Three decades of public health

Dr. Kiran Kumar celebrated his 30th year of working in public healthcare in the Cayman Islands the same month the Health Services Authority celebrated its 10th anniversary.

Dr. Kumar joined the Department of Health, which a decade ago became the Health Services Authority, on 8 July, 1982.

When the department became a government authority in 2002, public health came under the domain of the Ministry of Health, while the operational aspects of the service, the primary healthcare and running of the district health centres, became the remit of the Health Services Authority. Dr. Kumar heads up both sections.

He wears two hats – he is the director of Public Health and is also the medical officer of Health. In these roles, he is in charge of primary healthcare services at the public health clinics and oversees Cayman’s vaccination programmes and deals with issuing health-related travel alerts, such as the one seen last month when an outbreak of cholera in Cuba led to a travel advisory from Cayman.

He has been the chairman of a steering committee for developing the Health Practice Law, under which four separate councils – the Medical and Dental Council, the Nursing and Midwifery Council, the Pharmacy Council and the Council for Professionals Allied With Medicine – were established in 2004.

He was also instrumental in the implementation of Cayman’s smoking ban in public places, which came into effect at the end of December 2009.

In 2003, the United Kingdom – and by extension, its overseas territories, including the Cayman Islands – became a signatory to the Framework Convention for Tobacco Control. Subsequently, Dr. Kumar was invited to be chairman of a committee charged with developing a tobacco law in the Cayman Islands.

“It took longer than expected,” Dr. Kumar admitted. The law was completed in 2008, passed in 2009 and fully implemented in 2010.

Dr. Kumar gave up smoking in 1989 when, as the head of public health, he was involved in education campaigns about the dangers of smoking. “I couldn’t smoke and advise the public, so I quit,” he said.

As the chief advocate for public health in Cayman, Dr. Kumar himself tries to stay as fit and healthy as he urges others to be. For exercise, he uses a thread mill while watching his favourite TV shows from India, and he reckoned he had taken only about 10 days sick leave in the last 30 years.

As the Medical Officer of Health, Dr. Kumar is at the forefront of dealing with public health risks and over the years has seen his share of health threats to Cayman, including the H1N1 swine flu in 2009, SARS (severe acute respiratory syndrome) in 2002/2003, various incidents of imported dengue fever over the years, and even anthrax scares.

“I’m proud of the way we were able to deal with the H1N1 epidemic,” he said, “and also after 9/11, the anthrax threat and alerts.”

Dealing with those issues over the years means that there is now streamlined, multi-disciplinary and multi-departmental cooperation involved in developing processes to handle such situations.

Dr. Kumar said previous experience in coping with such threats led recently to a quick multi-agency response from the HSA, the Public Health Department, the Cayman Islands Airports Authority and the Department of Environmental Health to the cholera outbreak in Cuba, which prompted the speedy issuance of a travel advisory to people in Cayman going to and coming from Cuba.

Dr. Kumar is also proud of Cayman’s vaccinations programme, under which 98 per cent of school-age children are immunised. During the next school year, HPV vaccines will also be made available to high school girls in the government schools in Cayman.

The expansion and usage of public health clinics in the outer districts of Cayman is also a source of pride for Dr. Kumar, who recalls a time when most were only open a few hours a week or people had to travel to George Town for treatments.

Dr. Kumar, who hails from a town called Vijayawada in Andhra Pradesh, India, came to the Caribbean in 1980, after working an assistant to a professor of epidemiology at the Institute of Public Health in Calcutta. He answered an advertisement in the British Medical Journal for a job as a lecturer in Social and Preventive Medicine in the University of the West Indies in Jamaica and when he got the job, he and his wife and two young children moved to Jamaica in January 1980.

“It was tough in Jamaica at the time because of the violence,” he recalled.

While working at the university, he met Janice Solomon, the supervisor of public health in Cayman, at a seminar. She told him about a position for a medical officer of health in Cayman. He applied, got the job and moved to Cayman.

“Thirty years later, I’m very proud to be here,” he said.

One of Dr. Kumar’s children – his son – has followed him into medicine and is a doctor at a family practice in the UK, while his daughter is a lawyer.

Dr. Kumar’s efforts in public health were recognised when he was named as a recipient of the Cayman Islands Certificate and Badge of Honour in the Queen’s new year honours.

“I got a call from the Governor’s Office one day in December 2006… The first thing Governor [Stuart] Jack said was ‘I am not calling you about the flu pandemic plan and went on [to ask] if I will accept the Certificate and Badge of Honour… I was not expecting it at all. I thanked him for the gesture and accepted it without hesitation,” he said. At the time, Cayman, as well as other jurisdictions around the world, was preparing a influenza pandemic plan.

Dr. Kumar said he considered that the award was made to the Public Health Department and not just him alone. The certificate is framed and displayed in his office.