Last Sunday I wrote about joining in the celebration of the success of 48 young doctors passing the final medical exams of the University of the West Indies, at the Cave Hill Campus / Queen Elizabeth Hospital. I commented that the role of the UWI’s Faculty of Medical Sciences in producing well educated doctors for Barbados and the Eastern Caribbean is very much taken for granted, but that it’s critical to recognise how important this achievement is, and the potential it creates for our development and prosperity. And I emphasised that their education was specifically tailored to the needs of our Caribbean people in our Caribbean environment, with prime focus on our most common and important problems, and on the clinical skills needed to avoid high cost investigations which we may not have access to and often can’t afford. I also emphasised the modest numbers in our programme and the importance of close patient contact.

On Monday this week I had the pleasure of giving a similar but perhaps more inspiring graduation address to the new doctors celebrating in Nassau, New Providence, in the Commonwealth of the Bahamas, judging by the overwhelming response. And I was struck by many things, but especially by the importance with which the Bahamian government and people view this event. The Bahamas, like Barbados, have been emerging from a colonial period of serious health care neglect, and the School of Clinical Medicine and Research of the University of the West Indies, led by urologist Dr. Robin Roberts, has been performing virtual miracles to transform health care. The graduation of a new cohort of 44 doctors is therefore greeted as a HUGELY important event to celebrate.
It was so important that the new Prime Minister, the Deputy Prime Minister, the Ministers of Health and Education and other cabinet ministers were there, with addresses given by the PM and Ministers of Health and Education before my own graduation address. And the audience numbered more than a thousand!

My messages to the new doctors were not dissimilar to those to our own graduates a few days earlier. I shared the wise words of Sir William Osler, the great Canadian physician of almost God-like status in the medical world, who said: “To study medicine without books is to sail an uncharted sea, but to study medicine without live patients is not to go to sea at all.” And so my first message was that they’ve just begun their life-long learning. But I tried to emphasise the importance of being role models for their patients – this in a country where severe obesity in women is the norm rather than the exception. It’s a country with a fabulous motto – “It’s better in the Bahamas”, but it’s also true that “It’s bigger in the Bahamas” as obesity prevalence is much greater than any other Caribbean country. In fact, it leads even Barbados (37 per cent obesity rate, Barbados 33 per cent). It comes in at number 10 in the world, surpassed only by Polynesian islands and Quatar and Kuwait.

I also emphasised the importance of being a caring doctor and a sharing person. Of the many personal thoughts and maxims I shared, there are no truer words than those of St. Francis of Assisi: “For it is in giving that we receive”; and of Mother Theresa: “love is service, AND service is peace”; and of “Mr. Spock” (the late Leonard Nimoy) of Star Trek: “The more we share, the more we have.” And I recognised the extraordinary work of the School of Clinical Medicine and Research, and the inspiring patriotism of Bahamian doctors, since more than 90 per cent elect to work in the Bahamas. The warmth of my reception was breath taking, but even more impressive was the brilliant response speech given by the top student, Dr. Theo Strachan, who is clearly a born leader.

I learnt a great deal about our sister CARICOM country in two intensively busy days there. First, amazing hospitality and sociability. Secondly a determination among the professionals I met to change things for the better and to make a difference. And thirdly, a remarkable public expression of the determination to right wrongs and bring “infelicities” of the last administration to court.

I have always had a great fondness for the Bahamas, because my wife and I have had many friends there – classmates and colleagues – and I calculate that I’ve been there at least 15 times, since a visit as a medical student in 1963, travelling deck between Nassau and Bimini. The first European settlement there was by the Eleutheran Adventurers, on Eleuthera, in 1648, led by William Sayle from Bermuda, who later became, briefly, the first governor of Carolina at Charlestown (now Charleston), settled by Barbadians in 1670. In that same year King Charles II granted the Bahamas to the Lord Proprietors of the Carolinas, who included the Barbadian visionary Sir John Colleton. So you can see some of the early connections between Barbados and the Bahamas.

One of the impressive features of the current state of medical care is the recently built new wing of the Princess Margaret Hospital. This splendid facility includes all of the most important, state of the art facilities, including new operating theatres and medical, surgical and neo-natal intensive care wards, as well as a little garden of meditation. There has been no “pie in the sky” talk of abandoning the old hospital and building a brand new one for a billion dollars. A phased programme has been planned, and the rest of the old buildings are now undergoing rehabilitation to bring them up to modern standards internally. This is just one of many examples of good, sensible management practices that we could learn from our Bahamian friends. And a fundamental reason for such pragmatic, common sense approaches is that there has been wonderful collaboration between the School of Clinical Medicine and Research and the Ministry of Health in planning development.

Another highly commendable development has been the School’s emphasis on and success with postgraduate training in family medicine. Given the huge number of islands and populations across the archipelago, there is a need for many competent family practitioners on the islands beyond Nassau and Grand Bahamas. It’s another brilliant example of collaboration between University and Government …

But the biggest impact of all on any visitor to Nassau this week has been the reporting of the Budget debate in Parliament. There is a clear and compelling determination expressed across the debate by Government leaders that the malfeasances and infelicities of the previous administration MUST be brought to book. The Prime Minister himself, Dr. Hubert Minnis, and other members of the new government, which “swept out” the Progressive Liberal Party with an extraordinary 90 per cent voter turnout, gave examples of contracts given outside of the tender process, to “connected” individuals, sometimes without appropriate abilities; and of questionable multi-million dollar payments.

While opposition parties across the Caribbean frequently threaten during election campaigns that corruption will be punished, they rarely follow through on winning the government. And now seasoned electorates cynically accept such practices, just as pledges locally of bringing to book politicians who bribed voters in the last election were promptly forgotten, and the cynical population accepts it along with other alleged infelicities. We wait with interest to hear the outcome of the new government’s pledges in the Bahamas, and to hear their plans to rescue their beleaguered, highly indebted economy. Perhaps we should be talking to them.

Bouquet: To the charming, hospitable people of Nassau, who keep their city and environs far tidier than we keep Bridgetown.

(Professor Fraser is Past Dean of Medical Sciences, UWI and Professor Emeritus of Medicine and Clinical Pharmacology. Website: profhenryfraser.com)

For more on this story go to; https://www.barbadosadvocate.com/columns/things-matter-letter-nassau-bahamas