 Hello and welcome, I'm Delia De Law. Through a series of programs, I'll introduce you to many of the services, achievements and future improvements to St Lucia's health system. During the making of these programs, I realised that I held many perceptions of what the health service was all about, and I was surprised to find out about the many services available and the areas of expertise health professionals employ at our hospitals, polyclinics and wellness centres. I also talk to people responsible for planning our health system, from the Minister of Health and Wellness, Senator Hon. Mary Isaac, to the providers of Quality Health Care. This program also features Creole interviews with Fanelle Neptune, and we'll ask you questions and give you their answers immediately, and I know you'll get them right, right? Let's learn more about St Lucia's health service now. The Health and Wellness Minister says, health personnel understand the importance of confidentiality and she commends health workers for their service and commitment. Understanding how strategic governance works, community and mental wellness health services explained and the importance of preventative health, but first, public not aware of many services on offer. A wide range of services are provided, not only at hospitals, but also at clinics, wellness centres and outreach programs. Anyone can attend these health services no matter where they live. St Lucia's health personnel are not as qualified as international teams. St Lucia's medical professionals and staff are trained and retrained in St Lucia and internationally. This is an ongoing procedure and a job requirement. People with mental health issues are demonised. Yes, people still think that way, but they couldn't be more further away from the truth. The stigma of health care is the problem. Mental health issues can be managed. Regina, when it comes to St Lucia's health care, what improvements have you seen and what would you like to see in going forward? I have noticed with suicide and depression becoming more of a concern in this country that there's been more attention to that area. I've seen a lot of advertisements on social media and even on commercials about counselling and treatment for different types of mental illness areas. As far as what I would like to see, I've also heard a lot of reports on elder abuse, and particularly with people who have Alzheimer's and dementia. So I would really like to see awareness in this area. There's no cure for it, so I believe that with all the research and evidence out there that we can find ways to prevent the risk factors of developing Alzheimer's and dementia. And if we can reach it from that end, that lowers the numbers in the next 20 years. Because St Lucia is also part of a group of countries that are at a higher risk for incidents in the next 20 years. Our aging population is a little bit, well, it's more older and then younger. And since we have, most of the Caribbean's actually have people, families who are abroad. And so that even leaves less, that leaves less people to care for those. So there's areas in that same area is the people affected with the dementia, the families who are caring for them, and then the professionals who are caring for them. And there needs to be a lot of attention with all of it because it's not just an individual condition. It's not just a family condition. It's a community condition. It's not just something that the government has to do. We all need to do it, too. We all need to participate and help. Thank you. OK. Producing this program helped me to understand the functions and services the Ministry of Health and Wellness provides. It enforced very quickly how I relied on my common sense and level of intelligence and what acquaintances told me. And so I made assumptions about the health services available to me. I say this to you to prove that if I didn't go straight to the source of information, I wouldn't know the facts. I assumed that St. Lucia's health system could not provide adequate diagnosis, wasn't able to plan proper care, and thinking about the finances of it all was daunting. I was placing full responsibility of my health education onto the Ministry. Are we in the same boat? Fact is, we have a responsibility to ask questions about our health care. Let's pay a visit to the Minister of Health and Wellness, Senator the Honourable Mary Isaac. Hello, Minister. I'm so glad that I had the opportunity to speak with you because during the producing of these videos, I recognise that the Ministry of Health must be one of the most important, perhaps it is the most important ministry because without our health, we can't work, rest or play. Now, as the Health and Wellness Minister, the buck stops with you. How do you decide how you need to go ahead with your rumours? How do you decide about the strategy that the Ministry should take? Well, you know of the incidences of NCDs in St. Lucia. And one that is on top of our list is the whole issue of diabetes. So we have a whole long list of people waiting to get dialysis in St. Lucia. And what we have done is we have increased the amount of people that we can see on a regular basis. We can dialyze on a regular basis. So we have extended our care to provide an additional shift in the dialysis units. And this, I believe, is a great accomplishment because we have been able to take on a lot more patients who are waiting, you know, to get care in our dialysis unit. So that is a major accomplishment, not only for the ministry, but for the patients and for the entire country. The ministry have always had plans there because all government ministries have plans, they have strategic plans and so on. But what we found when I came into office is a very scattered system. It's very chaotic and there does not seem to have any kind of, you know, methodology to really address a lot of the issues that we have in health care. What we are doing right now is we are putting together a plan that is very holistic, a plan that starts with primary care in order for us to address a lot of the care that we need at the end of the spectrum. So we are focusing more on primary care and also looking at the issues that we have on the ground right now. So it is a very holistic plan that we have for health care. And I think that our health care system is in a much better place right now. You have a lot of issues because we are encountering a lot of issues and what is happening now is we are actually bringing them to the floor. They are actually coming out and we have to deal with them because they have become so big, you know? So in dealing with some of these issues, we have decided that we must focus on everything in health care at the same time because you cannot look at the end of the problem before you look at the source of the problem. So like I said, primary care has to be strengthened and then at the same time, simultaneously, we are taking care of the current issues. So it is quite a burden that we have to deal with when you are looking at health care in solution. You know that we have the OKEU. We are transiting from Victoria Hospital into OKEU. OKEU has a lot more equipment. It will require a lot more human resource capital. It will require a lot more finances than we have currently. And those finances have to come from somewhere. So all of these challenges we have to be able to deal with and we have to be able to deal with it all at once. So this is taking some time because it is a humongous task. We have never in our history had to transit from one hospital into a hospital that is, this is a state of the art hospital. And although we have spent a lot of money bringing it up to what it is supposed to be, we are still continuing to spend money so that we can have a product we can move into and when we move into it, it will function properly. So our plan includes all of these different issues. We are looking at infrastructure. We are looking at human resource capital. We are looking at finances. You name it and we have to deal with it at this point in time. I've met doctors, nurses, administrators, so many people who work in the healthcare system and I was amazed by the compassion, the passion, everything that they go through. And I think sometimes the public forget that the service is provided by people just like them. Can you speak to that? You are quite right because right now we have the highest amount of, I will say, sick people on our hands to take care of. Our NCDs are at an all-time high. We have other diseases that you are looking at and finance in terms of agencies, financing healthcare is at an all-time low. You do not have so much coming from the EU, coming from the US, coming from those other international agencies that used to assist before. So most of it has to come from government posts and that is where our doctors and our nurses come in. They understand the situation that we are in as a small island state and these people come in on a daily basis, they give their all and they go over and above the call of duty to serve our population. They are doing so with very limited resources. As you know, Victoria Hospital, the old plant is in terrible shape and no matter what happens, they hang in there and they provide the services for the people of San Jose. So these people really have to be applauded. We do have one or two bad apples, but that does not come close to the amount of hard-working people we have in that system that is causing it to function as efficiently as it is right now. I think a lot of times there's a lot of negativity going on out there about the Ministry of Health. But we must understand that that ministry deals with a very critical subject and patient confidentiality is very, very high on our agenda. Sometimes things come out and we really cannot expose certain information to the public because you are dealing with people who are already sick, you are dealing with people who are already in a mental state that necessitates that we be sensitive about the issues. So a lot of times you hear all the negativity and people are not sensitive enough about the area that the Ministry of Health staff serves. So, and given our, like I said, our limited resources and the marvelous work that these workers are doing, the Ministry of Health is really very pressed in terms of staffing, in terms of the resources that we need to do the job. And people tend to just take the negativity and spread it all over the place with little regard for the work that the Ministry is doing. But I would want St. Lucia to look at all the positive things that's coming out of the Ministry, all the help, all the assistance that we give to everybody who is in need, who come to us. We help them in one way or another, whether it is to give them free medication because they cannot afford to pay for the medicine, free surgery because they cannot afford to pay for it, whether it is to call on doctors and nurses to assist them in one way or another, giving a lot of charity to a lot of people in St. Lucia. I think that we as a people, as a country, have to be very, very grateful that we have the workers and these people at the Ministry of Health who do not just go out there and blab people's business because they recognize that people's business, the business that they deal with, the people that they deal with require us to maintain a level of confidentiality. I have a question for you now with the answer provided right afterwards, followed by the Creole segment with Fennel Matthews. Question. What is one of the major achievements of the Ministry of Health and Wellness? Is it A, extended care for diabetics? B, knowing the number of patients being treated in hospitals? The answer is, A, extended care for diabetics. Extended care for diabetics is an achievement not only for the Ministry but for the large number of people suffering from diabetes. This is why the Ministry of Health and Wellness has been able to provide policies for the country and the North. The Ministry of Health, Senator Onewab Mary Isaac, spoke to you about the achievements of the Ministry of Health. I have many achievements in the Ministry of Health. It's not just me, but it's all the same people who have been treated by the Ministry of Health. The people who have been treated by the Ministry of Health are actually the people who are present here and all the different qualities of the Ministry of Health. And we are also the people who are in charge of taking care of these people. So, actually, we are taking care of the people who are not paid to buy medicine, we are not paid to be doctors, we are not paid to be different people. We are the people who are treated by the Ministry of Health, we are doctors, the people who are treating people. The people getting the vaccine, the women are taking care of these people and we are giving them up for the地方 for treatment and the Under- taxes. Then, the Ministry and the Shah Program They are those who do that. The program that they are making I have a plan to do this, and the ministry will be able to protect me, and the whole ministry will be able to help me in my work. I have a lot of money in my work, I have diabetes. I have a lot of money from treatment, and I have still got treatment. In Cholmola, I have had a lot of shifts for dialysis because there is no exception. I have a lot of dialysis. So I have put a new shift, and I have bought a new first dialysis, and I have a new shift, now that I have a new shift. Minister, do you have plans for the Ministry to develop in order to set a set list for the future of Turkey? The plan is to develop by setting a set list for the future of Turkey before the future of Malaad. That's what we're going to do with preventative care. So we want to go to the doctor if it's two or three times a year to make sure that they don't join Malaad. If it's anti-Malaad, we want to make sure that they don't have to go to the hospital or that they have to gather enough money to make sure that they don't have to go to the doctor and to make sure that they don't get sick. We don't want to make plans for the future. We don't want to do the SPA. I'm going to make sure that Malaad will be able to come to the hospital if it's three times a year. We want to go to the doctor before Malaad to get sick. We were checked out so that we would not get sick unnecessarily. We had to take care of the disease by just starting to get it to work. So this is the first part that we are planning to do. After that, we will take care of all the other diseases. We will take care of the people that are sick and take care of the sick and the sick. I will just help the elderly and the women because I am sick and I can't work. So we have to take care of the people that are sick and we are the people who are sick here. We will take care of the hospital in Victoria because the hospital in 12 cities So what is the Neff Hospital? The European Union is called the Neff Hospital. We are going to take these people to the Victoria Hospital and put them in the Neff Hospital. We are going to take care of our health before we leave. We are going to simply take care of the people who are affected and all the organs are in the Neff Hospital. We want to pay for the people who are responsible for their health and we want to leave the Neff Hospital and come back to the Neff Hospital. This is the quality of the Neff Hospital. We want to have a system that is for the vaccine, that is for the doctors before they come back to the Neff Hospital. We want to take care of the people who are sick and come back to the Neff Hospital, to the health centre and the clinic. We want to pay for the people who are in the clinic. But the clinic is not accessible and we want to have a good time. We are going to take care of the clinic and then we will connect to the clinic and then we will leave the clinic. The strategic planning unit at the Ministry of Health and Wellness is the government's think tank. The right hand of the permanent secretary, they plan, execute, evaluate and assess the services of the ministry. As Dwight Calyxt, the ministry's chief strategic planner. I guess I could start with the history of our department. The department started with three persons, the chief planner, the secretary and the project officer. That was the core of the unit at the time. As the unit grew, it grew to an expanded mandate of the ministry with respect to health reform. It grew from the three to now, I think we have almost 10 persons within the unit. It grew to reflect the different services that are required and the different functions of the ministry. For instance, we have as part of the unit, we have health planner, we have a social planner, we have research officers, we have projects unit and more recently we have added the quality and monitoring evaluation components to the unit. The ministry of health has a very key mandate in terms of protecting the health of the nation. That is our primary mandate. But within that there are many facets. We need to look at policy formulation for the health sector, that's key to the ministry of health. We need to look at monitoring evaluation of our health status because we have to plan and deliver programs with respect to the change in health profile that we have. We have to look at setting the standards because APR to deliver services must be to a particular standard to a particular quality. We also have a clear mandate with respect to informing the public with respect to health education and showing there is a competent and reliable workforce to deliver the health service that we are supposed to. As well as doing the overall, not only in the public sector but the private sector monitoring of that entire health sector. So within that there is this broad mandate that we are charged with and it speaks to ensuring that there is a health sector that could provide efficient, reliable, timely health services to the public. By way of achievement we have been able to, in keeping with the mandate for health sector reform to produce our national strategic plan within which sets out some of the core principles in terms of health service delivery. I'm proud to say that we as a unit from the beginning of every budget year assess the resources given to us within health and we implement the full capital program. We also work with each of the heads to monitor and implement their programs and it's through these programs that we are able to meet those health gains, those positive health outcomes. So whether it is environmental health, whether it is Victoria now, OKEU, whether it is Gruzley or Souffredown in the south, we are the officers that integrate and interface with the heads to ensure that these programs are implemented. So we have some small successes on our belt. The health information system started with a thought with corporate planning and epidemiology. The new national hospital also started with a thought and put it in place the necessary requirements that the EU now accepted and gave us that the biggest gift that they have ever given to any single country within this particular region. So we are the boevers and shakers in the background. We are the ones that sit and work through the night to ensure that these programs are met, these programs are delivered. I know we don't take any accolades, but the team and myself we work very hard to at least achieve those health outcomes. Mr. Calyxt continued by giving a description of the health sector and the overall services provided by the Ministry of Health and Wellness. Preference to the STRAT plan and the services and our core, the delivery of our core set of services. Our STRAT plan has seven core drivers. We have seven core drivers. And with that I will move into the description of how we deliver those services. So we have organization and management. We have sustainable health gains. We are looking at efficiency, cost efficiency and effect in the delivery of services. Information system, infrastructure, quality, these are the core drivers of our health system and all of that is delivered through a core infrastructure. We have at present the three health centers with two general hospitals, both which essentially on its way to completion. We have two district hospitals, that's Denry and Soufere, and we have a polyclinic. So within that infrastructure the Ministry of Health actually delivers its costs as a services, health promotion, education, disease prevention and management, diagnostic services, treatment and management. So when we speak of non-communicable diseases, the treatment and management is delivered through the length and breadth of the island through our wellness centers, through our polyclinic, disease surveillance and outbreak investigation and management, rehabilitative and palliative care. So that speaks to the services, our secondary services delivered through our hospitals and our tertiary institutions and mental health and also to an end point. With respect to our general services, the Ministry of Health is responsible to deliver within the infrastructure that we have for the health sector, we deliver core services like health and education, health promotion, our disease prevention that speaks to environmental health, our Port Health Program. And given the new and emerging infectious diseases, we now deal with Trigongunia, Zika, H1N1, all of these are essential in terms of doing our disease prevention. So environmental becomes very critical in terms of food management, water investigations to ensure that we have good portable water and so on. So very important. We also look at diagnostic services, palliative care and rehabilitative services. These are the core services when we speak of our secondary services and tertiary care that covers services at our millennial health complex which now would house our Owen King, our mental wellness and our end point institutions as well as St. Jude's. Some of these services are now also delivered within our district hospitals which is Sufer and Denver. We also look at treatment and management, pharmaceutical services, disease surveillance and outbreak investigation. All of these are delivered through the length and breadth, through the wellness centers that we have spread across the island. Question. The Strategic Planning Department answers all your needs in the health service, true or false. Answer? False. The Strategic Planning Department plan, execute, evaluate, educate and provide access to health services. They are the government's think-tank. At the Ministry of Health, we have a unit called the Corporate Planning, which is the responsibility to lead the Ministry of Health. The unit is the one that has a goal to play a quality service that the Ministry offers. We also have the responsibility to plan and visit these services in the health sector. The York Achievement Unit Corporate Planning, is the one that has a goal to play a quality service that will lead the people to their health. The Chief Officer of the Health Service, Dwight Kalecks, is the one that has a goal to play a quality service that the Ministry offers. The Chief Officer of the Health Service, Dwight Kalecks, is the one that has a goal to play a quality service that the Ministry offers. The Chief Officer of the Health Service, Dwight Kalecks, is the one that has a goal to play a quality service that the Ministry offers. I am a student of the APFU and I am a teacher. I am also a student of the APFU and I am a teacher. I am also a student of the APFU and I am a teacher. S Unit Corporate Planning is a study program for the Ministry of Health and the Ministry of Health. Yes or No. We are a group of students. St. Lucia's primary healthcare consists of community-based care, immunization and mental health. The St. Lucia National Mental Wellness Centre is a specialized healthcare facility which provides psychiatric care. It is located at the Millennium Heights Medical Complex in Castries. To tell us more about the St. Lucia National Mental Wellness Centre, here is Executive Director Jennifer Forrester. The St. Lucia National Mental Wellness Centre is a tertiary care facility. It is one of the facilities of the New Medical Heights Complex. It was established in 2010 or commissioned in 2010 as part of the National Police's mental health reform. We have 110 beds at this facility and part of which of those 110 beds is specially dedicated to children and adolescents. All of our services are free at the Mental Wellness Centre. The Mental Wellness Centre services are guided by the Mental Health Act of 2001. There is also a current revision of the Mental Health Bill of 2008. This song was passed and acted by Parliament. Currently guided by the Mental Health Hospitals Act of 2001 and in addition, there is a current revision of the bill of 2008. It is under review. It has not been passed and acted by Parliament but this is also an upgrade when it is passed by Parliament to support our Mental Health Act of 2001. The facility was just one component of the Mental Health Reform project which is a national policy. This also encompasses the National Mental Health... sorry, the Mental Health Reform also included legislation. I spoke of the Act of 2001 and also the revision of the bill of 2008. It is also supported by the Mental Health Policy. Moving from Boudreau Hospital into this facility here was really a welcomed and needed additional expansion of mental health services improvement of mental health services where we offer our services in an environment that is user friendly and that patients can be able to be rehabilitated towards providing their part of the society. Our services are all offered free to the general public and what we do here constantly is try to ensure that our services are always improving based upon the data we collect here and also our national statistics. And based upon this there is our information we have recently introduced or at one point introduced a child and adolescent unit for children only. We also recently introduced an in-house dental clinic of all of the services that are free. It is a comprehensive service to the public. We are strengthening our psychological services to the public as well and we also establish a national helpline. This is the 203 helpline that is used. It is manned by 24 hours by trained call responders and this is what we are offering at this facility. I just want to assure the public that our services are confidential and despite the fact that we all know that there is a stigma attached to mental illness we are thus able to strive as much as possible to be professional and to provide care in an environment that is very conducive and supportive towards ensuring that patients are rehabilitated and function in the day to day life. Call the St Lucia National Health Helpline from any phone at any time. The number is 203 and it's free. The helpline provides services for persons having suicidal thoughts or other overwhelming emotions. Question. The St Lucia National Wellness Centre's services are confidential and provides care that is supportive to patients and their families. True or false? Answer, true. Services at the St Lucia National Wellness Centre are confidential and provides care in an environment that is conducive and supportive to patients and their families so that they can all have a better quality of life. Question. The St Lucia National Health Helpline number is 203. True or false? Answer, true. If you have suicidal thoughts or other overwhelming emotions call the St Lucia National Health Helpline by dialing 203 from any phone at any time. The call is free. The St Lucia National Health Helpline is a mental health service that is very important. And for the reasons of the Ministry of Health it is necessary to establish a mental wellness centre that provides psychiatric services. It is a place where people who have problems and are not affected by it are treated well. The mental wellness centre is established in 2010 and it is also where people can work. It is also a place for the government to make changes to their health. It is also a place where people can have a discussion that is especially important for mothers and children. All services that are provided are easy to handle. What is the purpose of this service? The director of the mental wellness centre, Moms and Jennifer Forester, says that the organisation needs to work well to ensure that the services that are provided are met. For example, if you are in a unit with your mother or if you are in a clinic for a certain matter and you also have a helpline, what is your problem is that you have a problem and you have to commit suicide. If you are in a unit with your mother or child and you don't want to be a professional and you don't want to be an assistant, you also have to pay for the service. What is the quality of the service that is provided by the mental wellness centre? A. It is a place for people to work, B. It is a place for people to work. C.Through the helpline with me, there is a place for nothing. The service provided Have you ever felt stressed, anxious or overwhelmed by certain situations? I know I have many times. The Saint-L inspect frontline has been instrumental in listening and helping people to manage their mental wellness. Emotional distress can be extreme at times to the point that people become suicidal. We should not be afraid of or hold on to stigmas about the mental wellness centre. Care is provided by a team of professionals ranging from psychiatrists, clinical counsellors, clinical psychologists, social workers and occupational therapists and they are supported by the nursing team, pharmacists and non-clinical staff. We asked Dr Julius Gilliard to tell me about the services provided and the helpline. We are trying to extend the clinics to Wednesday. So Wednesdays we are trying to start off a child psychiatry clinic, a child and adolescent psychiatry. So the Mondays and Thursdays would continue as the adult psychiatry clinics and the Wednesdays would be specifically for children and adolescents. As well what has been happening is that we've had an improved staffing of the department. So whereas before, when I came here two years ago, it was just three consultants, we now have three junior doctors as well. So the services that we would offer to the persons who come to the clinic as well as persons who are admitted to the units would be improved because they would have more regular visits by the doctors and we now able to discuss cases among ourselves and reach better decisions with regard to patient care. In addition we've had improvement in the psychological department in that we've had another psychologist or clinical psychologist come on board so that the counselling is not only done by two persons and I know before those persons would have been overwhelmed by the workload and now that they've shared a little more and we get a lot of assistance from the counsellor of the helpline who as well shares in the counselling workload that the department experiences on a day-by-day basis. I think the public needs to know that mental illness should not be demonized so we live in the 21st century and whereas before it was demonized and persons were convinced that it was a spiritual thing we are now sure that it is not and there is help so anybody who is experiencing any kind of mental distress and this is what is important so persons who are distressed mentally are those who either seek help or are brought for help by their family members and those persons can be assured that the help is available at the mental wellness centre that we do have staff who are qualified and who are trained to help them with whatever situation they may be encountering so like I said earlier persons who are acutely ill and severely ill who may need admission to hospital if it's a first-time admission they would need to get a referral or clearance from an emergency room or a general doctor then they would come to the centre for admission if that is necessary and we see all kinds of patients from patients who are acutely psychotic to patients who are suicidal and who may be at high risk of attempting suicide or persons who have attempted recently who are still at high risk so those persons can be treated either via the inpatient wards or if the illness is not acute or not severe then they can be seen at the outpatient clinic but the help is available for everybody who needs it it's called the solution national health helpline and it was started in 2015 the government at the time saw the need for the services that are offered by the helpline at the time this suicide rate was between 13 and 15 what happened is that after the helpline was started the rate went down to about 7 and that continued from 2015 until 2017 when the rate went back up to about 12 I'm not sure what was happening at the time but in 2018 the rate went back down to 3 so far this year we've had three suicides three complicated suicides the services that the helpline offers are that somebody who is feeling this stress somebody with a lot of emotional distress would call and the responder would help them with those emotions if they would do an evaluation of the person so if the person is at high risk of suicide then a safety plan would be done up with that person or with a relative of the person or a friend or whoever is close by if that person is not able to be kept safe then advice would be given to the person on the end of the line that they should take the person to the nearest emergency room if that person does not have somebody who is able to do that then the police would be called and that person would be taken to the nearest emergency room for evaluation and if need be they would be brought to the wellness centre for admission and treatment if there is no risk of suicide or low risk of suicide then an appointment would be made for that person to see the helpline counsellor the counsellor would then help the person work on the emotions that they are having at the time and any other issues that they may be going through a lot of the persons who call or persons who are depressed or very anxious or have issues that maybe came up suddenly that are making them feel overwhelmed so those would be worked up with the counsellor and that person would be brought to a better place emotionally before they discharge from counselling the helpline is persons are not as sensitized that they should be to the helpline but it's catching on slowly but surely we have had programs over the last 2-3 years where we are trying to bring the services more to light in the public so for example last year we had an entire week for suicide prevention that's in September 10th last year and that came in with a health fair in the constitution park but members of the public were really taught about suicide and the services that are available in St. Lucia to help them when they have thoughts of suicide or any other distressing thoughts that would put them at risk of attempting suicide Question The St Lucia National Health Helpline is for people with mental health issues True or False? Answer False The St Lucia National Health Helpline is for everyone so whether you are concerned about your wellness mental or otherwise a trained counsellor is available for support and guidance The service is confidential and manned 24 hours by trained call responders The Ministry of Health is helping us to develop a mental wellness system The first St Lucia National Health Helpline is for people with mental health issues to be able to help them to get their own health care for their own wellness The psychiatrist, Dr. Julius Gilead will be the one to tell you about the St Lucia National Health Helpline The St Lucia National Health Helpline is for people with mental health issues the St Lucia National Health Helpline is for people with mental health issues that are not available for them the St Lucia National Health Helpline is for people with mental health issues to be able to help them to get their own health care for their own wellness they can actually do for Work natural health you'll pay with a letter, you'll depress or you'll come and develop anxiety or a lot of malady because they won't allow you to go to a cafe or a cafe for free. But if you appreciate it, you can come and pay with a letter, please. If you have any problem, you'll come and depress or you'll come and develop anxiety or a lot of malady you'll approach a wellness center. For example, if you're a doctor, who are you? If you have any questions, you can answer them. If you're a woman, if you're a young woman or a psychologist or a counselor, I'm referring you to a counselor to deal with your capacity. We have clinics, we have malady, malady and JD. We can try to put a lot of malady, malady, sorry, malady to make you a teenager. So, we can try to put a lot of malady, malady and JD. But as a clinic, we have two young doctors and two young counselors. We have doctors who will help you with your services and your benefits. If you're a counselor, you can refer to your counselor. If you're a woman or a lady, you can refer to your counselor to help you with your services. The Ministry of Health and Wellness provides dental services for everyone, but the ministry also has a surgery specifically for patients of the St. Lucia Mental Wellness Center, where they can receive many procedures like cleanings, fillings and extractions. I asked Dr. Jeanine Dublin McIntyre about the services the unit provides. We do consultations, examinations, cleanings, fillings, extractions. We also give oral health education to the patients and on occasion we go to the unit to help them with their proper tool bushing techniques. I think most of the patients are very eager to have their teeth cleaned, because some of them, because they don't get access to the health centers and you have to pay for the service, they haven't done it in a long time. So, when they have the services provided here, most of them come in and ask, when can they clean the teeth? We say that a lot also, we see quite a bit of extraction because there's a fee and some people don't have that money to pay. They might have something they haven't had in a while to attend to and then when they go to the services, they come and ask if they can get their teeth extracted, they have something pending. When they come in, we either get them through a referral form when they come in as patients, when they are admitted, the doctors see them, they give us a referral and we see them or they come from out and they see the doctor, they give them a referral form to see us. So, they always refer to the doctor before we can attend to them. Generally, people don't see dental care as important as maybe going to a doctor for a general checkup. What we want them to know is that your oral health is the gateway to your overall health. When you need your teeth to chew or food to nourish your body, you need your teeth for your smile to maintain your face structure. You need your teeth to speak clearly. Also, with bad oral hygiene, people are at risk for gum disease, predental disease, chronic disease like diabetes, stroke, heart disease. Pregnant mothers also, if they have bad oral hygiene, it can also be an increased risk for them to have premature babies. So, a person needs to know that going to the dentist regularly is very important, and it's twice a year and you need to make it, put it on your schedule like something they have to do, not just something if you have a pain or something bothering you that you have to go to the dentist. Question. Dental services for patients at the St. Lucia Mental Wellness Centre include cleanings, fillings and extractions. True or false? Answer, true. A fully equipped dental surgery is available at the National Mental Wellness Centre for patients. More services are provided here than a regular health centre. Ministry of Health also reports that a dental service for patients at the St. Lucia Mental Wellness Centre is not an opportunity for joint dental services such as dental care, fillings, and other dental services. You also report your patient's performance at the St. Lucia Mental Wellness Centre. Your dentist at the St. Lucia Mental Wellness Centre, Dr. Jenin Dublin McIntyre, is also available at the St. Lucia Mental Wellness Centre. So, a dental service for patients at the St. Lucia Mental Wellness Centre is not an opportunity for joint dental services such as dental care, fillings and extractions. The primary care department provides health services of a preventative nature promoting health and wellness among the population. Health education and promotion is critical in reducing illnesses and diseases and lessens complications from diseases. Immunisation plays a huge role in reducing diseases and diseases. The primary care department provides health services of a preventative nature Immunisation plays a huge part in preventative care and it's an area that the Ministry of Health and Wellness can boast many achievements. Nurse Julieta Frederick Cassius tells us more. So, the role of community health in service is to be able to coordinate all of the activities within all of the wellness centres on the island. So, we do have 34 wellness centres that provide primary care services. And when we say primary care, so we talk about preventive health, we're talking about working with individuals, families and communities to help them promote their health and also to maintain wellness. So, our focus is not on diseases, but our focus is on promoting and maintaining health within the community. We have done quite a bit of improvement with our services. We have increased certain services that we were not offering before and also strengthened on some services. For example, we have introduced the Diabetic Retinopathy Program. We have been working with the public in terms of increasing ice-creaming throughout the islands. But we have enhanced that programme by including a component of Diabetic Retinopathy. Where all diabetics are going to be screened, they will come into the facility and persons who require laser treatment will be managed accordingly. Also, we have improved in our immunization programme. We have introduced certain new vaccines into our schedule and that has worked very well for us in terms of improving our vaccination coverage and also reducing outbreaks of diseases that can be prevented through vaccines. In addition to that, we have also increased our specialist clinics in terms of obstetrics and gynaecologies. We do have an obstetrician and kind of just one island who goes throughout the wellness centres to be able to provide that kind of care to our pregnant women. Also, we have our pediatric services throughout the islands as well and also in terms of our podiatry. This is one of the services that we have not had for a while but for over a few years we have been able to introduce that service to be able to provide foot care and foot assessments for our diabetics on that island. Overall, with the help of external partners, we have been able to train and retrain our nursing staff and other staff to be able to improve on our services and also include new services into our programme. Also, we don't only work as a nursing team, we work with all the healthcare professionals as a team to be able to coordinate our health activities. So we work with the dental department, we work with the Bureau of Health Education, we work with the nutrition officers. So it's really a team approach out there in the community to be able to provide that kind of level of care to individuals, to families, to communities. Also, we have increased a lot on our outreach programmes. So we realise persons' part of accessing care has kind of shifted. So to increase accessibility, so we actually go out into the communities, we target various groups within the communities to be able to further make available those services to persons who otherwise would not be coming into our facilities. We do provide quite a bit of services in the community at rural health welfare centres and also in the community as well. So we have anti-natal services, we have services for pregnant women, we have for the mother when she delivers, so we care for the child as well. We have pap snares that we offer to our women. Let me just say generally cancer screening because not only for the women, but we also have cancer screening for the men. The men can come into the facility and get screened and we can send in for necessary investigations. We also, over the years, have tried to include our men in our clinics because realise this is one such group that we have not placed a lot of focus on. So we actually have some facilities that do have men programmes targeted for just men. So when we want to encourage the men to come forward and to empower them with information that they can make informed choices about their health. In terms of the public's perception of our services, even when talking to persons within the community, they are not aware of the services, the magnitude of services that we offer in the community and we do provide a wide range of services in the other wellness centres in terms of encouraging persons to promote wellness with themselves of course and with their families. So in terms of the services, persons of the belief that is of a poor quality, which is really not so. Our services are of very high quality and also they are offered by trained, experienced and personal within the community. We do go through refresher courses, we go through training just to be updated and abreast with current trends and in terms of management and care of persons. And that includes persons with chronic diseases that means the pregnant woman, that means the child. So it's a wide range of services that are available in the community and persons need to know what services there are. So we encourage persons to visit the wellness centres. We have a discussion with the staff there to be able to identify what other services are available and the services that are of interest to them and they can take advantage of. Question. Podiatry is available to all and provides foot assessments and care, especially for diabetics. True or false? Answer, true. Podiatry has been reintroduced to provide foot assessments and care, especially for diabetics. The partner Community Nursing Service is the only one who has the ability to approach and facilitate services that can help patients with different diseases to see the health benefits of the population. The partner can also coordinate activities of different populations of diseases. Therefore, it is important for patients with different diseases to have problems with their diseases. The partner also has the ability to educate the people in their communities. The most important thing in the department is the measures to help people with different diseases to get vaccinated. This has been done by a large number of services that can help people with their diseases, such as gynecology services and Pueca services. Additionally, I am also doing a demonstration to visit the communities that have come to the hospital in the 7th place. Are you happy with the achievement of the Community Nursing Service? These services can help people with different diseases to get vaccinated. The Bureau of Health Education's main aim is to influence change in the environment by educating individuals, organisations and society to help improve their understanding of health issues. I asked the Director of Health Education, Natasha Lloyd Felix what role the Bureau of Health Education served in the ministry. Within the Bureau of Health Education what we do is bring health to people. We are very people-centred, people-focused. Essentially, what we bring is heart to health. So we know, typically, health is seen in a very clinical way and the person sometimes feels detached from the messaging. They feel that they are not sufficiently obeyed with issues put into health. So what we try to do through our programming is improve person's understanding of health issues. Whether it be preventative health or person's living with conditions so they know how to better manage their conditions. Our approach is through an ecological model which simply means we look at various levels of intervention. We look at it through the individual, the family, the community. We look at organisations and communities and then we look at the overall structure of society be through policy interventions. And so as a result of that we have a very all-embracing approach to health. We look at health in a way that we can influence change not only for the individual but the environment within which individuals live, individuals work and socialise. So in terms of what we do our programmes are centred within settings. As a result of that you find that our interventions happen in schools, communities, workplaces and as a result of that we target various audiences through our interventions. So though we look at health across the board we realise that issues vary depending on which audience we want to reach or target. Through the department our services are delivered within various settings. Priority settings which would include workplaces, schools, communities and within our health institutions. We reach specific target audiences which would be our school children persons within active employment etc. Because we recognise health issues vary dependent on who it is you want to provide a health message to or deliver health information to. As a result of that what would happen is that our programmes would be aligned to the needs these audiences have. So within a school setting for example we would be given information on healthy eating habits which would be supporting what has happened with the nutrition department with their own interventions. Within the workplace we would look at how we encourage health practices within a working environment and so that persons can adopt healthy habits not only within their homes but within their workplace settings. And by doing that what we find is that we are better able to align programmes to the needs of the audiences we want to reach. So we look at determinants of health so we don't only look at persons current health status but the factors that influence their health and we know there are number of factors that would result in how people's health is manifested. So these would include things like your current status in terms of employment or not being employed. We look at gender factors we look also at resilience issues whether the person is within a setting of family support or not all those come into play and as a result of that we work with a range of agencies not only within the Ministry of Health but outside of it be it other allied government agencies NGOs, community organisations because all of these influence and impact our health outcomes to some degree. Within that we have a number of programmes that we implement one of which I think has been identified as one of our markers of success is the chronic disease self management programme. This programme has been supported through funding from the Pan American Health organisation and has been endorsed by the standard Stanford University and is globally implemented is a standardised programme and St Lucia commenced our programme in 2015. During that time we have been able to train persons to be trainers and implementers of the programme. That programme specifically targets persons living with chronic conditions cancer, diabetes, hypertension etc. as well as their caregivers because we know that chronic disease is a critical issue within St Lucia. Now knowing what I indicated earlier that health promotion and health education looks at improving persons understanding of health issues, that programme is developed especially along those lines that we are looking for persons to understand their health issues and better control their health issues but apart from looking at whatever condition they are diagnosed with we look at the determinants of their health their eating habits, their budgeting we look at things like stress all the factors that would influence health so that way we look not only at living or diagnosed with a condition but factors that influence the condition the determinants of their health so that those persons can better manage and prevent complications of their diagnosis. To date we have done a number of training workshops and we have done it across the island and so we have found that the response over time has been improving because others have been able to indicate the benefits that they have achieved by undergoing the programme which actually runs for 6 weeks. We have had persons who have been able to reduce their dependence on medication for management of their conditions we have had persons who were smokers who have actually been able to quick the habit of smoking persons have reduced alcohol intake so the results have been real tangible results all of which we know can improve health outcomes so it is not only about providing information but also providing skills and that is critical to what our department does it is one thing to have the information but to be able to provide persons with the skill set to manage is what adds the value to what we do so it is not just for persons to be able to know but also for them to be able to do. Question. An ongoing health educator is St. Lucia's chronic disease health management programme which targets people with chronic diseases like cancers, diabetes and hypertension. True or false? Answer True. St. Lucia's successful chronic disease health management programme is a globally implemented programme it looks at factors that influence health like eating habits and stress so that patients are not just living or diagnosed with a condition that can be influenced to better manage and prevent complications of their illnesses. Education Bureau of health education is an opportunity to manage and change people so that they can educate organizations and society to help them to solve problems so that they can deliver conditions so that they can work at school or at work Education Bureau of health education programme chronic disease health management programme is a programme that supports people with chronic diseases like cancer, diabetes and other diseases so that they can live with chronic diseases programme is a programme that supports organizations to help them so that they can do special work on how to manage their patients Education Language Centre Visit your community's places of health and wellness, talk to their staff, learn about the services that interest you and take advantage of them. Many of the services are free. Talk to your staff, if the services you require aren't provided at your local centre, where you can go and in some cases, once a doctor's referral isn't needed, staff at your local centre can make an appointment for you. Men, don't forget there are many services that are developed and provided just for you. The Ministry of Health and Wellness has professional teams with ongoing training. Don't let your assumptions keep you stuck in fear. See you next time when we explore our health service, goodbye.