GREAT BAY:--- Like many other countries in the world Cardiovascular diseases (CVD) are the main cause of death in St. Maarten and the number of people with Cardiovascular Risks (CVR) is increasing. When no measures are taken, the wave of complications resulting from obesity and diabetes mellitus type 2 (DM2) will lead to a catastrophe for the well-being and finances of the population of St. Maarten.
There is obviously momentum with different stakeholders ready to pick up the glove to fight challenges in diabetes care. Stakeholders have already started some initiatives to optimize diabetes care, among which awareness campaigns and case finding in the communities. But efforts are necessary to align initiatives and make them complimentary to each other. Otherwise the synergy between multiple activities will not be achieved. Instead of moving directly into action, a comprehensive program was designed with lessons learned elsewhere.
In 2009 the then Sector Health Care on St. Maarten had taken the initiative to develop a Diabetes Mellitus Disease Management (DM-DM) frame¬work. After consultations with stakeholders the scope was broadened to include all patients with cardiovascular risks in the program and not only the ones with a diagnosis of DM2. The strategy for the Cardiovascular Risk Management (CVRM) Program on St. Maarten is based on the first Care Standard for CVRM. The Care Standard is developed by the CVRM Taskforce, which consists of representatives of all relevant stakeholders of CVRM care on St. Maarten.
The CVRM care standard describes an integrated care program to shape care for this population. Not the
diagnosis, but the specific health problems of the patient are the primary approach in integrated care. The care needs of patients, necessitating chronic care can be categorized based upon the health problems to be treated. These problems can be disease specific, such as hypertension for CVRM and the diabetic foot for diabetes mellitus. But there are also disease--‐overarching problems, relevant to both disorders, such as smoking and overweight.
The implementation of the CVRM program will start with a two year pilot program. The execution of the pilot program will be a collaboration between the Diabetes Foundation, Public Health Department, Collective Prevention Services and 4 or 5 family physician clinics. Two diabetic nurses will be recruited to assist in the execution of the pilot, the vacancy notice will be published in the newspaper next week. Qualified diabetic nurses can send their CV and motivation letter to the Diabetes Foundation, nurses living abroad who are willing to return home are also encouraged to apply.
World Diabetes Day which is observed every year on the 14th of November was selected to officially launch the pilot program. The Minister of VSA and the Diabetes Foundation both committed to a successful implementation of the pilot program.