 I bid you a cordial good afternoon and welcome you to our first ever Hearts recognition ceremony with a special emphasis on the healthy lifestyle counseling module of the Hearts technical package. Over the years, as solutions, we have been able to accomplish much through the collaboration with the Pan American Health Organization and it gives me great pleasure to welcome Mrs. Fiona Antony, our country program specialist, to give the opening remarks. I'd like to welcome you all this morning to this very exciting prestigious event and it gives me great pleasure and honor on behalf of Dr. Yatada Skibre, the PAHO WHO representative for Barbados and Eastern Caribbean countries to welcome you all to the Hearts recognition ceremony and presentation of chronic care passports to commemorate Wellness Week in the Americas 2021. This is an opportunity to recognize the clinics that have done well, not only for clinics who are part of the Hearts project but also recognition of all clinics in St. Lucia who have been advancing in blood pressure control. The Hearts technical package is the initiative of countries led by the Ministries of Health with participation of local stakeholders with a technical cooperation of PAHO. The initiative seeks to integrate seamlessly the progressive, progressively into already existing health delivery services to promote the adoption of global best practices in the prevention and control of cardiovascular disease and improve the performance of the services through better control of high blood pressure and the promotion of secondary prevention with emphasis on the primary health care. This is in keeping with the Sustainable Development Goals 2030, specifically 3.4 which speaks to by 2030 reducing by one-third premature mortality from non-communicable diseases through prevention and treatment and promotion of mental health and well-being. Hearts is being implemented and expanded in 16 countries of the region to include 739 health centers which together cover approximately 7.5 million adults in the respective catchment areas. The Hearts model will be the model for the cardiovascular disease risk management including hypertension, diabetes and dyslipidemia in primary health care in the Americas by 2025. It is highly commended that in the context of the COVID-19 pandemic that we are here today to recognize the successes in St Lucia in the implementation of the Hearts technical package. As we are aware people with underlying health conditions such as non-communicable diseases including cardiovascular diseases, diabetes and cancer have a higher risk of severe COVID-19 disease are more likely to die from COVID-19. It is therefore important that such persons are controlled. The chronic care passports are also a valuable tool for patient education and self-management particularly in the context of the COVID-19 pandemic. We therefore recognize the great national effort in the implementation of the Hearts technical package in St Lucia and further commend the ongoing efforts in the context of the COVID-19 pandemic. We congratulate all staff involved and the patients themselves in the execution of this excellent initiative and look forward to actively participating in this recognition ceremony. As a ministry we fully acknowledge the devastating effects of non-communicable diseases such as cardiovascular disease, diabetes, cancers and chronic respiratory diseases on the quality of life and the length of life of our population. In St Lucia cardiovascular diseases have led to more deaths than other causes over the past few years noting the significant contribution made by high blood pressure as a risk factor for our number one cause of death. Today on September 24th although we've celebrated Caribbean Wellness Day two weeks ago and although last week we celebrated Wellness Week in the Americas we choose to still look at wellness in the context of the importance of blood pressure control, blood pressure control through a holistic approach. In an effort to alleviate the morbidity and the mortality associated with cardiovascular disease risk factors specifically high blood pressure the Ministry of Health and Wellness in collaboration with the Pan American Health Organization launched the Hearts Technical Package in October 2019. The Hearts Technical Package a module of the Global Hearts Initiative provides a framework for implementing the integrated management of non-communicable diseases through cost effective interventions. The Hearts Technical Package through strong political will was first implemented in six sites in 2020 and has been expanded to include two new sites in 2021. Over the past 20 months and despite the many challenges posed by the COVID-19 pandemic tremendous effort has been placed in assessing and improving the implementation and success of hearts in St Lucia. These efforts include the production of an upbeat jingle which you just heard which encourages persons to eat healthy, seek medical advice and to stay active. Through collaboration with PAHO simple guides for healthy lifestyle counseling have been prepared for use by healthcare providers. Recently through the substance abuse advisory council secretariat SACS training of healthcare providers to be competent in tobacco cessation counseling began. Tremendous commitment has been shown by our ministers our heads such as our chief medical officer our accountants our procurement officers as essential drugs and technologies have been made available to our clients despite financial constraints. Much effort has been placed in revising workflows in our clinics providing refresher training for healthcare providers and the diagnosis of high blood pressure and the appropriate measurement of high blood pressure. In all primary care sites only validated monitors that is monitors which accurately measure blood pressure are used for diagnosis and monitoring hypertension. The Stanford self-management program continues to provide a framework for patient education and counseling through the healthy lifestyle module of the hearts technical package and from September 2020 chronic care passports have been used by clients in the heart facilities to improve at home education and monitoring. Today we want to highlight the importance of these chronic care passport but we also want to let the public know that those passports will not only be available in the heart sites but they will not be available in every primary care center in Senusia for patients who are hypertensive and or diabetic. While we want to focus on blood pressure control we seek to highlight the responsibility of both patients and healthcare providers in the management of overall health especially during this pandemic where the evidence points to the increased vulnerability of persons of NCDs to severe forms of illness and more adverse outcomes when infected of the COVID-19 virus. The purpose of the heart's recognition ceremony and focus on the chronic care passports is to recognize the hard work of our healthcare providers and to promote the benefits of the heart's technical package as well as to sensitize the public on the need for adequate blood pressure control and overall cardiovascular risk factor control. It is hoped that the presentation of and the focus on the chronic care passports will help educate the public of the need for self-management and education and provide a tool for improved self-care particularly during the COVID-19 pandemic. Thank you ladies and gentlemen. Now I would remain here to take you through the rest of the program. My name is Dr. Shana Sirifilbet. I'm the senior medical officer for non communicable diseases in the Ministry of Health, Wellness and Elderly Affairs. In 2019, as I said previously, the Ministry of Health launched the heart's technical package. And there were six centers, the Babunau Wellness Center, Bervey Wellness Center, Sickness Wellness Center, Grand Riviera Wellness Center, and the Lacuamingo Health Center as well as the Rich Four Wellness Centers. In 2021, we added the Miku Wellness Center and Souffre Primary Care Clinic. This afternoon, we fortunate enough as a country, I dare say, and we grateful and I just want to highlight the work that the health management information system has done throughout this process. We now have a very efficient health information system. And today's awards are based on the assessments done of blood pressure control in our primary care clinics over the 12th month period in 2020. Now, if you listen to that jingle, you'd realize that heart is an acronym and it refers to H, healthy lifestyle counseling, E, evidence based treatment protocols, A, access to essential medicines and technologies, R risk assessment as in cardiovascular risk assessment, C, a team based approach and S systems for monitoring. This afternoon, our first award will be what we call the best heart's clinic award. And this award was open to all six heart's sites, the initial six sites in 2020. And the criteria used for selection was the following. We looked at access, as in the air of hearts, access to essential medicines. And that was measured by the availability of medicines throughout the year, which which clinic had the available medicines available, the essential medicines available for the whole 12 month period. We also looked at C, the team based approach. And we looked at the training aspect of that. And we looked at how which clinic had the most people who had actually done the heart's training course. The third criteria used was the blood pressure control, overall blood pressure control in 2020. And the heart's clinic with the highest total score was the Babuno Wellness Center. Let's give them a round of applause, ladies and gentlemen. The Babuno Wellness Center. Let us welcome the principal health nursing, the public health nursing supervisor, Mrs Beverly Samuel to collect the award for the best heart's clinic, which goes to Babuno Wellness Center. Our principal nursing officer, nurse Julieta Cassius will hand over this plaque, best heart's clinic. This now this plaque will not only stay with Babuno, this plaque will go very good. Who's taking the pictures? Yes, let's make sure we get pictures of this. As mentioned previously, thanks to our electronic health records, we are able to objectively note objectively assess blood pressure control in all of our primary care sites. The health center with the highest average blood pressure control from January to December of 2020 is the Eatangs Wellness Center, the highest average blood pressure control. Thank you. Round of applause and their percentage of their average percentage control throughout the year was at 51.3%. Now, mind you, we're going for 70% or above. But remember, we just started and we had quite a few constraints because of COVID. So 51.3% is going towards 70%. Yes, we're hoping. So let's give them another round of applause and we now welcome our public health nursing supervisor, nurse Lamontine, to collect this plaque. And again, we will have our principal nursing officer, nurse Julieta Casius, who will hand over this award and we will be taking a picture again. Congratulations. In second place, when we looked at the average blood pressure control in the clinics, in second place, we had the La Fag Wellness Center and the percentage control was 48.9%. Just a little bit below Eatangs, 48.9%. And so we welcome again our public health nursing supervisor for that region, nurse Lamontine, to collect the certificate which we will be giving her and our assistant principal nursing officer nurse Tecla Jabatis will be handing over this award. Nurse Jabatis, we welcome you. So second place, Gossela Fag Wellness Center. Congratulations. So this region has collected two awards. Lovely. In third place, with an average percent control, blood pressure control of 45%, we have the Tirochet Miku Health Center, 45% in third place, for average blood pressure control Tirochet Miku Health Center. And again, this certificate will be given by our principal nursing officer, nurse Tecla Jabatis. And it will be collected by the public health nursing supervisor of that region, nurse Persha Ajoda. Welcome ladies, round of applause. Okay, we're making sure we do it twice. Ladies and gentlemen, HEX is about monitoring progress. You don't know how you're doing unless you monitor so that you could improve. And we encourage our staff and our patients to make continuous assessments and improvements. Our last plaque today, our last award, will be given to the Lacroix Mango Wellness Center. And this plaque is for most improved HEX clinic in 2020. In the period from January to June of 2020, the blood pressure control, the average blood pressure control percent was 25% in Lacroix. In our next period, July to December, when we average blood pressure control, they went up by 5%. Now, this may not seem significant, but since we're looking at people and Lacroix is a big clinic, it is significant because blood pressure control translates into improved outcomes in terms of cardiovascular disease. So we want to commend Lacroix and we want to encourage them to do even better next time. And so our most improved clinic plaque will go to Lacroix and this plaque will also be going around to other clinics every time we have an award ceremony because we want persons to continually improve. So at this time, I want to invite our principal nursing officer, nurse Yolanda Alcindor, to give this plaque and our nurse Yasmin Jules, our principal public health nursing supervisor, Yasmin Jules, will collect this award on behalf of the staff of the Lacroix Mango Health Center. Congratulations. This is the first ever. We need to make sure this is recorded. Now, I said that hearts is an acronym, right? H-E-A-R-T-S. Every letter stands for something. The first letter in hearts stands for healthy lifestyle counseling. This is not coincidental. Chronic conditions like diabetes and hypertension can be difficult to manage and persons need constant education and encouragement to do well and to prevent complications. The Stanford self-management program is an integral part of the healthy lifestyle counseling module of the hearts technical package. From September 2020, small colorful booklets called the chronic care passports. And the name on those booklets, the name says a guide to a healthy lifestyle solution. Those booklets have been used by our clients, and this was done so that we could help improve the at-home education and monitoring of our clients. We are fortunate today to have with us Nuseolanda Alcindor, a family nurse practitioner and a master trainer of the self-management program. And Mrs. Natasha Lloyd Felix, the director of the Bureau of Health Education, who have been instrumental in the implementation of this program. Mrs. Felix will tell us more about the Stanford self-management program. When someone gets a diagnosis of having a chronic condition, you can imagine the range of emotions and how one might feel disempowered. But through this program, which is facilitated through the Ministry of Health, through the support of the Pan American Health Organization, we've had the opportunity of having over 8,000 Saint Lucians exposed to skills and knowledge to better self-manage. Within our context, there is a tendency to think health is managed by a healthcare provider. But this program helps every individual who participates to recognize the instrumental role they have in partnering, in being part of that health team, to improve their health outcomes and to take ownership of their health and to know that their chronic condition is not a death sentence. It's not the end. There is hope and there's the opportunity to change, to improve and be an instrument of change for others. And so this program started in 2016, has been very, very impactful, has helped in improving knowledge and skills for people who are diagnosed as well as caregivers, because in some instances, those diagnosed are unable to be in attendance themselves due to their conditions. By so doing, we have seen many, many changes. Some of them are stories that we continue to tell of people who have been tobacco dependent, who stopped their smoking habit. People whose blood pressure levels were more controlled. Individuals who changed their lifestyle habits, like water consumption, as simple as that or weight loss. And so this tangible improvements, very measurable improvements have been noticed. COVID-19, Delta difficult blow to every and anyone. And so our program also got faced with the challenges of COVID-19. It's a face to face program delivered over a six week period. And because of COVID-19, that element of engagement was discontinued. And so there was a gap in time. And during this period, we realized the opportunity of going virtual as the whole world has gone. And from last year, the team of leaders, those who train have been exposed to a virtual component of the program. And by so doing, we can now offer the virtual platforms for conducting this program, giving us some flexibility and widening our reach. And we look forward to the day where we have more face to face sessions being done, despite that opportunity for virtual engagement. We ask anyone who is interested to visit or call rather, their community wellness center, or they can contact us at the Bureau of Health Education. We are on Facebook and our numbers are listed in the directory. And there you can register and we can have a group put together where you can participate and benefit and take better control of your health. Thank you, everyone. Congratulations to all the teams at the different wellness centers that will recognize this afternoon. Our chronic health care passport is given to persons living with chronic conditions, for example, diabetes and hypertension at all of our wellness centers. These chronic care passports were produced by the Ministry of Health in collaboration with the Pan American Health Organization. This booklet is used as an educational tool for the health care workers, persons living with chronic conditions and their families. It helped individuals to self-manage their chronic condition. The passport is very colorful and interactive. Some of the topics addressed in the passport are what to expect at each visit, healthy eating, physical activity, food care, how to manage diabetes and hypertension, what tests are to be done and how often the normal values of blood tests, example, blood sugar, cholesterol, etc. It allowed individuals to also record the glucose level and hypertension, high blood pressure recordings when done at home, and individuals can set goals and compare how they are doing with the normal values. The chronic care passport allowed persons living with diabetes and hypertension to actively participate in their care. So I'm also going to translate in Creole for our audience. Those persons in our district that we interact every day with, that today we are here, well, Jordanu is here, for the first time in my life, I have visited Wellness Center, where I have lived with diabetes, high blood pressure, and I have lived with a lot of people. I have lived with a lot of people who have information about how to manage their condition and how to deal with the effects of COVID-19 the the the the the Also, in the living room, we have a place for people who live in Pissadu, we have a place to manage these different living conditions, we have a place to test for managers, and we also have a place to test for people who live in Pissadu. So, all these living conditions, we have a place to visit, a wellness center, we have a doctor, a nurse, and we also have a place to test for people who live in Pissadu, and we also have a place to take care of our children, if we have a place to go, we also have a place to go. So, all these living conditions, we have a place to participate, manage these different living conditions, and we also have a place to test for people who live in Pissadu, and we also have a place to participate, actively manage these living conditions. Thank you very much. I want to congratulate the teams, the health teams of all of the wellness centers who have been awarded this afternoon. Your achievements have really shown this afternoon, and the Ministry of Health really recognizes all of the efforts that the health team of the various wellness centers, and of course the region, has given two words, blood pressure control of clients within the communities. So, I really want to thank all of the health teams again. At the center all of this we know is always the clients. We provide care, but we know that the care that we provide, the client is the most important part of the team. So, I want to also congratulate the clients for being empowered, and for ensuring that they manage their blood pressure adequately to be able to control it, that they do not complicate and be able to have all of the cardiovascular complications that we hear about. So, clients well done, and we heard of the self-management program. We heard of the booklet, self-management booklet. So, if you have not received your booklet, please visit your wellness center to receive your booklet so it can assist you in managing your condition and also in ensuring that you are well controlled. So, in closing, I want to encourage the facilities to continue striving. As Dr. Seere said, she wants the awards to be rotating, but I also want to urge you to work hard so you can keep it, but at the same time encourage the other facilities, so then we may have to need more awards. I'm Dr. Seere, next time. Because I really want as much as we've implemented hats at some of our wellness centers, we need to be able to use the principles of hats at all of our facilities and not just at the hats facilities. So, I want to encourage facilities that are not listed as hats to take a page from all of what has been going on at those facilities. I know we've started a series of training, and as Dr. Seere said, we've included Miku and Sufre. So, I'm hoping in 2022, we can include all of our wellness centers and they become. And I do not want us to also say it's a hats facility. I want us to incorporate hats into what we do. So, we will be phasing out the word hats, but at the same time, we know that we have incorporated all of the hats principles into the management of the clients living with high blood pressure. So, once again, I recognize all of the teams, I recognize all of the health centers, and I want to encourage all of us to continue striving to ensure that we have a nation that with healthy hats, with happy hats, sorry, and we have a healthy nation. So, once again, I want to thank all of you for attending our recognition ceremony this afternoon. Thank you.