Changes in health conditions in Guyana since the nineteenth century

ABSTRACT

Guyana is almost unique in being a tropical country for which reasonably reliable vital statistics for the nineteenth century are available. Overall death rates were higher than birth rates so that, without the substantial immigration of East Indians then taking place, the population would have decrease. For example, mortality rates for young adults (20-34 years) in 1893 (about 30 per 1,000) were four times greater than in the U.K. at the same time, ten times greater than in Guyana in 1960 and thirty times greater than in the U.K. in 1965. Chief causes of death were fevers (including malaria), pneumonia, dysentry, tuberculosis and chronic nephritis. Infant mortality ranged 200 and 300 deaths per 1,000 live births per annum. The medical profession took much interest in health problems as is shown by numerous valuable articles in the 21 volumes of the British Guiana Medical Annual published between 1887 and 1915. Important original contributions to medical knowledge included the first recognition in the Caribbean of the importance of hookworm as a cause of fatal anaemia. The relationship of malarial infection to chronic nephritis, the first adequate description of Granuloma inguinale and Mansonella ozzardi and the demonstration of the differences in the reaction of ethnic groups to certain diseases, including malaria and filariasis. Partly owing to the interests and efforts of the medical profession a revolution in the public health of Guyana started between 1910 and 1920 and was accelerated by the eradication of malaria from the coastlands in 1949. In contrast to the nineteenth century, the important causes of death in adults are now from chronic degenerative or noplastic conditions rather than from infectious disease and a rapid natural increase in population is occurring (AU)