An aneurysm bleeding at the base of the brain, next to the tissue that keeps the heart beating and the lungs working, was, until recently, one of the most dangerous things that could happen to a Caribbean patient, and a common reason to be put on a plane to the United States. At the University Hospital of the West Indies, surgeons now treat it through a small puncture, without opening the skull, and with little risk of complication.

“Whatever the standard of care is, no matter where in the world you are, we want to have it here in the Caribbean,” medical chief of staff Dr Carl Bruce told the Caribbean Neurosciences Symposium on June 27.

Most of the gain is in time. The hospital now aims to restore blood flow to a stroke patient’s brain within 90 minutes of arrival. That target rests on a dual-energy 128-slice CT scanner that reads the brain and spine quickly, and a biplane Philips Allura cath lab that shows the vessels from every angle and can build a 3D scan while the patient is still on the table. Treatment is faster and less invasive than it was a few years ago, Bruce said, and the hospital’s death and complication rates have come down.

He was direct about who paid for it. The Ministry of Health and Wellness, regional governments working through the UWI, the International Atomic Energy Agency and private companies all put in money, in what Bruce called an investment in regional health security. To decide what to buy and what counts as a fair price, the hospital uses ECRI, an independent international non-profit that assesses medical technology and pricing.

Barita Investments, the symposium’s title sponsor, made the financing case. “Capital flows where there’s good governance and trust,” said its senior vice-president, Dave Dixon, who pointed to recent pension reforms he said could free billions of dollars for long-term health infrastructure.

Every machine sits inside the University Hospital, Bruce said, and every patient who comes through can use it, public ward included. “When we are not well, we want the best possible care, so that we can be treated and fully recover,” he said.

The symposium has since concluded at Half Moon Resort.