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Low-cost Dominican surgeries spark warnings by US

Posted on April 1, 2014 in Economics, Ethos, Industries, Strategy, Tactical

Go Lean Commentary

To the family of Beverly Brignoni, according to the foregoing news article, the publishers of the book Go Lean … Caribbean, SFE Foundation, extend condolences for the loss of their dearly departed loved one. This article – as follows – shows the down-side of medical tourism, an accidental death from an apparent lax oversight in a cosmetic surgery clinic.

By: Ben Fox and Ezequiel Abiu Lopez
Beverly Brignoni was a young New Yorker seeking a less expensive way to enhance her appearance and she did what many other people are now doing: travel to the Dominican Republic for cosmetic surgery; (see undated “selfie” photo posted to her Instagram account, courtesy of the Brignoni family).

It went horribly wrong. The 28-year-old died Feb. 20 from what the doctor told her family was a massive pulmonary embolism while getting a tummy tuck and liposuction at a clinic in the Dominican capital recommended by friends. Family members want local authorities to investigate.

“We want to know exactly what happened,” said Bernadette Lamboy, Brignoni’s godmother. “We want to know if there was negligence.”

The district attorney’s office for Santo Domingo says it has not yet begun an investigation because it has not received a formal complaint from Brignoni’s relatives. Family members say they plan to make one.

Shortly after Brignoni’s death, the Health Ministry inspected the Vista del Jardin Medical Center where she was treated and ordered the operating room temporarily closed, citing the presence of bacteria and violations of bio-sanitary regulations. The doctor who performed the procedure and the clinic have not responded to requests for comment.

Brignoni’s death is unusual, but it is not isolated. Concerns about the booming cosmetic surgery business in the Dominican Republic are enough of an issue that the State Department has posted a warning on its page for travel to that country, noting that in several cases U.S. citizens have suffered serious complications or died.

The U.S. Centers for Disease Control issued an alert March 7 after health authorities in the United States reported that at least 19 women in five states had developed serious mycobacterial wound infections over the previous 12 months following cosmetic procedures in the Dominican Republic such as liposuction, tummy tucks and breast implants.

There were no reported deaths in those cases, but treatment for these types of infections, which have been caused in the past by contaminated medical equipment, tend to involve long courses of antibiotics and can require new surgery to remove infected tissue and drain fluid, said Dr. Douglas Esposito, a CDC medical officer.

“Some of these patients end up going through one or more surgeries and various travels through the medical system,” Esposito said. “They take a long time typically to get better.”

The Dominican Republic, like countries such as Mexico, Costa Rica and Thailand, has promoted itself as a destination for medical tourism, so-called because people will often tack on a few days at a resort after undergoing surgery. The main allure is much lower costs along with the promise that conditions will be on par with what a patient

would encounter at home.

In 2013, there were more than 1,000 cosmetic procedures performed in the Dominican Republic, 60 percent of them on foreigners, according to the country’s Plastic Surgery Society.

The Internet is flooded with advertisements and testimonials from people who say they have had successful procedures in the Dominican Republic, and an industry of “recovery houses” has sprung up to serve clients, along with promoters who canvass for clients in the United States. The price is often about a third of the cost in the United States.

Dr. Braun Graham, a plastic surgeon in Sarasota, Florida, says he done corrective surgery on people for what he says were inferior procedures abroad. He warns that even if a foreign doctor is talented, nurses and support staff may lack adequate training.

“Clearly, the cost savings is certainly not worth the increased risk of a fatal complication,” said Graham, past president for Florida Society of Plastic Surgeons.

Brignoni was referred to the Vista del Jardin Medical Center by several acquaintances in the New York borough of the Bronx where she lived, said Lamboy and Lenny Ulloa, the father of the 4-year-old daughter she left behind.

“Supposedly, it was a high-end clinic, one of the best in the city,” Ulloa said.

The doctor who performed Brignoni’s procedure, Guillermo Lorenzo, is certified by the Plastic Surgery Society, but there

are at least 300 surgeons performing cosmetic procedures who are not, said Dr. Severo Mercedes, the organization’s director. He said the government knows about the problem but has not taken any action. “We complain but we can’t go after anyone because we’re not law enforcement,” Mercedes said.

The number of people pursuing treatment in the Dominican Republic doesn’t seem to have been affected by negative reports, including a previous CDC warning about a cluster of 12 infections in 2003-04.

In one recent case, the Dominican government in February closed a widely advertised clinic known as “Efecto Brush,” for operating without a license. Prosecutors opened a criminal case after at least six women accused the clinic of fraud and negligence. The director, Franklin Polanco, is free while awaiting trial. He denies wrongdoing.

There was also the case of Dr. Hector Cabral. New York prosecutors accused him of conducting examinations of women in health spas and beauty parlors in that state in 2006-09 without a license, then operating on them in the Dominican Republic, leaving some disfigured. Cabral pleaded guilty to one count of unauthorized practice of medicine in October 2011 and returned to the Dominican Republic, where he still practices.

In 2009, Dominican authorities charged Dr. Johan Tapia Bueno with illegally practicing plastic surgery at his apartment after several women, including a local television personality, accused him of malpractice that left them with infections. Awaiting trial, he has pleaded innocent to charges that include fraud.

Juan Linares, a lawyer hired by Brignoni’s boyfriend, said he is still awaiting an autopsy report.

Because she arrived in the country late at night on a delayed flight and was on the operating table early the next morning, a main concern is whether she received an adequate medical evaluation before the procedure. Graham, the Florida surgeon, said sitting on a plane for several hours can cause blood to stagnate in the legs and increase the risk of an embolism.

Brignoni paid the Dominican clinic $6,300 for a combination of liposuction, tummy tuck and breast surgery. Lamboy said she had decided not to have the work done on her breasts and was expecting a partial refund. The woman, who worked as a property manager, had lost about 80 pounds about a year earlier after gastric bypass surgery.

Brignoni was clearly excited about the procedure. Her final post on Facebook was a photo she took of her hands holding her passport and boarding pass for the flight from New York to Santo Domingo.

“She wanted it so bad,” her godmother said. “It felt like she was going to have a better outlook on life, getting this done.”

Associated Press writer Ben Fox reported this story from Miami and Ezequiel Abiu Lopez reported in Santo Domingo.

Source: Associated Press (AP); retrieved 03/31/2014 from: http://news.yahoo.com/low-cost-dominican-surgeries-spark-warnings-us-042418398.html

This is a very important issue for the planning and execution of the new inter-governmental agency: Caribbean Union Trade Federation (CU). First of all, someone died – life is too precious to skim over this issue with indifference. The Go Lean book serves as a roadmap to introduce and implement the CU, so as to re-boot the region’s economic engines, including avenues of medical tourism.

There are also peripheral issues associated with this news story, many of which are examined, as missions, in great details in the Go Lean book. The issues/missions are:

Image: Confidence in the competence of service providers is sometimes based on reputation and branding. This is para-mount in medical fields. While the Caribbean is home to many excellent medical schools, facilities and practitioners, there is no regional “sentinel” role-player. The CU mandate is to zealously protect and promote the image and branding for industrial developments. So now when the media portrays “negative” depiction of Caribbean life, culture and people, there is no formal response mechanism. But with the CU’s implementation, there will be an entity to effectuate an anti-defamation response and better manage the region’s image.
Health Administration: The Go Lean roadmap recognizes healthcare as a basic need for the people of the Caribbean. As such, there is the acknowledgement that health delivery systems generate excessive costs and risks for a community. As a planning tool, the roadmap commences with a Declaration of Interdependence, pronouncing regional integration (Page 11) as the strategy for optimized benefits:

IX. Whereas the realities of healthcare and an aging population cannot be ignored and cannot be afforded without some advanced mitigation, the Federation must arrange for health plans to consolidate premiums of both healthy and sickly people across the wider base of the entire Caribbean population. The mitigation should extend further to disease management, wellness, obesity and smoking cessation programs. The Federation must proactively anticipate the demand and supply of organ transplantation as developing countries are often exploited by richer neighbors for illicit organ trade.

Self-Government Entities: The foregoing news story involves a clinic regulated by a Caribbean member-state, the Dominican Republic. The Go Lean roadmap institutes an arrangement for medical/research campuses as SGE’s (Self-Governing Entities) that are only regulated by the CU federal authorities. Had this tragedy occurred on such a facility, the response would have been immediate and comprehensive, employing best-practices of trauma medicine arts and sciences, thusly requiring a post-mortem lessons-learned process that would be fully transparent and accountable.
Lean Government: The Go Lean roadmap also extends optimizations to the member-states governments, requiring a separation-of-powers dictum to transfer oversight and administration of certain state functions to federal authorities. This includes standards, licensing and administration of healthcare facilities. The application of best-practices would most assuredly minimize the risk of medical negligence.
US Exceptionalism: The Go Lean roadmap maintains that other countries have their own version of the American Dream. The quest for life, liberty and the pursuit of happiness is not exclusively American. Whereas there are millions of negligent deaths in the US hospitals/clinics every year, one American dying in a Caribbean facility does not constitute an exceptional event; bad things do happen to good people … everywhere, in the US, in the Caribbean and in the Dominican Republic. Having a tourism-based regional economy means we always want to extend hospitality to our American guests, but embarking on medical tourism, also means assuming some degree of risks, for the facilities, the doctors and most importantly the patients.

The foregoing article crystalizes the need for the CU Trade Federation, a super-national administration to regulate, protect, promote and foster quality delivery of the most vital public services. The publishers of the Go Lean roadmap will hereby “sit back”, observe-and-report on the manifestations of this case, hoping for the quest for justice and accountability to be fulfilled. And remembering the unconscionable loss of the beautiful 28-year-old woman, Beverly Brignoni; RIP.

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Air Antilles Launches St. Maarten Service

Posted on March 21, 2014 in Industries, Strategy

Go Lean Commentary

This below news article is good news for the Caribbean region. A new airline option has stepped in to fill the void.

See the news story here:

By the Caribbean Journal staff:

Air Antilles Express has launched its first-ever service between St. Maarten and Pointe-a-Pitre, Guadeloupe.

The service could provide a boost for Guadeloupe’s bid to attract more tourists from the United States market, as St Maarten is a major hub for flights from the United States.

The thrice-weekly service is being operated on Thursdays, Saturdays and Sundays. Air Antilles Express made its first flight between the two Caribbean destinations last week. The St Maarten-Guadeloupe service is part of a wider expansion for the company across the region.

The regional carrier launched another new flight out of Guadeloupe at the end of last year, serving Antigua.
Source: Caribbean Journal Online News Source (Retrieved 02/11/2014) – http://www.caribjournal.com/2014/02/11/air-antilles-express-launches-guadeloupe-st-maarten-service/

This foregoing article is just the “tip of the iceberg”; this is the latest development in a long string of eruptions in the Caribbean Air Travel space. The first eruption was November 2011 when AMR Corporation filed for Chapter 11 bankruptcy reorganization. AMR Corporation, the Fort Worth, Texas based airline holding company was the parent company of American Airlines, American Eagle and Executive Airlines, the Puerto Rico based regional American Eagle carrier for the Caribbean. Executive/ American Eagle ceased operation on March 31 2013, leaving a gap of service for the Eastern Caribbean islands.

Change had come to the airline industry. American was the last of the remaining legacy airlines in the US to file for bankruptcy; the prior business model had become unsustainable for every American carrier. Along the way, AMR “spun off” all American Eagle regional carriers including Executive Airlines, shedding the debt and union contracts as a weight off its bottom-line. This step was too little, too late. Despite US$ 24.855 billion in revenues for 2012 and $4 billion in cash, the company still posted losses of $1.876 billion. The merger of AMR with US Airways Group on December 9, 2013 form the new entity, American Airlines Group, and a new lease on life. But still, there is no Eastern Caribbean resurrection!

The book Go Lean … Caribbean serves as a roadmap to navigate the changed landscape of the globalized air transport industry. It pronounces that change has come to the Caribbean and despite due warning the region is not prepared. The Go Lean roadmap portrays the need for regional integration, administration, and promotion for Caribbean air carriers. The book posits that transportation and logistics empowers the economic engines of a community. The above news article/Press-Release definitely asserts this premise. There must be air carrier solutions to service the transportation and tourism needs of the Caribbean islands. There is the expectation that air travel will continue to grow and impact Caribbean society – thus the need for more regional coordination. New models are detailed in the book in which tourism can be enhanced with “air lifts” to facilitate Caribbean events.

Now, for much of the Caribbean, air service is the only viable transportation option, but this Go Lean roadmap introduces the Caribbean Union Trade Federation (CU) and its Union Atlantic Turnpike initiative (Page 205) to offer more transportation solutions (ferries, toll roads, railways, and pipelines) to better facilitate the efficient movement of people and cargo.

Air Antilles Express is based at Pointe-à-Pitre International Airport in Guadeloupe. It is a regional airline operating scheduled and seasonal services in the French Antilles (Caribbean). The airline began operations in December 2002 owned by the Dubreuil Group, the same as French Guiana based Air Guyane Express, using the same call signs, IATA (3S) and ICAO (GUY).

This carrier’s strategy, tactical and operational plan is to fill some of the gap left from the American Eagle absence, as follows:

Air Antilles Express –Destinations*	American Eagle – Puerto Rico Hub Destinations*
Antigua	Antigua
	British Virgin Islands – Tortola
Dominican Republic Punta Cana (July–August only) La Romana (July–August only) Santo Domingo	Dominican Republic Punta Cana Santiago Santo Domingo
French Guiana	Dominica
Guadeloupe	Guadeloupe
Martinique	Martinique
Saint Barthélemy St Maarten	Saint Kitts and Nevis St Maarten
Saint Lucia	U.S. Virgin Islands Saint Croix Saint Thomas

Information is retrieved from Wikipedia on February 11, 2014

Everyone is encouraged to lean-in to the best-practices and empowerments defined in the Go Lean book.
🙂

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The Erosion of the Middle Class

Posted on March 21, 2014 in Economics, Ethos, Planning, Social

Go Lean Commentary

As for the direct issues in this article, the experience has been the same in the Caribbean. The high-end tourist resorts have flourished since the Great Recession, while properties catering to the general middle class have floundered. The one exception being the emergence of the cruise industry as a viable vacation option for the general American population. The CU therefore plans to empower the industry directly, and to elevate the cruise industry’s impact on Caribbean society.

New York Times, February 2, 2014 – In Manhattan, the upscale clothing retailer Barneys will replace the bankrupt discounter Loehmann’s, whose Chelsea store closes in a few weeks. Across the country, Olive Garden and Red Lobster restaurants are struggling, while fine-dining chains like Capital Grille are thriving. And at General Electric, the increase in demand for high-end dishwashers and refrigerators dwarfs sales growth of mass-market models.

As politicians and pundits in Washington continue to spar over whether economic inequality is in fact deepening, in corporate America, there really is no debate at all. The post-recession reality is that the customer base for businesses that appeal to the middle class is shrinking as the top tier pulls even further away.

If there is any doubt, the speed at which companies are adapting to the new consumer landscape serves as very convincing evidence. Within top consulting firms and among Wall Street analysts, the shift is being described with a frankness more often associated with left-wing academics than business experts.

“Those consumers who have capital like real estate and stocks and are in the top 20 percent are feeling pretty good,” said John G. Maxwell, head of the global retail and consumer practice at PricewaterhouseCoopers.

In response to the upward shift in spending, PricewaterhouseCoopers clients like big stores and restaurants are chasing richer customers with a wider offering of high-end goods and services, or focusing on rock-bottom prices to attract the expanding ranks of penny-pinching consumers.

“As a retailer or restaurant chain, if you’re not at the really high level or the low level, that’s a tough place to be,” Mr. Maxwell said. “You don’t want to be stuck in the middle.”

Although data on consumption is less readily available than figures that show a comparable split in income gains, new research by the economists Steven Fazzari, of Washington University in St. Louis, and Barry Cynamon, of the Federal Reserve Bank of St. Louis, backs up what is already apparent in the marketplace.

In 2012, the top 5 percent of earners were responsible for 38 percent of domestic consumption, up from 28 percent in 1995, the researchers found.

Even more striking, the current recovery has been driven almost entirely by the upper crust, according to Mr. Fazzari and Mr. Cynamon. Since 2009, the year the recession ended, inflation-adjusted spending by this top echelon has risen 17 percent, compared with just 1 percent among the bottom 95 percent.

More broadly, about 90 percent of the overall increase in inflation-adjusted consumption between 2009 and 2012 was generated by the top 20 percent of households in terms of income, according to the study, which was sponsored by the Institute for New Economic Thinking, a research group in New York.

The effects of this phenomenon are now rippling through one sector after another in the American economy, from retailers and restaurants to hotels, casinos and even appliance makers.

For example, luxury gambling properties like Wynn and the Venetian in Las Vegas are booming, drawing in more high rollers than regional casinos in Atlantic City, upstate New York and Connecticut, which attract a less affluent clientele who are not betting as much, said Steven Kent, an analyst at Goldman Sachs.

Among hotels, revenue per room in the high-end category, which includes brands like the Four Seasons and St. Regis, grew 7.5 percent in 2013, compared with a 4.1 percent gain for midscale properties like Best Western, according to Smith Travel Research.

While spending among the most affluent consumers has managed to propel the economy forward, the sharpening divide is worrying, Mr. Fazzari said.

“It’s going to be hard to maintain strong economic growth with such a large proportion of the population falling behind,” he said. “We might be able to muddle along — but can we really recover?”

Mr. Fazzari also said that depending on a relatively small but affluent slice of the population to drive demand makes the economy more volatile, because this group does more discretionary spending that can rise and fall with the stock market, or track seesawing housing prices. The run-up on Wall Street in recent years has only heightened these trends, said Guy Berger, an economist at RBS, who estimates that 50 percent of Americans have no effective participation in the surging stock market, even counting retirement accounts.

Regardless, affluent shoppers like Mitchell Goldberg, an independent investment manager in Dix Hills, N.Y., say the rising stock market has encouraged people to open their wallets and purses more.

“Opulence isn’t back, but we’re spending a little more comfortably,” Mr. Goldberg said. He recently replaced his old Nike golf clubs with Callaway drivers and Adams irons, bought a Samsung tablet for work and traded in his minivan for a sport utility vehicle.

And while the superrich garner much of the attention, most companies are building their business strategies around a broader slice of affluent consumers.

At G.E. Appliances, for example, the fastest-growing brand is the Café line, which is aimed at the top quarter of the market, with refrigerators typically retailing for $1,700 to $3,000.

“This is a person who is willing to pay for features, like a double-oven range or a refrigerator with hot water,” said Brian McWaters, a general manager in G.E.’s Appliance division.

At street level, the divide is even more stark.

Sears and J. C. Penney, retailers whose wares are aimed squarely at middle-class Americans, are both in dire straits. Last month, Sears said it would shutter its flagship store on State Street in downtown Chicago, and J. C. Penney announced the closings of 33 stores and 2,000 layoffs.

Loehmann’s, where generations of middle-class shoppers hunted for marked-down designer labels in the famed Back Room, is now being liquidated after three trips to bankruptcy court since 1999.

The Loehmann’s store in Chelsea, like all 39 Loehmann’s outlets nationwide, will go dark as soon as the last items sell. Barneys New York, which started in the same location in 1923 before moving to a more luxurious spot on Madison Avenue two decades ago, plans to reopen a store on the site in 2017.

Investors have taken notice of the shrinking middle. Shares of Sears and J. C. Penney have fallen more than 50 percent since the end of 2009, even as upper-end stores like Nordstrom and bargain-basement chains like Dollar Tree and Family Dollar Stores have more than doubled in value over the same period.

Competition from online giants like Amazon has only added to the problems faced by old-line retailers, of course. But changes in the restaurant business show that the effects of rising inequality are widespread.

A shift at Darden, which calls itself the world’s largest full-service restaurant owner, encapsulates the trend. Foot traffic at midtier, casual dining properties like Red Lobster and Olive Garden has dropped in every quarter but one since 2005, according to John Glass, a restaurant industry analyst at Morgan Stanley.

With diners paying an average tab of $16.50 a person at Olive Garden, Mr. Glass said, “The customers are middle class. They’re not rich. They’re not poor.” With income growth stagnant and prices for necessities like health care and education on the rise, he said, “They are cutting back.” On the other hand, at the Capital Grille, an upscale Darden chain where the average check per person is about $71, spending is up by an average of 5 percent annually over the last three years.

LongHorn Steakhouse, another Darden chain, has been reworked to target a slightly more affluent crowd than Olive Garden, with décor intended to evoke a cattleman’s ranch instead of an Old West theme.

Now, hedge fund investors are pressuring Darden’s management to break up the company and spin out the more upscale properties into a separate entity.

“A separation could make sense from a strategic perspective,” Mr. Glass said. “Generally, the specialty restaurant group is more attractive demographically.”
Source: Retrieved March 21, 2014 from: https://www.nytimes.com/2014/02/03/business/the-middle-class-is-steadily-eroding-just-ask-the-business-world.html

This issue of income inequality has been covered widely in the book, Go Lean … Caribbean. The reality of the middle class is that their numbers represent too many of the population to ignore. To foster growth in the economy, there must be growth for the middle class, or something amazing happens: people leave. This is the experience of so many in the Caribbean Diaspora. If despite the adherence of best practices (education, law-abiding, savings-and-investments), the average middle class family cannot obtain societal progress and contentment, they will simply relocate. For the Dutch and French Caribbean, this relocation eventuality has resulted in emigration to The Netherlands and France; for the American Caribbean territories, the emigration has resulted in the abandonment of the islands for the US mainland. For example, Puerto Rico has 4.7 million people living in the US mainland (compared to 3.9 million on the island) identifying themselves with a Puerto Rican heritage. The ratio is the same for the US Virgin Islands. The English-speaking Caribbean has many expatriates that have abandoned their island homes for foreign shores, often in England, Canada and the US. The region’s Diaspora is estimated at 10 million.

The Go Lean roadmap advocates a 10-Step approach to elevate the middle class of Caribbean society. This advocacy championed the belief that the “American” Dream is viable for other locations as well. So a balance must be carefully maintained for the CU efforts to impact an achiever class versus efforts of egalitarianism. We want to raise all the poor to middle class status (egalitarian in theory), and all the middle class to wealthy – One Percent – status, but that’s not what happens in reality. Achievers will always emerge ahead of their peers. The CU posits that there should be no impediments to this emergence, rather excellence should be fostered and even incubated. With this roadmap, the Caribbean can be a better place for all to live, work and play.

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Tourism’s changing profile

Posted on March 21, 2014 in Implementation, Industries, Locations, Strategy

Go Lean Commentary

The experiences in the Caribbean correspond to the observations of this article. Change has come to the Caribbean. Tourism continues to be the primary economic driver in the region; this is a static fact for the last 50 years, even though the dynamics of this industry is in constant flux. The Go Lean … Caribbean roadmap depicts that 4 major change agents have impacted this industry: technology, demographics, globalization, and climate change. This article affirms these issues.

Unfortunately the Caribbean region has not always planned for changes or adapted to them. There is still the expectation that the tourists visiting the islands would be North American or Western European and that the standard languages of Dutch, English, French and Spanish would suffice. Alas, this article depicted that the profile of modern tourism reflect a more global reach. Therefore, Caribbean communities must prepare for this change. They must accomodate the need for language translations, community education and racial/ethnic tolerance.

By: Lyndon Thompson

Tourism has shown remarkable staying power in recent years. Despite political instability, wars, natural disasters and a global financial crisis, the industry keeps getting up for another round. Japan is good example. After the 2011 earthquake and Fukushima nuclear accident, the number of visitors to the country plunged. But in 2013 more than 9 million tourists visited the country, a record high.

International tourist arrivals generally surpassed 1 billion in 2012 and are forecast to reach 1.8 billion by 2030. OECD countries account for nearly 60% of international tourist arrivals, but a shift in the global economy promises to change this picture somewhat as people in emerging economies travel more than before. Today, China spends eight times more on tourism than it did 12 years ago. Chinese tourists spent US$102 billion in 2012, a 37% increase over the previous year and more than any other country.

Russians are also more footloose, and rank fifth in terms of spending on outbound tourism. The number of tourists from India has also doubled since 2006. The UN World Tourism Organization estimates that by 2030, overall annual growth in outbound tourism will amount to 17 million in the Asia-Pacific region, 16 million in Europe, 5 million in the Americas, and a combined 5 million in Africa and the Middle East.

Emerging economies are drawing in more tourists, too. Over the next 15 years, the share of arrivals in emerging economies will increase by 4.4% annually, double the rate of arrivals in advanced economies, with South Asia topping the list. North America, on the other hand, will slip to the bottom.

Tourism directly accounts for 4.2% of GDP, 5.9% of employment and 21% of exports of services in OECD countries, enough for governments bruised by the financial crisis to see the industry as a catalyst for growth. They are becoming more dynamic, bringing in new business models and cutting red tape. They are shortening waiting times by offering online visa applications and automatic border checks, too: Turkey, for instance, introduced e-visa applications in 2013, reducing the need for tourists to queue on arrival.

The profile of today’s travelers differs sharply from that of their predecessors. Demographically, tourists are older–23% aged 55 or above–and more frugal, preferring shorter trips closer to home. Geographically, they tend to live in emerging economies rather than in developed ones. Most holidays are now booked online instead of through travel agencies. The holidays sought are often far off the beaten track and focus on a theme: adventure, culture and heritage, or food and wine. New niche markets have arisen, such as “diaspora”, gay and lesbian holidays, humanitarian tourism to work for good causes, and tourism for medical treatments.

Two other trends in tourism are also worth noting. First there is risky “dark tourism”, from hiking in Afghanistan to hunting pirates off the Somali coast, or even photographing conflict zones in Syria. This fashion should not be confused with the rather more solemn “memorial tourism”, which promotes trips to the scenes of great tragedies and wars, such as Ground Zero in New York, Auschwitz in Poland and war cemeteries across Europe.

With 2014 marking the 100th anniversary of the outbreak of the First World War, expect a rise in “memorial tourism” in the year ahead, particularly in Flanders in Belgium and the Somme region of France. In Japan there is a proposal to build a tourists’ village near the Fukushima nuclear plant, with fortified hotels to shield guests against any elevated radiation, the aim being to remind future generations of the 2011 tragedy there.

Such emotionally challenging trips allow travelers to reflect on the follies of humankind and the vulnerability of life. They can also serve to bond people together and build co-operation against future conflicts. Rather than an escape, they echo what the writer Samuel Johnson saw as the true reason for travelling: “to regulate imagination by reality, and instead of thinking how things may be, to see them as they are.”

Source: www.oecd.org/cfe/tourism/

The book Go Lean … Caribbean purports that the Caribbean is the greatest address in the world. In order to appeal to the global market, the book, as a roadmap, posits that regional tourism stakeholders must engage these other ethnic populations. The roadmap advocates the use of Internet Communications Technologies and Social Media for bookings, and to sell the attractions of Caribbean culture and amenities. The plan also calls for establishing Trade Mission Offices in divergent cities like Spain and Tokyo for outreach to Mid & Far Eastern markets.

The Go Lean roadmap also advocates 10-Step approaches for elevating events and fairgrounds in the region. The tactical approach is for a technocratic Trade Federation that would finance and construct facilities and amenities as amusement parks, arenas, stadia & other venues structure as Self- Governing Entities. These bordered grounds would be independent of actual member-state governments.

This magazine article was published in the OECD Observer “e-Zine”. This online journal is the public relations arm of the OECD – Organization of Economic Cooperation and Development – an international economic organization of 34 countries founded in 1961 to stimulate economic progress and world trade. It is a forum of countries committed to democracy and the free-market economy, providing a platform to compare policy experiences, seek answers to common problems, identify good practices, and co-ordinate domestic and international policies of its members. The OECD promotes policies designed to …
1). Achieve the highest sustainable economic growth and employment and a rising standard of living, while maintaining financial stability, and thus to contribute to the development of the world economy;
2). Contribute to sound economic expansion in Member as well as nonmember countries in the process of economic development; and
3). Contribute to the expansion of world trade on a multilateral, nondiscriminatory basis in accordance with international obligations.
Source: www.oecd.org/about/ (Retrieved November 2013).

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John McPhee – LCD versus an Entrepreneurial Ethos

Posted on March 21, 2014 in Government, Industries, Social, Strategy

Go Lean Commentary

The book Go Lean … Caribbean is more than just a publication, it is a movement. This movement is designed to elevate the Caribbean’s economic, security and governing engines. The book serves as roadmap for the introduction and implementation for the Caribbean Union Trade Federation (CU). As such, we are proud to feature role models – institutions, companies and individuals – that extoll the values, community ethos, that we hold dear. This role model, John McPhee, is a prime example.

Among the many community ethos, strategies, tactics, implementation and advocacies in the book is the proposal for the consolidation and integration of the region’s Taxi & Limousine Regulatory Commissions. The book posits that many of the initiatives envisioned for the region are too big an undertaking for any one Caribbean member-state alone; therefore the roadmap call for this functionality to be consolidated and integrated into CU oversight.

John McPhee is on the frontline of Bahamian tourism – he is a taxi driver. But to call him just a taxi driver would be an insult; it would expose a blatant ignorance. John McPhee is the anti-taxi driver; he “zigs” while everyone else “zags”. The industry for taxi drivers is based on the Lowest Common Denominator (LCD); John, on the other hand, rises above the fray, he stands out like a stalk of wheat in a field of weeds. He drives a Chrysler Town & Country mini-van for its roominess, durability and fuel efficiency. (The is the same vehicle class as the Nissan NV200 depicted in Appendix-VIDEO below and on Page 328 of the Go Lean book).

Mr. McPhee also accepts credit cards. This is an anomaly among taxi drivers in the Bahamas.

Lastly, he arranges appointments and delivers on schedule. He is the walking embodiment of the vision for the Caribbean Union’s Taxi & Limousine Commission.

John McPhee delivers on a business model that can be profitable, efficient, and effective (as frontline ambassadors) for forging change in a region too accustomed to the status quo (failure); a region with governmental policies designed to benefit the LCD and thus they miss out on victories that one champion can achieve. This is the winning model of both the industrial and information revolutions, where individuals, entrepreneurs and industrialists transformed society with their innovations. John McPhee represents that new corps of Caribbean entrepreneurs.

In a person-to-person interview, recorded in the Go Lean book at Page 39, these were his responses:

What are the details of your project?

A Cashless Payment System for Taxi Cabs. This will allow for passengers to pay their fare by means of any major credit/debit cards. Considering the reality of The Bahamas where many citizens, even in the middle class, do not possess credit cards, the target market will be tourists, and the corporate sector. This service should empower taxi drivers to have a competitive advantage over their peers. This project’s goal is to have 50 cars within a fleet, and to provide all of their dispatch services.

Who are the competitors of this service?

There is the Bahamas Taxi Union, a cooperative among individual taxi drivers. Then there are other private entities like H. Forbes Charters and other similar companies.

Why did you not leave, like the many before you?

The Bahamas can still be a land of opportunity. This is what the people here deserve. This is a small country, I should be a big fish in this small pond, but I’m not. If I’m not the head-of-the class here, how can I expect to succeed as a small fish in a big pond somewhere else. So I do not intend to leave.

How do you feel about Bahamian/Caribbean Security?

A lot is lacking here. All citizens can easily be in danger of the pervasive crime and violence.

How do you feel about Bahamian/Caribbean Economy?

Even more is lacking. This country is not suited to encourage entrepreneurism. Economic growth is only going to come from the private sector, not the government. For the private sector to flourish there must be the appropriate structure, incentives and economic drivers. These ingredients are not here now. For my project, I had to sue the government agency (Taxi Commission) to force their hand in doing the right thing. The governing principle used here follows the policy of egalitarianism. This sounds good on paper, equal opportunity for all, but in practice, it’s a disservice for job creation. Catering to the LCD sets the bar low. Excellence does not emerge from that.

What areas are you most disappointed in when considering the last 20 years?

There is a trend towards social equality, which is good if the equal status is a high standard of living and high moral fortitude. But instead, there seems to be a steady decline in all aspects of Bahamian life in which we are all becoming equally mediocre, inadequate. This indicates a fault in leadership; there is a lack of vision and no plan to elevate, if not for all the people, then at least for an achiever class.

What do you want to see in The Bahamas in … 5 years?

Turn-around from the current path, otherwise there will be a collapse of the middle class.

What do you want to see in The Bahamas in … 10 years?

All societies must innovate, or be overrun with innovations from abroad. If the current trend continues, there will be a disenfranchisement of Bahamians in their own country.

What do you want to see in The Bahamas in … 20 years?

I want to see a social and political revolution; the status quo cannot continue. While a revolution denote a quick sudden change, perhaps an evolution (slow, steady and consistent) is better. But we must start now, by first abandoning these LCD policies and expectations.

What features of North American/Europe would you like to see here?

In addition to a NATO-like force, the Caribbean should be more connected/integrated; there should be a central trading/purchasing entity to represent the entire region.

Where do you consider to be the best place to live?

Canada. They seem open to growth, inviting foreign nationals. There is a common language – but respect for minorities – and plenty of opportunities in the areas that entrepreneurs seek.

How would you feel if your children emigrate?

Being a husband and father, I fear that my son will one day leave. He will need such a move to soar in his endeavors. If that happens, while we will miss him, we will simply accept and support him.

Download the book Go Lean … Caribbean – now!

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Appendix – VIDEO: New York Proclaims “Hail Yes!” as First Nissan NV200 Taxicab Hits the Streets of Manhattan – https://youtu.be/za1xO3WcnQs

Published on Oct 29, 2013 – NEW YORK (October 29, 2013) — A new era in public transportation has begun with the Nissan NV200 taxi now in service on the streets of New York City. The meter on the first NV200 taxi fare officially kicked-off at JFK International Airport on October 23, dropping its inaugural passenger near 13th Street and 6th Avenue in Manhattan. Mr. Ranjit Singh, an owner/operator of Medallion No. 7F20, took delivery of his NV200 taxi from Koeppel Nissan in Queens on October 18.
AMC131029102.

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