v v Limited Time Only. © 2023 Burger King Corporation. Hot Honey Garlic Crispy Chicken Available Grilled Bridging the jobs gap Page 6 In photos: Women's Dive Day Page 14 Established 1965 Your most trusted news source cayman compass $1 | Funding local journalism | Weekly, 21-27 July 2023 US revoking visa waivers for travellers Page 5 Cuba ESTA ban Law may change for mentally ill inmates Page 10Matinees (matinee price before 6pm) • Seniors $9.00 (Mon-Fri before 6pm) Additional charges apply per 3D/VIP tickets 640-FILM (640-3456) Cayman Cinema@cbcinema6cbcinema6 SATURDAY NIGHT: For your viewing pleasure, minors under the age of 18 will not be admitted to any lm starting after 6pm, unless accompanied by their parent. 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Compass Centre, Shedden Road, George Town, Cayman Islands SEND US YOUR VIEWS OR NEWS: P.O. Box 1365 Grand Cayman, KY1-1108 Cayman Islands Telephone: (345) 815-0095 • Email: newsdesk@compassmedia.ky ADVERTISE WITH US: T: (345) 949-5111 • E: sales@compassmedia.ky • W: caymancompass.com weather Friday Forecast FORECAST Slight chance isolated thundershowers SEA STATE Moderate with a wave height of 3 to 5 feet. WINDS East to northeast at 10 to 15 knots 90°F HIGH 83°F LOW NEWS EDITOR CAROLINE JAMES ISSUES EDITOR JAMES WHITTAKER HEAD OF SALES CHERYL BIRCH-GILLIES news in brief Gigi Hadid arrest spotlights Cayman ganja rules The arrest of model and TV personality Gigi Hadid for marijuana possession on 10 July thrust the Cayman Islands into the international spotlight as media organisations from around the world reported on the incident. The 28-year-old American, who was ordered to pay more than $2,000 in fines and legal costs for bringing the illegal drug into the island, later claimed through her public relations representatives that she had a medical licence for the marijuana. Days after her court appearance, Hadid posted to social media a video on Seven Mile Beach, seemingly unbothered by the incident, with the caption, “All’s well that ends well.” Hadid, whose first name is actually Jelena, was arrested on 10 July along with her friend Leah Nicole McCarthy, according to Customs and Border Control. The women had arrived on a private jet from the US and were arrested following a search of their luggage, where 25.39 grams of marijuana was recovered. According to court records, Hadid and McCarthy were charged with one count of importation of ganja and another of importation of a drug utensil (a grinder). Hadid entered guilty pleas to both charges when she appeared before Chief Magistrate Valdis Foldats on 12 July and was fined $1,000, in addition to a costs order of $1,016.25. McCarthy also pleaded guilty and was fined $1,000. No conviction was recorded against the women. Bush pleads ‘absolutely, definitely not guilty’ in rape case Former Premier McKeeva Bush entered not guilty pleas to charges of rape and indecent assault, stemming from allegations dating back more than two decades. Bush, the MP for West Bay West and the former Speaker of the House, has already publicly protested his innocence. When asked to enter a formal plea to the charges before Grand Court Judge Cheryll Richards on 14 July, he said “absolutely, definitely, not guilty”. The particulars of the charges, which were read out in court, state that on a day unknown between 1 Jan. 1999 and 31 Dec. 2001, Bush had unlawful carnal knowledge of a woman. The matter was listed for a seven-day trial starting 6 Nov. Bush was released on bail. NCC chairman McFarlane Conolly dies in snorkelling incident National Conservation Council chairman and Older Persons Council member McFarlane Conolly died following a water-related incident on 17 July. In a statement, which did not name Conolly, the RCIPS said officers responded to a report around 3:10pm of a person in distress on the shore off Austin Conolly Drive in East End. It was reported that a man had been in the water snorkelling when he experienced difficulties. He was assisted back to shore by family and members of the public, who administered CPR until the arrival of emergency services. He was transported to hospital by ambulance, and subsequently pronounced dead. Conolly had been a longstanding member of the NCC, and was first appointed chairman in 2018. He was again named NCC chair in February 2021 following controversy over government’s failure to appoint members to the National Conservation Board. Cabinet later named and gazetted the new board. Connolly was also a former member of the Prisons Inspection Board and previously worked in the banking industry. In 2019, he was named an Older Persons Month ambassador. Brac resident killed in crash Cayman Brac resident Marlon Everton Findley was killed in a single-car crash on 15 July, police confirmed. The 23-year-old died after his car left Dennis Foster Drive near Public Works on the Brac and crashed into a fence and building in an early morning collision. Police said no one else was in the vehicle at the time. The incident happened just after 2am. Police said Findley was travelling east when his Honda Fit car crashed. He was pronounced dead on the scene. Road traffic collision experts from Grand Cayman travelled to Cayman Brac on the day of the accident to assist with ongoing investigations. $2,600 raised for sharks Local conservation efforts got a $2,600 boost as shark enthusiasts gathered for a Shark Week fundraiser at the CayBrew taproom last week. The event featured a special talk from Department of Environment shark project officer Johanna Kohler on conservation efforts and the partnership between DoE and the Cayman Islands Brewery. “The partnership between the DoE and the Cayman Islands Brewery dates back to 2008. Together with Marine Conservation International, the DoE and CayBrew created the White Tip beer and the funding programme to generate additional resources for local shark research. Since then, a portion of every bottle, can, and draught of White Tip sold goes directly to DoE’s shark research,” she said. Gigi Hadid was arrested for possession of marijuana in the Cayman Islands on 10 July. - Photo: dpa/Alamy Live News cayman compass 2 N news WEEKLY, 21-27 JULY 2023Changing how Cayman beats cancer. We know that cancer is a complex disease that requires outstanding levels of treatment. Our experienced cancer specialists are ready to support you every step of the way. Health City’s comprehensive cancer care services provide access to the best possible treatment, right here at home. Dr Troy Gatcliffe Specialist in Gynaecologic Oncology & Robotic Surgery Welcome to 1 (345) 640-4040 | info@healthcity.ky | www.healthcity.ky cayman compass 3 WEEKLY, 21-27 JULY 20231234567 89 101112 13141516 17 181920 212223 2425 1234567 89 101112 13141516 17 181920 212223 2425 ACROSS 1 English royal house 1485-1603 (5) 4 Shaped by hammering (7) 8 Play on words (3) 9 Author of Doctor Zhivago (9) 10 French post-impressionist painter (7) 11 Lure into trap (5) 13 Lichen-derived dye (6) 15 Person’s physical condition (6) 18 Detect by smell (5) 19 Floor show (7) 21 Spanish portrait painter (9) 23 Female fallow deer (3) 24 Strictly (7) 25 Scottish river and cloth (5) DOWN 1 Characteristic (7) 2 Composer of Don Pasquale (9) 3 Come to maturity (5) 4 Founder of Methodism (6) 5 Behind arrival time (7) 6 An alcoholic spirit (3) 7 Hungarian sweet wine (5) 12 English poet and philosopher (9) 14 Not disconcerted (7) 16 Rashly impetuous person (7) 17 Keep busy (6) 18 Cleave (5) 20 Composer of Carmen (5) 22 Section of relay race (3) The Compass Crossword Puzzle The Compass universal kakuro Puzzle 17375 The numbers in the black cells are clues. Numbers above the slash are across clues. Number below the slash are down clues. The goal is to enter digits 1 - 9 in the white cells to add up to the number clues. You cannot enter any digit more than once when adding up to clue. TODAY'S SOLUTIONS Puzzle 17375 ACROSS: 1 Tudor, 4 Wrought, 8 Pun, 9 Pasternak, 10 Cezanne, 11 Decoy, 13 Litmus, 15 Health, 18 Sniff, 19 Cabaret, 21 Velazquez, 23 Doe, 24 Rigidly, 25 Tweed. DOWN: 1 Typical, 2 Donizetti, 3 Ripen, 4 Wesley, 5 Overdue, 6 Gin, 7 Tokay, 12 Coleridge, 14 Unfazed, 16 Hothead, 17 Occupy, 18 Sever, 20 Bizet, 22 Leg. What they’re saying Online Letters to the editor Governor Jane Owen was among the hundred or so people who took part in the 3-kilometre Pride Rainbow Walk on Seven Mile Beach on Saturday, 15 July. Organised by the Cayman LGBTQ Foundation, the event, which raised $1,850 for the group’s back-to-school drive, offered participants a chance to come out to support LGBTQ+ equality and acceptance. The governor, pictured with Noel Cayasso-Smith, founder and president of the foundation, told the Compass, “It’s lovely to see Cayman supporting love and friendship and togetherness in all its forms.” - Photo: Rebecca Bird You know it’s hot in the Cayman Islands when you’re prepared to spend more with CUC than at Foster’s Supermarket every month! Actually, the prospect of losing weight in comfort is appealing to me. I’ve lived in the Caribbean for 20-plus years, but I can’t recall being this miserably hot. I find myself thrilled at the prospect of going to the office because I can turn the thermometer up for the day at home… how depressing is that?! In fact, I’m writing this from the office on a Sunday to avoid running the AC at home. While I’m here at the office I might as well do a little work, so it’s a win-win with my employer, right? Growing up in a single-parent household we did not waste anything. Running fans and opening windows was mandated until the Texas heat became unbearable. Currently, we are in the unbearably hot stage here in the Cayman Islands, but I’m still prepared to make some sacrifices (excuses). I can’t very well exercise outside with this heat, can I? Best to wait until the trade winds of December. I’m also now prepared to share the community pool with nine screaming children who see me as a potential playmate for Marco Polo. Additionally, I know I must stay hydrated, but question if ice cream or water is best to beat the heat. It’s been so hot out that I worried when my elderly mother and her sisters were here last week for a visit. They wanted to see everything. After we did all the big tourist things, they finally asked me about a tourist place in West Bay. “What’s Hell like?”, they asked. I smiled and said, “ Just step outside your hotel at noon today!” Bob Nickoles $21M West Bay housing plan challenged over mangrove clearing Haven’t we removed enough mangroves? How in good conscience can the government ever agree to remove any more? Bruce L. Yes, how can government possibly think this is okay? We know and they know the importance of mangroves and yet they permit this to happen over and over again. Soon the island will be one gigantic asphalt city sitting on top of a desert. Concerned C. Just say no. No to destruction of mangroves. Sarah Rowlands Leave the mangroves alone! Amanda Nicholls Let them modify their plans to retain the mangrove buffer. Charlotte Cloete Special report: Rising fear as robberies escalate A major problem is that the law apparently states that a Caymanian MUST be released on bail except in the case of a capital crime, murder. Imagine a neighbour calls the police and a criminal is arrested. What is the first thing that criminal will do when released on bail? Look for the person who called the police. The answer is obvious. Change the law to prevent the release on bail if the crime is a serious one. Norman L. The unbelievable has reached [these] safe haven shores. Although this may be inevitable with growth, it is coming to pass fast and furious, along with the possibility of losing what Cayman has always been known for. For Caymanians to be fearful is not an ordinary mindset for them either. If there is no ‘zero tolerance’ for armed robberies, you will enter the not-safe zone just like some other islands and no longer have the reputation that has been the [foundation] of your core values and why families have always come to your shores. Evelyn C. Island Games: Basketballers grab silver and bronze Led by our swimmers, Cayman performed very well against stiff competition, finishing 11th out of 24 in the medal table. Looking at the individual results, aside from our swimmers, we had some excellent results across the board in every event where, although we may not have achieved medals in all sports, our athletes still had some great performances without the home advantage that makes a big difference. Trusty2man D. Tourism minister: ‘We have not been paying enough’ minimum wage Nothing will change until they are up for election again and then it will be [a] manifesto pledge. In the meantime, people will still be paid as little as possible. They have had plenty of time to change this. Steve Ilsley A hot mess Rainbow on the beach pic of the week cayman compass 4 news N news WEEKLY, 21-27 JULY 2023WEEKLY, 21-27 JULY 2023Cayman travellers warned visa waivers may be revoked JAMES WHITTAKER jwhittaker@compassmedia.ky If you are thinking of visiting Cuba and aim to travel to the US on an ESTA visa-waiver at any stage in the next few years, the advice from travel experts is simple – don’t. Anyone who has visited the communist island since January 2021 is no longer eligible for an ESTA visa waiver – making it much more difficult and expensive to travel to or through the US. The Electronic System for Travel Authorisation is the swift, cheap and easy online approval process used by anyone travelling to the US on UK passports and a number of other eligible countries. People who have been granted ESTA visa waivers – which last for two years – have been contacted in the past week and told that those waivers have been cancelled and they cannot apply for a new ESTA. In every case, this was because the US authorities had become aware that they had travelled to Cuba since January 2021. As of this month, the ESTA visa application form contains a question asking applicants to indicate if they have been to Cuba. Anyone who checks ‘yes’ will not be eligible. That means that instead of a 10-minute, US$21, online application for a visa-waiver, they will have to apply for a full visa and travel to the US consulate in Jamaica for an in-person interview, and pay an application fee of $160, before being eligible to visit the United States. That process – required even to transit through the US – can take several months to complete and success is not guaranteed. “Right now, we are advising people not to travel to Cuba if they normally use the ESTA scheme to fly to or via the USA,” said Fiona Brander, of Travel Pros of Grand Cayman. “A visa can take months to get and involves travelling to Jamaica. If you need to go to the US, or even travel through the US, it doesn’t make sense to visit Cuba.” Once you have a US visa, it is valid for 10 years, so if you have the need to travel to Cuba and the US, that’s considered the best long- term option, but Brander warns it can take a while. ‘Sponsor of terror’ The Compass reported late last year that travellers were starting to feel the impact of a US government decision to reclassify Cuba as a ‘state sponsor of terrorism’, which came into effect in January 2021. At the time, the exact details of the policy or how it was being enforced were vague and travellers’ experiences seemed to vary. Some were turned away if they had a Cuban stamp in their passport, while others got through. The US stance seems to have been clarified and hardened in the past week, however, with several people from Cayman having ESTA applications refused or past authorisation cancelled on the basis of travel to Cuba since 2021. Previously, Cuban authorities had been willing to forego the passport stamp to make it easier for people to visit. That loophole, which allowed some to travel freely to the US despite having visited Cuba, appears to have been closed. ‘Big Brother is watching’ Even people without a Cuban stamp in their passport have been refused entry in recent weeks. “If you have been to Cuba they seem to know about it. I’m not sure how they know, but they know,” said Brander. “Big Brother and his family are watching.” She said a number of clients had ESTA visa waivers pulled while others had been refused. Anyone with an ESTA who has visited Cuba since January 2021 should check if it is still valid, she said. The recent addition of a specific question about Cuba on the application form – as of 12 July – makes it crystal clear that anyone who has visited one of Cayman’s closest neighbours will not have easy access to the US. Brander said lying on a TSA (Transportation Security Administration) form was not an option and carries significant penalties. Maria Leng, deputy head of the Governor’s Office in Cayman, confirmed that the US had recently updated its official websites to make the policy clearer. “If you have visited Cuba on or after the date it was designated a State Sponsor of Terrorism (12 January 2021) then you are not eligible to enter the US on an ESTA and anyone who already holds an ESTA but has travelled to Cuba since 12 January 2021 could have their ESTA revoked,” she said in an emailed response to the Compass. Leng added that the US authorities appeared to have information about passenger travel history regardless of whether a passport was stamped. “I have been advised of individuals with no stamp in their passport having the ESTA revoked,” she said. She added that some had been informed of this while trying to board flights to the US. Others had been contacted and advised their ESTA was revoked, even without any planned travel to the US. The policy, which affects travellers all over the world, has a disproportionate impact on Cayman. Cayman Airways flies twice a week to Cuba and many living in the jurisdiction are likely to have visited the island at some point. Some rely on the air-link with Cuba to maintain family connections, while political issues between the two islands, including the vast number of Cubans arriving in Cayman to claim asylum, sometimes make official travel necessary. The same is true for Cayman Islands residents who rely on travel to the US for a host of reasons, including for specialist medical treatment. The Compass reached out to both Cayman Airways and the Ministry of Home Affairs for comment but had received no response by press time. For more on this issue, read Fiona Brander’s new Travel Watch column on page 12. US denying ESTAs over Cuba travel “I have been advised of individuals with no stamp in their passport having the ESTA revoked.” Maria Leng, deputy head, Governor’s Office Travel to Cuba has become more complex for many travellers, particularly those from one of its closest neighbours, the Cayman Islands. - Photo: File Travellers from Cayman, or anywhere else, are no longer eligible to visit the US on an ESTA, if they have visited Cuba recently. - Photo: File cayman compass news N news WEEKLY, 21-27 JULY 2023 5JAMES WHITTAKER jwhittaker@compassmedia.ky The skill set, qualifications, and interest of jobseekers in Cayman is mismatched with the opportunities likely to be available as the island’s economy expands and diversifies, according to a new report on the islands’ labour market. Emerging industries, including solar energy and tech, are expected to create hundreds of additional jobs in the next year. But research shows little interest in those fields from Caymanians looking for work. The Cayman Islands Labour Market Assessment warns this could lead to an increased reliance on work-permit holders, even as new jobs are created. It recommends a massive effort between government and educational institutions to bridge this gap and generate interest and opportunity for Caymanians in more varied fields. “There is a misalignment between the demand and supply side with jobs of interest not aligned to future jobs in demand except in the case of accounts and finance,” the report concludes. The survey – carried out by Market Research Services Limited – involved 123 employers representing the major sectors of Cayman’s economy and 435 Cayman nationals who are either unemployed or under employed. The assessment, a partnership between WORC, the Chamber of Commerce and the University College of the Cayman Islands, was linked to the Resilience, Sustainable Energy and Marine Biodiversity program for the Overseas Territories, a post- COVID resilience initiative from the European Union. The greatest discrepancy between the desires and qualifications of jobseekers and the demands of businesses appears to be in the tech sector. The survey showed almost no interest in jobs in software and web development, software engineering or IT consultancy, which collectively amount to a quarter of the positions expected to be in high demand in the coming years. There is also a mismatch in the construction industry where demand for skilled craftsman, such as carpenters and masons, far outstrips interest from the job market. Only accountancy and customer service jobs attract the kind of interest that matches demand. The firms surveyed indicated high confidence in the Cayman economy, with job growth likely in the coming year. Over the next 12 months, a quarter of firms expect to add to their staff. The tourism, energy and tech sectors appear to be the most likely to recruit in numbers, according to the report, which also includes snippets of comments from employers. Businesses outline concerns One hospitality boss quoted in the report highlights a lack of interest from Caymanians in the tourism sector, claiming they were compelled to hire a bartender from Jamaica. “It’s a cultural thing, Caymanians are only interested in certain types of jobs,” they wrote. A construction boss lamented, “Good staff such as carpenters that are trained finish carpenters are very hard to find here.” There is also an identified skills gap in the sectors most likely to create jobs in the coming year, as well as in currently available positions. A third of jobseekers surveyed highlighted lack of qualifications as the key barrier to employment. Lack of childcare or transportation were also key challenges unrelated to skills or experience. Almost 90% of new opportunities are expected to be in skilled professions. At least half of those opportunities are classed as ‘semi- skilled’ – meaning the training requirements are not as advanced. That statistic suggests that, with the right policy initiatives, the gap could be bridged. One potential growth area is in solar energy, where new jobs are anticipated across the skills spectrum. “We’re seeing a big technology shift to renewable energy,” one employer wrote. “We need to shift our workers skill levels.” The tech sector too is facing a shift in its skills base as Cayman expands to new niches and older technology becomes obsolete. “We have to have training programs to help rescale and retool our workforce,” wrote one ICT professional. Fears for current employment While the report highlights growth in opportunity, there are significant fears that the changing economy and, in particular, advances in technology, will leave some currently employed people behind. An increased reliance on work-permit holders in Cayman is expected if something is not done to better prepare the local workforce. “Employers are already concerned about the unavailability of Cayman nationals for specific jobs, but should not expect any meaningful change in the immediate future without a concerted effort on the part of policy makers and key stakeholders to bridge the gap,” the report concludes. “Without such efforts, the Cayman Islands can expect to see an increase in the reliance on non-nationals with work permits for required skill sets as firms anticipate business growth and greater diversity in the range of jobs that will be available.” It recommends swift action to generate interest from Caymanian jobseekers in key growth professions, including hospitality, information and communications technology and renewable energy. Further conversations with employers are needed, it states, to precisely define the type of skill sets and qualifications necessary for future opportunities and help educational institutions prepare. Even with those efforts, it warns that the “extent of the dissonance” between job interest and job demand means any change will likely be gradual and take time to implement. Growing job opportunities but no one wants them The Cayman Islands Labour Market Assessment warns this could lead to an increased reliance on work- permit holders, even as new jobs are created. Renewable energy installations are among a number of semi-skilled jobs that are expected to increase. - Photo: Taneos Ramsay cayman compass 6 news N news WEEKLY, 21-27 JULY 2023Energy Smart Upgrades Hybrid/Electrical Vehicles 100% financing Term: up to 8 years 1% commitment fee waived Collateral: Bill of Sale, Police Lien and Comprehensive Insurance 100% financing added to existing residential mortgage Term: Over remaining term currently in place or term being extended 1% commitment fee waived Interest rate: 0.25% less than the existing mortgage rate Interest only payments for 3 months Collateral: Loan to value cannot exceed 95% Fixed rate offering available upon request Solar Panels or Batteries/Energy Efficient Propane Appliances or Generators | Other Terms and Conditions apply * * 100% GreenLiving Financing caymannational.com REBECCA BIRD rbird@compassmedia.ky Legislators plan to examine if the use of non-lethal self-defence tools like mace and pepper spray should be legalised, after residents raised the topic at a public meeting on crime. Minister Kenneth Bryan, who with Minister Sabrina Turner hosted the 13 July event at Constitution Hall, told attendees “there’s a legitimate reason for discussion among the lawmakers”. The discussion started when a commenter watching the live broadcast on social media raised asked if use of self-defence tools during an attempted robbery could be made legal. Inspector Ian Yearwood, head of the community policing department, responded simply: “It is not legal, and it’s not permitted at this time.” The Penal Code says “any weapon of any description or design, adapted for the discharge of any noxious liquid or gas” is prohibited. Anyone who imports, manufactures, sells, hires or has in their possession a prohibited weapon risks a fine of up to $10,000 and 10 years in prison. Yearwood said, “In a robbery, let’s be quite honest and frank, do you want to, under those circumstances, have a confrontation with your attacker at that time? “Our advice to you would be to be very compliant. You stand a better chance of your own safety than trying to antagonise the situation and can make it worse off for yourself.” His response provoked a strong reaction from some members of the audience, with one saying he disagreed “vehemently” that people should not defend themselves. Following a round of applause, the speaker said, “I understand why one would want to be cautious, would want to not be overzealous in doing things in a reckless way, but I do not like the idea that people are being discouraged from defending themselves, because the history of criminals is that they do not care what the law says." Self-defence with guns The Cayman resident then brought up the Firearms Act, which allows people with a firearm user’s (restricted) licence to use their gun for “the lawful protection of his person or property or of the person or property of some other person”. “In other words,” the man said, “in existing law, people who lawfully own firearms, and that’s the key word – lawfully – can defend themselves against crimes.” He said there is an element of crime prevention that police cannot do “and that is sometimes a person has to survive the attack, before they can call for help”. He suggested that the police service should be willing to recommend to government ministers to modify the law so that people can have mace or pepper spray for self- defence. Another resident, who described herself as a walker, asked why pepper spray is not legal, and told the room that she mixes her own spray for her early morning walks. “We have no other way of protecting ourselves,” she said. “And for years, I’ve been saying – and I will keep saying it – why are we not allowed to use pepper spray?” Reason for discussion Chief Superintendent Brad Ebanks clarified that Yearwood had meant that residents who are victims of a robbery should not put their lives at risk for the sake of any amount of money. “Whether it’s $100, $1,000, $10,000 – it’s not worth your life to resist that person and cause that person to cause you fatal harm,” he said. To that, Bryan noted, “I think that’s a legitimate summary of what was said. “I think, though, based on the response I saw from the audience with that resounding clap, is that there needs to be an analysis on the public’s position on that.” The minister added: “There’s a legitimate reason for discussion among the lawmakers.” Superintendent Roje Williams, head of uniform and special operations, agreed: “It’s something that we will discuss at the policy level and police level.” The issue has previously been discussed in the House by Cayman's lawmakers. As far back as 2011, legislators unanimously passed a private member's motion to legalise pepper spray and mace for private protection but no further progress was made. Lawmakers to discuss legalising pepper spray Legislators plan to examine if the use of non-lethal self-defence tools like pepper spray and mace should be legalised. cayman compass 7 news N news WEEKLY, 21-27 JULY 2023Discounts for no claims of up to 30% on your premium. Insure your hull and receive free Third Party liability cover. Interest-free fl exibility: pay your premium in instalments instead of one lump sum. Why choose Island Heritage for marine insurance? Visit us online at islandheritageinsurance.com or call +1 345 949 7280 See policy for details. AD_why choose IH for marine ins._#1_original size_run_frid.june.9.2023.indd 1 AD_why choose IH for marine ins._#1_original size_run_frid.june.9.2023.indd 106/06/2023 4:53 PM06/06/2023 4:53 PM NORMA CONNOLLY nconnolly@compassmedia.ky Ozempic and similar drugs have been growing as the go-to treatment for type 2 diabetes in Cayman, but their recent popularity as weight-loss tools locally and worldwide is leading to a shortage of the medication for diabetics. Local doctors describe these types of injectable daily or weekly drugs as game-changers in the treatment of type 2 diabetes, which is one of the most prevalent diseases in the Cayman Islands. As well as lowering glucose levels, the drugs have proven to be extremely effective in suppressing the appetite, leading to weight loss, and making it the latest diet fad. Physician Dr. Fiona Robertson, who works in both the public and private sector, and treats many diabetics, explained why these drugs, known as semaglutides, work so well. “They basically keep the food in the stomach for longer, so you feel full,” she says. “It’s like having a Christmas turkey dinner – you feel like you don’t need to eat for another two days. “Effect number two is that they alter how you want food, they alter appetite, and they tend to alter it so you don’t want starchy foods, so you’re going to pick your foods better. And the other thing they do is they alter the way you store your sugars in the liver as glycogen.” These drugs were originally designed to treat type 2 diabetes, with the US Food and Drug Administration first approving 1 mg injectable doses of Ozempic in 2017. Then, in June 2021, it approved Wegovy, a stronger injectable semaglutide in 2.4 mg doses, for chronic weight management in adults with high blood pressure, type 2 diabetes or high cholesterol. Diabetologist Dr. Diane Hislop- Chestnut says she has been treating her diabetes patients with semaglutides for three or four years, but since the FDA approved the drug for weight loss, it has become harder to find on island. “I’ve used it for our diabetic patients for years, and I’ve never had an issue getting hold of it until the last few months, since it’s been in the news for weight loss,” she says. She warns, though, that the drug does not work for everyone and it is not a quick fix, either for weight loss or for the treatment of diabetes. “It’s another tool to use, but by no means does it work for everybody,” she said, adding that she explains to her diabetes patients that it can take up to three months to start to see results, and they can expect to be on the drug for two years or more. Hollywood's latest weight-loss craze The FDA recommended that the drugs, manufactured by Novo Nordisk, be used for ‘chronic weight management’ in patients with a body mass index of 27 or greater who have at least one weight- related ailment, or in patients with a BMI of 30 or greater. However, they are being used by some to lose weight when they are not obese or very overweight. Its appetite suppressant qualities have made it what US National Public Radio called ‘the worst kept secret in Hollywood’. Reports and rumours of the widespread use of the drug in Hollywood led this year’s Academy Awards host Jimmy Kimmel to joke, “Everybody looks so great. When I look around this room, I can’t help but wonder ‘Is Ozempic right for me?’” Among the famous people who had admitted to using it is Twitter and Tesla CEO Elon Musk, who, in response to a tweet asking him how he kept a good physique, replied, “Fasting. And Wegovy.” Side effects Apart from a supply-shortage issue, there are also concerns that some of those taking the drug for weight loss are not informing themselves about the side effects, of which the FDA lists many, but the most common are nausea, vomiting, stomach pain and bloating. Robertson stresses the importance of anyone being prescribed the drug to have proper medical counselling and advice. She says she has seen patients, who have been prescribed the drug by other clinics on island, come to her complaining of abdominal discomfort and nausea that they had not known to expect. “Some people just don’t want to think about it,” she says. “They just want to take their Sunday injection and not think about it for the rest of the week. But I’m worried about those people because it means they’re not thinking about their food generally. So these people all need counselling and coaching.” She adds, “It’s not a matter of just taking a medicine, you’ve got to choose your foods... This is not a free ride to weight loss. The side- effect profile is quite severe. These medicines make you feel bloated, and if you go on eating when you shouldn’t or eat the wrong stuff, you’re going to feel nauseous.” Some patients have told her they stopped taking the medication because it made them feel bloated or sick, but “that’s what it’s meant to do”, she says, and that’s why it is vital that those patients “listen to their bodies” and adjust their diets accordingly. Hislop-Chestnut says she has also had patients who had taken it one time and then said they won’t ever use it again because it made them so unwell or uncomfortable. Nutritionist Andrea Hill says while Ozempic does show improvements in blood sugar levels and weight loss, there are no major studies yet that evaluate the long- term outcomes of that weight loss. “In other words, what happens when the person stops the medication? If they haven’t learned how to navigate their meals and adjust poor lifestyle habits, this drug will only do so much,” she said, in an emailed response to queries from the Compass. She added, “How you eat (adequate protein + fiber + healthy fats, consistent meal timings) and how you live (good sleep hygiene, moderate exercise, limited/no alcohol) are bigger players in long- term success with both weight management and blood sugar.” Pricy option Ozempic is expensive, costing around $400 for a month’s supply. Mounjaro, another anti-diabetes drug that is proving very popular for weight loss, costs twice that. Currently, insurance companies in Cayman are only covering the cost of the drug for diabetics, and won’t pay for its use just for weight loss, Hislop-Chestnut said. For some morbidly obese patients, bariatric surgery has been the option they’ve turned to. Robertson runs the Health Services Authority’s bariatric unit, where very obese individuals undergo surgery to help combat weight-related health issues. She says she’s seeing similar weight-loss results with the use of Ozempic as through the bariatric surgeries. She says at least 200 bariatric surgeries have been carried out at the HSA through the government’s CINICO insurance system, as most private insurance companies do not cover such treatments. Semaglutides like Ozempic and Wegovny are not the only prescription injectable weight- loss products on the market. There are also Eli Lilly’s anti- diabetic medications Victoza, a daily injection, and Mounjaro, a weekly one, which are tirzepatides that act in a similar fashion to semaglutides, but are thought to be even more effective. “These drugs are going to change the way type 2 diabetes is managed,” Robertson says. “Over time, as we get more, as they get cheaper, as we coach people, we may be able to give these drugs to prevent type 2 diabetes.” ‘Amazing’ treatment Another local physician, Dr. Virginia Hobday, described the impact of the drugs as a diabetes treatment as “amazing”. “There are very few diabetics it does not help. I know some who have lost 15% of their body weight, as much as if you had undergone bariatric surgery,” Hobday says of some of the patients she has seen. But she pointed out, “The problem with prescribing it for someone who is not diabetic, at some point there’s going to be a supply issue. It’s a concern if, at one time, if everyone takes it, would diabetics be able to get it?” Robertson said in the 30 years she has been treating patients on island, there has been a major increase in the number of cases of type 2 diabetes she is seeing, as people’s lives become more sedentary, and more fast food and processed meals are available. She said the shortage of the drug, not just in Cayman, but worldwide, is because it’s proving so popular for weight loss that the manufacturer, Novo Nordisk, cannot keep up with demand. “It’s not that it’s selling out, it’s just we can’t get it in,” she said. She understands why it’s so popular as a weight-loss option. “This is the first weight-loss medicine that we’ve had that doesn’t really stimulate your heart rate, that doesn’t push your blood pressure up, that doesn’t make you stuffed with caffeine or use some hormone you shouldn’t be on. And they’re not fillers or laxatives,” Robertson says. Weight-loss clamour leading to shortage of diabetes drug Ozempic has been a ‘game-changer’ in diabetes treatment, but its popularity as a weight-loss drug has led to shortages. - Photo: File cayman compass 8 news N news WEEKLY, 21-27 JULY 2023cayman compass 9 WEEKLY, 21-27 JULY 2023Next >