The State of St. Lucian Healthcare, In-Depth by STAR Publishing

THE STAR Businessweek DECEMBER 29, 2018

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The State of St LuciaN Healthcare, In-Depth By ED Kennedy, STAR Businessweek Correspondent

The end of one year and start of a new one always brings with it new resolutions and plans. To many people in business, common new year goals for the growth of a company or progression in one’s career are often accompanied by very personal ones, like the desire for greater health and happiness in the year ahead. Continued on page 4

AB InBev in cannabis drinks tie-up AB InBev, the world’s largest brewer, is teaming up with Canadian pot company Tilray to research cannabisinfused drinks in the latest sign some of the world’s biggest consumer companies are developing a taste for the drug Page 3

Year in a word: Windrush Britons were appalled at the harassment and wrongful deportation of immigrants Page 7

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CARICOM agrees measures to breathe life into integration process By David Jessop

The two-day meeting looked at increasing the rate of implementation of the CSME and making sure the benefits are available for Community nationals. Pictured, national representatives of CARICOM’s 15-member delegation.

ARICOM heads of government have agreed several measures intended to breathe life into the stalled regional integration process. However, doubts remain whether all member states will implement what was agreed or as they wish, encourage greater citizen support and awareness. Meeting at a specially convened summit held in Port of Spain on 3-4 December, CARICOM Heads of Government issued a declaration intended to enhance free movement and address some of the issues holding back completion of the Caribbean Single Market and Economy (CSME) first agreed in 2006. In their ‘St Ann’s Declaration’ CARICOM heads said that they remained ‘committed to take action at a national level to advance the regional integration agenda’ and were ‘determined to ensure the equitable distribution . . . of the gains realised through the regional integration process’. However, it remains unclear how many states will implement measures of direct relevance to ordinary citizens and businesses relating to the free movement of labour and the mutual recognition of CARICOM companies registered in other member states.

Among the matters on which Caribbean Heads of Government agreed, were to: • Amend the Treaty of Chaguaramas to establish a formalised, structured mechanism to facilitate dialogue between the private sector and labour and CARICOM’s various Councils; • Finalise the regime that permits citizens and companies of the Community to participate in the Public Procurement processes in Member States by 2019; • Deliver the steps necessary to enable the mutual recognition of CARICOM companies across all member states; • Develop appropriate recommendations for a regime of sanctions against member states as allowed for under the Treaty of Chaguaramas; • Move towards full free movement within the next three years between member states ‘so willing’; • Reinforce security mechanisms to enable the safe implementation of the free movement of CARICOM nationals; • Examine the re-introduction of the single domestic space for passengers in the region so that eventually there would be a single security check for direct transit passengers on multi-stop intra-Community flights; • Take steps to deepen cooperation and collaboration between the Secretariats

These are times which cause us not to know which side of the bed we are going to wake up on because of the difficulties related to trade wars and the rise of nationalism in the world today. We have therefore, against that background, to create stability and to be able to create predictability for our citizens wherever possible

of CARICOM and the OECS to avoid duplication and maximise the utility of scarce resources; • Hold a special session on air and maritime transportation at the next CARICOM Heads meeting in February 2019 to focus on how ‘the resolution of issues might contribute to regional integration’; • Establish a restructured high-level Commission on the Economy to advise on a regional growth agenda under the leadership of Professor Avinash Persaud. Speaking to the media at the end of the summit about the decisions reached, Barbados’ Prime Minister Mia Mottley was optimistic, noting that at the meeting there “was the absolute commitment to push past . . . issues, and put progress on the regional project ahead of any division”. “These are times which cause us not to know which side of the bed we are going to wake up on because of the difficulties related to trade wars and the rise of nationalism in the world today. We have therefore, against that background, to create stability and to be able to create predictability for our citizens wherever possible. We hope that by the actions that we have taken today that we have gone a Continued on page 5

Cannabis Industry

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DECEMBER 29, 2018

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AB InBev in cannabis drinks tie-up World’s largest brewer agrees joint venture with US-listed marijuana firm Tilray Alistair Gray and Nicole Bullock in New York

B InBev, the world’s largest brewer, is teaming up with Canadian pot company Tilray to research cannabis-infused drinks in the latest sign some of the world’s biggest consumer companies are developing a taste for the drug. The involvement of the drinks company behind Budweiser in recreational cannabis brings new legitimacy to an industry previously the domain of drugs cartels. Canada became the largest country to completely legalise recreational pot use in October, and several US states, including California, have made similar legal changes. Under the latest partnership, which will be confined to Canada, ABI will work on a joint venture with Tilray in London, Ontario. Each company will invest $50m to research how recreational cannabis drinks might be brought to market, exploring factors including flavouring and the length of the high. In an interview, Tilray chief executive Brendan Kennedy said: “We’re in the middle of a global paradigm shift. We’re seeing an entire industry develop and really transform, transitioning from a state of prohibition to a state of legalisation.” Cannabis legalisation was “disrupting” several industries, including pharmaceuticals as well as alcohol, he added. There was evidence that “cannabis was a substitute in some settings for alcoholic beverages”. “We don’t know how big this will be but what is happening is we are seeing a rapidly emerging industry — at a time when there’s not a lot of global

Beer Brewer AB InBev (NYSE:BUD) has joined the list of the many companies who are exploring the cannabis industry. The world’s largest brewer has established a partnership with Canadian pot firm Tilray Inc. (NASDAQ:TLRY). Each of the two will put in up to $50 million as an investment. In total, they will raise $100 million, which will go towards the study of non-alcoholic beverages containing THC and CBD.

growth available.” Tilray’s tie-up with ABI comes on top of a partnership it announced earlier in the week with the pharma group Novartis to develop medical marijuana. Shares in the company, which floated earlier this year, jumped 17 per cent to $82.80 in after-hours trading on Wednesday, compared with an issue price of $17 each. This month Marlboro cigarettes maker Altria struck a deal to take a stake in Canadian marijuana company Cronos for C$2.4bn. Earlier this year ABI rival Constellation Brands pumped almost $4bn into Canopy Growth, another Canadian pot group, and Aurora Cannabis in May struck a $2bn deal to buy the medical marijuana group MedReleaf. ABI’s involvement will be through its subsidiary Labatt Breweries. Kyle Norrington, president of Labatt Breweries, said in a statement: “We intend to develop a deeper understanding . . . that will guide future decisions about potential commercial opportunities.” Tilray took its place in the history books this year as the first cannabis company to go public in the US, listing on Nasdaq in July. US exchanges are able to list companies so long as their operations are legal in the jurisdiction where they operate. In a sign of investors’ mounting interest in the sector this year, Tilray’s more than quadrupling in value from its offer price makes it the best performing US-listed initial public offering in 2018, according to Dealogic. Shares have been volatile, however. Of the ABI drinks tie-up, Mr Kennedy said: “Decisions around commercialisation will be made at a later date but this was the right way to start.”

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The State of St LuciaN Healthcare, In-Depth Continued from page 1

and greater collection of data to be used in evidence-based policy-making — ultimately need a new examination, given the breadth of criticism levelled. In late September the World Bank announced it would approve US$20 million towards the improvement of Saint Lucia’s public healthcare sector. The provision of funds via the International Development Association was put forward with the specific targets of improving efficiency, accessibility and responsiveness among the nation’s key healthcare services. How this proceeds in the new year will be interesting to observe; also the plans of the Chastanet government for the construction of a new wing at the existing St. Jude hospital complex in Vieux Fort. Expectations of rapid-fire improvements via new infrastructure alone would be shortsighted, but no fair mind can be blind to the simple maths that more beds should equal more care.

Local and Global Benefits The go-again, stop-again St Jude’s reconstruction project has come to epitomize Saint Lucia’s inadequate capacity to deliver satisfactory healthcare to the island’s citizens. According to the government, new work on the hospital is slated to begin in early 2019

Ultimately, health and happiness will always be tied together, and the ability to have the latter will always be informed by the former. But it’s a reality that for much of the past year, observers would have found plenty to be unhappy about when it comes to the state of healthcare in Saint Lucia. Then, news of a new beginning arrived in the later months of the year. So what is the state of Saint Lucia’s healthcare at the end of 2018? And what can we expect for the sector in the year ahead? Let’s look now in-depth.

Saint Lucians in 2019

Saint Lucians will be cheered to know that this island’s residents are living longer. Life expectancy has grown in recent years. Any Saint Lucian boy born in 2018 who has a life of good health can expect to see his 73rd birthday. Any girl can expect to

see beyond that, with a life expectancy of 78 years. While the longer lifespan is certainly good news, the commendable work done by authorities in tackling Saint Lucians’ national health issues surrounding infectious diseases has been replaced by a rise in chronic non-communicable diseases such as heart disease and diabetes. These trends are mirrored among many nations worldwide but treatment for these diseases locally is reliant upon this nation’s healthcare sector exclusively. And within the healthcare sector, where there are literal battles between life and death, it’s been a tough year.

The Road of Recent History

Early to mid-2018 saw the state of Saint Lucian healthcare publicly criticised by the

Saint Lucia Nurses Association, the Vieux Fort Concerned Citizens Coalition for Change (VF4Cs), the Saint Lucia Medical and Dental Association (SLMDA) and the Civil Service Association (CSA). Criticisms were broad and diverse but poor infrastructure and resource allocation — where resources were available — was common. The apparent waiting time of up to four days for a hospital bed proved a lightning rod for critique. The November openings of three upgraded healthcare facilities across the island — in Mon Repos, Desruisseaux and Belle Vue — can be seen as a clear step forward. Nonetheless, these recent months show that the efforts in earlier years to improve administrative healthcare processes nationwide —by decentralising management, integrating multi-level care,

Improvements to the healthcare sector will not only be beneficial to Saint Lucians at home, but also for Saint Lucia’s brand abroad. While Saint Lucia is not alone as a nation that has battled with the notorious Zika and Chikungunya viruses, even one report of an isolated case can cause reputational (and economic) havoc, as would-be travellers to our tourismdependent nation might fear an island-wide outbreak is imminent. In reality, one report does not necessaruly mean that the whole island is affected, but the upgrading of Saint Lucian healthcare offers a two-part benefit. Firstly it provides a path for the more immediate treatment of any cases that arise locally; secondly it projects to the world that the nation’s healthcare sector can be quickly mobilised to rapidly treat any malady encountered while travelling.

Artificial and Actual: The Limitations of Future Tech in Health

Going into 2019 and beyond, global healthcare will continue to advance through

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the greater use of technology. Around the world, many hospitals and healthcare sectors have already began to incorporate emerging technologies into their operations. There is the Artificial Intelligence (A.I.) partnership between University College London Hospitals and the Alan Turing Institute in the United Kingdom, and the Eastern European nation Estonia’s use of blockchain for its e-health national database of medical records. As the capability of tech increases, so too can the expectation that it will play a great role in efficient healthcare services. This notwithstanding, healthcare remains at something of a distance from the immediate benefits that emerging tech offers. Undoubtedly, A.I., blockchain, and similar phenomena can aid in more efficient administration and basic service delivery, but the need for face-to-face interaction between a medical professional and their patient will remain central. This should not deride the good work of technologists, nor dismiss the benefits of future tech, but this sector is one where

reliance on advances of tomorrow to address the problems of today would be especially unfortunate. Certainly, looking ahead is always productive but the only certain fix for the problems of here and now is the work done to address them here and now.

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CARICOM agrees measures to breathe life into integration process Continued from page 2

A Clean Bill of Health

Identifying the right path between improvement of processes and upgrade of infrastructure will be essential, especially with a recognition of the limitations of tech. Those hoping for the medical field to be ‘hacked’ and get a disruptor like Uber or airbnb to come along will likely be waiting a very long time. Like the human body, Saint Lucia’s healthcare sector is complex. Like any other in the world, it has its share of issues and idiosyncrasies. Yet when so many stakeholders level such high criticism, as seen in 2018, it’s clear that many will not lament saying goodbye to 2018, and will welcome an opportunity to begin afresh in 2019 — with a hope that local healthcare will obtain greater fitness.

The Caribbean Community (CARICOM) is a political bloc of twenty Caribbean nations; fifteen member states and five associate members who collectively represent approximately sixteen million citizens

While new and increasingly sophisticated technology like artificial intelligence and telemedicine pose an opportunity to complement healthcare delivery and decrease the costs of healthcare administration, those who believe that new tech is a panacea for the fundamental issues that plague the island’s healthcare sector are sorely mistaken

long way towards giving Caribbean citizens the comfort that their leaders are taking this issue seriously,” Mottley told journalists. However, in the light of statements made earlier in the year about the importance of the meeting, the participation of just 6 out of 14 Heads of Government in the summit suggests that implementation of what was agreed may be slow in coming. Reflecting this at the start of the meeting, Jamaica’s Prime Minister, Andrew Holness, who has been instrumental in focusing attention on the importance of addressing CARICOM’s failings through the commissioning of the Golding report, described as “disappointing” the number of Heads of Government present. Given the pivotal nature of the discussions, he said, “the signal of commitment is, again, less than optimal”. As a result, uncertainty remains about which states will implement and when, not least because no timelines were published as to when the actions proposed were

intended to be delivered: an idea central to the reforms promoted by the CARICOM Review Commission, chaired by Jamaica’s former Prime Minister, Bruce Golding. Following the summit it became clear that other issues not covered by the communique had also been discussed. In the press conference that followed, Prime Minister Motley said that CARICOM leaders had expressed disappointment at the flow of information within the 15-member grouping and had agreed to a working group to examine the situation. The members of the restructured Commission on the Economy advising Member States on Growth are: Chester Humphrey; Damien King; Georgy McGuire; Roger McLean; Wendell Samuel; P B Scott; Therese Turner-Jones; Ngozi OkonjoIweala; and the former WTO Director General, Pascal Lamy. Originally published in CARICOM Insight

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FLOW FILES LAWSUIT AGAINST ECTEL Press Release

t. George’s, Grenada — The telecommunications company FLOW has filed a lawsuit against the Eastern Caribbean Telecommunications Authority (ECTEL), in a bid to revoke the 700-spectrum license granted to the Irish-based company, Digicel. Grenada’s Public Utilities Minister, Gregory Bowen told Parliament Wednesday that the lawsuit also includes the National Telecommunications and Regulatory Commission (NTRC). Bowen did not provide details on the lawsuit, but told legislators that FLOW, which is part of the British-owned Cable & Wireless, one of the leading telecommunications and entertainment providers in the Caribbean and Latin America, is claiming discrimination by the regulatory bodies because both telecommunications companies applied at the same time for the license and only Digicel received the approval. Bowen told Parliament that the licence was granted to the Digicel operations first because it was able to engage in discussion with a smaller telecommunications

ECTEL is the regulatory body for the telecommunications industry in its member states of Dominica, Grenada, Saint Kitts and Nevis, Saint Lucia, and Saint Vincent and The Grenadines. It is made up of three components – A Council of Ministers, a regional Directorate and a National Telecommunications Regulatory Commission (NTRC) in each member state. While FLOW and Digicel represent a duopoly in the Caribbean telecoms market, the lawsuit filed in Grenada is not the first time the two global firms have taken their bitter rivalry to the courts

company in Grenada which operates on the same frequency. “LIME/FLOW/Liberty had a clash with AIsleCom and discussion was encouraged,” said Bowen, adding that Digicel had also been the first to provide an amicable resolution between itself and

the small company. The 700-spectrum licence provides for Digicel to operate its recently launched Long Term Evolution or LTE service. This fourth-generation mobile technology service of Digicel was launched in St Lucia in November, followed by Grenada

in early December, and on Tuesday in St Vincent and the Grenadines. “Matters do take time in the court, but we hope that it will work out amicably,” said Bowen who informed the House that he felt it was important for customers to know about the development.

SAINT LUCIA GOV’T TACKLES BANANA EXPORT DILEMMA

Left to right: Prime Minister Allen Chastanet, Agriculture Minister Ezechiel Joseph, and Herod Stanislas, Member of Parliament for Soufriere/Fond St. Jacques

he government of Saint Lucia is attempting to tackle the dilemma facing banana export to the United Kingdom and is predicting higher production in the first half of 2019, according to a Ministry of Agriculture press release. On Thursday, December 20 Prime Minister Allen Chastanet and Agriculture Minister Ezechiel Joseph, along with his team, met with representatives of the National Fair Trade Organization (NFTO), Banana Productivity Improvement Project, and Winfresh, to discuss the matter. Winfresh had said that prior to Tropical Storm Kirk, it was selling 15,000 boxes of bananas per week to the UK but projection for 2019 falls to 6,000 per week. But Joseph said the market cut is unacceptable, adding that production of the fruit will be very high in the new year. “Moving forward we are seeing that the production will be very high in the first half of next year and the type of figures Winfresh is talking about cannot be accommodated, they have to go out there and get the

markets,” he stated in the news release. “So today the meeting was really to discuss that issue and I am happy they have understood our position as a government, and they will continue to collaborate with the NFTO to satisfy the marketing opportunities that we believe can be explored.” Following the meeting Chastanet said he was content with its outcome. “We’ve had meetings with Winfresh with regards to the statements they made. We don’t share their sentiments and I am very happy to see that whatever misunderstanding was in place, and what they were intended to try and do (which was not really to limit the industry, but certainly they were bringing up a problem in the market), we are satisfied that we have a strategy to resolve that,” he stated in the release. The prime minister said he is currently exploring opportunities in France and other countries which will consequently boost the banana export market. He also called on young farmers to find creative and innovative ways to exploit the entire banana plant rather than just the fruit. “I’m encouraging my young people to start looking at what by-products we can use with bananas, both with bananas itself but also the leaves and stems of the banana tree,” he remarked. “We need to earn money on every component of a banana tree, not just the banana, in order to be competitive, but I know we have the capacity and the innovation to do that in Saint Lucia, and I want to reassure the banana farmers and reassure the public of Saint Lucia that its government stands firm behind the sector,” Chastanet said.

UK Immigration

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Year in a word: Windrush

Britons were appalled at the harassment and wrongful deportation of immigrants By Miranda Green, FT Political Correspondent

INDRUSH: (noun) The ship that carried Caribbean passengers to the UK to fill the postwar labour shortage; recently adopted for a scandal of the same name where these immigrants and their descendants were harassed and removed. Photographs and newsreel footage of the June 1948 arrival of the HMT Empire Windrush at Tilbury docks in Essex show lines of skinny, sharply dressed men sporting hats and jazzy suits, disembarking with their suitcases and talking to reporters about a new life in London. These optimistic arrivals were the first of a wave that continued until 1971, when new laws restricted further immigration but confirmed the right to remain for Commonwealth citizens already living in the UK. These immigrants, and their families, boosted the public sector workforce in highly visible roles and passed into the UK’s national story. At the 2012 London Olympics, a model of the Windrush was borne aloft by actors in the opening ceremony portraying the evolution of modern Britain. This year it emerged that as part of the “hostile environment ” policy, immigration authorities had been wrongly detaining and deporting members of the “Windrush generation” and denying them National Health Service care. Britons were appalled at the callousness of bureaucrats separating the families of fellow citizens.

It is unclear how many people belong to the Windrush generation, since many of those who arrived as children travelled on parents’ passports and never applied for travel documents, but they are thought to be in their thousands

Some of this happened because of documentation destroyed by the Home Office, some because of zealous efforts to hit immigration removals targets. Denying that such targets existed cost Amber Rudd her job as home secretary in April. Her successor Sajid Javid, whose

Britons were appalled at the callousness of bureaucrats separating the families of fellow citizens

parents arrived from Pakistan in the 1960s, claimed recently that public outrage about the Windrush cases demonstrated Britain’s compassionate character. For others, noting that new aspects of the scandal are still being uncovered, the name has become a source of shame.

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DECEMBER 29, 2018

making moves

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Martin Hanna Introduces Penny Pinch! By Claudia Eleibox, STAR Businessweek Correspondent

enny Pinch is an online platform which connects consumers and businesses through coupon marketing. It was founded by Martin Hanna, a nineteen-year-old who is ardent about making his mark in the tech and business landscape on the island. Penny Pinch was in the making for about five months and started its unveiling in September of this year. STAR Businessweek sat down with Hanna to find out what Saint Lucia can expect from Penny Pinch ahead of its early 2019 launch.

now but we’re in the process of teasing it, meaning we’re just in the process of getting it out to the public, letting the public know that this is coming soon. Our website is www.pennypinchslu.com where you can actually visit it right now and sign up for our newsletter. This will allow you to get notified on our launch details and giveaways that we’re having right now.

Will there be any giveaways as part of the launch? Martin: So we’ve collaborated with

thirteen businesses that plan on coming on to the platform and they’re supporting by providing prizes that we’re giving away.

What about the desire for discounts? Martin: In Saint Lucia, whenever a sale

How did the idea of Penny Pinch come about? Martin: The idea came about because

Saint Lucia lacks technology and I myself use these coupon marketing platforms in first world countries, such as Groupon [and] Retailmenot; these already exist for shopping online. So, when I use these platforms, I’m thinking to myself, ‘Why does this not exist in the Caribbean?’ That’s why I had to really develop and plan the idea, in bringing it to the Caribbean, and starting off in Saint Lucia, and then hopefully expand out.

Martin Hanna, Founder of Penny Pinch, is launching his coupon app in early 2019. Sign up for early access at www.pennypinchslu.com

How does Penny Pinch work? Martin: So, the website is completely free

sh s!* a e N cpass I W ent

to use. You head onto the website and there’s basically a catalogue of offers: most popular, new this week, expiring soon, and then you could view coupons by the stores themselves or by categories. So, it’s all organised however you like it. If you want to search for beauty, you’ll see all the stores related to beauty products or services, or if you want to see a coupon under a specific store. On our home page we have the most popular categories so it’s basically a catalogue where a user can select which coupon they want and then, when they select the coupon, it provides them with a coupon code.

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How do you get businesses on board and what type of businesses do you target? Martin: I’ve been targeting the retailers in

Saint Lucia, mainly the high-end ones such as restaurants, clothing, vacation, automotive. I’ve been going to them myself or getting contact information and asking people to meet up to present the idea to them. So far, I’ve been getting some good feedback that the idea is very good. Some say that they’ve actually been waiting for something like this and they’re waiting for it to launch. In terms of the general public, I’ve also gotten good feedback and they also are waiting for this to launch.

Is the website in use? Martin: The website is not live right

comes on, everyone is already heading to it. And coupon marketing works. It’s been proven that coupons, especially when they’re valuable, are very effective in terms of bringing customers in and they would travel a significant distance to redeem these coupons. And even the online industry of coupons works very well. Whenever there are sales online, people tend to use these coupons while they last. Coupons also create urgency. Since a coupon is not forever–lasting, it will bring in people right away to drive in sales.

What sort of coupons should people look forward to? Martin: It all depends on the merchants.

The merchant has the option of picking a percentage or dollar value and they have the options of selecting what the coupon will be available for — whether it be selected items, new arrivals and so on. It’s all very flexible with the merchant to do so.

WILL THIS TAKE OFF in Saint Lucia? Martin: I’m going to say that it’s going

to be hard since it’s going to be something new. I’m hoping to develop a trend so my vision is to really revolutionize the shopping experience in Saint Lucia. And I’m not only limiting myself in Saint Lucia; I’m going to be trying to expand to the entire Caribbean in hopefully a few years.

How do you intend tO DO THAT? Martin: So expanding through the

Caribbean would be a little easier because it would be a website meaning there’s no physical goods that need to be pushed out to the public; its more or less getting the service out to the Caribbean. So I’d probably go to another island, do my market research and see which stores would be interested. The same that I would do here but transfer the knowledge I’ve learnt doing it in Saint Lucia onto another island and I just start to market it into that island.

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