If you don't go there and spread the word and know that there are doctors here, who can
train our doctors to give us the same kind of healthcare as going abroad because more
than perhaps 70% of the people cannot afford to go anywhere.
If Glenn wasn't working where he was working and myself and we didn't have our
little insurance to cover his bills what would have been our position?
We would not have been able to do anything, do you understand?
We would not be here today.
Johns Hopkins Medicine has a wonderful legacy and a great history
- it actually started late in the 19th century when a very prominent Baltimore
businessman, Mr. Johns Hopkins, donated $7 million to begin a medical school and a hospital.
His name really was Johns Hopkins. He was given the name of his maternal
grandmother as his given name and Hopkins is the family name that still remains.
So part of the organization to which he left his money is now Johns Hopkins
Medicine where we bring together the healthcare system as well as school medicine.
It's that joining that allows us to provide a full range of programs,
of educational programs and research to help improve healthcare.
It was in 2006 the then Minister of Finance who was the Prime Minister asked
me to serve on an executive committee which involved the Johns Hopkins Medicine International.
So we have the genetics. So we have a population that
hypertension-diabetes is a part of what we have, background so we knew that.
But we also have adopted the sedentary lifestyle, etcetera and there's a huge impact.
I don't know the actual percentage but I would guess 80% of
cardiac patients in Trinidad simply can't afford private care.
Before the government paid for cardiac services in the public sector, a patient
who needed valve surgery for example, either they had the money and they got the
surgery or they didn't have the money and they didn't get the surgery and that was
the end of it, there were no other options.
So now there is a public service, we just need more staff because we can't keep up
with the work load, but the bulk of the need is in the public sector and these
patients just can't access the private sector.
From a Hopkins' perspective the biggest attraction for us was that it would really
be a multi-pronged approach to help meet the objectives.
We would be training healthcare providers, nurses, paraprofessionals,
and doctors as well as working directly with patients and their families to help
educate them.
I always knew that I wanted to go pursue my Masters, I just didn't know where
and so since they had a program here and it was in relation to the TTHSI Program I
said "Hey, why not?" and so I did apply.
The decision was really made that although a full time program would be good to have
eventually the most immediate need was for an executive style program that would be
designed in a way that would accommodate working professionals.
Most of my classmates at least they're managers, lead technicians, what have you
so they're in positions, leadership positions and so the program allows them
to kind of understand their job better and to improve it and to also change just
systems step by step.
Glenn's condition did not allow us to have any sort of treatment very near other than medication.
There was no doctor that was available to do any sort of surgery on him which was
a total shock to me.
Baltimore area which has approximately the same population has somewhere in the
neighborhood of 250 cardiologists. When I finished internship in 2005 there
was only one cardiologist in the public sector.
So the fellowship program we did look at was because we found that we didn't have
specialized training in cardiology within the country so therefore the development
of a fellowship training program was essential because the people who were
specializing in cardiology went to America predominantly but of course they stayed
and there was no obligation for them to come back.
So therefore the development of a training program which was tailor made for
the Caribbean and for Trinidad in particular was of paramount importance.
But training here will allow everything to flow seamlessly from training into service
and it will suit everybody's desires. Just being part of the first ever
initiative I think even for Johns Hopkins this is the first time they've had
a fellowship training program outside of America where they were able to issue
certificates to fellows so just being part of the first group is very exciting.
I was at a meeting in San Fernando General Hospital, really the largest hospital I
think in Trinidad and Tobago which was walking down the hall and saw a sign over
a ward "Cardiac Unit" ,hadn't been one before, extremely satisfying to see
that the impact has been immediate.
For blood tests before, before the equipment, this new equipment came in we
used to have to wait like three months because every three months we come see the
doctor to get our results.
Sometimes you come the lab broke down, they didn't get the result also too,
they didn't get the blood results to be done, then you have to take back blood again
then get another result.
Very interestingly I spoke to a physician who was doing her internal medicine
rotation in Miami, I spoke to her over the weekend, and she said that in her clinics
in Miami Jackson Memorial she would have about eight to ten patients per clinic
and now the fact is some of our clinicians are having to see maybe 30, 40, or even 50
patients in one clinic, that's a four or five hour clinic.
Now it's impossible to deliver a high quality of care with that kind of
doctor-patient ratio.
The elements of our program include building professional capacity,
improving the delivery of first class diabetes care, and providing certain special services
related to the detection of complications of diabetes.
Most of my role in this job was helping implement Johns Hopkins' program
and making sure we are offering point of care and explaining the results and supporting
not only the patients but other clinicians like the nurses or making sure the
doctor's aware that we've done these tests and this patient needs to be seen
and making sure the patient is seen in a shorter pace of time than for them to
return in three months which is normally‬ ‪the case.
When I joined the TTHSI program Nancy Allen trained me to use the machines that
we use, the DCA Vantage Machine and the Cholestech machine to test cholesterol.
We went through a step by step process taking the patient's blood using the
cartridges, analyzing the data, and interpreting the data to the patient.
Now that they have the new machine we get the result right away.
The people who are working right now are educated more about how to change a lifestyle.
We've always maybe for the last 20 years we have known that we have had a major
problem with diabetes but I think with the outreach program the profile of diabetes
and the diabetes care has been raised and I think patients are becoming more aware
of the need to look after themselves.
At Johns Hopkins we're very proud to have been an important part of the Trinidad
and Tobago Health Sciences Initiative.
I would like to say that it's been an excellent collaboration.
I personally feel that what I loved about it - people might have rumbled and they
say "Why are you bringing in a foreign entity?" but nobody ever did that in the
past, nobody had the time to take on the education.
A fellowship program, we can do it, they said. Why hasn't it been done?
Everybody's busy with their practice, doing this, doing that.
You came and you said ok and you did the job.
Johns Hopkins has been fantastic and my only regret is they couldn't be here
a little bit longer. I think if they had another two years
and had to train another five or even more cardiologists it would have been that much better.