PHILIPSBURG--White and Yellow Cross Foundation (WYCF) official Bregje Boetekees says urgent attention is needed to develop a health care system that is affordable and accessible to all residents of St. Maarten.
She made the comments Wednesday in reaction to statements made by Vice President of St. Maarten Seniors and Pensioners Association, Raymond Jessurun at the United Nations Open-Ended Working Group on Ageing (OEWG) conference in New York recently. At that forum Jessurun highlighted the human rights perspective of persons with dementia in low-and high- income countries.
Boetekees said Jessurun raised some “important points” during the conference. She said too that Jessurun is knowledgeable about different forms of dementia and its presence and impact here in St. Maarten as he is also a member of the St Maarten Alzheimer Foundation (SMAF).
On the issue of care, she said in the Netherlands, more options are available for early diagnoses of dementia. Memory clinics are some of the newer additions to the health care field and the profession of geriatric doctors is becoming more and more important in that ageing society.
“St. Maarten is lagging behind in the sense that for many years we counted ourselves lucky being a young (migrant) society. However, the belief that migrants would return to their country of origin at retirement age is a myth and St. Maarten is ageing at a much more rapid pace than previously believed. This calls for a speed-up in actions from all parties: Government, insurance funds, health care organisations and suppliers and society in general. With ageing percentages doubled over these last few years we need to prepare for the care demands that come along with that,” she said.
She said the Ministry of Health, Labour and Social Affairs VSA is showing keen interest in ageing and its effects, having recently done an elderly survey and ageing conference and indicating support for an expansion of services of the White and Yellow Cross Foundation. She said an example was the construction of a new and larger elderly care home to cater to seniors who can no longer sustain an independent life in St. Maarten.
Social and Health Care Insurance SZV, via the AVBZ fund, is supportive of care for seniors and then especially those afflicted with a form of dementia. Since September 2012 the WYCF opened the first day-care facility in St. Maarten for clients with a psycho-geriatric disorder. “These 16 places in our day-care are fully funded by the AVBZ fund, enabling these clients to remain living at home with their loved ones while receiving therapeutic care during the day.
“Are we lacking important health care, also in comparison to other parts of the Kingdom? Absolutely! We desperately need a residential neurologist on the island, not only for our residents with a form of dementia but also for our high amounts of stroke victims,” she said. “But we do have the Mental Health Foundation with an excellent team of psychologists and psychiatrists who offer testing and diagnostic activities for clients who are suspected of a dementia disorder.”
Furthermore, “a neuropsychologist from Curaçao, Dr. Ebicilio, visits St. Maarten monthly and has his consultation hours at the WYCF for anyone that needs it.”
She said the disparity in health care within the Kingdom is not only present in the negative but also in the positive. “Our nursing home offers better care than some in Holland, where “pajama days” are present due to understaffing and showers are weekly instead of daily. Also, the ratio group leader to client in our Sister Basilia Center is better than in many centres in the Netherlands that cater to clients with an intellectual handicap.
“These examples of high quality care are often overlooked when comparison is made with health care elsewhere,” Boetekees said.
Boetekees said urgent attention is needed to develop a health care system that is “affordable and accessible to all residents of St. Maarten. Coverage of high quality offered here locally by the dedicated health care organizations and suppliers that we have. Monies spent on overseas health care referrals, if invested locally in our own hospital and other facilities, can result in quality health care for all.”
In his presentation in New York, Jessurun exemplified the vast difference in diagnosis and treatment of two patients based on location. He said for the last 15 years seniors’ organisations in the Dutch Caribbean, such as the St. Maarten Seniors and Pensioners Association have been protesting the inequality in the health care infrastructure and the health care quality in the Kingdom of the Netherlands as human rights violations.
He is of the opinion that access to an adequate health care infrastructure should be equal to all in all territories of the State. For quite some years now the Netherlands has had one of the best health care systems of the world.
“Persons with suspected dementia in the European part of the Kingdom of the Netherlands are diagnosed in general by neurologists and geriatricians in memory clinics, assisted by geriatric nurses and/or psychologists. These specialised memory clinics have specific diagnostic equipment. In St. Maarten there is no neurologist, no geriatrician, no neuropsychologist, no specialised memory clinic, and also there is none in any of the six islands of the Dutch Caribbean,” he noted.
He added that “globally eight out of 10 persons with a suspected dementia condition are not realising their right to health. As representative of Alzheimer’s Disease International (ADI), I can inform you that in the high-income countries six out of 10 persons with dementia (61 per cent) have not yet received a diagnosis.”
“But in the lower and middle-income countries the figures are worse: nine out of 10 persons with dementia (90 per cent) have not received a diagnosis,” citing the organisation’s World Alzheimer Report 2011. “Are these just differences or is this a structural violation of their right to health? Is not this lack of a proper diagnosis affecting or violating their right to an adequate standard of living and other human rights as well as the social and economic development of their families and their society?” he asked.
His suggestions at the forum include: “to use the Inter-American Convention on the Protection of the Rights of Older Persons as draft International Convention on the Protection of the Rights of Older Persons. To put the gaps and possible ways to repair legislation in human rights instruments which are affecting older persons and those with dementia, in particular, on the agenda of the seventh OEWGA to be included in a binding International Convention that protects rights of all older persons and their families.”
He also suggests “reviewing and adjusting the adequacy or the lack of sanctions in international public law and in international human rights politics to get states to comply and respect older persons’ rights.”
“To review and adjust international cooperation between states and to further elaborate on reparations to finance the right to development and the realization of all human rights in low and middle income countries; to charge an expert group with the task to ‘inventorise’ the gaps in international, public legislation and to propose how to eliminate these gaps, to guarantee that human rights of all, especially of older persons and the persons with dementia in the low- and middle-income countries will be adequately protected against violations.”
He later offered suggestions and urged the recognition and importance of dementia, calling it “the epidemic of this century,” with figures of those affected set to triple by 2050 (citing The Global Impact of Dementia 2013–2050 by ADI) and impacting society’s collective right to development.
