Towards health and well-being of the people of the nation.

Dear Editor,

Country Sint Maarten is a dynamic country which has enjoyed economic growth for more than four decades. It has been said at the international level, that the level of overall health achieved is an indication of the success of a country.

A healthy nation is a productive nation. Good health allows people to enjoy a productive and meaningful life – quality of life. Good health contributes to the prosperity of the nation – health is wealth.

Prime Minister of Grenada Hon. Tillman Thomas once said, "The Caribbean is the Region of the Americas worst affected by the epidemic of chronic disease. The human and economic cost burden of these conditions is not sustainable and could undermine the development of these small, fragile countries."

The prime minister is indeed correct; Non-communicable Chronic Diseases (NCDs) are heart disease, stroke, diabetes, cancer and chronic lung disease. The risk factors coming out of these are raised blood sugar; raised blood pressure; overweight/obesity; and abnormal lung function.

The common risk factors are an unhealthy diet, tobacco and alcohol use, physical inactivity, air pollution and heredity (family history of a particular disease).

In 2002, the 26th Pan American Sanitary Conference recognized NCDs as the greatest cause of premature death and morbidity in Latin America and the Caribbean. According to the Pan American Health Organization (PAHO), Caribbean countries are at a critical juncture, and the evidence is clear and the time has come for comprehensive and integrated action to reverse this deadly epidemic.

According to PAHO chronic diseases have not received the priority in public health policies and programs commensurate with their disease burden in this Region. There are clear evidence and cost-effective interventions available to prevent premature deaths from chronic disease. The PAHO says it is time to act to prevent the further loss of millions of lives and damage to economies.

The economics of a country goes hand-in-hand with public health. Social inequalities such as unemployment, social isolation, poverty, low self-esteem, feeling powerlessness for women can lead to heart disease, stroke, diabetes, cancer, and chronic lung disease according to the Caribbean Public Health Agency.

Chronic diseases are the leading causes of death for both women and men throughout the world. Infectious diseases is what killed our ancestors, chronic non-communicable diseases are mainly behaviour related or lifestyle.

Every country needs a "Country Health Plan." Such a plan would include health services delivery, governance and financing, health awareness and healthy lifestyle and empowerment of the individual and community to be responsible for own health.

Efforts are underway to make country Sint Maarten's national health system responsive and providing quality health care, and ensuring universal coverage for health care needs of the people. Talks have been held about the expansion of the St. Maarten Medical Center (SMMC) which should start some time in 2014 along with further improvement in the quality of care.

As a country, our human resources is an asset, however health is a national asset and must be given the highest priority at all times. A healthy nation is not only the responsibility of the Government and the business community, health is a personal responsibility of every citizen. Addressing the challenges of becoming a healthier nation lies with citizens and Government. Government cannot do it alone. Progress in dealing with public health concerns is only possible if everyone commits to the same goals.

Small island nations like ours are facing major decisions on how to finance public health in the future based on the worrying trends. In order to finance the public health needs of a country, a strategic plan would be necessary. Such a plan should also take into consideration medical tourism and what benefits that would bring for the population of an island.

An analysis of our health care system would show strengths and weaknesses; it would show a growing epidemic in NDCs and the burden on health services; shifting needs, demands and expectations among the population; along with rising healthcare costs.

Country Sint Maarten will need to think outside of the box and explore new strategies for further improving the performance of the health system in order to ensure that the new challenges and demands of the population are met.

A pioneering feature is the involvement of all sectors in improving health care and a commitment for developing broad partnerships within and outside the health sector in order to truly address the health and well-being of the people of the nation.

Roddy Heyliger