Home' Trinidad and Tobago Guardian : November 10th 2017 Contents A6 opinion
Friday, November 10, 2017
has shown that hyper-
tension is the single
most important risk
factor for stroke.
imately 30 per cent of the adult
population has hypertension. One
in three persons is not even aware
that they have the disease. For many
of those who are aware, the lack of
symptoms (silent killer) doesn’t
force them to access care.
In Trinidad and Tobago, heart
disease is the number one cause
of mortality. Heart disease, can-
cer, diabetes and stroke together
account for over 60 per cent of all
deaths annually. (MoH, 2011)
Pan American STEPS, 2012 sur-
vey revealed that Trinidad and
Tobago has one of the highest
prevalence, morbidity and mor-
tality rates for chronic non-com-
municable diseases (NCDs).
These NCDs share common risk
factors such as high blood pres-
sure, diabetes and high choles-
terol. Behavioural risks include
unhealthy diets, obesity, tobacco
use, alcohol abuse and physical
Several local medical research-
ers have documented the burden
of strokes in T&T over the years.
An average of eleven (11) strokes
per month were presented at the
Scarborough General Hospital
(SGH) from January to September,
2017. However, for October, 2017,
twenty (20) stroke patients were
admitted. This is alarming given
our small population size and it is
a cause for concern by both policy
makers and users of the service,
since this is associated with high
mortality and severe disability in
survivors. Notably, modifiable risk
factors namely diabetes mellitus
and hypertension were reported
in the majority of the strokes ad-
mitted to SGH.
Given the alarming statistics,
changes are necessary. In addi-
tion, the launch of the national
Non-Communicable Diseases plan
created a framework for the ad-
justment of policy as we confront
To be more responsive to the
needs of our Tobago population,
• Developed and commenced
Standard Operating Procedures
(SOPs) by both primary and sec-
ondary care services.
• Hosted outreach sessions in
four communities, to raise aware-
ness as well as allow members of
communities to participate in de-
termining the services that should
be provided to them.
• Pursued and received approval
for the establishment of a NCD
Registry, which would be the re-
pository for data. This was done in
recognition of the importance of
data for decision-making. It would
allow for the collection of informa-
tion on stroke patients admitted to
health facilities so as to monitor
and determine the magnitude of
the stroke problem
• Recruited additional medi-
cal officers to facilitate extended
hours of service in the primary
care centres, thereby improving
access to care.
• Utilised the data to design and
develop a stroke and diabetes
centre, which would provide out-
patient rehabilitation services to
• Continue to advocate for the
strengthening of health promo-
tion and disease prevention strat-
egies in primary care services,
for persons who are unaffected.
Particularly, we encourage the
adoption of healthy lifestyles,
the acceptance of responsibility
for one’s health and the improve-
ment of self-management, so that
patients can prevent hypertension
and other chronic diseases.
• Decentralised community so-
cial workers, nutritionists etc. as
part of the multi-disciplinary team
• Pursue the integration of pri-
mary and secondary care services,
which is necessary to improve the
delivery of service to our at-risk
• Dr Agatha Carrington is the Secretary
of Health Wellness & Family Develop-
ment, Tobago House of Assembly
Unarguably, the insertion of St Lucia’s former Tourist Board
director Louis Lewis as the first ever Chief Executive Officer
of the newly-minted Tobago Tourism Authority (TTA) is jus-
tifiably unsettling to industry stakeholders and Tobagonians.
Last November, Dominic Fedee, a St Lucian politician,
accused Lewis, an experienced and qualified tourism in-
dustry player, and his deputy director of “gross mismanage-
ment” of St Lucia’s Tourist Board funds.
Lewis and his colleague were fired immediately, although
they had already tendered their resignations.
By the time Lewis’ appointment was announced in To-
bago, having been recruited through the Barbados firm
Profiles Caribbean Inc, news of the allegations had already
swarmed social media.
Its subsequent ventilation by conventional media stirred
words of encouragement and assurance from Lewis as
well as Culture and Transportation Secretary Nadine Stew-
But did the reassurance come too late?
All things considered, the accusation against Lewis seem
similar to assertions on Vernella Alleyne-Toppin’s “Shop-
ping Toppin” and Shamfa Cudjoe’s $59,000 phone bill for
a four-day official stay in the Bahamas. All allegations were
made under the privilege of Parliament by opposing mem-
bers to ‘buss a mark’ or score points.
As in Lewis’ case, the accusation came as a new govern-
ment stepped into office. Unfortunately, we know only
too well that a new government blames the preceding one
for all real or imagined maladies facing a country. And of
course, under those circumstances the veracity of the as-
sertions cannot be ascertained.
In this case, it’s not that the former tourism director is
not suitably qualified for the job. After all, he holds a BA in
Economics, an MA in Business Administration and is a cer-
tified bank examiner and project management professional.
The problem is the revelation of the allegations levelled
against him. Could the story of his appointment and allega-
tions not have been ventilated prior to his appointment and
so avoid the impression that the CEO and Secretary were
simply attempting to do some damage control when they
fielded questions from reporters prior to leaving recently
for their trip to London?
Regrettably, what this has served to do is question the
credibility of the board members, the Tourism Secretary
and by extension the Tobago House of Assembly.
That being said, Lewis’ appointment only serves to
strengthen the public’s resolve that the four-year blanket
power given to Tobago’s political administration cannot
continue and a mechanism must be sought to allow the
public’s opinions to be part of important decisions.
This suggestion by noted Caribbean economist Dr Vanus
James and others has some merit. The powers and estab-
lishment of the Tourism Authority could have been part of
Presently, tourists arrival figures are down domestically
and internationally and the industry is in crisis and the
Lewis factor makes the situation even more unsettling. To-
bago does not need this.
Still, Lewis’ reputation speaks for itself. His contributions
to the St Lucia’s tourism industry are reportedly far-reach-
ing. But, can he be trusted him with spending from the
public’s purse and will be able to take the island’s tourism
sector out of its quagmire?
Only time will tell.
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QUOTE OF THE WEEK
“The time has come ... to have prepared meals and raw materials alike tested
for bacteria such as faecal coliform, salmonella or any other bacteria.”
Scarborough Secondary School’s Alumni Coordinator Kevon Mc Kenna commenting on
the need for the Tobago House of Assembly to monitor the School Feeding Programme.
The Louis Lewis factor
Institutional strengthening in healthcare delivery
Responding to Tobago’s needs
Dr Agatha Carrington
The Community Development
Department in the Tobago
House of Assembly’s Division
of Community Development
Enterprise Development and
Labour hosted another
Tobago Road Market
Experience at Gardenside Car
In photo, Secretary
Enterprise Development and
Labour Marslyn Melville Jack
and Assistant Secretary
Shomari Hector pose with a
past student from the
Division’s Vocational Skills
Classes, who got with her
completion certificate, during
the recent Tobago Road
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