The Social History of Medicine &
Public Health Policy in the Caribbean

Barbados 23rd - 26th May 2001

For further information, click on the links below:

• Contact Information

• Conference Objectives

• Submission of Paper Proposals

• Travelling to and from Barbados

• Travelling within Barbados

• Accommodation

• Provisional Programme

• Registration Form

Contact Information

To submit paper proposals or for further information contact the Conference Secretariat at the following address:

Faculty of Humanities
University of the West Indies
Cave Hill Campus,  PO Box 64
Bridgetown,  Barbados

Phone: 1-246-417 4015
Fax: 1-246-424 0634

E-mail: gfranklin@uwichill.edu.bb

All accommodation queries should be referred to Mrs. Cicely Walcott at: alphacor@caribsurf.com

Conference Objectives

An international interdisciplinary conference on the Social History of Medicine and Public Health Policy in the Caribbean will be held in Barbados from 23-26th May 2001 under the auspices of the Faculty of Humanities and the School of Medicine and Clinical Research of the University of the West Indies (Cave Hill Campus). 

Background:

It is a truism that good health is a fundamental prerequisite of social and economic development and sustainable prosperity for all communities. In pursuing the laudable goal of 'Health For All' articulated a generation ago by the World Health Organisation, a broad coalition of Governments, Non-governmental Organizations and International institutions have been focusing in recent years on promoting good health and wellness, strengthening health systems and services, safeguarding the environment, and forging linkages between health and development. The result is that global expenditure on health is currently over 2000 billion dollars, that is, almost 8% of the world's global product (and this expenditure is increasing). In 1995 the countries of the Americas spent about 12.8% of the hemisphere's Gross Domestic Product (approximately $1.2 trillion) on health - that is, over half of the world's total expenditure. In Latin America and the Caribbean the expenditure was $114 billion, or 7.3% of the region's GDP.

These heavy expenditures on various health intervention strategies have made a significant contribution to the health of nations around the world. In the case of the Caribbean, for example, Director of PAHO, Sir George Alleyne observed in a lecture entitled 'The Health of Small States' (delivered to commemorate the 50th Anniversary of the University of the West Indies, in Castries, St Lucia, on 1st October1998):

... when one examines their health status one is struck by the improvements made over the last 50 years. The health indicators for the group as a whole are better than for any subregion of the Americas except for North America. Infant mortality rates for the Caribbean are 22.0 per 1,000 live births, compared with 35.7 for Latin America and 24.8 for the Americas as a whole. The figure for North America is 7.0 and Cuba is very close to that number. Figures for life expectancy follow roughly the same pattern: life expectancy at birth for both sexes combined is 72.6 years which is higher than the average for the Americas as a whole. Coverage with immunisation is high and for five years the Caribbean has been free of measles except for one case imported into the Bahamas. Death from diseases that can be prevented by immunisation are rare indeed. 

However, as the Caribbean enters the twenty first century, the region is challenged to do more than merely maintain the tremendous progress achieved in medicine and public health over the past century. The region must come to terms with and seek to triumph over the rapidly emerging HIV/AIDS epidemic (the Caribbean is now second only to sub-Saharan Africa in its rate of infection), as well as re-emerging diseases such as Tuberculosis. In addition, an ageing population and changes in lifestyle and consumption patterns have led to a higher incidence of chronic diseases such as hypertension, heart disease, and diabetes. According to PAHO, such chronic diseases now account for well over half of all deaths in the region. These health challenges are compounded by social issues such as endemic poverty, as well as inadequate infrastructure for health care provision and limited or poorly applied financial and human resources.

While some believe that globalization and its attendants, trade liberalization and structural adjustment, will eventually bring economic and other development benefits to most parts of the world, including improvements in the area of health, others argue that structural adjustment policies and an increasingly skewed distribution of wealth will severely undermine social services and the general infrastructure for health in the developing world. Meanwhile, a growing incidence of disease, and especially the rise of HIV/AIDS, has meant that governments and international donor agencies are being forced to spend ever larger sums on health. For example, between 1986 and 1996 the World Bank alone committed over $550 million to HIV/AIDS prevention and mitigation effects world-wide. The development of effective public health policies in this changing global environment is another important challenge for the region.

If globalization has helped to compound the problem of ill-health world wide, it also provides many opportunities, especially through its technological and communication advances for nations to effectively pool their resources and skills to combat disease and other health problems. Against this background there is a clear and compelling need for the people of the Caribbean region to recognize the interconnectedness of the challenges they face and to act accordingly. Similarly, there is a strong case for adopting an historically informed regional perspective on key health issues - whilst simultaneously recognizing the importance of local concerns and issues - in order to develop strategies for dealing with the many health challenges the region faces. The HIV/AIDS epidemic, or pandemic provides us with a good example of why communities locally, regionally, and internationally must increasingly think in terms of greater dialogue and collaboration on health in the new century. It is this context that the current proposal for a Conference on the Social History of Medicine and Public Health Policy in the Caribbean has arisen.

The Conference, the first of its kind in the Anglophone Caribbean, will address the following basic questions:

• What are the historical roots of the continuing inequities in health care provision in Caribbean societies ? 

• What factors have contributed to the evolution of policies on public health in Caribbean countries ? 

• What successes and what failures have there been in the fight against disease? 

• What comparative perspectives may be brought to bear from experiences in other regions?

• How should Caribbean societies respond to the new health challenges they are facing in the 21st century, and how might the current neo-liberal climate of 'globalisation' impact upon the future provision of health care in these societies?

The Conference will provide a forum for the discussion of health issues in the Caribbean from a broad inter-disciplinary perspective, with the aim of enhancing our understanding of health conditions in the region and of providing a framework for building towards greater health equity in the future. Participants will include medical practitioners, historians, social scientists, economists, policy makers and others. Participants from outside the region are welcome. 

Specific Aims of the Conference: 

• To stimulate interest in and begin to document more systematically the history of medicine and public health in the Caribbean, with particular reference to inequities in the provision of health care; 

• To explore the history of various contagious and non-contagious diseases in the region and examine their broader social, economic and psychological impacts; 

• To analyze the effectiveness of strategies of intervention in the sphere of public health employed by the state, non-governmental organizations and international agencies in
  both the colonial and post-colonial eras; 

• To review current public health policy in the region, especially with a view to identifying gaps in provision and inequity in access to health care; 

• To discuss the challenges presented by globalisation, and to identify strategies which will contribute to the promotion of health equity in the region in the 21st century; 

• To make a distinctive contribution to our understanding of the peculiarities, both strengths and weaknesses, of the health situation of small developing nation states through a discussion of the historical, current and future health conditions of the countries of the Caribbean. 

Themes and Sub-themes:

• Documenting the Social History of Medicine in the Caribbean 
  
  a. Epidemic disease in colonial society
  
  b. Health in slave societies
  
  c. History of nursing and the medical profession
  
  d. Infant mortality and child health in colonial society
  
  e. Insanity and mental health
  
  f. Folk medicine
  

• The History of Public Health Policy and Planning
  
  a. Philanthropy and Public Health in colonial society
  
  b. History of sanitation; water supply; building regulations; Public Health Inspectors, etc
  
  c. Environmental health
  
  d. Poor Relief
  
  e. The Colonial Welfare and Development Act
  

• Society and Health
  
  a. Gender and health
  
  b. Diet
  
  c. Health and recreation
  
  d. Alcohol and drug abuse
  
  e. Violence & accidents
  
  f. Ageing and health
  

• Ethical and Economic Aspects of Health Care
  
  a. Viability of social security systems
  
  b. Poverty and ill-health
  
  c. Health and labour market policies
  
  d. Medical advances: benefits versus costs
  

• Current and Future Strategies for Health Equity Beyond 2000
  
  a. Health sector reform
  
  b. Confronting the HIV/AIDS challenge
  
  c. Health equity and community development
  
  d. The role of regional/international institutions
  
  e. Health and public education

Submission of Paper Proposals

Proposals (no more than 300 words) should be submitted to Dr Alan Cobley (Chair, Conference Organizing Committee) in care of the Conference Secretariat at the address given below no later than March 30, 2001. 

Travelling to and from Barbados

Barbados is accessible via several major airlines, both regional and international.  To make bookings, click on the links below to access the website in question or contact your favourite travel agency or call the relevant toll free number:

• Air Jamaica Air Jamaica has direct flights from Barbados to Trinidad; St. Lucia; Jamaica; New York; it also has connecting flights to Los Angeles, Miami, Fort Lauderdale, Atlanta, Boston; Bookings may be made through the link to the Air Jamaica web site above or by calling their toll free number 1 800 523 5585.

• BWIA West Indies Airways  Bookings may be made through the link to the BWIA web site above or by calling their toll free number 1 800 538 2942.

• LIAT (direct and connecting flights are available from Barbados to all islands of the Eastern Caribbean.)

• American Airlines (direct flights are available from Barbados to Puerto Rico; Miami; New York.)

• Air Canada (direct flights are available from Barbados to Toronto; Montreal.)

• British Airways (direct flights are available from Barbados to London.)

• Virgin Airways (direct flights are available from Barbados to London.)

Travelling Within Barbados

There is a reliable public transportation system operated by the Barbados Transport Board that covers all areas on the island and services in particular all the regular routes on the West and South Coasts, the most densely populated and, thus, the busiest regions in Barbados.  The fare to any destination is: BD$1.50.

Alternatively, participants may also choose to use the many privately owned minibuses and ZR vans which ply the same routes as the Barbados Transport Board.  Participants should be aware, however, that these have a less favourable reputation among Barbadians where safety is concerned (the occasional driver has been proved to be reckless).  Nevertheless, they are often used because more of them are to be found on the road as a result of which they are easier to catch and because they tend to get passengers to their destination more quickly than the public transportation system does.  The fare to any destination is: BD$1.50.

Visitors with valid driving licences may apply at the nearest police station for a temporary driving permit and rent a hired car for a limited period.  You should note, however, that to hire a car in Barbados is not cheap.

Given that Barbados is a tourism-based economy, there is a thriving taxi industry with a sound reputation for reliability and safety.  The following average one-way taxi fares may be of interest to you:

• Airport to UWI: BD$35 / US$17.50

• Airport to Worthing or Accra Beach (South Coast): BD$28 / US$14

• Airport to Sunset Crest, St. James (West Coast): BD$40 / US$20

Accommodation

All accommodation queries should be referred to Mrs. Cicely Walcott at: alphacor@caribsurf.com.

NB: All Rates quoted in US Currency.

Provisional Programme

Four sessions will be held daily at the following times:- 9-00am to 10-30am; 11.00am-12.30pm; 2.00-3.30pm; 3.30pm-5.00pm. The venue for all sessions (unless otherwise stated) is LR1 & 2 in the Teaching Complex, University of the West Indies, Cave Hill Campus. Registration can be completed at the Conference Secretariat located in the Teaching Complex from 8.00am on each day.

NOTE: All items marked * are subject to confirmation

DAY ONE

I Documenting the Social History of Medicine in the Caribbean

Session 1.

'The Changing Caribbean Disease Environment in Red, White and Black' Kenneth Kiple (Bowling Green State U., USA)'The Emergence of Health Care in Post-Slavery Caribbean' Glenford Howe (UWI, Barbados)

'Health Underdevelopment in Guyana: From Slavery to the Neo-Colonial State' Harold Drayton (U. Texas, USA)

Session 2.

'Tropical Medicine and Creole Societies: The Case of Guadeloupe before the Era of Pasteur' Dominique Taffin (Martinique)*

'Facing the Last Frontier: The Practice of Medicine in 19^th Century Trinidad' Rita Pemberton (UWI, Trinidad)'Gendered Health Care: Legacies of Slavery in Health Care Provision in Barbados over the Period 1870-1920' P. Welch (UWI, Barbados)

'Understanding the Nature of Rabies: A Trinidad Historical Perspective' K. Mungrue (Mount Coke, Trinidad)

Session 3.

'West African Healing in the Caribbean: Rituals, Beliefs, and Structures in West African and Caribbean Folk Medicine'* Deryck Murray (Barbados)'Phytomedicine in the Caribbean'* Clive Lewis (UWI, Barbados)

Session 4

'Auxiliary or Essential: Caribbean Nurses and the Construction of the European Welfare State' Laurence Brown (UWI Barbados) 'Nursing Changes and Challenges' Peggy Rickenson (RNA, Barbados)

DAY TWO 

II The History of Public Health Policy and Planning

Session 5.

'Forty Years: An Introduction to the Development of a Caribbean Public Health' Affette McCaw-Binns (UWI Jamaica)'Public Health in Colonial Georgetown' Juanita DeBarros (Canada)'The Genesis of the 1937 Nutrition Scheme for Barbadian Elementary Schools' Janice Mayers (Barbados)

Session 6.

'Coffee, Worms and Public Health: The Rockefeller Foundation and Transition from Hygiene to Public Health in Columbia and Central America: A Comparative View' Emilio Quevedo-Velez (Center for the History of Medicine, Bogota, Colombia)

'The Rockefeller Foundation's Experimental Strategy for Using DDT for Malaria Control in the Caribbean Region, 1941-1951' Darwin Stapleton (Rockefeller Archive Center, USA)

'A Comparative Study of the Rockefeller Public Health Programmes in the Caribbean and Mexico' Anne-Emmanuel Birn (New York, USA)

Session 7

'Health legislation in Barbados in the Nineteenth century' A. DeV. Phillips (UWI, Barbados)'The History of Public Health Policy in Barbados'* Farley Brathwaite (UWI , Barbados)

'Public Health and Sanitation Policy in St Vincent and the Grenadines: The Role of the Kingstown 'Town' Board, 1897-1927' Cleve Scott (UWI, Barbados)

III Society and Health

Session 8

'Interdependencies in health conditions between the Caribbean and Britain' Caroline Allen (CAREC, Trinidad)

'The Dynamics of a Welfare System: The Case of France' Jean-Paul Revauger (UAG, Martinique)'Approaches to Research in Health Care'* Henry Fraser (CDRC, Barbados)'Translating Health Research into Policy and Action in the Caribbean' Aldrie Henry-Lee (SALISES, Jamaica)

DAY THREE

Session 9

'Ageing and Health' Dr A. Hennis (CDRC Barbados)'Trauma Admissions to the Intensive Care Unit at UHWI, Mona Jamaica' A. Amata (University Hospital, Jamaica)'Alcohol and Drug Abuse'* Tessa Cadderton-Shaw (NCSA, Barbados)'Counselling Victims of Sexual Abuse'* Mark Yantzi (Jamaica)

IV Ethical and Economic Aspects of Health Care

Session 10

'Medical Ethics in the Caribbean Context' Derrick Aarons (Jamaica)'Changing the Health Care Culture Through Ethical Standards' Marion Howard (RNA, Barbados)'Ethical Aspects of Health Policy' Ed Brandon & Majid Amini (UWI, Barbados)

V Current and Future Strategies for Health Equity Beyond 2000

Session 11

'The Development of Policy Towards Combating the HIV/AIDS Epidemic' Prof. E. R. Walrond - SCMR, UWI, Barbados'Research on Sexual Behaviour in the Caribbean Since the Advent of HIV/AIDS' Caroline Allen, Sheila Samiel, Tiphani Burrell, Cheryl O'Neil & C. James Hospedales (CAREC, Trinidad & Tobago)'Perceptions of AIDS as a Communicable Disease and Its Associations With Racism and Xenophobia'* Gail Pool (Canada)

'Report from History Workshop Conference in Johannesburg (to be held in April 2001) on HIV/AIDS in Historical Context in South Africa'* Prof Shula Marks (England)

Session 12

'Leptospirosis' Paul Levett (SCMR, Barbados)'Asthma in the Caribbean' Malcolm Howitt (SCMR, Barbados)

'Telemedicine in Oncology in the Caribbean' P. Garsuad, K. Rome, F.Leconte, J.L.Ratoanina, A. Saint-Cyr, P. Escarmant (Centre Hospitalier Universitaire de Fort de France, Martinique)

EVENING SESSION: 8.00PM (In LT1, Teaching Complex, UWI Cave Hill campus)

Address by Dr George Alleyne, Director of the Pan American Health Organisation*Followed by a Cocktail Reception hosted by the Principal.

DAY FOUR

10.00am - 2.00pm: Island Tour (US $20-00 per person)

DEPARTURE

REGISTRATION FORM

Please print and fill out the following:

NAME (Block Letters):

MAILING ADDRESS:

TELEPHONE: FAX: EMAIL:

I AM PRESENTING A PAPER ENTITLED:

ARRIVAL -- I expect to arrive in Barbados on

Airline & Flight No: Date: Time:

DEPARTURE -- I expect to leave Barbados on:

Airline & Flight No: Date: Time:

HOTEL ACCOMMODATION* - Please list your 1st and 2nd Choices

1 Single G Double G Sharing G

2 Single G Double G Sharing G

3 Student Accommodation 9

4 Accommodation on Campus: 9

5 Own Accommodation 9

ISLAND TOUR - Contribution of US$20

Please indicate your interest in the Island Tour on Saturday, May 26 YES 9 NO 9