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Health

UK hospital agrees to operate on severely disabled Saint girl – but only after judge denounces three others that refused

Nuffield Orthopaedic Centre, by Steve Daniels. Published under Creative Commons licence - click the pic to learn more
Nuffield Orthopaedic Centre, by Steve Daniels. Used under Creative Commons licence: click the pic to learn more

A Saint teenager with “catastrophic” disabilities is to be given a desperately-needed operation in the UK – but only after three National Health Service trusts REFUSED to treat her.

St Helena’s chief justice, Judge Charles Ekins, said it was “shameful” that three hospitals apparently could not afford to take her, even though she was entitled to NHS treatment.

The 19-year-old girl, who can be referred to only as K, has severe deformities in her arms, “useless” lower limbs, and severe spasticity – among other conditions. Her profound learning difficulties mean she can barely communicate.

She was due to sail for Ascension Island on 21 April 2015 to meet a dedicated medical flight, but the judge said it would too dangerous to send her with no hospital prepared to receive her.

Only after she had missed the boat was a place found for her at the world-leading Nuffield Orthopaedic Centre, part of the Oxford University Hospitals Trust. The centre has a reputation for taking difficult and expensive cases from outside its own area.

She must now wait until 11 May 2015 to leave the island – where she could not safely have the operation she needs to amputate parts of her legs and ease her enduring pain.

K was discovered by Paul Bridgewater, a newly-arrived social worker, living in Barn View in Longwood, a “care home” used mainly for elderly people.

Mr Bridgewater had her moved to hospital but she was moved back to Barn View, only to be re-admitted – malnourished and suffering a serious ring worm infection.

Her condition is so severe she has to be kept lying down.

The island’s Supreme Court has been given responsibility for taking decisions about K’s care now that her mother is ageing.

A solicitor in England, Michael Trueman, has been appointed to act on her behalf. It was through his efforts, and the commitment of a consultant surgeon at the hospital, Mr Tim Theologis, that a solution was found.

K’s operation was recumbent by a visiting surgeon on St Helena, Sergio Villatoro Bran. He advised removing both her legs from above the knees – bilateral supracondylar amputation.

The hope is that it will make her more comfortable and reduce the risk of a fatal infection.

Judge Ekins pointed out that a protocol with Britain allows four St Helenians to be treated by the NHS each year. He made a point of saying that K is a British citizen – interpreted by some as a way to interest UK media in her case.

In a judgement issued on 23 April, he said: “Three NHS consultants had been approached by the date of the RMS St Helena’s departure.

“None would undertake to admit K. A response is still awaited from the last enquiries made.

“The risk to K of embarking up upon a passage to the UK without a hospital to receive her is unacceptable.

“I cannot think that the decision to refuse to admit K to the trusts approach is a clinical one… it seems to me to be likely therefore that the decision in each case is resource based.

“If that is indeed the case then the situation is a shameful one.”

He said the urgency of the case meant he would have to send her to South Africa if treatment is available there – “a much less preferable option in terms of K’s welfare.”

The High Court in England would take over responsibility for her in the UK. It is not clear what legal arrangements could be made in a foreign country.

K’s mother has been praised by the judge for trying to ease her daughter’s suffering, but he said she was “getting on in years” and there were concerns about her ability to take decisions about her daughter’s needs.

Judge Ekins said she had “been active over the years in doing her best to provide K with such suplementary comfort as she has been capable of.”

In 2012, Barn View, conditions at Barn View were severely criticised in a report by the Lucy Faithfull Foundation. Most of the report – on alleged abuse on the island – was kept secret, but a draft version was leaked.

It said a 16-year-old girl – thought to be K – was sharing a room with a dying elderly woman at the home.

Allegations of a cover-up of abuse, and the governance of the island, are now being investigated by Sasha Wass QC. She is understood to have asked for information about Barn View.

Judge Ekins included politicians in his criticism of K’s rejection by the NHS.

He said: “For some time now it has been claimed that the UK’s economy ranks amongst the wealthiest in the world. It is boasted that the UK’s economy ranks comfortably amongst the largest ten economies in the world.

“Political parties of every hue claim that the UK NHS is or will be safe in their hands.

“The two former make it even more shameful that it is apparently difficult, if not impossible, to afford treatment to a young British citizen with such catastrophic disabilities who is entitled to be treated by the NHS in the UK.

“The latter of the claims referred to frankly rings entirely hollow.”

Drinks tax does little for Dr Corinda Pepper…

St Helena’s councillors are sharing the pain when it comes to tax on alcohol.

“Everyone enjoys a good beer or a glass or wine and I declare my interest,” the Hon Brian Isaac told LegCo.

“Saints are known to enjoy socialising. If we put such commodities out of the range of Saints they will turn to other socialising activity which will impinge on the good of the island.”

New councillor Pamela Ward Pearce got an early lesson in making tough decisions.

“My husband has objected to me raising the price of beer,” she said, “but he understands that this is for the greater good.”

In fact, annual increases in tax on alcohol and tobacco have not led to a drop in consumption, said the Financial Secretary.

Excise duty has not gone up for fizzy drinks – a new tax that brought international attention when it was introduced last year.

That appears to have been some relief for the Hon Dr Corinda Essex.

“I am sure the drinkers and smokers may not be very happy with the increase in duties,” she said, “but I am personally very relieved the duty on Dr Pepper has remained the same, even if this does not in fact incentivise any improvement in my lifestyle.”

Flights: chief sec admits doubts over medical care and crime

St Helena’s chief secretary has admitted to concerns about notorious crime at the airport that is to be the island’s link with the rest of the world – and about the future of medical referrals to Cape Town.

But Roy Burke could offer little response to an accusation of a “shameful” betrayal of Saints working on Ascension and the Falkland Islands, who could be left with no ship and no flights back to St Helena.

Comair Ltd will not offer a link to Ascension when St Helena’s first airport opens in 2016, because it would take pilots over their permitted flying time.

The Honourable Lawson Henry voiced anger, during Legislative Council’s closing adjournment debate, that Saints on sister islands had been left out.

He said it was their votes that had swung the referendum in favour of building an airport.

He also told how he had had his luggage interfered with at the airport, which is notorious for crime.

Mr Burke, in his closing speech, said: “We are all aware of Johannesburg airport’s issues. We will take action to make sure the citizens of St Helena and the travelling public are aware of the issues that are faced there.”

The Honourable Dr Corinda Essex had also voiced anxiety about whether hospital patients would still be sent to Cape Town, where a strong support network had built up among Saints and supporters. Johannesburg had no such network, she said.

Mr Burke said: “I too share that concern, as does the director for health, and we are currently in progress to find a way in which we can resolve that situation.

“Can the link to Cape Town be maintained? That’s a very good question and  I don’t have a short answer to that at the moment.

“But I would say that as far as medical referral issues are concerned, it does not necessarily mean that because Comair are flying to Johannesburg, that Johannesburg would be our evacuation point for a medical emergency, which is a different issue.

“It’s possible someone who needed to be evacuated very urgently might have to go somewhere else, and that might not be Cape Town either. So there’s a lot of work going on there to do with medical evacuation, which has yet to be concluded.”

Mr Burke could give little reassurance over future transport for Saint workers travelling for work on Ascension and the Falkland Islands.

They are to lose their current link between St Helena and Ascension – and onward flights to the Falklands – when the RMS is withdrawn from service in mid 2016.

The chief secretary said: “There are ongoing discussions about Ascension, particularly the link with St Helena: whether that is to be by air or sea. [There is] a lot of discussion to be had.

“Keep in mind that St Helena Government, in seeking to secure an air service provider, and also a freight service, included Ascension in the tender documents, although there was no requirement for those companies to provide [for that] as part of the contact.

“But those discussions continue and will continue until a resolution is found.”

Councillors Henry and Essex were among several elected members to welcome the news that Comair was to operate Saturday flights between St Helena and Johannesburg in a British Airways plane.

MORE AIR LINK COVERAGE: 
Saturday flights in BA livery confirmed for St Helena
‘Shameful’: workers left adrift by lack of Ascension flights
Don’t cast aside ‘family’ of carers in Cape Town, officials urged
I had my bag pilfered at Johannesburg, says Lawson
Ronnie takes flight
Flights to Europe and Cape Town ‘still up in the air’
Blast masters: Alan and co fire the last explosion on aircraft site

Don’t cast aside ‘family’ of carers in Cape Town, officials urged

Officials have been urged to continue sending medical patients for treatment in Cape Town when the island’s ship is replaced with flights into Johannesburg.

Legislative councillors heard that the “family” of people who support Saint patients in South Africa must not be cast aside.

“The electorate is really concerned about the likelihood of medical referral services being transferred to Johannesburg,” said the Hon Lawson Henry.

“All St Helena’s links have been with Europe and with Cape Town.

“The St Helena ‘family’ reside in Cape Town and they are the after-carers for the people who have to go off-island for medical treatment.

“Many of the St Helenians and those closely linked to the island who live in Cape Town have invested in enlarging their homes to accommodate our medical referrals.

“Are we now to cast all this aside and move it all to Johannesburg, where we have no established links for that Saint community who have done so much over the years to look after our people?

“I urge officials… to retain our links for medial services in Cape Town.”

The Hon Dr Corinda Essex said: “We are aware that hospital refurbishments and patient rehabilitation should reduce the number of patients requiring diagnosis and treatment overseas.

“However, it is likely to be the most critical and complex cases that will still require evacuation, and these individuals may well not be in a condition to cope without a strong support network.

“Such a network is long established in Cape Town, but none exists in Johannesburg.

“I am aware that a St Helena representative will be based in Johannesburg, but the support services that will be required extend far behind the scope of a single individual.”

  • Mr Henry hinted at dissatisfaction that councillors had no say in choosing an airline for St Helena. He said: “I contend that the St Helena Government did not make the decision to have the hub for our air services to Johannesburg: officials did.”

MORE AIR LINK COVERAGE: 
Saturday flights in BA livery confirmed for St Helena
Flights: chief sec admits doubts over medical care and crime
Flights to Europe and Cape Town ‘still up in the air’

Ship diverts 180 miles to pick up sick girl – after first offer of help was turned down

Big lift for a small girl: MV Traveller. Picture courtesy of BigLift shipping. Click the pic for a larger image
Big lift for a small girl: MV Traveller. Picture courtesy of BigLift shipping. Click the pic for a larger image

The Master and owners of a cargo ship have been praised for diverting to pick up a desperately sick child on St Helena – two days after being told their vessel was unsuitable.

The MV Traveller was the only ship to respond to a call for help put out by coastguards in the UK.

Update: sick child is ‘awake, talking and eating’

The ship’s Dutch owners, BigLift, waived all the costs of doubling back the 180 miles to St Helena, and then carrying the girl the 700 miles to Ascension Island.

The ship arrived in James Bay close to midnight on Friday, 6 March 2015, but the seven-year-old child could not be lifted aboard until 3.30 in the morning.

She was landed at Georgetown on Ascension at 2100 hours on Sunday, 8 March, and taken straight to a waiting military plane, arriving at Great Ormond Street Hospital in London on Monday lunchtime.

Martin Bidmead, senior maritime operations officer at the Coastguard Operations Centre at Falmouth, was on duty for most of the three and a half days of the evacuation effort.

He said: “Although the MV Traveller wasn’t the most suitable vessel, because she wasn’t very large, in circumstances that were fairly urgent it proved to be the best option.

“Despite being turned down initially, some time later they were asked to go back. Thankfully they were willing to turn round.”

Martin said a request for help from St Helena Radio was received in mid-afternoon on Thursday, 5 March – with the RMS St Helena five days away from the island.

“They sent a message to us asking for us to see if we could contact shipping to transfer a young female who was ill on St Helena to South Africa or Ascension for medical treatment.

“We spoke to South African authorities and there was nothing they could provide that could assist.

“We then did some satellite broadcasts, using our satellite tracking equipment for ships. There weren’t very many ships at all that could possibly help. In that part of the world the amount of shipping is fairly sparse, to be honest.

“One that did offer was a Dutch ship, the MV Traveller, a heavy lift ship.

“We spoke to the Traveller initially at 9.30 on the 6th. She responded to one of our broadcasts. We then spoke to St Helena Radio who said the vessel wouldn’t be suitable.

“She had a lack of accommodation and the medical personnel initially declined the offer. As time went on it became apparent the Traveller was probably the only option there was.”

At that point, the ship had already sailed past the island on its voyage from South Africa to the Virgin Islands, in the Caribbean, said Martin.

“I got hold of the owners in Holland and asked, would they be happy for us to turn the Traveller back to St Helena, because by this time she was nearly 180 miles to the north.

“They said they would, so I went back to the Master and asked him if he would return to St Helena, which is exactly what he did.

“The Master when I spoke to him said they were able to accommodate the casualty in their sick bay. I believe it was fairly small. The four person team who accompanied her I believe had to sleep in the saloon.

“All credit to them as well. I don’t know how they were going to get back.

“They took her to Ascension where an aircraft was waiting for her and flew her to London. They did it very professionally and very quickly.

“We were very grateful and I’m sure the young child’s family were grateful as well.”

The station at Falmouth, in Cornwall, is the international liaison station for the UK’s coastguard service.

“There is a team of four of five of us on watch,” said Martin. “We were all involved and all wishing this child a full and speedy recovery.

“The job was a little bit unusual because we tend deal with emergencies that involve shipping or leisure boats.

“It is reasonably unusual for us to have to assist someone who is on land and requires assistance from shipping.”

This was not the first occasion a call has been put out for shipping to take a dangerously sick person off St Helena, but it may be the last.

The mayday call went out only four months before a test flight is expected at St Helena’s first airport – due for completion in February 2016.

“We had a look on Google Earth and we could see it being constructed,” said Martin.

“It will be good for circumstances like this but it will effect lifestyles considerably. They will end up with people like me visiting.

“It’s one of the few places in the world I want to visit – I really do.”

  • BigLift, the owners of the MV Traveller, said in a statement that the ship was ten hours’ sailing time from St Helena when the request was made for the vessel to turn back to the island. “Her parents, a doctor and a nurse were taken on board. Assistance was requested and without hesitation, MV Traveller responded. The vessel was en route from Durban to the Virgin Islands so the deviation was relatively small. Despite the short notice we were pleased to assist and hope the girl will receive proper treatment and fully recover in time.”

Saints get free calls to UK helpline – thanks to SURE

A confidential telephone support line for people in distress on St Helena has been set up in partnership with the UK’s Samaritans charity.

The calls will go straight through to trained counsellors in Britain. SURE St Helena has agreed to cover all the costs of the calls, in a deal organised by St Helena Government (SHG).

The telephone number for this service is 20000. All calls are free. 

SHG’s Assistant Chief Secretary, Paul McGinnety, said: We understand the need for people on the island to be able to access confidential off-island support

“We are indebted to SURE who have agreed to cover the costs of all of the calls.

“Their team have provided us with a unique number which will not show up on individual bills.

“I would like to place on record our thanks to Samaritans and SURE.”

The Samaritans answer calls round-the-clock, every single day of the year to provide emotional support for people who are experiencing feelings of emotional distress.

Its volunteers are trained to listen without judging and to give people time to talk, to help them see a way through their troubles.

People wanting additional guidance on the new service can call the following:

Safeguarding Directorate: 00290 22713
Police Confidential Help Line: 00290 22888
Mental Health Services: 00290 22593
Human Rights Office: 00290 22133

Infants and old at risk as virus spreads through island

Click the pic see see an info graphic on RSV
Click the pic see see an info graphic on RSV

Large numbers of sick children on St Helena are reported to have been infected with a virus that can be serious for infants and old people.

Screen Shot 2015-02-19 at 10.31.07Many of those turning up at the hospital in Jamestown with the respiratory syncytial virus (RSV) have come from the same creches or other busy environments.

In the United States, the virus is the most common cause of bronchiolitis and pneumonia in children under one year of age, and a significant cause of breathing problems in older people.

A leaflet issued by St Helena’s health department on 19 February 2015 says:

“RSV is a respiratory virus that infects the lungs and breathing passages.

“Healthy people usually experience mild, cold-like symptoms and recover in a week or two. But RSV can be serious, especially for infants and older adults.

“Infants under six months old in particular can get seriously ill.

“The virus produces a thick mucus, which is difficult for the child to cough up.

“It does NOT respond to antibiotics.”

The virus spreads when droplets from a cough or sneeze come into contact with eyes, or when someone touches an infected surfaces and then touches their eyes.

Screen Shot 2015-02-19 at 10.30.54Symptoms include prolonged coughing, wheezing, mucus, and severe tiredness.

Patients may not have strength to eat, drink or cough.

The most important advice is to wash hands before and after contact with children.

The leaflet also encourages people to:

  • make children sleep in a cool room, with head raised
  • encourage drinking
  • avoid contact with infants
  • avoid smoking near children
  • limit visitors

St Helena Government has not disclosed the number of patients known to have contracted the virus.

Read more here

United Nations cash provides a refuge from violence

A new refuge is to be set up for domestic abuse victims on St Helena, thanks to a windfall from the United Nations.

A building from the government’s housing stock is to be used to provide a place of safety for victims and, if needed, their children.

Its location will not be made public.

Executive councillors agreed to the project on 3 February 2015 after hearing how the island had been awarded £40,000 from surplus funds by the UN.

An initial request for funds did not fully meet the requirements of the UN Development Project scheme, but the island was given a share of money not taken up by other nations.

Medics perform St Helena’s first heart op

Medics on St Helena have saved a patient’s life by performing the island’s first-ever heart surgery, reports St Helena Government. 

It was carried out in at the hospital Jamestown by Senior Medical Officer Dr Attila Frigyesi and Surgeon Dr Carlos Soto on Friday 16 January 2015, assisted by the theatre nurses.

The emergency surgery was successful and the patient was doing well and recovering at home, said a press release. 

Dr Atilla said: “Friday’s operation highlights the fact that it is possible to perform relatively advanced healthcare on St Helena if we have appropriate trained staff and suitable equipment.

“I would like to thank all of the team involved for their efforts in saving the life of this patient.”

St Helena shows UK the way with fizzy drinks tax

St Helena appears to be showing Britain the way to tackle obesity, by introducing a sugar tax.

A levy on high-sugar drinks was announced in the island’s budget in the very month that England’s chief medical officer warned that the British government might have to consider such a measure.

But Dame Sally Davies said she hoped it would not be needed in the UK.

St Helena Government (SHG) is introducing the 75p-per-litre excise duty from May.

It is a move that some on the island have long campaigned for, including shop owner Nick Thorpe, who sees the vast scale of imports of sugary foods and drinks.

The island is reported to import nearly a million cans of fizzy drinks per year, for a population of just over 4,000 people.

The island’s incidence of type 2 diabetes, which is linked to obesity, is among the highest in the world. The government has warned that the cost of treating the condition has put a massive strain on the island’s health service, as well as damaging the lives of diabetics.

The new budget includes an additional £692,000 for the health service, and more than £1.5 million has been set aside to fund infrastructure improvements to the hospital, including the furnishing of a diagnostic suite.

Colin Owen, the island’s Financial Secretary, said: “The introduction of a new tax on high-sugar drinks and higher-than-inflation increases on tobacco form part of a raft of measures which demonstrate that SHG takes the health of St Helena seriously.”

He also announced the introduction of liquor duty at £3.50 per litre, and a new duty of £1 per litre for drinks with an alcoholic content of 3% or below.

Councillor Ian Rummery pointed out the timeliness of the move in an email to St Helena Online. He wrote:

“I see that a sugar/fat tax is being debated in the UK media with statements from Dame Sally Davies, the Medical Officer, and the BBC World Service Business Matters programme has a week-long special on obesity and discussions on a fat tax.

“While the world talks about it, here on St Helena we have just introduced a tax on sugary carbonated drinks.”

Dame Sally first raised the prospect of a sugar tax in comments to the UK Parliament’s Health Select Committee. She also suggested that sugar might be addictive – though some scientists disagreed.

In his budget speech, Mr Owen said: “On St Helena, over 300,000 litres of carbonated sugar sweetened beverages are imported per year.

“This equates to around 67 litres per year for each person currently on island, each of us drinking around 200 cans a year. Within this, some people will consume very little, while others may consume many more.

“Just to be clear on the figures, we import just under ONE MILLION cans of fizzy soft drinks each year. And each can on average contains over 35 grams of sugar.

“We currently have a very high rate of obesity, and type 2 diabetes. This has a very high cost to the St Helena health service and there is significant evidence to show direct links.

“Every additional regular can-sized, sugar-sweetened drink per day, increases the risk of developing type 2 diabetes by 18%.

“A number of studies document a link between fizzy soft drink consumption and higher blood pressure.

“And dental health is negatively influenced by consumption. Studies have shown that consumption nearly doubles the risk of dental cavities in children.”

He added that healthier diet drinks were currently more expensive than high-sugar drinks, especially those from South Africa.

“Research has shown that increasing the price of fizzy soft drinks will lead to a fall in consumption, as consumers switch to alternatives.”

The island budget also included a range of tax increases for alcohol, and a 5% increase in tax on all tobacco goods, taking the cost of a packet of 20 cigarettes to just under £5.

Mr Owen said: “The rate of throat cancer on island is one and half times more than the UK, the highest risk factors for throat cancer being smoking and drinking alcohol to excess. This above-inflation increase supports the health service.”

In his speech to Legislative Council on Friday, 21 March 2014, Mr Owen said:

“Madam Speaker this budget is different. It seeks to support not just economic development, but to support SHG’s top priority, health – and not just the health of individuals but that of the nation.

“I do not believe it’s right anymore to sit on the sidelines. We need to grab every opportunity available to support our health and green objectives, and that includes using the tax system to provide appropriate financial incentives. We need to change our tax policies to address the growing number of concerns around diabetes and cancers.”

He said the budget had been compiled by councillors, not just officials, which had brought fresh ideas.

SEE ALSO: 
Killer diabetes puts island under strain, says the Castle
Diabetes cases soar as island struggles with cost of healthcare
My sadness and anger at diabetes crisis, by writer Doreen

Plastic bag tax aims to cut landfill waste

The budget included new taxes of 5p on plastic bags and 1p on styrofoam containers for takeaway foods – both excise taxes, imposed within the island, as opposed to customs duties.

Mr Owen said: “Both products are made from petroleum and are not degradable. St Helena does not have the facilities to dispose of them and they end up in the landfill.

“Roughly 500,000 bags and containers are used per year and this is only likely to increase as tourism grows. Similar policies to reduce use of plastic bags have been very successful in places such as Wales.”

Budget facts

In his budget speech, Mr Owen said:

Prices in island shops rose by only 1.5%, against a forecast of just over 5%. But it was expected to rise during 2014.

The resident population averaged 4,297 people through 2013, and is forecast to reach to nearly 4,500 people in 2014.

More than 360 Saints were working on the airport project and unemployment was at an all-time low, with vacancies in government and the private sector. In total, 550 people were working on the project.

Income tax was set to have raised £3.4 million, some £325k ahead of targets.

Saints are letting out more properties than ever before.

Earnings from customs duties on alcohol and tobacco exceeded targets by £115,000 and £10,000.

The offshore fishing vessel MFV Extractor had been purchased, partly with funds from Enterprise St Helena (ESH) and would soon be leaving Cape Town to fish St Helena’s seamounts.

ESH had assisted in 30 youth training schemes and five public-private partnerships. More than 40 people enrolled as apprentices.

A 30-year planned maintenance programme for government housing began with the rewiring of flats in Jamestown.

Planning permission was granted for 65 homes in Half Tree Hollow, featuring wheelchair access and rainwater harvesting.

Two new “chuck and chew” waste lorries had been procured, along with 1,500 new wheelie bins.

Four conservation and environmental projects, due to start in April 2014, attracted grants worth more than £260,000.

Significant advances were made in standards of education. Almost half of the young people who took GCSEs in 2013 achieved a C grade or better in English and maths.

Mr Owen also said that December 2013 saw the introduction of a Minimum Income Standard. “St Helena should be proud that it is leading the world in ensuring that our benefits system properly reflects the actual costs of living here,” he said.

“This will be reviewed at least annually, with benefits adjusted accordingly – a tangible demonstration of our commitment to protect the most vulnerable from the rising cost of living. But this is only a starting point and we all know that there is much more to do.”

Other recommendations in the Sainsbury Report, commissioned from York University, would be considered over a five-year period – including a child benefit allowance, which the government planned to introduce from April 2015.

But he added: “Bringing benefits up to the level that we all see as desirable will be expensive, and to introduce every proposed reform now would simply be unaffordable.”

A settlement of £13.55 million in UK aid was confirmed on 13 March 2014 – an increase of £150,000 – with a further £4.5 million to cover the running costs refurbishment of the RMS St Helena.

The amount set aside for overseas medical referrals rose to £947,000, more than double the previous year’s figure.

Mr Owen said the budget also reconfirmed the government’s funding for the National Trust, New Horizons, Heritage Society and South Atlantic Media Services, and saw increased funding to SHAPE and the Public Solicitors Office, along with new funding for the Human Rights Office.

European funding of around 21.5 million Euros was likely to be made available for infrastructure development on St Helena, Tristan da Cunha and Ascension Island over the period 2016-20. Specific projects had yet to be formally agreed.

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