quality health care in JamaicaIn an interview with The Borgen Project, native Jamaican Shamella Parker describes the dire consequences of a lack of access to quality health care in Jamaica. On an evening in February 2023 in Montego Bay, Jamaica, Parker’s aunt Mary, a live-in cook, shared a dish with her employer containing susumba, commonly known as gully bean, a type of green berry popular in Jamaica. Shortly after the meal, both Mary and her employer fell ill.

The man’s family took him to a nearby hospital. “The hospital that he went to, I believe they treated him on the spot because he was wealthy and I guess known in the neighborhood, but my aunt – not being as wealthy – went to another hospital in the area where she was from,” said Parker. In contrast, Mary went to a hospital in St. Catherine and spent a long time waiting to be attended to in the waiting room despite being an emergency case. Eventually, she lost consciousness and became unresponsive. Nurses and doctors attempted to revive her, but it was too late. Parker and Mary’s husband feel the hospital did not do all it could to save her.

According to Mary’s husband, the forensic pathologist was away at his wife’s time of death. For example, in 2015, the Jamaican government employed only two forensic pathologists who perform autopsies for everyone who does not have insurance. When Mary’s husband returned, the pathologist deemed Mary died of an accident – consumption of a poisonous seed. But, to Mary’s family, unequal access to prompt and quality health care in Jamaica stood as the true cause.

A Public Health Crisis

Jamaica’s iconic reggae and beaches backdrop a public health crisis. The legacy of the colonial slave-based economy birthed the traumatic, post-emancipation public health care system present in Jamaica today. Health care is a dimension of poverty on the island; the Multidisciplinary Poverty Index (MPI) of 2022 estimated that 78,000 Jamaicans lived in multidimensional poverty in 2020. The Index splits poverty into three dimensions – health, education and standard of living – and scales the intensity of deprivations for each. Compared to selected other Caribbean and Latin American countries at that time, health care deprivation was greatest in Jamaica, at 52.2%; the next highest was Trinidad and Tobago at 45.5%.

Insurance and Unequal Access to Quality Health Care in Jamaica

The National Health Plan estimates that 500,000 out of 2.7 million Jamaicans have insurance. This means roughly 80% of Jamaicans do not have it and have to rely on public hospitals. These hospitals do not have enough equipment to meet this demand, with World Data estimating that there are 1.32 primary care doctors per 1,000 civilians and 1.7 hospital beds.

Many Jamaicans do not have insurance due to inflated premiums, rendering insurance inaccessible. Even those who have it are discouraged from exceeding the lifetime maximum benefit. As a result of poor insurance or lack thereof, many reserve medical attention for emergencies.

Just taking her aunt to the hospital, Shamella Parker said, meant “it was a serious thing… we do not just go to the hospital for anything.”

Health Education

Non-communicable diseases (NCDs) comprise 79% of mortality in Jamaica. These include diseases such as diabetes, heart disease or cancer. Teaching healthy habits is one way to combat NCDs. Though there is a National School Feeding Programme, public schools increasingly apply the protocol with “unevenness,” according to the Ministry of Education and Youth (MOEY) report.

As it is, many schools are not mandated to provide nutritional food, exercise programs or health classes that destigmatize illness. According to the Jamaican Health and Wellness Minister Dr. Christopher Tufton: “…there is actually a lost generation around that crisis, a cohort of citizens who unfortunately will have to spend the rest of their lives trying to make themselves as comfortable as they can…”

Transportation Infrastructure

Hospitals are difficult to reach. People often live far away from health centers and hospitals. Reliable infrastructure is essential for continual access to health care in Jamaica. However, rural roads are often unpaved, secluded and vulnerable to climate damage. Bad weather resulting in landslides and flooding is common and may disrupt transportation by “cut[ting] off access to health care, education and other essential services,” according to a 2018 report. Blocked roads complicate transporting patients. Jamaica’s “limited funding” for transportation maintenance causes drawn-out repairs when roads erode and bridges collapse.

Ongoing Efforts

In 2020, the Jamaican government signed the Vision for Health 2030, a 10-year health improvement strategy to reorder Jamaica’s fragmented care. Alongside the Pan American Health Organization (PAHO), this plan tackles noncommunicable diseases and maternal health by increasing the number of hospitals on the island and modernizing services to boost equity and efficiency while delivering “higher technical quality.”

In 2019, the government introduced the National School Nutrition Policy. This legislation forms part of the government’s efforts to mandate healthy eating and exercise in young people. Its provisions include measures such as color-coding foods permitted in schools and providing competitions to incentivize healthy eating, according to the MOEY report.

Additionally, various efforts are underway to reform infrastructure, according to the National Development Plan (NDP). Goal 9 of the NDP includes the country’s largest infrastructure project worth up to $800 million to upgrade roads and access to water, sewage and internet.

In 2016, UNICEF began assisting the government in adopting regulated, cold-chain transport. It is a temperature-controlled supply chain essential for reducing waste and improving the integrity of goods necessary for health services.

Looking Ahead

Efforts to address the public health crisis and improve access to quality health care in Jamaica are underway. The government’s Vision for Health 2030 and collaboration with organizations like PAHO and UNICEF aim to modernize health care services, tackle noncommunicable diseases and enhance infrastructure. The introduction of the National School Nutrition Policy highlights efforts to promote healthy habits among young people. As these initiatives progress, there is hope for a more equitable healthcare system that prioritizes the well-being of all Jamaicans.

– Caroline Crider
Photo: Unsplash

Charities Operating in JamaicaLimited health care resources including insufficient facilities and professionals, pose a significant challenge to Jamaica’s well-being. The economic aftershocks of COVID-19 resulted in an approximate 9% plunge in the country’s real GDP between 2019 and 2020. Further exacerbating the situation is the prevalence of food and water insecurity, where many communities face inconsistent access to clean water and affordable, nutritious food.

Fortunately, many organizations in Jamaica are actively engaged in the recovery process with poverty reduction initiatives. Highlighted below are five charities operating in Jamaica, all of which help to support the most vulnerable communities across the island.

5 Charities Operating in Jamaica

  1. Angels of Love Jamaica – A complex web of societal challenges such as outdated health care systems, prevalent violence and income inequalities closely connect to the deprivation of children in Jamaica. According to a 2017 report, Jamaica was among the countries that experienced the highest rates of child homicide in 2015, at a total of 13 per 100,000 population. On top of that, Jamaican children are also prone to HIV/SIDA, with around 10% of patients under 18 years of age. To address issues of physical and mental illnesses, Angels of Love Jamaica began its journey in 2009. This non-governmental organization focuses on improving the conditions of these children by providing critical services, including lifesaving treatments, health care provisions and educational assistance, among other supportive contributions. In 2017, 50 Jamaican children with cancer enrolled in the NGO’s programs for free medical examinations, weekly hospital visits, sorting prosthetics, financial support and more.
  2. ISSA Trust Foundation – Couples Resorts established the foundation in 2005. It strives to provide a system of prevention, promotion and community health improvements for the people of Jamaica. The Issa Trust Foundation also emphasizes its vision to improve the welfare of Jamaican children through a concentrated focus on pediatric health care and education. It undertakes a variety of proactive campaigns, such as hosting annual charity concerts and constructing children’s health care centers. Moreover, the Foundation facilitates the provision of essential medical equipment and services, all of which focus on enhancing the quality of life for the younger generation. Since its establishment, thousands of Jamaican children have been treated with care in Negril and Ocho Rios.
  3. Heart Foundation Jamaica – Cardiovascular disease is another prevalent contributor to mortality in Jamaica. In 2014, noncommunicable diseases resulted in 15,380 deaths, of which cardiovascular disease accounted for a substantial 6,504 cases. Out of cardiovascular conditions, cerebrovascular disease caused a total of 2,637 people’s lives. In response to these death rates, the Heart Foundation Jamaica aims to improve conditions by providing cardiovascular health research, training, treatment and promotion. For more than 50 years, the foundation has been raising awareness, generating necessary funding and orchestrating various events, from golf tournaments to marathon runs/walks. The Foundation’s goal is to reduce premature mortality from cardiovascular diseases in Jamaica by 25% in 2025.
  4. Food for the Poor – In 2020, the issue of food insecurity worsened in Jamaica, with 12.8% of the population reporting inadequate access to food in 2021. This figure doubled the projection that the United States Department of Agriculture Economic Research Service made in pre-COVID-19 times. On the other end, water scarcity has also been a problem for many Jamaican residents. Challenges surrounding water insecurity are primarily due to old and overwhelmed water systems. Some elements of which were established as far back as the 1800s and others in the 1960s, causing difficulties in meeting water demands of the population. Based in the U.S., Food for the Poor is “the largest charity organization in Jamaica.” Since 1982, it works with various organizations across the country, including churches, directly helping the poor. The organization has its own emergency relief aid programs that focus on helping people struggling with water, sanitation, health care, housing, agriculture and more. In January 2023, the organization provided around 1,000 food packages to people living in rural communities of Jamaica with the goal of “spread[ing] the joy of giving to those in need.”
  5. Jamaica Red Cross – Jamaica is no stranger to natural disasters, frequently facing various forms of environmental threats such as droughts, storms and floods. According to the World Bank, between 1980 and 2020, the country experienced an annual average of 20 storm events, seven instances of flooding and three periods of drought. The Jamaica Red Cross confronts the need for effective disaster management alongside many other supportive programs. From youth development and first aid training to restoring family links and equipment rental, the organization carries out a diverse portfolio of initiatives to improve the well-being of residents in Jamaica. The organization’s “Meals on Wheels” program provides approximately 100 Jamaican citizens per week with necessary food in and around Kingston.

These five charities operating in Jamaica play an essential role in addressing the country’s pressing issues from poverty and health care shortages to food and water insecurity. Along with many other organizations, charities in Jamaica are filling crucial gaps and offering hope to those in need. Through their dedicated work, such groups are not just providing immediate relief but are also working towards long-term, sustainable solutions that aim to reduce poverty and foster a more resilient nation.

– James Bao
Photo: Pixabay