JAMAICA’S struggling health sector has been attracting a growing number of overseas patients seeking cheaper access to sophisticated medical equipment and expertise to treat complicated illnesses.

In the last several years, more Jamaicans have also been staying home to access these state-of-the-art equipment, acquisition of which has put the island ahead of the rest of the English-speaking Caribbean and on track to match up with developed countries.

So optimistic is the outlook for development of health tourism that an upbeat John Junor, the health minister, has been actively encouraging financially ailing hospitals here to go after the business.

“The country has begun to go in that direction and that is why I encourage private hospitals that are losing money to look into the possibility of establishing centres of excellence as business,” Junor tells the Sunday Observer.

“We are definitely open to that possibility, because when we open centres of excellence and we have professionals with a reputation and the equipment that comes from countries where people feel comfortable in doing procedures, there is room for it,” says Junor.

Some of the medical services that Jamaicans would routinely go overseas to access but can now get at home – because the equipment are here – include cardiac, optical, gynaecological, physiotherapy, in vitro fertilisation, embryo freezing and sperm freezing.

“We are not yet at first-world levels, but for a country of our size and development we are definitely carrying our weight,” Junor says of the equipment Jamaica now has in hand.

The recently opened cardiac centre, run by the Heart Institute of the Caribbean (HIC) at Balmoral Avenue in Kingston, claims bragging rights for having the only piece of equipment in the Caribbean that offers comprehensive diagnostic treatment.

At a cost of $2 million, the centre has acquired:

. a gama camera which does cardiac imaging;

. an ultrasound echo unit that enables the function and structure of the heart to be examined; as well as

. a fully automatic stress unit (similar to a treadmill).

The centre also has an ECG machine, which gives more detailed information about the heart.

HIC consultant cardiologist Dr Edwin Tulloch Reid shares Junor’s optimism about the potential for health tourism. He points to the fact that since it opened its doors in January, the centre has already attracted patients from the United States, Cayman, St Lucia, and St Kitts and Nevis.

“The health care cost in North America is astronomical and so there are a lot of people leaving the country to get good health care,” he says. “Jamaica is a stone’s throw from there and the rest of the Caribbean, where they don’t have state-of-the-art equipment.”

Tulloch Reid estimates that almost US$30 million flows annually from Jamaica to the United States for cardiac care.

“That is a tremendous drain on the country’s resources,” he says. “We probably have people that are more highly skilled than the people in the Miami community hospitals.”

At his cardiac centre, an ECG costs $9,000, a bone scan is done for $16,000, while a nuclear cardiac scan costs $62,000.

Patients from outside of Jamaica make up about 10 per cent of the approximately 150 patients treated each year by Dr Matthew Taylor, a gynaecological oncologist at the Kingston-based Ripon Surgery Centre.

The centre offers laparoscopic surgery for things such as the removal of fibroids, a common problem among Jamaican women.

This involves using a laparoscope, which is an instrument through which structures within the abdomen and pelvis can be seen.

Nowadays, the images can be transmitted to a television monitor.

The procedure facilitates minimal tissue damage and so reduces recovery time, thereby permitting the patient to return to normal activity in a shorter period of time. It is Taylor’s view that in this area, Jamaica is on par with the rest of the world.

“Patients can get the same quality care at home that they would get overseas,” he says. “For the overseas patients, it is cheaper for them to come here, get the surgery done and then go back home, than if they were to pay for the surgery abroad.”

Taylor uses laparoscopic surgery mostly for conditions that are gynaecologically related, such as fibroids and chronic pelvic pain. The cost of this kind of surgery ranges from $120,000 to $200,000.

One drawback stressed by Taylor is heavy import duties on these machines which push up the costs to bring them into the island.

“We have to pay top dollar,” he says. “We (often) end up paying more than what it costs in the US.”

Out of the recognition of the devastation caused by glaucoma, a cruel eye disease, consultant ophthalmologist Dr Leon Vaughan established the Glaucoma Diagnostic Unit just over a year ago at Merrick Avenue in Kingston. It is the only one of its kind in the island.

The diagnostic unit has state-of-the art equipment called the Heidelberg Retina Tomograph (HRT) II, which allows the detection of glaucoma six years earlier than with previous technology.

“We are definitely on the cutting edge,” says Vaughan, noting the importance for diagnosis and management of early glaucoma. “Glaucoma is far worse in our race… and even more so in North America, and so we have to be able to pick it up early and treat it.”

The unit charges $4,500 for diagnostic evaluation.

Also providing top-rate services in the area of glaucoma detection and treatment is Dr Albert Lockhart, the Jamaican ophthalmologist who, with Professor Manley West, developed the glaucoma drug Canasol from marijuana.

Lockhart says extensive surgery is no longer needed to treat glaucoma because of the effective drugs available. But he promotes a glaucoma filtration procedure, depending on the degree of advancement of the disease.

The goal of the glaucoma filtration procedure is to create a new passageway by which fluid inside the eye can escape, thereby draining the fluid from a high pressure area to a low pressure area. The cost for this surgery is $40,000 and an additional US$60 (approx $3,700) if an implant is required.

Lockhart also does testing for glaucoma using equipment such as the aponative tonametre, which is an instrument for measuring hydrostatic pressure within the eyeball, used to detect glaucoma. He also uses the HRT II laser.

“Eye care in Jamaica is pretty good. We have a lot of equipment that is available elsewhere in the world,” Dr Lockhart says. “In glaucoma we have the latest equipment.”

Dr Wendell Guthrie, a veteran gynaecologist and obstetrician, uses an instrument called a hysteroscope, which is a thin telescope that is inserted through the cervix into the uterus to diagnose bleeding.

“This one has been around for a while but people are now using it more,” Dr Guthrie says.

Another piece of equipment that Dr Guthrie uses is the colposcope, which is a lighted magnifying instrument used by a gynaecologist to examine the tissues of the vagina and the cervix. This is used to do a procedure called a colposcope which allows close examination of the cervix for abnormalities.

“It decreases hospitalisation, expense and trauma,” Dr Guthrie says.

The University Hospital of the West Indies (UHWI) has the only state-of-the art conception unit in the island and has been offering invitro-fertilisation for nearly three years, providing hope for women who can’t conceive naturally.

“In the infertility world, we are doing everything that everybody else does,” says Denise Everett, an embryologist at the unit.

Some of the equipment used in the procedure includes a micro manipulator that cost US$38,000 and an incubator worth US$8,000. The invitro-fertilisation procedure itself costs J$6,000.

The unit also offers embryo freezing and sperm freezing at a cost of US$300 and US$200 respectively.

Suzie Foreman, the owner of a company called Gaitech, has taken physiotherapy to the next level. She has the only GaitScan in the Caribbean, which is a computerised diagnostic device containing 4,000 sensors that monitor the time and pressure of the feet – how a patient stands, walks and runs.

Additionally, it enables a specialist to determine how the feet function and identifies problems.

With this device, Foreman, a physical therapist who represents Orthotics International – the Canada-based manufacturer of shoe inserts – is able to design a suitable custom-made medical shoe insert, called Orthotics, for individuals. The initial consultation costs $3,300.

“The GaitScan, along with a clinical exam, helps a clinician decide if a patient would benefit from Orthotics. It also picks up a lot of information that we can’t clinically see,” she says. “It has the potential to save our health care system a lot of money.”