Community Health: The Out Island Look

"I wanna feel the sun on my face and the wind in my hair."-Chris Cagle (When I Get There)
Photo: Domonic Archer

As I sit in my bungalow, appreciating the tranquility that I can freely enjoy tonight, I cannot help but reflect on my first day on the island of San Salvador, The Bahamas. 

Firstly if you're not familiar with The Bahamas, it's an archipelagic country in the Atlantic Ocean. Tourism is our main industry and this can be appreciated more on an island like San Salvador. The livelihood is based on the  Club Med resort. The resort employs the majority of the inhabitants of the island which has both its advantages and disadvantages. Some of the advantages is the fact that the residents are paid fairly well which allows them to live comfortably however in the event the resort closes there would be a lot of unemployed  persons who may have to consider relocating to another island such as New Providence or Freeport. 

The week on the island is flying by (as I expected it would have) and to be honest, I'm not ready to say good-bye just yet. You see it's easy to get use to having two miles of beach to yourself in a place where people scarcely bother you, to be able to train for a half marathon or a full one as the island is 12 miles long and 5 miles wide. My colleagues and I spent our mornings running at least 2 miles either on the road or along the shore followed by an intense leg and abs workout; it was only fitting that we rewarded ourselves with an elaborate breakfast (I'm talking homemade blueberry and strawberry waffles here) all before heading to the clinic. 

We had the pleasure of working alongside Dr. Darville, who takes joy in her work and it shows through her interaction with each patient including her pediatric patients. It was this drive, excitement and enthusiasm that she demonstrated that made me appreciate Family Medicine and the work of the General Practitioner. 

You see, as an island resident Physician, you are responsible for the well-being of each person on the island, for San Salvador we're looking at 2,000 people not inclusive of the foreign residents employed and living on the resort. As Rum Cay (a smaller inhabited rock that makes up the chain of islands) lies within close proximity to San Salvador, Dr. Darville is also in charge of the clinic there. So in total, her clientele is close to 3,000 persons inclusive of children.

I'm sure by now you can picture the challenges one Physician can encounter in such a location. For now, I'll just list some of the top challenges Dr. Darvile faced on a daily basis below: 

1. Limited Resources

Working on an island, especially one of the southern most islands, poses its own challenges. In the medical industry, one can easily be forgotten by those in the Department of Public Health on the capital of Nassau. 

Residents on the islands depend heavily on the mailboat for supplies ranging from food items and groceries to toiletries and medical supplies. 

The items that are sent however, have to be rationed and utilized in the best means possible to ensure supplies are available in the event of an emergency.

2. Medical Emergencies

In the event of a medical emergency, Dr. Darville and her team had to do their best to ensure patients are able to be flight lifted to Nassau in a timely manner. Air ambulances are not always on stand-by on the island, so at times it's good to know a pilot who is willing to assist and possibly waiving a fee or working out a deal on cost to ensure a patient can be transported to Nassau for medical attention. 

3. Social Issues

One would think that as a Physician, the social lives of patients are the least of our worries. Living arrangements of the elderly in particular are extremely challenging when they no longer have relatives on the island to care for them as they advance in age or relatives are no longer taking interest in their well-being. This then becomes an added burden to the society and that of the Physician. 

Health is wholistic. In order for one to recuperate adequately, there are things such as running water, electricity and a clean environment just to name a few, which should be in place. Social issues are sensitive but still something to investigate especially when  a patient is not recovering as they should. 


This trip was an eye-opener and very sensitive. It showed me how as humans, Darwin's theory of survival rings true even today in such an advanced technological and scientific era. We're becoming more and more educated and less humanistic.