Economic benefits and social consequencies

| 03/05/2010

Just the other day I read a news story of a gentleman from Indianapolis, Indiana flying over to Wales for a medical operation. The lowest cost he could find in the USA was $34,000 – in the UK he got the same procedure done for £1,700.00.* There is definitely a market out there for Shetty’s hospital.

Whereas the economic success of the hospital and its actual owners is not really in question, the same results for Caymanians do not appear nearly as guaranteed.

Had there been a history of around the corner queues of Caymanians trampling over one another to enter the myriad of health professions I would be more optimistic.

The health industry is NOT, I repeat, NOT a glamorous one. Have we forgotten, for example, that the vast majority of Caribbean people who emigrated to the UK in the 50’s and 60’s did so to fill up many of these posts. The custom of "3rd world" nationals emigrating to the super nations as health care employees is still in full effect. That alone should put some degree of doubt or skepticism in the minds of people when considering this proposal. I am not trying to be an elitist, as I actually believe this very attitude is a major contributor to our current state of affairs, but I strongly believe in calling things the way they are.

We have long been regarded as a country with one of the highest standards of living in the Western Hemisphere, boasting a higher average salary than the USA, UK or EU etc. Therefore, the subsequent mindset of our people really has to be taken into consideration at a time like this.

It is important that we are clear of what we are talking about when we mention "health care".

Most Caymanians that have since drank the kool-aid are now harbouring pipe dreams of an unnaturally high number of world class Caymanian surgeons and specialists (insert the "How dare you suggest that Caymanians are unable to become qualified doctors!" remarks). This is not what I am saying at all people, but we need to be realistic when it comes to simple statistics. We are a tiny community and world class doctors, as would be required by such a facility, do not come a dime a dozen nor are they concentrated in a tiny island of 45,000 Caymanians.

Therefore, if we are to seriously consider the actual "opportunities" that this project will bring for Caymanians then we need to be focusing on the more achievable and available support roles of a medical facility: nurses, nursing assistants, general assistants, carers, therapists, porters, rehab, workers, etc.

How many Caymanians do we know that are sitting around just hoping that a few of these posts would open up to their satisfaction? What is the ratio of Caymanians to expats that actually fill these posts in our existing medical centers? What actual salary levels will be offered by Shetty’s hospital? Will these salaries be sufficient to maintain the average Caymanian living a basic Caymanian lifestyle (not 8 adults crammed in to a 2 bedroom bargain apartment)? Will the prospect of home ownership in the Cayman Islands even be a foreseeable one by way of these salaries? These concerns, in my opinion, are of fundamental importance. However, I am disappointed with the lack of attention being paid to them thus far.

I am sure many may object to my perspective on this issue and some will in fact insist on a necessary shift in regards to the typical Caymanian mindset, to which I would agree to some extent. However, this is much easier said than done as can be witnessed by the current uproar in the UK (and EU) in regards to the recent influx of Eastern Europeans that are "taking all of the jobs" – may I remind all that immigration is the #1 concern of this upcoming UK election.

In any event, posts will have to filled at the Shetty Hospital – and they will be. I am of the opinion that at the time its doors are opened there will not be nearly enough prepared (mentally / skilled) Caymanians to take up said posts. However, there are literally hundreds of thousands if not millions of Indian (and other) nationals eyeing this proposal with baited breath. While I am of the opinion that this project could, in fact, be beneficial for actual Caymanians, provided all of the above issues are properly addressed and enacted upon, I am afraid that all of this requires time and a gradual evolution. In the meantime, substitutes will be found.

This carries the further risk of even lower salaries, for I am willing to bet my left pinky that no skilled, experienced, immigrant worker will be let go in order to empower a newly qualified Caymanian. Business simply does not work this way.

Other concerns, of course, are the social issues that will no doubt arise with the (suggested) immigration of high numbers of Indian / Asian nationals into a predominantly Black / Brown Caribbean country. (Yes I said it.)

We all know of the great (color based) North vs. South Indian divide. We know of color politics in that country – to the point of its entrenchment in the very tenets of its predominant religion / way of life – Hinduism. By now we should all have heard about the "untouchables" within Indian society.

Seriously, I ask – has any consideration been given to this at all in regards to this overall proposal. These issues are alive and well throughout all levels and sectors of Indian culture. Not to mention the economic and social clan-like nature of Indian people. Actually, it could be argued that certain exclusionary elements of Indian culture has worked well for them as a people when they have emigrated into wider societies, however, such practices run the risk of being a hindrance more than a help onto the Caymanian way of life. Certainly, by now many may feel somewhat insulted or shocked by my words. However, again, I am just calling it the way I see it.

Anyway, I just wanted to highlight a few issues that I felt were being overlooked in this overall project. As we can see there are many potential pitfalls and risks involved. Sadly, Caymanians have a long history of not loving or respecting themselves enough to acknowledge the existence of many of these associated risks.

In any event it appears that all systems are "go" on this project. I guess there is nothing more to say than "we shall see". However, I believe that the fact that we have to rely on a "fingers-crossed" approach at this stage of such a significant development is quite a short-coming on the behalf of our government.

Oh yeah, almost forgot – I hope we are all prepared to be further criticized and attacked by the USA media and politicians as we prepare to eat some of their supper. The US health care industry is BIG business! Let us hold on to our hats. The news blitz will be amazing for every botched operation at the "Shetty Hospital".

* CNN: ‘I can’t afford surgery in the U.S.,’ says bargain shopper

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  1. Anonymous says:

    How big is 500 acres?

    Most average-sized shopping malls sit on less than 50 acres.

    1 square mile = 640 acres = (5,280)^2 ft^2 (sq ft)

    500 acres = 202.34282112 hectares

    Stated another way, Dr. Shetty’s land gift = <5% of Grand Cayman


    • Anonymous says:

      First, what matters is the percentage of undeveloped land on Grand Cayman thats being used.  Second, this does not include all the development around it for housing etc. which will take up a lot more.  20,000 people according to the PPM.  Practically a new town.

      • frank rizzo says:

        Cool. Maybe we will even have the opportunity to buy a roast on Sunday.

      • Pipple Pottle says:

        "20,000 people according to the PPM.  Practically a new town"  Or one third of a country if you can call this a country.

  2. Anonymous says:

    Some of the points are valid and need to be considered carefully, however, this provides a great opportunity for many Caymanians to train and enter a new carrier field where previously they may have not had the opportunity to do so on Island. At the end, it is up to Caymanians to make the most of this opportunity to ensure that they are a part of this project. Just sitting back, complaining and waiting for someone to drop everything in their laps is not going to get them there.

    I am a Caymanian and I have a two young daughters, and I hope that this will perhaps expose them to a potential education path that otherwise they may not have considered. I have family members located overseas who are trained in various areas in the medical field, but in order to get the necessary exposure and carrier opportunities, they had to stay overseas. Now they might actually have the opportunity to work in their trained field right here on Island.

    • Anonymous says:

      Complaining?  Criticism is neccessary for anything with important consequences.  What do you want, a one sided debate?  People to just listen to the government and not ‘complain’?

      • Anonymous says:

        Yes, I agree, criticism is necessary but is only valid if reasonable alternative solutions are suggested at the same time. It is easy to point out all the flaws and negative side of things. I think the majority of the people here will agree that we all hope that certain mistakes (which the various governments over the past decade have made) will not be repeated again.

        That said, in order to move forward, we have to embrace change and we have to refocus again to see things in a positive light. With the good will always be some bad.

        I am sure there will be a lot of issues encountered with this project along the way but I think this is the nature of the biest.

        Cayman will need to decide whether they want to develop and move forward or be at a standstill, but I would suggest that the recent events have all reminded us that we shouldn’t be putting all of our eggs in only one or two baskets (being finance industry and tourism), especially when they are interlinked.


        • Anonymous says:

          "Yes, I agree, criticism is necessary but is only valid if reasonable alternative solutions are suggested at the same time".

          Not true. Whether or not criticism is valid is purely dependent upon the merits of the criticism itself and not on whether there are also alternative solutions suggested. It may be frustrating but it is not invalid.    

      • Anon says:

        No, constructive criticism, i.e. don’t just criticise.  If you know so much perhaps you could also make suggestions?

  3. Shock and Awe says:

    I agree Whodatis, there wasn’t much critical thinking about this project.  As usual, it was the carrot before the horse.  Being an expat coming from a country with a long history of exploitation I came to Cayman with a different mindset.  That being, I would not be one of those types. And I have tried my best not to be and have tried to treat my host country with the respect it deserves.  But given that, I still see where it begins.  When politicians have money waved in front of them and go for expediency rather than a long term outlook it is generally the people who question later….what happened to all the jobs.  And where did our country go?

    It should be made quite clear from the outset in any negotiations with foreign investors that part and parcel of any investment will be a firm (and written) commitment that whatever benefits will be distributed firstly in the local workforce with training.  And it is the investor who pays for the training.  Otherwise, it’s just selling a piece of land and another piece of a heritage. I don’t want to see that happen further in Cayman.

    I came here to escape that behavior.

    • Watler says:

      How can there be critical thinking in the LA?

      We have a party-system. Whoever gets in run things! There is no brainstorming, because the leader of the party has the last say! 

      This is very unfortunate!

      At the beginning, I never agreed with party-system politics. Look at how divided our country is now, and look at what the last party did for the country.

      I say it would have been better if the House consisted of only INDEPENDENT MEMBERS – then I think we would have had more debates and critical thinkers in the House before making big decisions.

      Not saying that this decision is not a good one, BUT WITH McKeeva, I find I have trouble with "HOW" HE ALWAYS CARRIES OUT HIS TASKS. He makes good decisions and comes up with good ideas, but I always find myself questioning his "HOW" he deals with them


      God Bless

      • Anonymous says:

        A party system is not inconsistent with critical thinking. The problem occurs when the leader of the party in power is a dictator. 

        Get over it. The days of independents are over.   

        • Anonymous says:

          Party politics is a cancer on democracy.  Its like two gangs fighting over the government, winner gets his friends pockets filled with the public coffers.

  4. Anonymous says:

    You are right to point out these issues. The UN and EU and others are looking at using international law to ban "transplant tourism" and our government has just signed up to bring it here. Just wait until the US health care lobby gets hold of that one particularly when the US government has just decided to get more into the health care sector. If we thought that the criticism we get in relation to our financial sector was bad, just wait until they start showing poor farmers who were somehow persuaded to sell a kidney or a lung to a hospital in the Cayman Islands.

  5. Anonymous says:

    I’m kinda hoping there could be a nursing/medical college our youth could attend after graduating to become fully qualified in one of the many medical fields this establishment will promote.  If this kind of investment was being made, with the aim of encouraging and teaching young Caymanians into the medical profession, I would be fully supportive. 

    • frank rizzo says:

      I believe this is inthe MOU.

    • Anonymous says:

      You go to the hospital. You sign up as an ‘intern’ (not sure the title they use). Once you’ve shown you’re willing to work and can take what the job gives they’ll train you up so you can get your nursing certificate(s). – This hospital will give Caymanians nothing (training, job types) that they can’t get now. Hopefully it will bring some new money without making the mistakes the viewpoint points out.

  6. Anonymous says:

    wow… a caymanian accusing indian nationals of racism even before they get here…..zzzz

    warning for any indian coming here:

    caymanians are the worst thing about cayman!..lucky they are in the minority though…

    please come! you will welcomed by the hardworking, educated, tolerant expat community

    • CHT says:

      So why are you here? Since Caymanians (not those that were here for two years and given status by some favor) are so bad why aren’t you on the next flight? We are certain there is something here that you want, most likely something financial, but you don’t like to deal with the "natives". They were here long before you came, when there was nothing but mosquitos, bush, and hard life, and they stayed and played a critical part in the development of these lovely islands. When you go to Rome you do as the Romans do, if you don’t like Caymanians then leave Cayman! Try somehwere like Iraq or Afghanistan maybe they will be more accomodating. Caymanians don’t hate foreginers as misguided individuals like you express or imply. Caymanians simply don’t appreciate people who plunk themselves down in their living room and demand that things be done the way they were in your own country or to your personal  liking. Many have come to these islands and have lived and appreciated the Caymanian way of life and  wish to continue that beautiful relationship. Most if not all have integrated very nicely and love the relationship with Caymanians. Please discontinue your diatribe of stupidity and ignorance, there are many foreigners here who love Caymanians and their way of life and wish to remain a part of the culture. 

    • Hmm... says:

      Well actually Caymanians are not a minority, since there are 30,000 in a population of 50,000. But I don’t mean to criticise. Perhaps you only meant some Caymanians… well then you should have said so.  But how would one distinguish between them? Also just so you know racism means assuming that you are superior to someone on the basis of skin-colour, although I’m sure that’s not the grounds for distinguishing between Caymanians that you would use. Colonialism means assuming that you are better than someone on the grounds that your country has/had power over theirs, but perhaps that not what you are thinking of either. With xenophobia its simply that they come from a different country. All of these things are of course related and they are all hallmarked by universal thinking, i.e. all people who are x are y. e.g. all expats should just go home, Caymanians are the worse thing about Cayman. Well no, that can’t be right either. It looks like I am going to have to end with an apology. I have simply failed to capture the educated, tolerance that so clearly characterises your post.

    • Anonymous says:

      Oh yes, ‘hardworking, educated, tolerant expat’, take a look at the U.K.  They once said ‘please come!’…now look!

  7. Anonymous says:

    The issue I have is the amount of land it will take for this project.

    A whopping 500 acres of cutting down forestry and bull-dozing land in the East! I mean that’s alot of land clearage we are talking about. And all of this is on the east side of the country.

    I wonder what the Environmentalist or National Trust are saying?  Will such a large development hurt our environment?


    No one likes the word, but I could see why people are recommending Payroll tax… because if society (the people) has helped you to become successful, you should be willing to give back a percentage of your salary. Payroll tax is a "sustainable revenue" that I believe will not have such a major impact like VAT or other taxes. Expecially, if the Payroll tax is not a FLAT ONE where the low-wager has to pay the same as the upper class citizen. Such tax should be scaled in accordance to what people make.


    Revenue into the country is good, but if its going to hurt our tourist product – the environment, I think we better introduce a "sustainable revenue" instead!

    Anyways, that’s my 2-cent


    • sandra says:

      I disagree with all you said…

      But I agree with you on the cutting down of 500 acres of trees in the East End area. This will definitely effect our wildlife, weather, and environment.



    • Anonymous says:

      Doubtless there will be huge environmental fallout from this project where-ever it is built. The loss of habitat on the actual site is one part of the equation, but please don’t forget the GARBAGE this facility will produce.  In addition, roads will have to be built, and there will be the normal infrastructure requirements including housing, supermarkets, more police and fire trucks nearby etc.

      Therefore, it is CRITICAL that the Conservation Law be passed immediately, as that is the only hope of ensuring that the environmental impact of such a large developmnt is minimized. Unforturnately, this too falls under Min. Mark Scotland’s portfolio and it remains to be seen if he will have corurage to do what is right and pass this Law now before it is too late.

  8. Anonymous says:

    Sone good points, whodatis. I was just making some of the same points in a conversation with friends this afternoon. Of course it is now heresy to sound any note of caution about the proposed hospital. Critical thinking has become a cardinal sin. Only euphoria is acceptable.