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Posted: Monday 16 March, 2009 at 2:52 PM

Healthcare: The unusual proposal that became Development Bank’s flagship project

David Fox of the Development Bank discusses with Patricia Richards-Leader (right) and her assistant, Eudora Griffin
Press Release

    BASSETERRE ST. KITTS (March 16, 2009) -- She returned to her homeland in 1996 with the sole intention to do field work for a masters degree dissertation and return to her top flight job in the UK.  But what she saw grounded her. Instead of going back to the UK to continue with her duties, she went to pack only to return and settle in St. Kitts where she started a project that is a beacon in the region on how we care for the elderly.


    Dr Patricia Richards-Leader is truly a child of two worlds. England was proud of her, and St. Kitts is proud of her. Rather than be torn in between as the proverbial African hyena, she commented without mincing her words: “I always say that St. Kitts gave birth to me but actually England nurtured me, made me to who I am.”


    She was born in Tabernacle Village and went to school in Tabernacle (now Edgar T Morris) Primary School and the Basseterre Senior High School. Shortly after leaving school, she had a few months nurse training locally. She was not in that position for long, because at the age of 18 she left her island home to pursue further nurse training in the England where her father was resident.


    In England she did not go to perform a supporting role for her father. She instead made him proud by rising to the top of her profession. She said in an interview recently: “I am a nurse basically. I am a registered nurse, UK trained. I am a registered midwife. I have got a masters degree in nurse education. I have a masters degree in midwifery, I have got a masters degree in medical anthropology and I have got a PhD in medical anthropology.”


    She said as a matter of fact she was “very fortunate that I had some very high profile jobs while I was in the UK.” She at one time managed one of the largest health authorities in Hammersmith in London. She went on to be a nurse/midwife lecturer at City University, which is attached to one of the most famous teaching hospitals.


    With that string of achievement, one would expect Patricia Richards-Leader to be still in England earning big money. That is not so. Since 2000 she has been doing what one would rightly call a job of love. She is the manager of the Grange Health Care Facility in Ottley’s. One would wonder how much money they are paying her for her to have quit her enviable positions in UK. The answer is she is the owner of the facility.


    The Grange Health Care Facility is the first of its kind in St. Kitts that offers nursing and residential and convalescent care to the elderly. Its double-barrel mission statement is ‘To provide high quality professional care in an ambience conducive to enhancing optimum benefits for each individual.. To offer our services free from discrimination and in a manner which reaches out to each sector of our community’.


    The need to set up such a home arose in 1996. She said, “I was doing my masters and I chose St. Kitts to do my field work for my dissertation which was on the knowledge and usage of medicinal plants in St. Kitts and Nevis. I had to gain entry to the homes of the old people because they are the ones who had the oral history. We rarely had little written down apart from Dr.. Milton Whittaker’s work.


    “In going into the homes of these people I realised how profoundly and culturally our perception and care of old people had shifted. It disturbed me so much. So, I went back to London and it just kept on bugging me and I came back six months after and I visited some of the some people with their permission and found out that the situation had not changed.”


    She observed that while such old people had relatives sending money to them, there was no one in particular to take proper care of them because even their relatives at home would be out at work most of the day. These elderly people would then be left at home for most of the time during the day without adequate supervision or care.


    She decided that she would set up the first privately owned health care facility in St. Kitts. “I pursued it from there and the Grange Health Care Facility was opened in August 2000,” stated Richards-Leader.


    She however explained the problems she encountered, since the money she had saved was not enough to put up the facility of her liking. She did not want to come to St. Kitts and do something that was sub-standard. She wanted to have a purpose built facility with all the necessary requirements consistent with international standards of care.


    “I started searching out banks,” she recalled. “I must say I was extremely disheartened by the first three banks I went to. In fact one of the bank managers literally laughed at me and said they would never give money for such a thing because people in St. Kitts would not put their old people in homes – it’s not going to make it.”


    She was then told about the Development Bank of Saint Kitts and Nevis. She said: “I went and explored what they did at the time and one of the things they told me is that they do not normally cover health because health should be a governmental domain. But after seeing my business plan, I think that they were convinced that care of the elderly was actually something they needed to take on board.”


    Development Bank of Saint Kitts and Nevis’ Delinquency and Recoveries manager David Fox confirmed that the bank reviewed Patricia Richards-Leader’s convalescent care project proposal and found that although it was not one of the projects that it would ordinarily finance, based on lending parameters, they found it interesting.  


    “After in dept discussions, on the contribution that such a facility could make towards the social structure in St. Kitts, the bank realised that such an opportunity could not be overlooked,” commented Fox. “The Development Bank bought into the concept and gave high consideration to the contribution that the key person Mrs Patricia Richards-Leader a Kittitian, would bring to the health care profession. Our challenge at the Bank was to find possible ways to transfer these years of experience from London, and make them available to the senior citizens of St. Kitts.”
    The bank obtained the necessary approvals from the Minister of Finance and its support for their request to the Caribbean Development Bank for technical expertise and funding for the project. He admitted that the project was unusual, and therefore presented with several unique problems, but with perseverance they eventually succeeded.
    “The Grange Health Care establishment stands today as a beacon in the Federation for the provision of  high levels of  health care to our Seniors, and the provision of professional training for local health care workers,” states Fox. “It has maintained a cordial working relationship with the Bank over the years, and continues to occupy the position of ‘flagship project’ for the Bank.”


    Looking back, Patricia Richards-Leader, stated that she got and bought land that was part of the old Grange Estate as she wanted the building to be away from the road because some clients who have got Alzheimer’s could easily stray off on the road. She first put up a unit for sixteen clients.


    On its opening they had two clients. She noted: “Within six months I had ten clients and then very soon what was supposed to be sixteen clients became nineteen because I had to make the doctor’s office into a room and what was supposed to be the chapel became a high dependence unit because I was getting quite a few clients coming out of the hospital who really were not well, but there was nothing more that the hospital could do for them.”


    Within a year and a half they were over capacity. Luckily for her, a visiting English man said to her that his father who had worked as an Anglican priest in St. Kitts had left some funds in a trust and that they would have wanted to invest some of it in a facility like the Grange. It was through that instrumentality that the second wing was put up, which pushed them from an original capacity of 16 to 30.


    The last stage of expansion is a cottage which caters for two clients, meaning that the Grange has a total capacity of 32. They have just two people in a room, which are then individualised according to their clinical needs.   


    “We have an affiliated doctor,” said Richards-Leader. “I am a registered nurse consultant. I have a senior nurse who is my deputy. I have three other registered nurses, full or part time basis, I have practical nurses and I have trained and untrained care assistants. We have our own in house training as well.”


    She commented that from the 3rd of November last year, she was offered a contract through the BNTF and the Ministry of Gender and Social Affairs with CDB’s funding to train home care workers in the communities. They graduated on the 3rd of February. She concluded: “So, the Grange has gone from just being a clinical place to an educational place as well.”


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