-related treatment. Canada is ranked the top medical tourism destination overall for 2016, followed by the United Kingdom, Israel, Singapore and India, respectively.

NEWSLETTER

Dr. Sani Amatti Consultant Paediatrician & Neonatologist

Douglas Moore Chief of Clinical Services

Dr. Deonne Ranglin-Robinson Anaesthetist

TCIH LIFE SAVER TRAINING CENTRE EXPANDS TRAINING DISCIPLINES TCI Hospital recently added a new discipline to its in-house Life Saver Training Centre following a Paediatrics Advanced Life Support (PALS) Course facilitated by the American Heart Association.

Five employees - two Paediatricians and three Emergency Medicine Physician Specialists - are now certified to train other healthcare providers in these resuscitation procedures. The pass mark to become a certified PALS Trainer is 84%. Other participants included EMT’s from the government.

Lead Instructor for Life Saver Training Centre at TCI Hospital, Dr. Denise Braithwaite-Tennant stressed the importance of maintaining the competency of health professionals. The course was assisted by Dr. Gustavo Flores, Senior Instructor from the American Heart Association.

Previously, the Life Saver Training Centre provided training in the areas of CPR, Basic Life Support and Advanced Cardiovascular Support.

TCI Hospital continues to increase the number of certified training instructors in various fields across the organisation. This eliminates the need to outsource instructors to deliver training and refresher courses.

Above: Participants of Pediatric Advanced Life Support (PALS)

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community interaction

The facebook posts above are apart of IHC’s #ThankfulThursday Marketing initiative.

All employees are encouraged to participate. It’s simple. Just write what your thankful for on a sticky pad, and give us your best smile. Snap Snap.

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NEWSLETTER

EMPLOYEES BECOME CERTIFIED MANUAL HANDLING TRAINERS

Eight newly certified Manual Handling Trainers have been added to TCI Hospital’s compliment of Mandatory Training facilitators following a 3-day Load Management & Client Handling Techniques course held at Cheshire Hall Medical Centre in early September.

Veteran Trainer and Registered General Nurse, Jan Crawford of Centaur Training Centre in England, returned to the facility after five years to train a new batch of enthusiastic health professionals.

Participants were from Inpatient Services, Emergency, Facilities Management, Dialysis, Medicine and Physiotherapy.

Crawford trained her first batch of TCI Hospital employees in 2011.

A wide variety of patient handling techniques were examined to increase participant’s knowledge and understanding of safe handling procedures. These included rolling and turning a patient in bed, inserting side sheets, repositioning patients in a chair, theatre techniques and emergency techniques.

Certificates are renewed every two years. Every 6 months trainers must undergo an assessment which will be marked to ensure the standard is maintained.

These individuals are now equipped to impart their knowledge into other members of their various departments.

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DEVELOPMENT OF DISEASE Symptoms and signs typically occur within 2 to 12 days after the mosquito bite. The illness is usually mild. Symptoms usually resolve within 2 to 7 days.

Asymptomatic infection is common. Symptoms develop in 20 to 25 percent of individuals . Zika virus infection has been associated with congenital microcephaly and fetal losses among women infected during pregnancy. An increase in the rate of Guillain-Barré syndrome has been observed in association with Zika virus infection.

MICROCEPHALY

Zika is a Public Health Emergency of international concern Eleven cases of Zika have been recorded in the Turks and Caicos Islands as of October 6th, 2016. Three cases are confirmed to be imported and the others are attributed to incountry transmission. All specimens are based in Providenciales and include one pregnant female.

GEOGRAPHIC DISTRIBUTION There are two major lineages of the Zika Virus -- the African Lineage and the Asian lineage. Zika virus is named after the Ugandan forest where it was first isolated in a rhesus monkey in 1947.

The virus spread to Southeast Asia and the first major outbreak occurred in the Yap Islands of Micronesia in 2007. Another large outbreak occurred in French Polynesia in 2013, where public health officials estimated infection rates of 70 percent on some islands. Zika is transmitted from mother to child, sexual intercourse and blood transfusion.

The Brazilian paediatric neurologist Vanessa Van Dor Linden is one of the first researchers to link Zika virus to microcephaly. She has seen microcephaly babies with 24hr crying bouts, spasms, extreme irritability, difficulty swallowing, hearing loss, seizures, and joint contractures. There is still a big unknown because it can take years to find out about other neurological disorders such as learning disabilities or developmental delays.

GUILLAIN-BARRE This is a rare condition in which the body’s immune system attacks part of the peripheral nervous system. People of all ages can be affected, however it is more common in adults and in males. Even in the best of settings, 3%-5% of GBS patients die from complications, which can include paralysis of the muscles that control breathing, blood infection, lung clots or cardiac arrest.

Zika is currently spread by two species of mosquitoes, Aedes aegypti and Aedes albopictus mosquito. The latest studies conducted in China, Canada and Brazil are showing the possibility of adding the Culex mosquito which is prevalent in the northern section of North America.

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CURRENT INTERNATIONAL STATISTICS

EMERGENCY FUNDING

To date 73 countries and territories have reported evidence of mosquito-borne Zika virus transmission since 2007. 56 reported outbreaks from 2015 onwards. 5 have possible endemic transmission or

On September 30, 2016 the U.S. congress passed $1.1billion dollars for Zika funding. $394 million

evidence of local mosquito-borne Zika infections in 2016. 12 with evidence of local mosquito-borne Zika infections in or before 2015. 12 countries reported evidence of person to person transmission of Zika virus since February 2016. 21 countries or territories have reported microcephaly and other CNS malformations. 4 out of 21 countries reported microcephaly babies born from mothers in countries with no evidence of Zika virus transmission but who reported recent travel history to Zika affected countries. 19 countries and territories have reported an increased incidences of GBS and/or laboratory confirmation of a Zika virus infection among GBS cases.

for mosquito control efforts. $397 million to assist in the development of a vaccine against the virus and to improve Zika testing. $66 million to Puerto Rico to ease the healthcare burden Zika has inflicted upon the island territory.

Contributor SRN Subrena Pedican

NEWSLETTER

DOCTOR’S ORDER: PLAY GOLF!

IT’S THE CLIMB! Grand Turk Native, Janelle Hamilton, is one example of how mentees can become official position holders in the very same organization that inducted them into the specialty area they once dreamed of mastering.

Hamilton was employed as the sole Pharmacist at the Cockburn Town Medical Centre in February 2016 after years of shadowing professionals in practice.

She worked part-time at the Government clinic and later the Grand Turk hospital as a pharmacist assistant from 2001 – 2013. She then decided to formalize her training and pursued her Masters in Pharmacy at Keele University in the United Kingdom. During summer breaks, she would return to the Grand Turk Clinic/Hospital and community pharmacy to capitalize on summer internships.

As a part of the organization’s succession plan, Hamilton is now the sole person responsible for medication top-ups at Cockburn Town Medical Centre and all clinical checks for prescriptions.

She is now holding the position she once dreamed of and is grateful to have amassed such valuable experience in the field over the years, which made settling into her big role much easier.

A team of golf fanatics from TCI Hospital secured third place at the 2016 Premier’s Cup Golf Tournament which raised $50,000 for TCI’s Cadet Corp.

During the annual sporting event held at the Provo Golf Club in July, Team Interhealth Canada won a $1,600 cash prize.

After a long period of squinting in the sun clad in polyester slacks, TCI Hospital returned to the wards as the real winners — not in the test of sportsmanship, but in their showcase of charity.

The hospital team was one of few top finishers to donate 100% of their winnings back to the TCI Cadet Corp.

The TCI Cadet Corp seeks to promote the core values of leadership, discipline, voluntarism and patriotism among high school students between the ages of 12-18.

@TCIHOSPITAL Be sure to follow our page, like and share our posts. If there is anything exciting you think is worth sharing, feel free to contact PR/Marketing Manager, Nikira John.

Your feedback is important to us.

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NEWSLETTER

Welcome to the first edition of ‘Safety First’ produced by Interhealth Canada’s Health & Safety Committee.

Our aim is to provide useful tips and information to help improve our workplace safety. This month our message will focus on easy steps to reduce workplace related illnesses and accidents, which we hope you will find informative and useful.

Quite often, injuries on the job result in employees being out of work for long periods of time. This creates a financial strain on the employee, impacts his/her colleagues and generates overtimes costs for the organisation due to additional hours worked.

Although Interhealth Canada TCI has very low rates of workplace related accidents and illnesses, these issues are common around the world. By raising awareness of preventive measures, it can be easy to avoid these issues, and work together to further improve our position.

Below are 10 workplace safety tips that every employee and employer should know to avoid and reduce the possibility of accidents in the workplace.

1. Know the Risks Certain tasks have associated risks. It is important that we understand these risks and follow the training and advice given in relation to the task at hand.

Only then will we be better prepared to take the appropriate steps to avoid a work-related injury. This is important for all roles and tasks, but even more crucial if you are working with dangerous or heavy equipment, chemicals or biohazards.

Remember, if in doubt, seek advice from your Line Manager and never attempt a workplace task that you are not trained to do.

2. Reduce Stress in the Workplace The connection between workplace stress and work-related injuries and illness is often overlooked. Circumstances that can create workplace stress include: working extended hours, increased workload, insecurity on the job, and conflicts in the workplace. If you have experienced any of these issues, please speak to 16

your Line Manager or Human Resources representative to resolve your concerns.

3. Take Breaks It is important that you take breaks as they are scheduled. This will help you stay alert, and avoid stress and injuries. Try to schedule the toughest tasks for a time of day when you have the best concentration level. Some employees are more proactive during the early morning hours.

4. Be Careful When Lifting If your job involves heavy lifting or any other laborious task, please ensure you execute these duties in a safe manner. Use the right equipment, ergonomically set furniture, and make sure items can be easily reached. Ensure that you have completed our in-house Manual Handling Training. If you have any questions related to this tip or wish to complete further training, please contact the Education Department.

NEWSLETTER

5. Use Mechanical Aids

7. Know Your Surroundings

Mechanical aids are there to help us, so we should take advantage of them! Use trolleys, pallet trucks, hoists, wheelbarrows, etc. when lifting heavy items to avoid injuries on the job. Gauge the weight of an item prior to lifting. If mechanical aids are not available, request assistance from trained personnel.

It is important to know your surroundings in the workplace so you can assess any possible risks. Once you are aware of areas considered to be hazardous such as specialist clinical areas, kitchen areas, steam rooms, plant rooms, utility rooms, areas with potential wet surfaces or hot areas, you can potentially avoid these situations. Be careful around machinery as inattention can lead to serious injury.

6. Check out Safety Resources It is always a good idea to check out tips on various safety resources from time to time.

There may be new information available that can help you stay even safer in the workplace.

Some of the safety resources include: • • • • •

Health & Safety Portal Education Portal Health & Safety Notice Boards Health & Safety Bulletins on Snap Coms Health & Safety page in IHC Newsletter

8. Keep Good Posture Remember to maintain a good posture on the job. This will prevent back, neck, and shoulder pains, and help to avoid back injuries. It is easy to stay in perfect posture. Simply shrug your shoulders, move them back, and then drop them, and you are in perfect posture.

9. Have Accessible Emergency Exits All emergency exits are easily accessible.

Ensure you are aware of all escape routes from the building. There should be no equipment or other items blocking these exits.

10. Report Unsafe Conditions to Management or utilize Pavisse It is imperative that your supervisors are aware of any unsafe conditions in the workplace. It is their job to correct these issues, but if they are not aware of them, nothing will get done. The more they know, the safer your workplace will be. This includes reporting ‘Near Misses.’

According to statistics, one workplace accident or injury is prevented for every 10 ‘Near Misses’ reported, investigated and resolved.

Thank you for reading our first submission, and we hope you enjoyed. Together we can build a safer Working Environment!

The Health & Safety Committee 17

NEWSLETTER

FAREWELL FROM JOANNE KINBOROUGH MATA QUALITY RISK AND PATIENT SAFETY MANAGER I am still struggling to believe that exploring opportunities in other parts of Friday 21st October will be my last work- the world. ing day after two incredible years on I leave with great confidence in the the Turks and Caicos Islands. I people here, knowing that you are would like to thank each of capable of overcoming you for every amazing exany hurdles that will perience shared, friendcome up and offer“I have had ship made, opportuing excellent quality nity offered and good two incredible years, care in a first class times had during this environment to everytime. I have learned one who walks through now it’s time to a great deal from my the door. Between friends and colleagues us we have laid the say goodbye.” and will miss your foundation of something company. I do hope that very special and I am sure the feeling is mutual, although that you will build upon this I do appreciate that I have been a bit to ensure that the Hospital receives of nag at times! accreditation at Diamond Level for the third time in a row. This provides me I think it was the toughest decision with a great sense of pride and gratiof my life not to renew my contract for tude. It has been a great pleasure workanother two years. I will take with me ing with you. I wish you all the very best some fond memories of the islands and in the future. Do keep in touch - joanne. the people who live here while I am off mata@sky.com

upcoming events internal & external OCT 16TH MDR Week Employee Church Service Start time: 10:30 am Bethany Baptist Church Blue Hills, Providenciales

OCT 8TH In The Pink Charity Event The Regent Palms Start time: 7 pm

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OCT 18TH MDR Week Grand Exhibition 10am - 12 pm CHMC Main Lobby

OCT 17TH Interhealth Canada Press Conference on latest Cancer statistics and trends in TCI -- 1:00pm - 1:30 pm at CHMC. A media circuit involving appearances on radio shows will also be conducted the same week.

OCT 19TH MDR Special Symposium 4:30 PM - 6:00 PM Cheshire Hall Medical Centre

OCT 22ND Breast Cancer Luncheon Beaches Resort Start time: 1pm Ticket: $65.00 each

“Nursing is a calling, a lifestyle, a way of living.”

Nurse Renay Robinson died on Wednesday, September 14th, 2016 at Princess Margaret Hospital in Nassau Bahamas where she was receiving care. She had more than 16 years of experience working in the Dialysis Unit. TCI Hospital held a moment of silence and made a special donation to the National Kidney Foundation in her honor. Vice President of the NPO, Leon Wilson, raved about Nurse Robinson’s contribution to kidney patients and expressed gratitude. She will be remembered in a memorial planned by TCI Hospital Human Resource Department.

RIO OLYMPICS WITH A TWIST As the world turned its attention to the Olympics in Rio De Jenario, TCI Hospital held its own track meet at the Providenciales National Stadium on Friday, August 12th. Chief of Medical Services, Dr. Denise BraithwaiteTennant spoke to more than 30 children from Little Ladies and Gents Summer Camp about the importance of healthy eating and exercise. The athletic activities planned by the Marketing Department included relay races, bum-a-balloon, an inflatable tug-of-war challenge and a watermelon eating competition. Highlights below.

BIRTHDAY CORNER October: Jyothi George, Aneka Dean, Beanca Clare, Isableo Cuadras, Denwell Cox, Barbara Ferguson, , Oneil Ruddock, Veronica Rigby, Shantell Gardiner, Basillia Otuonye, Aileen Cagauan, Soliman Raafat, Tamara Johnson, Clarita Tucker, Magdala Hyppolite, Shamire Moore, Barbara Saunders, Venice Brooks, Julie Togie, Martin Wintz, Rafeeza Seecharan November: Voneric Forbes, Shevaughn Annikie, Shawna-Kay Hewitt, Whitney Jeanty, Straudy Jackson, Girum Mussie, Oluwayemisi Olugbanmu, Babatunde Ajimoti, Elizabeth Mckenzie, Orlane Jolly, Wayne Anderson, Dionne Betty, David Banton, Surbrena Pedican, Bridget Williams, Lesly Jean-Baptiste, Schiler St. Juste, Michael Williams, Dian Tucker, Georgia Brown 19

Infection Prevention and Control Team prepares for Caribbean Week 2016 A TCI Hospital delegation is scheduled to travel to Barbados this month to attend the Infection Prevention and Control Caribbean Week.

Healthcare organizations from across the region were asked to submit fun photos of their infection prevention and control teams.

The adjacent image was submitted

by TCI Hospital’s link champions.

A TOAST TO QUALITY HEALTHCARE! Do you often find yourself using words such as ‘umm….’ or ‘ahh...’ as you crossover to your next sentence when conversing with others?

Even some of the greatest oratorians still experience an onslaught of nerves and butterflies before taking centre stage to give high-profile speeches.

Speakers may appear confident because they have simply mastered the art of ice-breakers and other self-calming tactics, or in the case President Barrack Obama -- they are masters of the art.

Overcoming such emotions can start with practicing a 3-minute spontaneous speech about a completely random topic and opening yourself to frank criticism from peer evaluators. This is a strategy commonly used by Toastmasters during regular meetings, one of which was recently held at Cheshire Hall Medical Centre.

Effective communication is important in every healthcare organization. Contact Jacqueline Moe-Cox of the Education Department to learn more about how you can join.

Toastmasters is a non-profit organization developing public speaking and leadership skills through practice and feedback in local clubs across the world since 1924.

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