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PHILIPSBURG/NEW YORK--St. Maarten Seniors and Pensioners Association (SMSPA) Vice-President Raymond Jessurun highlighted the human rights perspective of those afflicted with dementia in low- and high-income countries as a panellist at the United Nations Open-Ended Working Group (OEWG) on Ageing Conference in New York on Tuesday.

After highlighting recent global and regional policy developments, standards and principles, Jessurun exemplified the vast difference in diagnosis and treatment of two patients based on location.

He later offered suggestions and urged the recognition of importance of dementia, calling it “the epidemic of this century,” with figures of those affected set to triple by 2050 (citing The Global Impact of Dementia 2013–2050 by Alzheimer’s Disease International) and impacting society’s collective right to development.

“Henry (67), a Dutch national born in Aruba, and Vivvet (50), a national from Guyana, are migrants with dementia symptoms living in St. Maarten … a non-independent country, part of the state the Kingdom of the Netherlands.

“Four years ago Henry (67) got three strokes. Two years after those strokes his family noted symptoms of dementia and feared that Henry had Alzheimer’s. When one year ago Henry went to Colombia to consult a neurologist for his cardiovascular health condition, he got the diagnosis ‘vascular dementia’ for his brain condition!

“Vivvet (50), for five years already, is searching for a diagnosis of her dementia condition. Persons in St. Maarten who suspect dementia can go to a general practitioner for a memory test, and that’s it! No referral to specialised memory clinics in the Kingdom or to memory clinics in the region to determine the type of dementia!

“The family made out-of-pocket expenses to look for a diagnosis in neighbouring St. Martin, a Collectivité of the French Republic, and in her home country Guyana, but the doctors could not find anything.

“In the Netherlands, you can get the dementia diagnosis of a specialised memory clinic in one day! Are these just differences or is this geo-political discrimination?” he asked.

“I think there is something lacking in the monitoring instrument of the human rights covenants. The system of reporting and of getting observations and recommendations has to be re-examined and adjusted.

“Reporting, giving observations and recommendations over a period of 20 years in the case of the Kingdom of the Netherlands, has not brought an equal implementation of the right to health in all parts of the Kingdom.

“For the last 15 years, seniors’ organisations in the Dutch Caribbean, such as the St. Maarten Seniors and Pensioners Association, are protesting this inequality in the health care infrastructure and the health care quality in the Kingdom of the Netherlands as human rights violations!”

In addressing the right to health care, he said, “Access to an adequate health care infrastructure should be equal to all in all territories of the State. For quite some years now the Netherlands has one of the best health care systems of the world.

“Persons with suspected dementia in the European part of the Kingdom of the Netherlands are diagnosed in general by neurologists and geriatricians in memory clinics, assisted by geriatric nurses and/or psychologists. These specialised memory clinics have specific diagnostic equipment.

“In St. Maarten, there is no neurologist, no geriatrician, no neuropsychologist, no specialised memory clinic, and also there is none in any of the six islands of the Dutch Caribbean. …

“Globally, eight out of 10 persons with a suspected dementia condition are not realising their right to health. As representative of Alzheimer’s Disease International, I can inform you that in the high-income countries six out of 10 persons with dementia have not yet received a diagnosis.

“But, in the lower- and middle-income countries the figures are worse: nine out of 10 persons with dementia have not received a diagnosis!” citing the organisation’s World Alzheimer Report 2011.

“Are these just differences or is this a structural violation of their right to health? Is not this lack of a proper diagnosis affecting or violating their right to an adequate standard of living, and other human rights, as well as the social and economic development of their families and their society?”

He concluded with a number of suggestions to prepare for next year’s OEWG:

“To use the Inter-American Convention on the Protection of the Rights of Older Persons as draft International Convention on the Protection of the Rights of Older Persons.

“To put the gaps and possible ways to repair legislation in human rights instruments which are affecting older persons and those with dementia in particular on the agenda of the seventh OEWG, to be included in a binding International Convention that protects rights of all older persons and their families.

“To review and adjust the adequacy or the lack of sanctions in international public law and in international human rights politics to get States to comply and respect older persons’ rights.

“To review and adjust international cooperation between States and to further elaborate on reparations to finance the right to development and the realisation of all human rights in low- and middle-income countries.

“To charge an expert group with the task to ‘inventorise’ the gaps in international public legislation and to propose how to eliminate these gaps; to guarantee that human rights of all, especially of older persons and the persons with dementia in the low- and middle-income countries, will be adequately protected against violations.”