Dr. Rosina Carreras, my much respected, former colleague in maternal and child health, recently passed to the great beyond. I am moved to reflect and salute her stellar service to the people of St. Kitts and Nevis.
In 1997, Dr. Carreras was the first Cuban national employed in the government’s health service. She left health care, particularly the care of low-income pregnant females, better than she found it. Such is the definition of a transformational health care provider.
Despite best efforts, by the 1990s, the number of stillbirths and neonatal deaths in St. Kitts remained unacceptably high. Single mothers, who invariably were low-income, accounted for 80% of deliveries but 90% of neonatal deaths.
Global research is that high-risk conditions in the pregnant female account for two-thirds of neonatal deaths. The remaining one-third of deaths are due to complications in the newborn. Similar findings were observed in St. Kitts.
Topping the list of high-risk pregnancies are those complicated by high blood pressure, high blood sugar, anemia, early teen age, multi-births in quick succession, and repressive work conditions. Overall, the local 1990s data screamed for universal access to specialist obstetric care particularly for low-income pregnant females.
Acting on advice, then Minister of Health, Dr. Earl Asim Martin, a Cuban-trained general practitioner, made representation to the government of Cuba for the recruitment of an Obstetrician/Gynecologist. Dr. Carreras was speedily dispatched.
She set about her assigned tasks with boundless energy and the highest level of professionalism. Unwavering was her commitment to excellence in community-based health for which Cuba is a global leader.
The difference Dr. Carreras made was this: Before her deployment, lack of money caused access to high risk prenatal care to be denied or delayed. The result was a high number of stillbirths and neonatal deaths. Through Dr. Carreras clinical stewardship, a needed service was brought close to where pregnant females lived and worked. The results were dramatic: In 1998, stillbirths dropped by 50%. By 1999, the infant death rate (per 1000 livebirths) for St. Kitts and Nevis dropped below that of African-Americans.
Ours is a country whose growth and development will always be wholly reliant on its human resource base. Good health builds human capital. Cuba’s contribution to both is unrivalled.
Dr. Rosina Carreras, Cuban-born and trained, pioneered universal access to high quality obstetric and gynecological services in Community Health Centers. I regard as an icon of 21C health care improvement in St. Kitts and Nevis.
Farewell thou good and faithful servant!
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