Heal Thyself

This Saturday, 12 September, the region observes Caribbean Wellness Day. It was born in 2007, when CARICOM Heads of Government signed the Port of Spain Declaration and set aside the second Saturday of September as a day of action against chronic disease. This year, CARPHA is placing https://caribbeancurrents.org/medical-mondays-adolescent-health-caribbean/“>youth wellness at the centre of the observance, calling on the region to shape the choices, opportunities, and environments we create for young people. Across the region there will be health fairs, blood pressure checks in church halls, fitness walks at dawn. Hospitals and clinics will help organize many of them.

But this year, we want to turn the stethoscope around. We write as two healthcare executives working in different spheres of the region’s health systems, alongside colleagues across the Caribbean every day. Our Caribbean Wellness Day message is not for the public. It is for us — every one of us who wears the badge. The physician finishing a clinic list that ran two hours over. The nurse on her third twelve-hour shift this week. The midwife, the pharmacist, the lab technologist, the radiographer, the EMT, the community health aide, the porter, the ward clerk, the kitchen and laundry staff, and yes, the executives and administrators. The people who run our health systems.

We will be honest: this message is also for ourselves. We see the grind daily — and we have lived it. We have each had our own moments when life caught up with us; when the body quietly presented the bill for years of long days, missed meals, and postponed check-ups. Nothing teaches the lesson of this piece faster than becoming, however briefly, the patient.

Here is the uncomfortable truth we rarely say out loud: the hands taking the community’s blood pressure belong to people with the same odds of high blood pressure. Our workforce is not imported from some healthier place. We are our patients’ mothers, sons, and neighbors, drawn from the very communities whose statistics keep us up at night. Non-communicable diseases already cause the great majority of deaths in our region — projected to reach roughly 81 percent of deaths in Latin America and the Caribbean by 2030 — and PAHO reports that the non-Latin Caribbean carries the highest NCD mortality rates in the Americas, with about one in five of our men and one in six of our women dying of a chronic disease before age seventy. Several Caribbean nations record hypertension in 45 percent or more of adults aged 30 to 79, yet across the Americas only about a third of adults with hypertension have it controlled. Adult diabetes prevalence stands at 17.6 percent in the Dominican Republic, 13.2 percent in Barbados, and 12.5 percent in Jamaica.

There is no reason to believe a white coat, a uniform, or a badge protects anyone from those numbers. If anything, the work itself conspires against wellness. Shift work and on-call rotations disrupt sleep and metabolism. Meals are skipped or grabbed fast and fried. The physician who counsels lifestyle change all morning has not seen her own doctor in three years; the clerk who books patients’ appointments somehow never finds time to book his own. And there is a culture — quiet, well-meaning, stubborn — that says the carer’s job is to give care, not to need it.

The old instruction “physician, heal thyself” was always a little unfair, because it made wellness the worker’s burden alone. We read it differently now, and we read it broadly: nurse, heal thyself; pharmacist, heal thyself; executive, heal thyself — and institution, heal thy people. We audit our generators and our drug stocks. We should be just as rigorous about the health of our workforce, because no strategic plan survives a depleted staff.

So this Caribbean Wellness Day, we are asking our fellow executives, administrators, and managers across the region to bring the day inside the building. When we set up screening tents for the public, let us run a line for staff — pressure, glucose, BMI — open to every cadre from consultant to cleaner, with results handled privately and followed up properly. Let us give employees protected, guilt-free time to attend their own medical appointments and treat that time as sacred as any shift. Let us look honestly at what our canteens and vending machines sell to people working sixteen-hour days, and at whether our rosters leave any realistic room for sleep, family, and movement. And let us make it culturally safe — from the executive suite to the consultant’s office to the ward floor — for any health worker to say “I am the patient today.”

To every colleague, whatever your title: the region needs you well, not just present. This Saturday, before you take a single pressure reading in a church hall or a market square, let someone take yours. We will be doing the same.

Happy Caribbean Wellness Day.

About the Authors

Mrs. Mary Miller Sallah, MHA, Managing Editor, and Dr. Ricky Brathwaite, Editor-in-Chief, of Caribbean Currents are healthcare executives working in different spheres of Caribbean health systems. They write on health systems and leadership in the region.

Sources

1. Declaration of Port-of-Spain: Uniting to Stop the Epidemic of Chronic NCDs, CARICOM Heads of Government (15 September 2007); full text hosted by the Healthy Caribbean Coalition — https://www.healthycaribbean.org/declaration-of-port-of-spain/
2. PAHO, “Information for action: towards a regional integrated NCD surveillance system” (2021) — non-Latin Caribbean has the highest NCD mortality rates in the Americas; probability of premature NCD death (ages 30–70): men 21%, women 16.1% — https://www.paho.org/en/news/25-11-2021-information-action-towards-regional-integrated-ncd-surveillance-system
3. Population Reference Bureau, “Noncommunicable Diseases in Latin America and the Caribbean” — NCDs projected to cause ~81% of deaths in LAC by 2030 — https://www.prb.org/resources/noncommunicable-diseases-in-latin-america-and-the-caribbean-youth-are-key-to-prevention/
4. PAHO ENLACE data portal, Hypertension (adults 30–79; NCD-RisC 2019 data) — prevalence ≥45% in the Dominican Republic, Dominica, Grenada, Jamaica, and Saint Kitts & Nevis; population-level control ~36% in the Americas — https://www.paho.org/en/enlace/hypertension
5. IDF Diabetes Atlas, 11th edition (2025; reference year 2024) — adult diabetes prevalence: Dominican Republic 17.6% (https://diabetesatlas.org/data-by-location/country/dominican-republic/); Barbados 13.2% (https://diabetesatlas.org/data-by-location/country/barbados/); Jamaica 12.5% (https://diabetesatlas.org/data-by-location/country/jamaica/)

Medical Mondays publishes one clinical voice from across the Caribbean and its diaspora every Monday. Submissions: how to pitch.