The Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH)

OBJECTIVE: To examine high-priority environmental and occupational health (EOH) risks in Suriname and those common to the increasingly vulnerable Caribbean region. DESIGN AND METHODS: Multi-pronged needs assessments were conducted to document baseline capacity levels and community needs focused upon health outcome data, laboratory capacity, training programs, and environmental health policy. EOH research included determining gold mining-related mercury contamination; assessment of occupational and community risks for agriculturally related pesticides; and analysis of medicinal plants and nutriceuticals. RESULTS: EOH policies in Suriname and other Caribbean countries are either absent, or where present, not enforced. Mercury contamination had been confirmed in fish species, sediment, and communities near gold-mining areas but there were also indications that climate change may have influenced mercury deposition in non-gold mining areas. Produce analyses for key pesticides used in agriculture showed the presence of banned pesticides at levels above the WHO Maximum Residual Levels. Mobile health technology-enabled and competency–trained Community Health Workers assisted their community in identifying key pesticide use–related concerns and messages to promote safe pesticide use. CONCLUSION: The overarching significance of the CCREOH preliminary studies has been to gain insight into the major EOH issues Suriname is facing. Knowledge of the mercury-related contamination of the country’s estuaries and contamination of agriculture products with pesticide residues provide evidence-based direction for future EOH research. Assessing the healing properties of medicinal plants and nutriceuticals has the potential to advance knowledge in a culturally competent manner. CARPHA plays a key role in CCREOH’s policy translation and research dissemination.

Redefining national and regional views on health

The Windward Islands Research and Education Foundation (WINDREF) was founded in 1994 in Grenada, West Indies, to develop worldwide multi-diciplinary research and education programmes that would advance the understanding of health and the environment. The WINDREF resource centre coordinates international collaborative research in the areas of medicine, veterinary medicine, anthropology, marine and terrestrial biology, and ethics. Offering academic opportunities to scientists from the Caribbean and around the world, it encourages the development of the understanding of local and international communities. It believes in the sharing of relevant scientific information with these communities. WINDREF's emphasis on internationalism and its commitment to community service and participation makes it unique among most developing and developed countries' research institutions. In the past six years, WINDREF has covered an impressive list of projects, ranging from non-communicable diseases, such as diabetes and alcoholism, to communicable diseases including HIV/AIDS, dengue fever, and nutritional parasites. Work has also focused on the use of medicinal plants and studies of the Mona monkey population. WINDREF has played a role in both undergraduate and graduate education and has established and maintained wide Caribbean and international collaboration and links (AU)

Medicine and its alternatives: health care priorities in the Caribbean

In the Caribbean as as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.(Au)

Environmental health: catching up with the developed world

Environmental health is the ecological balance that must exist between man and his environment in order to ensure his well being. This paper describes the range of environmental hazards (physical, biological, chemical and social) and discusses the differences in level and quality of environmental health programmes between developed and developing countries. The hazards are the same in both realms; the difference is in the level of advocacy and, thus, the demand for implementation of sound environmental health policies and practices. Issues which developing countries need to address to improve environmental health management are outlined.(AU)

Is serious research possible in the Caribbean?

This essay describes the rich tradition of research in the English-speaking Caribbean and the possibilities for meaningful colloboration between Caribbean researchers and scientists from developed countries. Significant contributions includes work related to the human T-lymphotropic virus (HTLV-I), Jamaican vomiting sickness, veno-occlusive disease of the liver, J-type diabetes, and the role of skin sepsis and streptococcal infection in the etiology of glomerulonephritis. In the fields of malnutrition, human metabolism, child development, and sickle cell anemia, the Caribbean has been at the forefront of medical research internationally. Many characteristics of the Caribbean population including the disease profile, offer advantages and unique opportunities for significant research, despite difficulties related to the "brain drain" and weaknesses of the infrastructure. (Au)

Cooperation in health in the Commonwealth Caribbean

Reviews past and present efforts regarding cooperation in health and proposes that the existence of a strong institutional framework is essential for the development and success of any cooperative initiatives. The existing institutional frameworks are described, viz., the University of the West Indies and the Pan American Health Organization/World Health Organization (PAHO/WHO). The priority areas of health care are outlined including environmental protection, human resources development, food and nutrition and maternal and child health. The future of health co-operation, particularly in public health, is the final area of discussions, which includes a discourse on the Commonwealth Caribbean Medical Research Council. (AU)

Beleidsnota gezondheidszorg 1982 - 1984 / Policy note on health care 1982 - 1984

This policy paper on health care 1982 - 1984 is based on the government statement. Starting point is that health care should be available, attainable, affordable for and acceptable to everyone. That is why the accent of health care policy has been shifted to the further development of primary regional health care