Dr. Ronald E. Georges. Photo: VINO.

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The Pulse magazine is one of the productions of the BVI Health Services Authority in its attempt to reach out to the public.

Ronald E. Georges is the Acting Chief Executive Officer of the BVI Health Services Authority which is responsible for the primary and secondary health care in the Virgin Islands.

Dr. Georges has served in various capacities within the public health sector here in the BVI over the last twelve years but his passion for wanting to bring about change and make a difference to a wider cross section of people is what led him to get into the public health care management.

“Public Health Management is what I want to do.  Whereas as a clinical specialist one principally deals with the patients in front of you, a lot of clinical specialists as they grow in their careers and mature begin to feel that is not all that they want to do. A lot of them eventually find themselves in public health. I felt that way from very early and that’s why I got into public health - to be able to impact the system positively, not just individuals but communities and the whole population. That seems to be a lot more important than making a difference in one or two person’s lives, at least to me” said Dr. Georges.

Being raised in Trinidad to a Trinidadian mother Esther Georges and Virgin Islander father William Georges, Ronald spent most of his early life in Trinidad but his holidays were often spent at upper Main Street coming for vacation with his father’s aunts and subsequently his uncle Michael, Aunt Celia, and cousins who also lived on Main Street and has ever since had a natural love for his ancestral home.

Dr. Georges and having graduated from Mount Hope Medical School in Trinidad in 1996, and subsequently spent 18 months of internship at Port of Spain General Hospital and one year of Psychiatry and community medical in different medical clinics and emergency rooms in Trinidad before moving here.

After his parents moved to the Virgin Islands, Dr. Georges was motivated to follow. He was further pushed by Dr. Irad Potter, Chief Medical Officer to come and work here as a young doctor with local heritage which is much needed in the VI.

At that time, Dr. Georges was heading off to the UK to take up further studies in Psychiatry but opted to follow his parents and Dr. Potter’s advice and come to the VI in 1998, a move that he is very happy and pleased that he made.

His first job in the VI was as a medical practitioner on Virgin Gorda where he spent two years, an experience that he enjoyed tremendously and which taught him a lot about the VI its people and its culture. The young medical doctor also worked for sometime in Road Town, at several community clinics, and at the Emergency Room which further galvanized his passion for public health.

In Virgin Gorda, Dr. Georges said he was able to learn in a different working environment, and have great respect for the people of Virgin Gorda. While there, he was also able to see the many advantages and good systems that exist in the health care system but the experience also allowed him to see the gaps in the system and the need for improvement, thus his desire to further his training and knowledge in Public Health and Health Care Management.

With the personal goal to better the health care system for the populace, Dr. Georges proceeded to the United Kingdom to pursue higher education. He was unable to benefit from paid leave or local scholarship since he had not reached the amount of years required in the service in the VI, but the very optimistic and focused young doctor, took it upon himself and went on no-pay leave to complete his studies at his own expense.

While at the London School of Hygiene and Tropical Medicine where he obtained his first Masters Degree in Public Health, he was offered a scholarship by the British Council and opted to complete his second masters in Health Services Management.

In 2003, Dr. Georges returned to take up a position in the Ministry of Health as a Medical Officer of Health in the field of Epidemiology and Disease Prevention. In his role as Medical Officer, he was able to put together a surveillance system to collect data on communicable diseases. He also sought to put together a system to monitor the Swine Flu, one that has been reengineered to deal with cholera should there be an outbreak here and any other epidemic that may follow.  As Medical Officer of Health, he advised the Chief Medical Officer and Ministry on health policy matters and while it may seem that it had nothing to do with medicine, Dr. Georges found the experience invaluable in providing a window into how Government functions and how the system works at the policy level.

It wasn’t long before, in April 2007, he was seconded to the BVI Health Services Authority to become the Director of Primary Health Care with responsibility for the Community Clinics.

When he took over as Director of Primary Health Care in 2007, he set about to put together a strategic plan for primary health care to guide the department and set about trying to bring about change, the job offered him the opportunity to have a more direct impact in the health care services than previously.

“In the ministry I was doing more policy work with more long term kind of impact but here in the BVI Health Services Authority I am working with the health care troops on the ground where we can make a more direct impact on the population’s health,” said Dr. Georges.

While his initial goal, like many who want to make a difference and find solutions to problems, was to try to fix all that he saw needed fixing, Dr. Georges soon realized it was much more difficult to do than say.

Initially it was a slow start with various setbacks and obstacles that hindered the progress of the implementation of the strategic plan, however, he said eventually the staff bought into his plan, and he started to put systems in place for increase accountability and began to see some amount of positive impacts.

The challenge of following Ms. Winifred Charles Crabbe’s footsteps as Chief Executive Officer of the Authority in August 2008 took a while to sink in with stakeholders but eventually he was able to get their respect and support as he strives to better the health care system.

He said the biggest obstacle as he sees it is to get people to make that culture shift in their minds and accept that there is both need for change and that change is possible in the health care system from the top right down to the bottom.

Some of those changes are beginning to take place, as within the Health Services, the system of collecting funds has seen the service collecting revenue from less than a million to almost four million last year and an ambitious target of 8 million set for this year.  There has also been meaningful improvements in service quality and service delivery at the Authority.  Persons appear more committed to the cause.

Dr. Georges, who is also member of the American College of Health Care Executives, noted that this year, the BVIHSA has also been able to make convincing arguments at the Standing Finance Committee for the need to change regulations in the area of exemptions and fees so that revenue can more meaningfully offset expenses.

“The fees currently have no bearing on cost and fees have to represent at least cost if we want to maintain a system that guarantees access to care for those that need care can get care,” he said explaining how the implementation of the National Health Insurance will help to see that monies are collected for services rendered, maintain access to care, and at the same time support a quality service to those in need.

“That system together with a more accountable and rational manner of financing health care in the VI in my view will improve all dimensions of health care in the BVI including sustainability,” he said also pointing out a long term plan of expanding the health care market outside of the Virgin Islands.

“Health care tourism is huge in other countries particularly the Far East and more recently Central America.  We in the VI have to also think strategically.  Some things that can be done well in BVI can be marketed to visitors to help offset the cost of care to locals,” said Dr. Georges.

The passionate doctor also noted the higher risk for the future generation of chronic diseases and the inevitable reduction in their life expectancy below that of their parents if something is not done soon to curb the growing unhealthy lifestyle trends.

He said a lot more needs to be done to reduce the risk factors and it is important for all to understand the importance to make and support drastic changes in lifestyles, from the top right down to the bottom to address this serious health care issue.

“It is really a big economical risk to the country to have your workforce at such a risk of ill health and if they are unhealthy and expectancy is going down, one can imagine the long term effect on productivity and the economy” he said.

He iterated that a lot of reinforcements will have to be done from the policy level to ensure that persons follow certain guidelines and that they are equipped with the knowledge and support to make the necessary lifestyle changes.

“There is a tremendous of work to be done at the Authority but now there is definitely a glimmer of hope because we are beginning to see the critical changes in people’s minds where it can be done and is achievable.  Persons seem to understand the vision that we are communicating and now feel comfortable to follow” said the head of the BVI Health Service Authority.

However the need for wider change in the health sector has to be led by the Government to bring about the change in the national perspective,” he charged.

His advice to young people is for them to take up a career in something that they are passionate about and to do it to their best of ability.

He further advises young people to: “Remember that you exist in an environment and need to give back to your community and I think if you contribute positively and have that kind of thinking then personal goals will fall into place. If it’s about the personal goals alone, it will be hollow, but if you have wider goals and commitment people will value you for what you do and the change you can help to bring about.”

Among his accomplishments, Dr. Georges was a member of the Medical and Dental Council of the Virgin Islands for 5 years and Chairman for the last three, ending in 2008.

In that role, he oversaw the completion of the recommendation for changes to the act, set up the Council's Accounts and Annual Reports, and Revised the Rules for Registration of Medical and Dental Practitioners including Alternative Practitioners.

When he is not busy trying to improve the health services in the Virgin Islands, Dr. Georges enjoys gardening, cooking, reading and researching and spending time with his family, his wife Lisa and daughter Juliana.