The Star (St. Lucia) - - COMMENT -

It re­mains al­to­gether con­jec­tural why our re­cently re­as­signed for­mer prime min­is­ter—if he truly be­lieved all he said about Walid Juffali last Novem­ber—al­lowed, if not en­cour­aged, many among us to be­lieve that un­der his Good Sa­mar­i­tan cos­tume the multi-bil­lion­aire Saudi was just an­other schem­ing low-rent scum­bag.

Less than half a dozen Saint Lu­cians had heard of him be­fore his widely pub­li­cized im­broglio over money with his third wife, an Amer­i­can for­mer cal­en­dar pinup named Christina Estrada, when he sought refuge be­hind the im­mu­nity af­forded him by his po­si­tion as this coun­try’s rep­re­sen­ta­tive on the board of the In­ter­na­tional Mar­itime Or­ga­ni­za­tion.

Estrada’s lawyers had chal­lenged Juffali’s de­fense, in the process dump­ing Saint Lu­cia smack dab in the mid­dle of a mi­asma of neg­a­tive pub­lic­ity that re­ver­ber­ated around the world—es­pe­cially af­ter a UK court had ef­fec­tively de­clared Juffali’s ap­point­ment a sham, a pa­pier mâché shield against his for­mer wife’s pe­ti­tion for a di­vorce set­tle­ment to­tal­ing multi-mil­lions of dol­lars.

On­line re­ports about the case had been in cir­cu­la­tion over a week when the then leader of the op­po­si­tion United Work­ers Party, Allen Chas­tanet, took to the air­waves to de­mand that the day’s gov­ern­ment ac­count for the year-old no longer se­cret mar­riage of con­ve­nience. It be­ing the sea­son of elec­tions, it was hardly sur­pris­ing that at least half the coun­try con­curred with Jus­tice Hay­den’s con­clu­sion: that Juffali’s mar­itime ap­point­ment reeked of shell­fish and sar­dines; that in the murky de­tails a shark lurked. Many spec­u­lated openly about what they saw as yet an­other of­fi­cial pay-for-play ar­range­ment. Oth­ers choked on em­bar­rass­ment!

As I un­der­scored last week, the doomed prime min­is­ter de­cided Chas­tanet’s ques­tions un­wor­thy of a rea­son­able re­sponse. Typ­i­cally, he hit back with an ill-con­sid­ered non

sequitur: while on a pri­vate visit aboard his lux­ury yacht Dr. Walid Juffali had some­how tracked him down to ex­press sin­cere love and ad­mi­ra­tion for our in­com­pa­ra­bly beau­ti­ful is­land and to of­fer sal­va­tion to its ne­glected sick and dy­ing pop­u­la­tion.

Most of what the prime min­is­ter de­liv­ered from the steps of his fa­vorite Cas­tries perch was hastily cal­cu­lated hy­per­bole. We, the peo­ple, were left to spec­u­late about the IMO ap­point­ment: did the vis­it­ing bil­lion­aire sheik prof­fer his spe­cial ser­vices? Was it he who made the of­fer at once pres­ti­gious and timely? As by now the whole world knows, at the time of his ap­point­ment as Saint Lu­cia’s IMO rep­re­sen­ta­tive Dr. Juffali was only months away from death by can­cer. He never at­tended a sin­gle meet­ing of the or­ga­ni­za­tion. And even if he could’ve at­tended, he was wholly at sea on mar­itime mat­ters and ab­so­lutely un­qual­i­fied for his po­si­tion— hence Jus­tice Hay­den’s un­sur­pris­ing de­ter­mi­na­tion.

What Walid Juffali knew a lot about was W Science, a pri­vate com­pany that he founded for the stated pur­pose of es­tab­lish­ing med­i­cal and sci­en­tific part­ner­ships. Dr. Juffali was its chair­man un­til his death last month. By re­li­able ac­count, Ernest Hi­laire (re­cently elected MP for Cas­tries South) was in­tro­duced to the bil­lion­aire when Hi­laire was still Saint Lu­cia’s high com­mis­sioner in Lon­don. Their post­pran­dial dis­cus­sions over sev­eral months had led to Juffali’s com­pany agree­ing to un­der­take a study of di­a­betes in Saint Lu­cia.

Shortly af­ter Juffali’s pass­ing, Hi­laire in­formed lo­cal re­porters that a $2mil­lion fund ex­isted for the pur­pose of set­ting up a di­a­betes re­search cen­ter here but it all de­pended on the present gov­ern­ment’s at­ti­tude to the pro­ject. Doubt­less, he was cog­nizant of the fact that Juffali had been per­mit­ted to be­come a po­lit­i­cal foot­ball at elec­tion time; that some­thing good may have been al­lowed to go bad on the al­tar of self­ish po­lit­i­cal mo­tives. In all events, the fea­si­bil­ity study was un­der­taken in 2015—an­other se­cret that has only now come to light. The ex­pec­ta­tion was that the study would al­low W Science to gather per­spec­tives and ex­plore the in­ter­est and ca­pac­ity for a col­lab­o­ra­tion with Saint Lu­cia and the rest of the Caribbean com­mu­nity, and learn how the com­pany could work with the peo­ple to have a pos­i­tive and mean­ing­ful im­pact on their well-be­ing.

“It was also hoped there would be op­por­tu­ni­ties to de­velop sus­tain­able part­ner­ships and pro­grams cen­tered on the spe­cial needs of peo­ple with di­a­betes in Saint Lu­cia,” ac­cord­ing to W Science per­son­nel.

Med­i­cal and re­search teams put to­gether by the com­pany vis­ited the is­land be­tween 2 and 5 Septem­ber 2015. They were al­lowed “un­prece­dented ac­cess to pri­vate and pub­lic hos­pi­tals, uni­ver­si­ties and tech­ni­cal schools, non-profit as­so­ci­a­tions, health-care pro­fes­sion­als and di­a­betes pa­tients.” With the en­dorse­ment of the health min­istry, a core com­mit­tee was as­signed to the vis­i­tors. One of its lead­ing mem­bers was for­mer se­na­tor and Vi­sion Com­mis­sion hon­cho Dr. Stephen King—which has me won­der­ing why he re­mained silent on Juffali while oth­ers played muddy po­lit­i­cal foot­ball with his rep­u­ta­tion.

In all events, and I men­tioned this last week, the study re­vealed some shock­ing sta­tis­tics that speak vol­umes about health­care in Saint Lu­cia. To quote di­rectly from the W Science re­port: “The com­monly cited Graven study from 2007 that in­di­cated Saint Lu­cia has the high­est preva­lence of di­a­betes in the world was flawed and dis­cred­ited by all stake­hold­ers ques­tioned. How­ever, mem­bers of the pub­lic still be­lieve what the study claims is true.” W Science con­cluded that set­ting the record straight had ei­ther not been at­tempted or had been un­suc­cess­ful.

The health min­istry, mean­while, had ac­knowl­edged it con­tin­ues to use “the dis­cred­ited sta­tis­tics as a means to pro­mote im­prove­ments in di­a­betes health­care. Re­gard­less, pub­lic aware­ness of the na­ture of the

di­a­betes prob­lem and the so­cial bur­den of the dis­ease ap­peared quite low. At the same time, peo­ple with di­a­betes are re­luc­tant to dis­close their con­di­tion for fear of dis­crim­i­na­tion and are un­aware of its se­ri­ous­ness, im­pact­ing neg­a­tively on man­age­ment of their dis­ease.”

Ad­di­tion­ally: “It is im­pos­si­ble to say ex­actly what the bur­den of di­a­betes in Saint Lu­cia is, due to a paucity of re­li­able in­for­ma­tion. There is no rea­son to sus­pect that any less than ap­prox­i­mately 9% of the pop­u­la­tion have di­a­betes.”

The re­port states what al­ready most of us have known from the hey day of long-de­ceased health min­is­ter Ro­manus Lan­siquot; both Vic­to­ria Hospi­tal and St Jude “are old and in poor re­pair.” How­ever, there was a sil­ver lin­ing: The new Owen King EU Hospi­tal was “soon to re­place” the 110-year-old Vic­to­ria Hospi­tal. It’s any­one’s guess when “soon” will turn to now.

At the time of the study— early Septem­ber 2015—the Owen King Hospi­tal (built with EUR54m as­sis­tance from the Euro­pean Union) was “in its fi­nal stage of fit-out prior to open­ing.” Nearly a year later a planned fifth wing to the hospi­tal re­mains un­re­al­ized, for lack of funds. (Nev­er­the­less, shortly be­fore the June 6 elec­tions the gov­ern­ment staged a much-bal­ly­hooed cer­e­mony to name the hospi­tal, with scores of in­vited over­seas and lo­cal guests, at a cost of well over $100,000.)

The W Science re­port also warned that with the open­ing of the new hospi­tal “health­care costs will in­crease.” As for the is­land’s 33 clin­ics, “they are over-run and of­ten suf­fer short­ages of med­i­ca­tions and sup­plies and poorly skilled work­ers with­out rou­tine su­per­vi­sion.”

Of great con­cern, the study re­vealed a short­fall of screen­ing and pub­lic aware­ness has led to the ma­jor­ity of di­ag­noses be­ing made when pa­tients present them­selves to health care staff with es­tab­lished com­pli­ca­tions of di­a­betes (end-care re­nal, car­dio­vas­cu­lar and other dis­eases.) “Some clin­i­cians sug­gested that a shock­ing 90% of all di­ag­noses oc­cur at this stage, with foot ul­cer­a­tion be­ing the most fre­quent pre­sent­ing com­plaint.”

Par­tic­u­larly dis­turb­ing, op­por­tu­ni­ties to pre­vent the dev­as­tat­ing com­pli­ca­tions of di­a­betes are rou­tinely missed or wrong di­ag­noses made—with dire con­se­quences both to pa­tients and to the na­tion.

The is­land does not have a na­tional di­a­betes registry, it was re­vealed. In­di­vid­ual hos­pi­tals and com­mu­nity pri­mary care clin­ics have had to de­velop their own. Vic­to­ria Hospi­tal re­ceived five com­put­ers that were still boxed at the time W Science vis­ited. They were do­nated by More­house School of Medicine to pi­lot the es­tab­lish­ment of a di­a­betes registry.

Again quot­ing from the W Science study: “There are eleven dial­y­sis ma­chines at Vic­to­ria Hospi­tal, ten at St. Jude Hospi­tal and five at Ta­pion— pri­vate and more ex­pen­sive. The ma­chines are fif­teen years old but work­ing well, since the staff is well fa­mil­iar with the ma­chines’ idio­syn­cra­sies. No home dial­y­sis is per­formed, due to risk of in­fec­tion. No kid­ney trans­plants are per­formed on Saint Lu­cia: pa­tients must travel to Trinidad, Mar­tinique or Bar­ba­dos.”

Ad­di­tion­ally: “The re­luc­tance of a sig­nif­i­cant pro­por­tion of pa­tients to seek help for di­a­betes is note­wor­thy. Many be­lieve in the health prop­er­ties of lo­cal herbs and plants; also that there are poi­sons in modern medicine which cause un­pleas­ant side ef­fects and so they need to cleanse their body of the poi­sons. The use of al­ter­na­tive medicine is ram­pant.”

Poverty is an­other ma­jor con­trib­u­tor to non-com­pli­ance. Lim­ited sup­plies force many pa­tients to ob­tain med­i­ca­tion via other sources that are not free, or go with­out. “Even if med­i­ca­tion is avail­able,” the sci­en­tists ob­served, “some peo­ple don’t have ac­cess to a re­frig­er­a­tor to prop­erly store their med­i­ca­tion . . . Peo­ple buy food they can af­ford, not what the di­eti­cian tells them to.”

Of spe­cial in­ter­est is the fol­low­ing, taken from the study: De­spite the po­lit­i­cal in­er­tia and the prac­tice of de­lib­er­ately pre­vent­ing the facts or full de­tails from be­com­ing known, “the coun­try ac­knowl­edges many of the prob­lems re­gard­ing di­a­betes health care and is ready for change and to col­lab­o­rate with W Science to im­prove the man­age­ment and care of peo­ple with di­a­betes in a sus­tain­able and ul­ti­mately self-fi­nance­able fash­ion, linked to ac­tive re­search pro­grams. Po­lit­i­cal will and sup­port was re­ceived at the high­est level—and most specif­i­cally the re­turn­ing high com­mis­sioner to the UK, Mr. Ernest Hi­laire.”

More­over, “the gov­ern­ment of Saint Lu­cia is open and sup­port­ive of in­ter­na­tional part­ner­ship to im­prove di­a­betes health care.”

But that was be­fore the Juffali wa­ters had been turned into a po­lit­i­cal cesspool by self-serv­ing elec­tion can­di­dates. What will be the im­pact since the Saudi bil­lion­aire’s death and the change of gov­ern­ment are all-im­por­tant ques­tions, at this time unan­swered. In­deed, the dis­tress­ing re­port from which I’ve quoted so lib­er­ally will prob­a­bly never be made pub­lic, thanks to ob­scu­ran­tist politi­cians that pay lip ser­vice to health care in Saint Lu­cia—with scant re­gard for the af­flicted hun­dreds of thou­sands!

A birds-eye of the new Owen King Hospi­tal: Only four of the five wings planned have b named last year amid much pomp and cer­e­mony but to date

Dr. Stephen King (right) was one of the hon­ored guests at the nam­ing of the hospi­tal in honor of his de­ceased fa­ther. He was also on a spe­cial ad­vi­sory com­mit­tee to a vis­it­ing team of ex­perts from W Science, chaired then by Walid Juffali.

been com­pleted, due to short­age of funds. The hospi­tal was e is not ready to re­ceive pa­tients.

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