The Tribune

• Nation losing 5% of ‘capital stock’ annually to storms

• IDB: Some health clinics using ‘condemned’ buildings

• Just over 2% of population are fully COVID vaccinated

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamas faces having to replace its entire infrastructure every 20 years due to its exposure to more severe and frequent hurricanes, an Inter-American Development Bank (IDB) analysis has asserted.

The just-revealed report, prepared as part of a $40m loan project to strengthen the Bahamian public healthcare system, said a United Nations (UN) report on disaster risk reduction showed that this nation is losing on average five percent of its “capital stock” per year due to the winds and storm surges created by hurricanes.

Defining “capital stock” as fixed assets such as roads, bridges, docks, airports and public buildings, the IDB analysis said that extrapolating out the UN’s findings suggests that The Bahamas is unlikely to gain the “full useable life” from its infrastructure investments as these will need to be renewed and replaced every two decades.

Taking the average annual loss (AAL) identified in the UN report, the IDB analysis said: “The UN Global Assessment Report on Disaster Risk Reduction indicates that the AAL for The Bahamas due to natural disasters is near to five percent a year as a percentage of its capital stock, well above the two percent average of the region.

“This figure indicates that, on average, every year The Bahamas loses five percent of its total capital stock due to natural disasters. This implies that The Bahamas would need to fully replace its capital stock every 20 years on average, well below the expected useable life of most infrastructure.

“Throughout the Caribbean, the main threat is from wind and storm surges that accompany hurricanes. According to this report, The Bahamas loses every year on average $2190m (sic) of capital stock due to natural disasters.” The latter figure seems extraordinarily high, and is more likely to be $219m, with the IDB analysis reflecting a typographical error.

However, the concerns are borne out by the estimated $2.464bn worth of damage inflicted on Grand Bahama and Abaco by Hurricane Dorian. When added to the $104m in damages suffered by the southern Bahamas during Hurricane Joaquin in 2015, the $373.911m stemming from Hurricane Matthew in 2016, and $32m generated by Hurricane Irma in 2017, total storm damages in The Bahamas over a five-year period come to almost $3bn.

The IDB’s findings are being used to justify why $19.954m, or almost 50 percent, of the health system strengthening loan is required to either construct new Family Island public clinics or upgrade existing ones by incorporating natural disaster risk mitigation measures in their design and construction. Dorian alone was said to have inflicted almost $38m in physical damage on the public healthcare system.

“The healthcare infrastructure in The Bahamas is aged and vulnerable to environmental hazards. Health facilities were built in the 1980s and have experienced a series of natural disasters, especially during the last decade,” the IDB analysis said.

“The clinics are scattered along the archipelago, which poses logistical and organisational challenges for appropriate maintenance and delivery of medications and supplies. Many clinics are aging and degrading due to an inadequate maintenance programme, making them less resilient to disasters and climate conditions. The population increase exceeds the clinics’ capacity, which is becoming insufficient to satisfy demand and signals the need to retrofit and expand them.

“The growing impact and the increasing number of these storms underscored the vulnerability of the health infrastructure to natural disasters, and prompted focus on climate resilience as a priority for healthcare infrastructure planning. To overcome these vulnerabilities, the Ministry of Health plans to upgrade the aging infrastructure. The scheme comprises capital works to retrofit nine clinics in seven different Islands, including Exuma and Andros.”

The report exposes the significant physical deterioration of several public health clinics, with the facility located at Smith’s Bay, Cat Island, presently housed in “a condemned building”. The Fresh Creek clinic in Andros, meanwhile, is based in a property that is “in a severe state of disrepair”.

Both areas are to get brand new clinics, while the facilities at Black Point in Exuma, Mangrove Cay in Andros and Rock Sound in Eleuthera will also be replaced by new builds. The former two are presently based in “inadequate rental” accommodation.

Besides the five new facilities, which will cost between $1.63m and $3.6m to construct, the clinics in Abaco, Andros, Long Island and Bimini will also be retrofitted and upgraded. Abaco’s primary health centre was damaged by Hurricane Dorian, while Bimini’s has “a leaky roof” that requires repairs.

Turning to the rationale for its $40m loan, the IDB said improving preventative care and early stage detection was critical to tackling the level of non-communicable diseases in The Bahamas and improving public health outcomes while reducing costs.

Disclosing that diabetes and hypertension together cost almost $35m per year, representing some 17.6 percent of the Government’s annual healthcare spending, the report said: “Appropriate preventive and curative care for non-communicable diseases in primary care facilities and hospital settings can reduce health costs and up to 25 percent of the mortality rates for these conditions.

“For example, more than 70 percent of breast cancer patients are diagnosed with late-stage cancer, which in turn reduces treatment effectiveness and life expectancy and increases the costs of care, whereas early screening increases life expectancy and reduces the costs.”

Disclosing concerns over domestic violence victims being able to access healthcare, the IDB added: “One in three women on average will experience domestic violence in their lives, and among those women that suffered a violent incident that required medical attention, an intimate partner (14 percent) or a friend or acquaintance (17.8 percent) caused the injuries.

“The Bahamas has taken significant strides to increase co-ordination and response to gender-based violence...... Nonetheless, human, and financial resources are still limited to address the number of persons needing assistance. Up to 22 percent of households report domestic violence, and the COVID-19 pandemic increased this problem by 11.3 percent.”

As for COVID-19, the IDB report said that as at June 4, 2021, just 2.2 percent of The Bahamas’ population - some 8,659 persons - were fully vaccinated against the virus. Some 55,037 doses had been administered by that date, with the Government set to request the first disbursement of an earlier $20m IDB loan within weeks to aid in acquiring vaccines.