Ethnics, medicine, and society in the Caribbean

While the Medical Faculty of the University of the West Indies has produced many outstanding scholars and practitioners over the past 50 years, social processes in many Caribbean countries have resulted in much suffering. Despite this, the social roots of disease and suffering often have been left out of our medical teaching and ethical discussions. The moral basis of medical care is oriented not only by the individual suffering of patients, but also by the collective experiences of humankind. Hence, failure to engage the social aspects of suffering undermines the moral and pragmatic aspects of medical practice. In the Caribbean, if you are poor, you are likely to have a poor health status. So ethically, medicine and medical teaching need to respond to social suffering, as health and social problems are inseparable. Moreover, the last 3 decades have all seen the call for respect for persons and justice as important values in medical practice in many societies. These values have given medicine its contemporary identify, stressing the paramountcy of the welfare of the patient, the need for informed consent, the requirement to make decent health care equitably available to all, and the importance of empathy and kindness as hallmarks of humane medical care. Historically, the practice of medicine has rested on two pillars: medical knowledge and expertise, and irreproachable medical conduct. Unfortunately, in the Caribbean society a huge discrepancy exists in the time and attention paid to these essential pillars. Nearly all of a doctor's occupations have ethical implications due to the nature of care involving persons: therefore medical teaching and conferences that focus only on the scientific and technical aspects of medicine, without addressing the ethics of care for patients or the developing and improving of the ethical competence of students and practitioners, are incomplete.(AU)

Report on a survey of nongovernmental organisations involved in health and health related services in Trinidad and Tobago

Survey reveals the existence of a number of organisations legally established entities with approved charitable status; some national in focus with many affiliated to international counterparts, varying memberships between one hundred and five hundred, and a wide age range programmes. These include providing: residential/day services; counselling/advisory services educational and health-related group/community activities, material/financial assistance and promoting projects. Comments on the critical input of volunteers and the willingness of some organisations to be involved in programmes relating to the control of AIDS and STD's. Funding include: limited government contribution, international sources, donations and fund raising activities. Concludes that most organisations, even those with declining membership, consider themselves just as dynamic as in the past. (AU)

The aged population in the Caribbean

There is at present more than a quarter million people over the age of 60 years in the English-speaking Caribbean, and deaths in adults now exceed those in children under 5 years. Thus there should be a change in emphasis in medical programmes aimed at catering for the needs of the region. It is felt that the aged population, previously neglected in favour of the pediatric age group, require urgent attention by policymakers. Public Health programmes must include screening for diabetes, hypertension, glaucoma, cervical cancer, and other disorders which if detected early can reduce morbidity and mortality in the Aged. (Summary)

Special problems in developing countries: the urban avalanche and child nutrition

The many interacting changes in family life and food availability resulting from urbanization, especially in less-developed, largely tropical countries, influence methods of infant feeding and hence the pattern of child nutrition (1,2). Dominant in these changes are a decline in breast-feeding, a rise in attempted bottle feeding with cow's milk, and a tendency to purchase expensive, processed infant foods (Summary)

An example of effective disease control in a tropical mining community

An account is given of the methods used during the period 1943-46 to effect a transformation in the individual and environment health standards of a small mining community at Kwakwani settlement on the Berbice River, British Guiana. The health standards which obtained prior to control measures being introduced are outlined and the systems of record-keeping as also of compulsory medical examination and treatment used are described. Directly measured improvements are stated in the form of general morbidity, malaria, hookworm and filaria infection rates and reference is made to the various directions in which the environmental standards of the community were raised. In particular the ways in which the social welfare of the community was catered for are mentioned with special reference to the formation of a health commitee from among the employees themselves. It is concluded that the results obtained demonstrated the effectiveness of giving balanced attention to the requirements of both preventive and curative medicine and that the disease control methods used are well worthy of emulation among settlement communities elsewhere in the tropics (Summary)