St Kitts and Nevis Prime Minister Dr Terrance Drew confirmed Sunday that he suffered a stroke late last month, in his first detailed public account of the health emergency that took him out of the country for treatment.

Drew, 49, said the stroke was caused by a dissection of the vertebral artery, one of the arteries at the back of the brain. He said the condition followed symptoms including nausea, dizziness, neck pain and balance issues, and that he was admitted to the Joseph N. France General Hospital in Basseterre on August 30. He was subsequently transferred to Martinique for further evaluation before being flown to Florida on September 2 for additional treatment. He has since been discharged from hospital and is undergoing rehabilitation, including occupational therapy, at a facility in Florida.

Speaking in an eight-minute broadcast to the twin-island federation, Drew, a trained medical practitioner, said the effects of the stroke “have been well controlled and well managed.” He said he retains movement in all his limbs, speaks without impairment, and that his cognition and coordination remain intact. “Both mentally and psychologically and also physically, I’m doing much better than my ailment will suggest,” he said.

Drew said he met with the full Cabinet while still hospitalised in St Kitts to outline a delegation plan before leaving for further treatment abroad, with all of his responsibilities assigned to relevant ministers. Deputy Prime Minister Dr Geoffrey Hanley has been serving in his stead. Drew described the transition as “extremely smooth” and said the government has continued to function normally in his absence, pointing to contingency arrangements he said have been in place since the start of his administration. “This administration is a mature and serious administration. We have multiple contingency plans in place, from the worst-case scenario to a minor disruption,” he said.

No date has been announced for Drew’s return to St Kitts and Nevis. He said he is looking forward to resuming his duties, including leading Cabinet and attending Parliament, and used the update to urge citizens to take stroke warning signs seriously and seek prompt medical attention.

A prime minister’s extended medical absence is a governance-continuity test for any small state, and the stakes are heightened in St Kitts and Nevis, whose economy leans heavily on its Citizenship by Investment (CBI) programme and on investor and diplomatic confidence more broadly. Drew’s emphasis on an orderly delegation of authority and an operational government is aimed squarely at that audience. With no confirmed return date, the key variables going forward are the pace of his recovery, whether further health disclosures follow, and how long Hanley continues to manage day-to-day Cabinet business in his place.

Prime Minister Dr Terrance Drew has done a good job of putting in place measures to diversify the economy and not place an over-reliance on Citizenship by Investment. St. Kitts & Nevis has a population of 60,000 with a total GDP of US$2 billion. The economy grew by 2.5 per cent last year. The country has a high Human Development Index (HDI). Tourism contributes 60 per cent of its GDP.

Dr Terrance Drew has turned to renewable energy and looked to stabilise prices against imported inflation. His administration has managed to reduce CBI’s contribution to GDP to less than 10 per cent. This is a significant achievement. He is looking to bolster the economy through the Sustainable Island State Agenda (SISA). 

At just 49, Dr Terrance Drew looks in good physical shape and seems fit. He looks younger than his years, but he must take time to eat properly, exercise, rest and recuperate. He must try not to be overwhelmed by the stresses of managing the affairs of the country. It is easier said than done, but he must heed this warning and take better care of himself.  He is a trained medical doctor and will know better than most the importance of looking after one’s health. He is recognised as one of the more competent leaders in the Caribbean and his personable manner is endearing.