When some of us were growing up throughout our country of Belize, the Healthcare System was comprised of a; Hospital, Public Health Clinic and a Mobile Rural Health Team. When a person got sick he or she was taken to the Emergency Room to see a Doctor. When the Doctor evaluated the patient, he or she would decide on whether to admit the patient or to send him or her home with medication and give them a follow up appointment. If the patient was admitted to the hospital, the Doctor would give the patient or his family member the reason for the admission. Not too much has changed much except for the type of healthcare we are receiving in Belize today. HOSPITALS THE OLD BELIZE CITY HOSPITAL In those days Belize City Hospital had the best equipment and Doctors so most Doctors from the other Districts would send their patients to the Belize City Hospital if they felt that their patients needed additional treatment. The Belize City Hospital was divided into different wards at the time and they were designed based on the patients’ illness and condition. The people from the other Districts in Belize felt that whenever a patient was sent to Belize City, it was because his or her condition was not good. Many of our citizens travelled back and forth to Belize to visit our family members. This is still happening today because some of the hospitals in the other Districts, do not have some of the medical equipment, Doctors and Specialists to do the testing, diagnosis and treatment. NO DIALYSIS MACHINE IN THE SOUTH I was told recently that for years the hospital in Dangriga, at one time had a dialysis machine but it was removed and taken to a hospital in the northern part of Belize. Currently, the Southern Regional Hospital in Dangriga that serves the Toledo and Stann Creek Districts, does not have a dialysis machine. There are many citizens in the south who suffer from Diabetes and are in need of this machine to get their regular treatment. Those people who have the money traffic back and forth to Belize to get their treatment at a high cost. While, those who cannot afford the cost of the travel and the treatment, stay in the south which result in their condition to get worse. A PICTURE OF THE SOUTHERN REGIONAL HOSPITAL IN DANGRIGA TOWN PUBLIC HEALTH CLINIC The Public Health Clinics in Belize were used to provide Preventive Care and After Care to our citizens. I remember when all the schools in Dangriga would take their students to the Public Health Clinic to receive their vaccinations and receive dental treatment. The Public Health Clinic Building by the beach is now sitting there with no activity taking place. RURAL HEALTH NURSE AND MOBILE TEAM There was a Rural Health Nurse assigned to the Dangriga Hospital and the other hospitals in the country. The Rural Health Nurses” responsibility was to, go in a vehicle to all the villages and provide healthcare and medical referrals to the citizens of the villages. If the nurse felt that a patient needed immediate care, that patient or patients would be brought back with them to the District hospital. BELIZE HOSPITALS TODAY KARL HEUSNER MEMORIAL HOSPITAL (KHMH) IN BELIZE CITY Over the years the country of Belize have seen a growth in its population and a demand for medical treatment. Especially, from Americans, Belizean Americans and Belizean citizens who want quality medical care. Most of these people have money to pay for their care or have medical insurance to cover the cost of their care. This has led to the establishment of private hospitals and medical institutions like; Belize Healthcare Partners, St Luke Hospital, Belize Medical Associates, Buttonwood Bay Medical Center and other private clinics. There are no laws in Belize to regulate the cost of these hospitals’ treatment and their prices keep going up. The average Belizean citizens cannot afford the cost of their treatment. According to a research I conducted on the state of Healthcare in Belize, below are some findings from PAHO and an International Travel Guide. Measures to achieve universal health coverage The National Development Framework for Belize (2010–2030), known as Horizon 2030, set out a long-term road map for development focused on youth, inclusivity, and the need to create “One Belize – Un Belice,” and development based on intersectoral collaboration. Two key health strategies in this development were a focus on health in the community throughout the life cycle and achieving universal access to health care – an adoption of the global move toward universal health coverage.3 The subsequent Belize Health Sector Strategic Plan (2014– 2024) builds on these key strategies with objectives to strengthen the national primary healthcare system, human resources in health, health information systems, and health system quality control. Improvements in health service management and health financing are specifically designed to help achieve universal health coverage.4 The focus on primary care deliberately targets health behavior as a more efficient and sustainable model of health care. The focus on shared responsibility and multisectoral collaborations recognizes that health is a social product and that health problems stem directly and indirectly from root social and economic determinants. Joint working is therefore an indirect attempt to tackle health inequalities, with persistent inequalities recognized between urban and rural populations of Belize and between ethnicities across the country. Efforts have begun on primary care capacity-building, particularly to address hypertension as the major precursor to cardiovascular disease. Interventions to address unhealthy diets are ongoing but multisectoral actions are needed to promote healthy eating among the general population. Several projects to bolster universal health coverage are ongoing. For example, the Health Sector Reform Project has implemented health system decentralization, and currently the model is being reviewed with the objective of improving efficiency and effectiveness geared toward an improvement of the quality of care. The community health workers program spearheaded by the Health Education and Community Participation Bureau is currently focusing on improved training for community health workers, and an increase in their number and regional coverage. The national health insurance scheme has been operating for two decades, in the southside of Belize City and the south of the country, with recent expansion to selected areas in the north. The scheme is a joint public-private partnership for providing health services, with an emphasis on expanded access to diagnostic and treatment. Equity in health service delivery has been recognized as a priority, and is being tackled with several initiatives, including an expansion of the health workforce in key areas (general practitioners, medical specialties, medical laboratory technologists, and nurses), expansion of the national health insurance scheme to the northern health region, improvement of community health facilities, and training for healthcare personnel in evidence-based healthcare. Challenges related to population health Belize has a relatively young population but is aging and the pace of this aging is predicted to increase. In 1980, the proportion of Belize’s population aged 65 and older was 4.5%. This proportion remained static in the intervening 40 years, nudging up to an estimated 5.0% by 2020, but is predicted to rise dramatically to 16.8% by 2060.5 This future increase of 11.8 percentage points represents a rapid rise in older adults that is above the regional average for the Caribbean of 10.7 percentage points, but below the average for the Americas of 13.7 percentage points. This demographic transition is in part due to Belize’s important progress in reducing the burden of infectious diseases. The burden of maternal and neonatal disorders, respiratory infections, and HIV/AIDS and other sexually transmitted infections have all reduced, with the disease burden shifting towards noncommunicable diseases. Cardiovascular diseases, diabetes, and cancers in 2019 were the top three causes of death and disability, collectively accounting for around onequarter of all healthy life lost.6 The burden of self-harm and violence, unintentional injuries, and transport injuries collectively accounted for 18.4% of all healthy life lost in 2019, with self-harm and violence of particular concern, rising by almost 50% since 2000. Mental disorders continue to increase in importance. Solutions to each of these challenges require multisectoral cooperation. Although the noncommunicable disease burden on the health system and on communities has not been economically quantified, the increasing noncommunicable disease disability among working age populations hints at the growing national impact. Rehabilitation services after, for example, heart attacks and strokes stand out as a key health priority that needs urgent attention. MY VIEWS ON MENTAL ILLNESS In the past and even up to today, many Belizeans look down at their citizens with mental illness. Little do they realize, that it is just an illness like many other diseases and that these patients need to be treated. Some Belizeans including some Police Officers, have been abusing our citizens with this disease and no action is taken against them. I believe that it is time for the Government of Belize, to establish a Psychiatry Department in all their hospitals to; ensure that our citizens with mental illnesses be given the protection and care that they deserve. Mental patients who pose a threat to themselves, family and the public at large, should be in the hospitals until it is determined that they pose no threat. This will reduce the amount of people with mental illness, walking the streets in our country getting abused or abusing our citizens. HEALTH INSURANCE A NECESSITY Many countries in the world depend on health insurance to pay for the treatment of their citizens. There are several Belizean American citizens, who want to go back home and live but the type of medical treatment in Belize and the insurance are the two main issues that is stopping them from returning home. There are a few American Insurance companies that provide worldwide coverage for their citizens such as; Cigna Global, Bupa/IHI and International Medical Group. The Government of Belize should grant these companies license to sell their medical insurance in Belize. This will encourage Belizean American to sign up with these companies and it will create jobs and revenues for our Belizean citizens. They should also encourage more insurance companies in Belize and abroad, to provide health insurance to make it competitive. POSSIBLE SOLUTIONS For Belizeans who are uninsured, the government of Belize should consider passing a National Insurance Act (NIA). The laws will ensure that the Government and businesses will provide Health Insurance to all their employees for a reasonable and affordable monthly deductible. This will generate revenues for the Government to maintain the cost of their; staff, hospitals and clinics. People who own their businesses and Independent Contractors, should be allowed to purchase health insurance in this pool as well. The funds for this insurance must only be used for its intended purpose by the government and for nothing else. They should also include criminal penalties for the unauthorized use of these public funds. This will help to prevent a person from using the funds unlawfully. There have been reports of people in other countries embezzling these types of funds. We want to prohibit the same to happen in our country. MEDICAL TECHNOLOGY SPECIALISTS AND TECHNICIANS When speaking to many of our Belizean citizens, it is being brought to my attention on several occasions, that our government need to improve our hospitals and clinics with; modern medical technology equipment, Specialists and Technicians in order to achieve quality care for our citizens. If not, some of our citizens will not be diagnosed, be given the wrong diagnosis, wrong treatment or become victims of untimely deaths. This is an issue that is a major concern for many of our citizens. CONCLUSION A PICTURE OF A DIALYSIS MACHINE WHICH IS DESPERATLEY NEEDED IN BELIZE VISITING A LOVE ONE IN THE HOSPITAL It is difficult for a patient or his family member to comprehend, that a relative or friend is suffering from Stage-4 Cancer or another chronic disease, when all along he or she was seeing his or her Doctor and it was never detected or told to them. This is considered Gross Negligence on the part of the; Hospitals, Doctors and Staff. It is painful to visit a love one in the hospital lying in bed helpless pondering his or her fate. I am a strong believer that our government and citizens, can all come together to improve our medical situation in our beloved country Belize, for all of our citizens to receive quality care and not just some.