Thursday, October 30, 2014

The Bahamas' Ebola readiness test

Officials Confirm Ebola Scare

By JonesBahamas:

The country’s readiness to deal with the scare of the deadly Ebola virus was put to the test yesterday as Ministry of Health officials confirmed that there was concern that a traveler to The Bahamas may have been inflicted with the disease.

In a statement released yesterday, the Ministry said a traveler who was being transported to The Bahamas via a charter aircraft from Tennessee, displayed symptoms of vomiting and diarrhea.

“Keeping in line with our established Ebola preparedness protocols, the aircraft was diverted to a designated location,” the statement read. “A health evaluation team was transported to the aircraft where the patient was then evaluated.”

It was determined that that patient did not travel to an Ebola-affected area, nor had any contact with anyone who had traveled to an Ebola-affected area.

There were no other passengers with any signs of illness upon evaluation.

“As there was no determined threat to the public’s health, clearance was provided for the aircraft to proceed to its destination,” the ministry said.

At least seven people in the United States have tested positive for the virus and along a stretch of West African nations at least 10,000 people have contracted the disease since March with half of those cases ending fatally.

Last week a team of officials from the Pan American Health Organisation (PAHO) and the World Health Organisation (WHO) applauded The Bahamas’ efforts in preparing for a possible outbreak of the disease.

October 30, 2014

Jones Bahamas

Monday, October 27, 2014

Dr. Gerry Eijkemans - Pan American Health Organization (PAHO) ...and World Health Organization (WHO) Representative to The Bahamas ...commends the Government for its efforts “to protect its people” from the Ebola Virus Disease

PAHO Representative Applauds Local Efforts to Protect Against Ebola

By Matt Maura - BIS:

NASSAU, The Bahamas – Pan American Health Organization (PAHO) and World Health Organization (WHO) Representative to The Bahamas, Dr. Gerry Eijkemans, has commended the Government of The Bahamas for its efforts “to protect its people” from the Ebola Virus Disease.

Ebola Virus Disease is a serious infectious disease spread between humans from person to person. Infection is transmitted by direct or indirect contact with the blood, body fluids or secretions (stool, urine, saliva, semen) of infected people, but only when they show symptoms. Ebola cannot be transmitted by air. The disease first appeared in 1976 in a village near the Ebola River in the Democratic Republic of Congo (former Zaire).

“Even if an Ebola case was to hit the shores of The Bahamas, the country has taken all of the measures – based on evidence, based on what is known around the world - to protect its people,” Dr. Eijkemans said.

“I want to commend the Government of The Bahamas and to tell the people of The Bahamas that please, fear is not necessary.”

Dr. Eijkemans said the fact that West African countries such as Nigeria and Senegal have controlled the transmission of the Ebola Virus in those countries and have been declared Ebola free means countries “with even limited means,” have the capacity to control and fight the disease through sound, public health measures.

The Bahamas is well known for its strong public health programme that is facilitated by the Department of Public Health and an excellent team of administrators, doctors and nurses.

That track record includes The Bahamas’ distinction of being the first country in the region to eradicate measles. Public Health Nurses have also led the fight against other infectious diseases and epidemics such as Malaria, Dengue and most recently Chikungunya.

Public Health teams have been conducting and will continue to conduct Ebola Sensitization Training Sessions in New Providence, Grand Bahama and the Family Islands including San Salvador, Eleuthera, Exuma, Andros, Abaco Inagua, Cat Island, the Berry Islands and Long Island under the auspices of the Surveillance Unit of the Department of Public Health.

Dr. Eijkemans encouraged Bahamians to not be taken in by the fear and/or hysteria surrounding the disease.

“As the Director-General of PAHO/WHO said recently, the fear that is going on around the world, including the United States of America, is unrealistic and disproportionate with the risk that Ebola presents to the world,” Dr. Eijkemans said.

“We have to be alert, we are ready, but there is no need to panic and there is definitely preparedness here that should put everyone at ease, and so I want to thank the Government of The Bahamas for the necessary actions they have taken,” Dr. Eijkemans added.

October 27, 2014

Saturday, October 25, 2014

How are we handling the issues of Chikungunya and Ebola?

High on Ebola, low on chikungunya


Since the recent outbreak of chikungunya in the Caribbean, four individuals with close connections who arrived back to the U.S. from the Caribbean region were hospitalized immediately and diagnosed with the virus. In addition, a few medical center employees communicated that they have seen an increase of patients from the region admitted to their medical facilities.

I am not a medical doctor, nor I do I play one on the television; however, based on the recent reports, chikungunya has seen a significant up-tick. On the other hand, an impression is being portrayed that it is under control on these shores.

The leaders must address this issue openly and develop a solid plan before this potential storm, where soon U.S. and other countries well-traveled by Caribbean people will begin to put the medical drone on the region. The drone concept is geared to destroy anything in its path when launched. However, could you blame the U.S. if they cut travel, and begin to set high alerts and screening of passengers from the region?

The recent death of Thomas Duncan from Ebola at age 42, after arriving in the U.S., has created an intensive focus on foreign travelers from many poor and developing countries. Although many believed Thomas Duncan’s death while in U.S. care would inevitably send a statement to others to not come, many people are now wondering what the color of medicine is after two dedicated Caucasian doctors who worked in Liberia contracted the virus and recovered. One of the silent tones in the Caribbean addressing chikungunya, I believe, is not the politics of the virus, which is often seen elsewhere – for this region, it is all economics.

Here is why: in most of the region, the economic engine is tourism, and if what has taken place in Liberia is any indication, the fallout could be worse than the economic collapse in 2008 which has left many still sneezing. I begin to wonder if the reason reports of this increasing tide seem a bit hushed up is to protect the tourism industry while many locals are suffering silently. The appropriate business model during a turbulent time is not only to be prepared, but also willing to inform about structural problems. This approach not only builds credibility, but also shows a level of leadership that is lacking today on several fronts.

This is not a call for a reduction of travel to and from the region, or high-level screening at airports; that would be premature at this point. On the other hand, when the local government is slow to educate people, it could be the beginning of a tornado building. Therefore, questions must be asked. Along these blue waters, there lies an undercurrent that can overflow the banks at anytime, and the long-term impact could cripple many lives, both medically and economically.

Managing these issues takes compassion and resources. Recently I saw a Facebook picture post of what appeared to be a sick person from the region who became more victimized as he was scorned because of the appearance of what was believed to be the symptoms of the Ebola virus. Furthermore, when it is reported that a few local doctors are contemplating refusing to report to work in the event of an outbreak due to the lack of medical supplies and other resources, it is troubling.

In today’s society, where billions are being spent on wars and politicians’ re-elections, it is hard to fathom that lack of resources and awareness, combined with scorn, can leave many more suffering. I hope elected officials, medical personnel and CARICOM step up to educate people and seek help through awareness, because potential problems such as what is occurring in Liberia and other West African countries, where perception is more dangerous than the actual virus, can happen here too.

These islands are unique and sometimes that can be their own downfall because the uniqueness creates a form of isolation. It further limits collaboration, as all seem to be competing for a piece of the visitors’ pie. Therefore, competition mutes concerns, while marketing becomes a “them and not us” mentality.

This virus is not just an island thing, and nor is it found only in third world countries. One of my less-informed friends stated that he is going to stop eating chicken and stop going to places where lots of chicken is found.

Education is key: no, you cannot get it from eating chicken or visiting places where chicken is in abundance. The name chikungunya derives from a word in the Makonde language, roughly meaning “that which bends up,” reflecting the physical contortions of a person disabled by the disease. Many reports have noted that it was first identified in Tanganyika (now Tanzania) in 1952.

According to the Pan American Health Organization (PAHO), the first known autochthonous chikungunya cases in the Western Hemisphere occurred in October 2013 on the island of Saint Martin. By March 2014, travelers to other Caribbean islands carried it to: Dominica; the British territories Anguilla and British Virgin Islands; overseas territories of France like Guadeloupe and Martinique; and the constituent countries of the Netherlands Antilles, as well as other areas such as St Kitts and Nevis; the Dominican Republic; and St Vincent and the Grenadines.

An estimated 3.6 billion people in 124 countries are at risk worldwide, such as the many who are exposed to dengue fever. Large outbreaks have also been seen on Indian Ocean islands, in India and South-East Asia, according to the Infection, Genetic, and Evolution Journal. It has also reached Asia and Europe, and North America has seen a few cases recently in Florida.

The National Institute of Health, the World Health Organization, public health departments and infectious disease authorities have noted that chikungunya is a viral disease that is rarely fatal. It is transmitted to humans by infected mosquitoes.

The symptoms include high fever and headache with debilitating joint pains, swelling and stiffness of joints, muscular pain, headache, fatigue, nausea, vomiting, and a rash that can last for several weeks. Normally within four to seven days after been bitten, the symptoms appear.

The mosquitoes become infected when they feed on an infected person during the viraemic period. Today, there are no specific antiviral treatments or vaccines available. However, it also has been reported that commonly used medications include ibuprofen, naproxen, acetaminophen, paracetamol, and aspirin. Although there have been reported deaths, the numbers are extremely low compared to Ebola; however, one should not discount it as a storm that will pass soon.

These regions have to debunk the notion that only certain medicines can cure this outbreak, while many studies have been reporting there are no known cures at this time for the symptoms. It is extremely important that people take serious preventive measures such as wearing bite-proof long sleeves and trousers. More information has been published by many health organizations.

It can be extremely difficult to track down all mosquitoes and apply chemical spray on an entire region to reduce concerns.

Today many travelers are still waiting on a concrete government plan on how they are handling the issue in a coordinated effort. If there is one, please post.

Although some awareness has been registered, and governments seem now to be taking steps to mitigate the potential problem, more needs to be done. Nevertheless, can we all be stratified?

As the region continues to attract visitors, it is also important that these visitors receive a disclaimer of this undercurrent taking place. The leaders must make sure that all proactive measures are taken, seek help and resources as needed and stop putting on a good face on such issues with a relaxed attitude. I am still optimistic that all can come together and weather this storm. Moms and I have a ticket ready to land soon to take a break from this upcoming winter.

• Derrick Miller is a trained U.S. Federal law enforcement officer that has been in the criminal justice field for more than 14 years.

October 22, 2014


Friday, October 24, 2014

Bahamas Immigration Policy Update

Fred Mitchell - Minister of Foreign Affairs & Immigration

" I wish to remind the public that the constitution of The Bahamas does not give citizenship at birth to those born here of foreign parents."

I wish to give a brief statement in response to the feedback on the administrative measures announced by me in the House of Assembly on Immigration.

I said that there would be certain changes expected on 1st November following a period of feedback.

Nothing that has come back by way of feedback on the policies indicates that there is a need to change that administrative starting date. The date will therefore stand as the commencement date of the policy.

The policy is not aimed at any national group in The Bahamas. It is generic in nature. It seeks only to better ensure that the people who live and reside in The Bahamas have the lawful authority to do so, either because they are citizens of The Bahamas or they have permits to reside or work here.

I repeat that with immediate effect, we are no longer accepting applications for first time applicants for residence or work permits from those who have no legal status in The Bahamas. Those persons also will no longer be able simply to demonstrate that they have departed The Bahamas. This is in response to the increased suspicion of fraud in connection with these applications. In order for such a first time application to be processed, where the individual has no legal status in The Bahamas, the applicant must be seen and certified as having been seen by an officer of the nearest Bahamian embassy if there is no Bahamian embassy in the applicant's home country. The embassies are in a position to process these certifications.

Secondly, all those who are not nationals of The Bahamas who live in this country beginning 1st November will be required to have the passport of their nationality and evidence that they have permission to live or work in The Bahamas.

This may represent a broad class of people. I wish to remind the public that the constitution of The Bahamas does not give citizenship at birth to those born here of foreign parents. Those children have a right to apply at their eighteenth birthday and before their nineteenth birthday for citizenship of The Bahamas. Up to the time they are granted citizenship, in law they are not Bahamian citizens. This means that these people will be required to have a residence permit to reside lawfully in The Bahamas.

This is a requirement for which there will be no exceptions, save and except where someone is stateless. In the case of a stateless individual, the Government will provide an identity document but otherwise the practice of issuing certificates of identity is to cease on 1st November. When the currency of existing certificates of identity expires, they will not generally be reissued or renewed.

We will speak with the all embassies in The Bahamas and we anticipate that embassies will be able to meet that demand for passports.

We anticipate also that in the case of one national group it may take administratively some three months to meet and process that demand and for the Department of Immigration to process the volume of applications for resident permits.

In any event, we expect that by 15th January 2015, most people will have complied with this requirement and certainly that children will have complied for the start of the school term in 2015. If any citizen has a difficulty, they should contact their local embassy for assistance with particular problems.

These measures are for the general good and will provide a more secure form of documentation for all who work and live in The Bahamas. I would therefore urge all citizens residing lawfully in The Bahamas to comply with these new measures.

Those who are not here lawfully should expect increased vigilance and enforcement on the part of the law enforcement authorities in The Bahamas.

I wish to thank the public for their support of the measures, and for the responsible manner in which these have been accepted.

In particular, I would wish to commend the continuing dialogue with leaders of the Haitian community and for their efforts to ensure compliance with these administrative measures.

The door remains open for continued comment and dialogue as we seek to make The Bahamas a more secure place to live.

Bahamas News Ma Bey

Tuesday, October 21, 2014

The High Cost Reality of National Health Insurance (NHI) in The Bahamas

NHI roll-out ‘could take years’

Guardian Staff Reporter

While the government has said it will implement National Health Insurance in January 2016, Minister of Labour and National Insurance Shane Gibson suggested yesterday it could take several years to fully implement that plan.

Gibson, who has ministerial responsibility for the National Insurance Board, said it is “impossible” to roll out the entire plan in just over a year, but the government will introduce it in phases.

“National Health Insurance is not something that you can implement wholly on one day,” he said following a press conference to announce Public Service Week.

“You can begin the process of implementation and you would generally have to implement it in phases.

“We have some countries where it took them as much as 10 years to fully implement.

“We are looking at implementing it on January 2016, [but] it is impossible to have it implemented 100 percent on a particular day over this short period of time.”

NHI is intended to provide universal access to affordable healthcare for all Bahamians.

The first Christie administration had pegged the cost of NHI at around $235 million annually, but the government has said it will cost a lot more.

Before the May 2012 general election, now Health Minister Dr. Perry Gomez pledged NHI would be implemented within the first year of a new Progressive Liberal Party term.

Gibson said the roll-out could be similar to that of the National Prescription Drug Plan, which was introduced in phases.

Sanigest Internacional, a Costa Rican-based firm contracted by the government to advise on NHI costing, has said it is “plausible” in some scenarios for NHI to cost more than $500 million.

Asked about that figure and the status of Sanigest’s costing report, Gibson said he plans to meet with officials this week to discuss the plan.

The consultants submitted a draft report in August.

October 21, 2014


Monday, October 20, 2014

The Bahamas is not ready for Ebola, says Free National Movement (FNM) Chairman - Darron Cash

Fnm Chairman Says Response To Ebola Threat Is Too 'Laid Back'

Tribune Chief Reporter

FREE National Chairman Darron Cash yesterday criticised the government’s response to the potential threat of an Ebola case as “laid back” given the enormous risk the disease poses for the country’s tourism-driven economy.

He added that he does not think the country is ready for an Ebola case, despite assurances from officials that the country is on high alert for the possibility.

Mr Cash called for a full briefing on the government’s national plan, particularly equipment readiness, decontamination and waste control protocols, and co-ordination with the United States’ Centres for Disease Control and Prevention (CDC).

In a press statement yesterday, he pointed to reports that a health care worker who might have had contact with the disease in Texas had been quarantined on a cruise ship in the Caribbean.

According to reports yesterday, the woman has tested negative for the disease.

However, Mr Cash said the scare “has enormous implications for the Bahamas”.

“The Bahamas receives an estimated 4.2 million tourists annually, and a significant percentage of them come ashore and interact with Immigration, Customs and police officers, taxi drivers, hair braiders, store clerks, surrey drivers and others. The potential reach of a single individual can be broad.”

Mr Cash continued: “The experience of the cruise passenger reflects the reality of just how quickly America’s phenomenally small experience of less than 150 ‘Ebola-related risks/contacts’ can reach the islands of the Caribbean. The lesson for the Bahamas should be crystal clear: we should have been ready.

“We are not ready. We now need to get ready, remain ready and well-drilled and take nothing for granted.”

There have been three confirmed cases of Ebola in America, which is the closest country to the Bahamas with confirmed cases, according to the CDC. Two nurses in Texas who cared for Ebola patient Thomas Duncan, who died at Texas Health Presbyterian Hospital earlier this month, have tested positive for the virus. Duncan entered the US from Liberia.

On Friday, Obama administration officials confirmed that a Carnival Magic passenger, who had handled a lab specimen from the Liberian man, was voluntarily self-quarantined on the cruise ship despite the fact that she had shown no signs of illness.

The Associated Press reported yesterday that the Dallas health care worker had tested negative for the disease, and the cruise ship was back in port in Texas.

This follows reports that Jamaica, Trinidad and Tobago and St Lucia last week announced immediate travel bans on anyone who would have come from or through Ebola-affected countries of West Africa, namely Liberia, Guinea and Sierra Leone.

In response to whether the country was also considering a ban, Dr Glen Beneby, chief medical officer (CMO) in the Ministry of Health, said workers at the ports were being educated and their awareness of Ebola increased. He said the country was prepared to close its ports to those travelling from Ebola-affected regions if it became necessary.

While he acknowledged that there were different levels of readiness among islands, Dr Beneby said that every island is ready to deal with the disease.

Officials also said that by Wednesday, every major Family Island or clinic will have the necessary equipment to deal with a possible Ebola case.

Earlier this month the Ministry of Health released a 51-page Ebola Preparedness and Response Plan, which was heavily scrutinised by some government and healthcare personnel for its lack of public education and medical training.

There is a brief section in the report addressing port surveillance, which requires medical officers to be on call and to be accessible 24 hours a day. It does not call for screenings of travellers at ports of entry.

The Ebola virus is a severe disease characterised by a sudden onset of fever, intense weakness, muscle pain, headache and sore throat.

These symptoms may be followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some in cases both internal and external bleeding.

Symptoms may appear anywhere from two to 21 days after exposure to Ebola virus, although eight to ten days is most common, according to the CDC.

In an updated statement sent out on Friday, the Ministry of Health advised travellers with Ebola-like symptoms to consult a health care provider or contact the ministry’s surveillance unit within 21 days of entering the country.

Contact numbers for the Surveillance Unit are: 502-4776, 502-4790, 397-1021, or 376-3533.

October 20, 2014

Saturday, October 18, 2014

Is The Bahamas prepared for Ebola?

Sands: Bahamas not prepared for Ebola

Guardian Staff Reporter

Free National Movement (FNM) Deputy Chairman Dr. Duane Sands said yesterday he is not convinced the Ministry of Health is prepared to combat the deadly Ebola virus.

“I am not convinced that we have done enough to protect the interests of the Bahamas and the safety of Bahamians,” said Sands, who is also a surgeon.

“The people at the Ministry of Health can get [upset] as much as they want. Bahamians feel that we have not taken this thing seriously enough.”

The World Health Organization (WHO) said the Ebola death rate has risen to 70 percent.

Up to Wednesday, the death toll was tallied at 4,493, nearly all of them in West Africa.

Acting Chief Medical Officer Dr. Delon Brennen said recently it would be “nearly impossible” to prevent at least one case of Ebola from entering The Bahamas.

However, Brennen said the Ministry of Health has developed a plan it hopes would prevent local spread of the disease.

Sands said the entire world is up in arms over the virus, but The Bahamas seems slow to act.

“Regardless of how well the people at the ministry think they have this thing on lock, they are not going to be the ones who interact with the patient,” he said.

“I am not convinced we are ready. We talk about spraying people down.

“The protocol the Centers for Disease Control and Prevention (CDC) uses for decontamination is a certain amount of bleach.

“But has anyone been trained on how to put on a hazmat suit, which can safeguard them, particularly now that we know that if it is not done precisely the way that the CDC suggests that you can still get infected? How many people are trained? Where are they?

“These are all important details that people need to know, just like when you go through the process of telling people to fill their bathtubs and get a tin of sardine and corn beef in preparation for a hurricane.”

The Ebola crisis has captured the attention of many people, including those in this region.

According to reports, Trinidad National Carnival Commission is considering postponing Carnival celebrations in 2015 due to fears associated with the Ebola crisis and the large number of visitors who enter the country for the festival.

According to the Associated Press, both St. Lucia and Colombia are banning visitors from Ebola nations from entering their countries.

October 17, 2014