Montserrat recorded 12 stroke cases and six heart attacks in 2024, according to Minister of Health Dr Ingrid Buffonge in Parliament on Tuesday. A recent study has also revealed that diabetes and cardiovascular disease are responsible for 59% of deaths at Glendon Hospital, the minister revealed.
This information was shared in response to a question from Member of the Opposition Donaldson Romeo regarding the government’s plans to improve healthcare, particularly in the management of strokes and heart attacks. In response, the minister said the government is actively working to improve stroke management protocols in line with international medical standards to enhance patient outcomes.
One of the most significant advancements in stroke care has been the acquisition of a CT scanner at Glendon Hospital, a long-awaited addition that had been requested for 15 years, Dr. Buffonge said. Over the past three months, this scanner has allowed for local stroke diagnosis, ensuring adherence to international guidelines that mandate immediate CT scans for patients presenting with stroke symptoms. Additionally, in the past two weeks, the Ministry of Health has procured the clot-busting medication, Alteplase, which is essential for stroke treatment.
Expressing gratitude to the medical staff, Dr Buffonge stated, “I would like to thank the doctors at Glendon who have requested this medication for a long time and have struggled to work without it. I honour their commitment to serving Montserrat despite the challenges.”
The minister also emphasised the need for current diagnostic equipment and medication to support doctors in providing appropriate patient care. “The ministry of Health intends to further improve their ability to manage patients. Doctors need current diagnostic equipment, Madam Speaker, and need current medication in order to appropriately manage patients, and I believe we are slowly, but surely getting their.”
In addition to local improvements, collaboration with a nearby tertiary healthcare facility is deemed essential for managing time-critical stroke cases. “Certain categories of strokes will still require medical evacuation to a tertiary facility. If the facility is nearby, patients can be transferred within an hour or two. Delays beyond a few hours can result in permanent disability or death,” Dr Buffonge stated.
Efforts are also underway to review and update protocols for managing heart attacks. The minister stressed the importance of ensuring that Glendon Hospital remains up to date with international standards of care to enhance patient outcomes. Previously, the lack of essential medications and prolonged medical evacuation delays had hindered patient care. Now, with clot-busting medication available on the island, doctors can manage heart attack cases more effectively.
Despite these improvements, some heart attack patients will still require medical evacuation for coronary mechanical reperfusion. “Delays in medical evacuation, particularly where Alteplase fails to restore blood flow, can result in cardiac failure and ultimately death,” Dr Buffonge explained.
Similarly, in cases of haemorrhagic stroke—where bleeding occurs in the brain, timely medical evacuation remains crucial. “An aneurysm bleed can sometimes be repaired if we get the patient across in a timely manner,” Dr Buffonge noted.
With a population of 4,396, recording 12 strokes in a year is a cause for concern, particularly when considering Montserrat’s high prevalence of hypertension (716 cases) and diabetes (392 cases). These conditions significantly increase the risk of stroke.
Some underlying issues that contribute to strokes include:
Hypertension (High Blood Pressure) – The leading cause of stroke, as it can weaken or damage blood vessels over time, leading to clots or haemorrhages.
Diabetes – High blood sugar levels can damage blood vessels and increase clot formation, raising the risk of ischemic stroke.
High Cholesterol – Can lead to plaque buildup in the arteries, restricting blood flow to the brain.
Obesity and Poor Diet – Diets high in salt, unhealthy fats, and processed foods contribute to hypertension, diabetes, and cholesterol issues.
Physical Inactivity – A sedentary lifestyle increases the risk of cardiovascular diseases, including stroke.
Smoking and Excessive Alcohol Consumption – Smoking damages blood vessels and increases clot formation, while excessive alcohol intake can lead to high blood pressure.
Lack of Immediate Medical Care – Delays in stroke recognition and treatment can lead to worse outcomes. The availability of a CT scanner and clot-busting medication is crucial to improving survival rates and reducing disability.
Given Montserrat’s healthcare challenges, including limited specialist care and the need for timely medical evacuations, the prevalence of risk factors in the population makes stroke prevention and management a public health priority. Addressing these issues through early screening, lifestyle changes, and improved medical infrastructure will be essential in reducing stroke-related morbidity and mortality.
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