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By guest contributors Dr. Sandeep Bhupendra Maharaj BSc. Pharmacy MBA DBA; Dr. Darleen Y Franco MBBS PG. Dip Family Medicine; and Professor Terence Seemungal PhD FRCP FACP
The incoming Chairman of CARICOM, Prime Minister the Honourable Gaston A. Browne has called for reparations for climate change issues in the Caribbean due to wealthier countries acting irresponsibly . This call is one which should be supported but also expanded to deal with the impacts of anthropogenic climate change which are likely to affect the Caribbean Region over the next decade. The Caribbean region faces the Triple C crisis – Climate Change, Chronic Non Communicable Diseases and COVID-19. Prior to COVID-19, Climate Change and Chronic Non-Communicable Diseases had a negative impact on Caribbean morbidity and mortality, which COVID-19 worsened.
The Caribbean region was born out of a history of colonization, which included the wiping out of its Indigenous inhabitants and the migration of slave and indentured labour to meet the needs of the metropole. These hinterlands suffered from a muscovado bias, in that they produced the raw materials but the finished high end value products were manufactured in the metropole. Hence the value of the finished goods was all kept in these metropoles and little was gained by the hinterlands. Indeed, Dr. Eric Williams also contended in his book Capitalism and Slavery that the sugar production of the Caribbean Islands funded the English Industrial Revolution . It is postulated that the Industrial Revolution started the copious release of carbon dioxide into the atmosphere leading to the start of the anthropogenic age.
In light of this legacy, a planetary health lens can help give context to the situation the Caribbean region is facing. This region, which is one of the world’s biodiversity hotspots, is increasingly endangered by rising sea-levels, warmer temperatures, more extreme weather conditions including hurricanes and droughts, air and water pollution; all of which undermine our food and water security and increase our risk to disease . Hence, our population is experiencing increased deaths due to climate change, biodiversity loss, lack of potable water and land misuse and abuse, to name a few. The disruption of the human-ecological balance has negatively affected our health, and has a direct impact on the spread and severity of both communicable and non- communicable diseases. In the name of development, we are disrupting ecology, increasing vulnerability to disease, and facilitating disease transmission. We are also experiencing an increase of conditions such as obesity, heart disease, respiratory diseases and diabetes and this combination may be classified as a planetary health emergency.
The ongoing COVID-19 pandemic has overwhelmed the health sectors in rich countries, so with rising numbers of positive COVID-19 cases in the Caribbean and ensuing multiplicity of negative effects on the tourist industry, we can unhesitatingly predict not only a health emergency but also an economic emergency.
To mitigate the impact of these problems, there has been a host of disparate regional fields of endeavour collectively dealing with human and animal health and the environment, such as public health education, One Health projects , eco-health programmes , plant and agriculture quarantine procedures , environmental conservation initiatives , poverty reduction programmes , oceanic acidification  and coral life interventions. These programs would benefit from greater cohesiveness and perhaps the Caribbean Community Secretariat (CARICOM) would do well to create a register for all of these projects. This would allow CARICOM to provide central leadership here.
To improve our lives, already threatened by environmental changes, there is urgent need to better understand the relationship between human health and the environment and thus ensure we are better prepared for the next health crisis. Addressing planetary health issues offers an important opportunity to recalibrate the relationship between human health and environmental sustainability and thus implement meaningful regional actions that simultaneously improve human health and that of the planetary environment . It should be noted that a number of the measures required to combat the COVID-19 crisis as well as the planetary health crisis are one and the same . Examples such as independent, sustainable food systems, less carbon intensive transportation systems (eg. biking), biodiversity protection, green buildings and changes in architectural designs, and planned land usage would have co-benefits of reduction in risk for both COVID-19 spread and emergence of other zoonotic diseases, while at the same time have a positive effect on planetary health outcomes. While economies are reeling across the Caribbean these new endeavours of research, policy and practice, can stimulate growth in existing sectors of the economy while creating new ones;
Therefore if reparations are to be given, an acknowledgement that a wrong has been done is the first step. There should be however mechanisms put in place to ensure Caribbean countries can have contextually relevant strategies and capacities to deal with the prevailing planetary health crisis. The former colonizing countries need to assist with:
- Education of health personnel from the Caribbean in the fields of climate change, food systems, urban planning, infectious disease control, specialists in NCD management and prevention, recycling of energy.
- Funding from the former colonial powers for not only for research which is relevant to Caribbean countries to solve the problems mentioned above, but also to build capacity to conduct research by Caribbean researchers.
- Technology transfer is critical, especially to support areas such as recycling, deforestation mapping, etc. given the region not having the economies of scale many of the technologies which are common in wealthier countries are unaffordable.
- Financing to assist in stabilizing Caribbean economies, especially given the social and economic situation of the region due to COVID, is a moral obligation of the former colonial powers because the consequences on the health profile can be disastrous.
Dr. Sandeep Maharaj (BSc. Hons, MBA DBA RPh) is a lecturer in the area of Pharmacy Administration and Associate Dean Distance Education Planning and Projects at The University of the West Indies Faculty of Medical Sciences St. Augustine Campus. He is also the Global Outreach Fellow at the Planetary Health Alliance. Dr. Maharaj focuses on Global Health issues and promoting equity and access to healthcare.
Dr. Darleen Franco is a Primary Care Physician working in the public health sector in Trinidad and Tobago. She has special interest in health systems research.
Professor Terence Seemungal is Dean of the Faculty of Medical Sciences at St Augustine, UWI. Prof Seemungal completed his MBBS (hons) degree at UWI and then proceeded to London where he did a PhD in the chronic lung disease and infections caused by respiratory viruses. He completed the UK specialist training programme in internal and respiratory medicine in London. He returned to Trinidad where he was appointed Senior Lecturer in medicine. In 2012, Professor Seemungal was elected President of the newly founded Thoracic Society of Trinidad and Tobago. His professional career has been focused on teaching and research and in 2017 he and his team completed the first National Study of chronic lung disease. In 2015 Professor Seemungal was appointed Dean of The Faculty of Medical Sciences and has led the Faculty through the current COVID-19 Pandemic when adjustments for online training for medical sciences were made.
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