Rodriguez, OD, PhD, MPH, associate professor at Inter American University of Puerto Rico School of Optometry, and colleagues wrote. “The previously mentioned factors are believed to increase a child’s

Santo Domingo.- The Ministry of Public Health (MSP) has taken proactive steps by activating its National Contingency Plan to mitigate the potential impact of tropical storm Franklin, anticipated for Tuesday, August 22, as forecasted by the National Meteorological Office (ONAMET).

Leading a coordination meeting with vice ministers and directors of the institution, Minister of Health, Dr. Daniel Rivera, instructed the Rapid Response Teams to initiate actions in line with the “Assessment of Damages and Analysis of Health Needs in Emergency Situations (EDAN-Salud).” This collaboration takes place in coordination with the Emergency Operations Center (COE).

Dr. Rivera emphasized the paramount importance of safeguarding the public’s health. He urged all personnel to be ready to respond to any emerging emergency situations arising from the impending weather phenomenon, as indicated by meteorological predictions. Preventing disease transmission is crucial, as episodes such as diarrhea, dengue fever, malaria, and other ailments tend to escalate during hurricane season and heavy rainfall periods. The implementation of effective health measures can mitigate the potential consequences.

Dr. Gina Estrella, Director of Risk Management and Disaster Care, noted that the Ministry of Health has been in a continuous session due to the looming threat of the storm. This state of readiness extends to both headquarters and Provincial Directorates and Health Areas. Dr. Estrella called upon local authorities to take appropriate actions to ensure the well-being and safety of residents in their jurisdictions. Special attention is given to provinces under alert, particularly Pedernales and Dajabón, where the storm’s impact is expected to be most pronounced.

Assured provision of medicines, supplies, and necessary resources is a priority for the Ministry to effectively assist those in need during the crisis.

Key actions include:

– Activation of the COE-Health in a continuous session.
– Ongoing monitoring from the Situation Room of the Directorate of Risk Management and Disaster Assistance.
– Activation of Provincial Health Committees, integration of Provincial and Municipal COEs, and response plan activation for hospitals in respective jurisdictions.
– Evaluation of temporary shelters identified by Civil Defense for authorization.
– Inventory of available resources for response needs.
– Activation of local rapid response teams.

The Ministry of Health underscores the importance of preventive measures during the rainy season. In particular, increased occurrences of acute respiratory diseases, epidemics, and the potential spread of diseases like dengue, leptospirosis, acute diarrheal disease, Covid-19, and others. Precautionary steps include practicing permanent hand washing, ensuring the safety of drinking water, maintaining hygienic practices for food and utensils, using tissues when sneezing, protecting vulnerable groups, and being equipped with necessary medications.

The Emergency Operations Center has placed the entire country under alert. The southern coast is on red alert, the central region and extreme east are on yellow alert, and the north and northeast coasts are on green alert. The forecast anticipates heavy rainfall across the nation due to the direct impact of the storm.

Santo Domingo.- Elías Matos, a deputy representing Constituency One of the National District for the Modern Revolutionary Party (PRM), highlighted on Monday that the Dominican Government has initiated the process of acquiring the land previously occupied by the Maharishi school. This land is being considered for the construction of a much-needed major hospital, especially in the southern region of the capital.

Matos specified that he has been advocating for the establishment of a large hospital to serve the sectors in the southern part of Constituency One and the entire National District since September 2020.

“We have received information that the Dominican Government has begun the necessary steps to acquire the land of the old Maharishi College,” stated the legislator. He also mentioned that the premises encompass an area of over 50,000 square meters, which could be repurposed for this purpose.

The legislator, who aligns with the ruling party, emphasized his commitment to the concept of creating a comprehensive hospital in Constituency One. He envisioned a hospital with specialized units such as geriatrics, pediatrics, traumatology, and a burn unit, among other healthcare specialties.

Matos expressed confidence that the Dominican Government will heed the voices of the citizens who are eager for a high-quality and accessible healthcare service. He noted that the hospital’s strategic location would help alleviate congestion in other healthcare centers and expedite assistance from the National Emergency and Security System 9-1-1.

Elías Matos acknowledged President Luis Abinader’s responsiveness to the needs of the people and expressed optimism that an official announcement regarding the construction of the major hospital in the southern part of the National District will be forthcoming in the upcoming days.

It is worth noting that on September 18, 2020, Deputy Elías Matos, representing Constituency One of the National District for the Modern Revolutionary Party, submitted a draft resolution through the General Legislative Secretariat of the Chamber of Deputies. In the resolution, he urged President Luis Abinader to consider the construction of a general hospital in the Miramar sector, located at kilometer 8 of Independencia Avenue.

In his address, the deputy highlighted that the population in the sectors of the National District exceeds 315,000 people, with a population density approaching 8,000 inhabitants per square kilometer. He emphasized the need for a general hospital in this area to alleviate pressure on other healthcare centers in the city, particularly within the coastal strip between the 30 de Mayo highway and the Sánchez highway, which accommodates around 200,000 residents.

They stated that during the 6th International Congress on Health Tourism, a private investment breakfast will be held in conjunction with the financial sector. New ventures in this booming niche market will be presented, providing the country with thousands of jobs and innovative medical technologies and services.

Cambiaso said that the congress will be held on November 1 and 2 of this year at the JW Marriott Hotel in Santo Domingo and will feature multiple innovations and business opportunities, highlighting, above all, the talent of the Dominican medical class and its achievements, according to the program Esta Noche Mariasela.

Amelia Reyes Mora said the event will be a meeting point for multi-sector leaders. The country will be projected as a health and investment destination, promoting international accreditations and the projection of Dominican medicine.

It is noted that the DR is the leading destination for medical tourism in the Caribbean, number 2 in Latin America, and number 19 in the world, according to the Medical Tourism Index.

(CMC) – The Trinidad-based Caribbean Public Health Agency (CARPHA) says regional countries need to take adequate steps to prevent the trans-boundary spread of infectious diseases, describing it as a threat to regional and global health security.

CARPHA held a two-day conference in Trinidad and Tobago last week to discuss the devastating impact of the COVID-19 pandemic and other public health concerns, reiterating the necessity for regional and global health security to protect and improve health.

It said that Regional Health Security (RHS) encompasses the capacities required for the Caribbean to prepare for and respond to public health threats, risks, priority issues and concerns that transcend national boundaries and potentially impact on economic stability, trade, tourism, and access to goods and services in the region.

“RHS offers a coordinated approach which is especially crucial in the Caribbean as the region, like the Pacific and African small island developing states, is characterised by small, under-resourced populations and varying surveillance, laboratory and human resource capacities,” CARPHA said.

“It is also highly interconnected with porous borders, heavily reliant on tourism, and susceptible to climate change and disasters.”

The agency noted that this combination of factors significantly increases the region’s exposure and vulnerability to disease spread, enabling rapid spread of highly transmissible communicable diseases.

Furthermore, the tropical climate, and abundance of competent vectors make the region particularly vulnerable to vector-borne disease outbreaks.

“Consequently, regional health security and prevention, preparedness and response to public health emergencies need to be improved not only at the national levels, but at the regional level, as functional regional capacities are greater than the sum of the capacities of individual countries for improving RHS in the Caribbean,” CARPHA said.

“The major outcomes of this meeting include the detailing and prioritisation of member states’ current needs, increased awareness of CARPHA’s integrated surveillance and capacity building work and strengthening partnerships. These elements will assist in developing the sustainable RHS Pathway in short order.”

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Efficient
pre-hospital care plays a critical role in saving the lives of people experiencing medical emergencies.

In cardiac and respiratory emergencies, the focus is on performing early cardiopulmonary resuscitation (CPR), defibrillation, in field diagnostics (ECG telemetry), initiation of treatment (aspirin, nitrates) as per protocol, and rapid transport to hospitals with capabilities of treating with cardiac emergencies.

The above-mentioned are the ideal scenarios, but in resource-challenged environments such as ours, these ideals remain only aspirational.

The chain of survival is a conceptual framework in the Emergency Cardiac Care community that outlines a series of six vital steps that are necessary to maximise a person's chances of survival during cardiac arrest.

Let us assess the readiness of Jamaica to provide the chain of survival for victims of cardiac arrest.

Link 1. Activation of the emergency response

Early recognition and activation of the prehospital emergency response is the first link in the chain of survival. Currently there is limited public awareness about recognising cardiac arrest symptoms. As a result, delays in seeking medical help are very common, thus hampering the effectiveness of this link.

Link 2. High-quality CPR

The immediate initiation of bystander CPR is essential for the success of any emergency medical response for cardiac arrest. In Jamaica, bystander CPR rates are dismally low due to limited knowledge and training among the general population. Reluctance to perform CPR may also be influenced by cultural factors and the fear of doing harm.

Over the past two decades the Heart Foundation of Jamaica has been an advocate for layperson CPR training as well as providing training for both prehospital and in-hospital medical responders. However, greater efforts are required to educate citizens about performing CPR, and to dispel the fears of people who may be willing to learn.

Link 3. Early defibrillation

This link speaks to the early use of automated external defibrillators (AEDs) on patients who are in cardiac arrest. It is used to deliver a "shock' to the patient. This is the only treatment for patients who are in cardiac arrest due to the lethal cardiac rhythms of ventricular fibrillation or ventricular tachycardia.

The availability of AEDs in public spaces is very limited. This may be due to two factors — cost and absence of legislation. The need for public access defibrillation is a cornerstone of the thrust to strengthen the chain of survival.

Link 4. Early advanced care

Prehospital Emergency Medical Care in Jamaica currently has two operational systems. There is a formal Ministry of Health and Wellness (MOHW)/Ministry of Local Government and Community Development (MLG & CD) emergency medical service. This service is manned by emergency medical technicians (EMTs), from the fire brigade-trained to the basic EMT level. This emergency medical service (EMS) operates in the parishes of Westmoreland, St James, Trelawny, and St Catherine.

The other system is that of private EMS operators. These private services operate in all parishes and provide a greatly needed service, although, operationally, they are largely unregulated. Great strides have been made over the years in training emergency room staff in basic and advanced life support, but there are still resource issues in our emergency rooms, which mitigate against offering patients the full level of care that is routinely available in places with more resources.

Link 5. Integrated post-cardiac arrest care

All patients who have achieved return of spontaneous circulation (ROSC) require admission to an intensive care unit (ICU). This high level of care is required because the underlying cause of the cardiac arrest often still exists, and the patient is at great risk of going back into cardiac arrest. The Jamaican reality is that there are simply not enough ICU beds available for the population.

Link 6. Recovery

The sixth link is recovery. It focuses on the need for continued treatment and rehabilitation of cardiac arrest survivors. It also focuses on the families and caregivers of the survivors.

Critical concepts for recovery include:

• Comprehensive post-cardiac arrest discharge planning for survivors and their families and caregivers. This includes medical follow-up and rehabilitative treatment. Advice on return to activity and work and management of these expectations.

• Assessment and treatment of the cardiopulmonary, neurologic, and cognitive impairments that often affect cardiac arrest survivors.

• Assessment and treatment of the many psychiatric ailments which beset near-death experiences. These include anxiety, depression, post-traumatic stress, and chronic fatigue.

Unfortunately, there is little or no focus on this very important sixth link.

Recommendations

To enhance Jamaica's readiness in providing the chain of survival, the following strategies are suggested.

1. Initiate State-funded public education programmes about recognising the symptoms of cardiac arrest and the steps in performing CPR

2. Create cardiac-ready communities. This involves the establishment of communities that meet the criteria for having:

*Laypersons trained in CPR. Free CPR training to communities empowers the citizens to provide immediate help in emergencies.

*Public access to AEDs. Increasing the availability and deployment of AEDs in public spaces, workplaces, and transportation centres can decrease the time to defibrillation.

*Blood pressure, cholesterol, and diabetic screenings. Identifies groups at higher risk of cardiac arrest. Allows for intervention.

*A functional EMS. Ensures timely and effective prehospital care and transport.

*Investment in road infrastructure. Improving road networks and addressing traffic congestion can facilitate faster EMS response.

*A properly equipped and staffed emergency room in the local hospital.

While Jamaica has invested in its health-care professionals with an emphasis on training and the existence of public and private EMS, there are significant challenges that impede its readiness to provide all the links in the chain of survival. A chain is as strong as its weakest link; therefore, the thrust must be to strengthen all the links.

By addressing the recognised issues of public awareness, CPR training, AED availability, and resource allocation, Jamaica can strengthen its pre-hospital, in-hospital, and post-hospital care, and contribute to a more robust chain of survival.

CPR week is being observed in Jamaica from August 21-24.

Dr Hugh Wong DM (Emergency Medicine) is the director of emergency cardiac care at the Heart Foundation of Jamaica. He can be contacted at hmarkwong@gmail.com

The meeting, led by the Pan American Health Organization (PAHO), comes as some countries in the region face large-scale outbreaks of dengue and intense circulation of chikungunya.

Members, which are made up of 35 national laboratories from across the region, technical advisors, and World Health Organisation (WHO) collaborating centres, will review ways to expand genomic and entomovirological surveillance to major arboviruses.

"At least nine arboviruses with public health impact — such as dengue, zika, chikungunya, and yellow fever — are circulating in Latin America and the Caribbean, so strengthening and expanding laboratory detection and surveillance capacities are key to ensuring a timely response to outbreaks and epidemics," Sylvain Aldighieri, deputy director of PAHO's Department of Health Emergencies, said.

Arboviruses are transmitted by the bite of arthropods (mosquitoes and ticks, among others). From the beginning of 2023 until the end of July, more than 3 million new dengue infections and more than 324,000 cases of chikungunya were reported in the Americas. With 27,000 cases across the region in the same period, Zika has a lower incidence rate, while sporadic cases of yellow fever represent a permanent risk of re-emergence of this potentially lethal disease.

"The epidemiological picture of arboviruses in the region is highly complex due to the epidemic potential of these diseases," José Luis San Martín, PAHO regional advisor on arboviral diseases, warned. "We must carry out an integrated prevention and control strategy that uses new innovations to closely monitor these viruses in laboratories," he added.

During the COVID-19 pandemic, genomic surveillance of SARS-CoV-2 proved key to understanding the virus, its variants, and advising public policy to prevent and control of the disease.

In the past years, investment and international cooperation have strengthened Arbovirus Diagnosis Laboratory Network of the Americas (RELDA) laboratories, and now at least eight countries in the region have introduced genomic sequencing within the framework of PAHO's Regional Strategy for Genomic Surveillance.

Many countries are taking advantage of these capacities and have started sequencing dengue, yellow fever, chikungunya, and other viruses, some for the first time. With RELDA's support, laboratories can expand this surveillance to find out the genomes of arboviruses circulating in their territory, their dispersion patterns, and analyse whether mutations are associated with greater transmissibility or severity.

For María Alejandra Morales, director of the PAHO/WHO Collaborating Centre on Viral Haemorrhagic Fevers and Arboviruses, National Institute of Human Viral Diseases (INEVH) in Argentina, "RELDA has a key role to play in the strengthening, growth, and continuous improvement of the laboratory component as part of an integrated management strategy for arboviruses."

Morales, who is currently the RELDA coordinator, also believes the expanded work of the laboratories with virological, serological, and molecular tests "will make it possible to generate timely and quality information for decision-making that can contribute to the prevention and control of arboviruses".

During the meeting, experts also discussed the status of entomovirological surveillance in the region, that is, the detection of viruses in mosquitoes before they reach humans. This type of surveillance, already conducted in some countries, can serve as an early warning system to anticipate arbovirus outbreaks or epidemics and allow for a more timely response.

PAHO began promoting entomovirological surveillance in 2017 and created the Entomo-Virological Laboratory Network (RELEVA), which currently includes laboratories in 14 countries. At the meeting, guidelines for this surveillance were presented and discussed. Laboratories in the network are also working on a plan for their implementation and plan to create a comprehensive arbovirus surveillance platform that includes mosquito surveillance data.

RELDA, which celebrates its 15th anniversary this year, is composed of 40 laboratories, technical advisors, and WHO collaborating centres, and is the operational arm of the laboratory component of PAHO's Integrated Management Strategy for Arboviral Disease Prevention and Control (known as IMS-arbovirus). Its main objective is to ensure efficient laboratory surveillance and a robust installed capacity to respond to arbovirus outbreaks and epidemics.

View the full post Minister actions on housing conditions in Mangrove, Carriacou on NOW Grenada.

Santo Domingo.- Santiago Hazim, the Executive Director of the National Health Insurance (Senasa), has confidently declared that the Dominican Republic boasts the most outstanding healthcare system across Latin America and even extends its influence into parts of North America.

This assertion is firmly grounded in the nation’s achievement of universalizing its healthcare system. Notably, the country’s coverage encompasses expenses up to two million pesos for an array of ailments, treatments, and essential medical procedures.

In a recent interview on the Despierta program with CDN, Hazim bolstered his claim by highlighting the extraordinary scope provided by the Dominican health system. He emphasized that this coverage extends to high-cost illnesses like cancer, organ transplants, chemotherapy, intricate surgeries, and neurosurgery.

Furthermore, this comprehensive coverage has yielded tranquility for patients, assuring them protection against various medical conditions, encompassing dialysis and other pathologies. This level of security, Hazim emphasized, is even absent in the United States.

Hazim contrasted the Dominican and American healthcare systems, revealing that in the United States, patients often grapple with substantial hurdles involving costs and prolonged waiting periods for medical care. Conversely, the Dominican health system ensures prompt and accessible care.

Dr. Hazim acknowledged that despite these commendable strides, the Dominican healthcare system still contends with deficiencies. Specifically, he mentioned the need to enhance imaging capabilities, such as X-ray equipment, 3D CT scans, and MRIs. He attributed these shortcomings to a cultural inclination and proximity to the United States, which fosters familiarity with cutting-edge medical technologies and advancements.

He further illustrated the situation, stating that the capacity for expanded coverage requires deliberation. Senasa, for instance, cannot unilaterally decide to cover laparoscopic surgery; an actuarial study by Sisalril (Superintendence of Health and Occupational Risks) is imperative to ascertain the frequency of such surgeries in the country, their costs at different facilities, and subsequently determine an average allocation for each ARS.

In closing, Hazim underlined the paramount importance of upholding the stability of social security and the healthcare system within the nation.