Alongside in Saint Vincent: This island has pharmacies, even ones open on Sunday. It also has gas stations and supermarkets.
What it doesn't have is a very elaborate road system. Very few of the island's roads are wide enough to have a centerline. Most are 1 to 1 1/2 cars wide with no guard rails, no center lines, and very often a drainage canal alongside that is maybe 16" deep. If you dropped a wheel into the canal, you'd break something.
There are lots of very substantial, large mountainside homes. The locals don't live in them, except as housekeepers.
The big homes belong to foreigners, probably white, who use them as second homes. We are given to understand that the local tax structure is generous enough to encourage the wealthy to claim St. Vincent as their residence - owning a home here makes it more believable.
I kept an eye peeled as we drove around the island on tour. I saw exactly 3 whites who acted "local" and one more who was not white but other than African in ancestry. Everyone else I saw was black except the tourists off our ship. In other words, it's a typical Caribbean island. If the big-house expats were here I didn't see them, but perhaps I wouldn't as they're probably in their tinted-window cars and not pedestrians.
Our driver said there are six medical schools on island, I wonder who the faculty are? Retired Med School faculty from the States and Europe? Probably.