Ambassador: Gurveen Grewal
Barbados, an independent democratic island country in the Caribbean, is considered to be a more developed country (MDC) with a population of an estimated 284,589 people in 2009.1 It hosts the headquarters for two Pan American Health Organization (PAHO) regional offices namely, the Office of Eastern Caribbean Countries (OECC) and the Office of Caribbean Program Coordination. It is a regional hub for transport and the country has an excellent network or roads with highways linking the airport, Bridgetown, the seaport, the industrial estates and the tourist belts. Its economic growth is underpinned by tourism, construction and financial services. Literacy rate is estimated at 97.4% and 94% of households had potable water supplied inside their houses, while the remaining 6% have easy access to potable water supplied. Health care services are provided free at the point of service in the public sector. The Barbados Drug Service provides drugs and other pharmaceutics listed in the Barbados Drug Formulary free of charge to persons in the public sector and to pre-defined beneficiaries in the private sector. Furthermore, the Ministry of Health (MOH) is the singular executing agency for the delivery of health care, policy-making, and regulation of the health sector. It is also responsible for protecting the health of the population.
Which aspects of Pandemic Preparedness is most pertinent to your country and why?
A primary concern for the MOH is the increasing prevalence of overweight, obesity, and chronic non-communicable diseases in the general population. In terms of pandemics, Barbados is concerned with HIV/AIDS, dengue fever and more recently the H1N1 influenza. Between 2001-2006 there was a 65% decline in the number of HIV-related deaths, however, this trend has reversed in recent years. In 2007, there was a 53% increase in the number of reported deaths due to HIV. HIV/AIDS is among one of the main causes of illness and death among 15-24 year olds in Barbados and in 2007, it was responsible for 5% of deaths in Barbados. Furthermore, dengue fever is endemic to the region and can occur throughout the year. There has been a marked increase in the number of reported cases of dengue fever across the region in 2007, including 399 confirmed cases in Barbados to date.
How would you as the WHO Ambassador of your country address this issue?
This issue is best addressed by having proper vaccines available, increase awareness to public about the prevalence of the issue and develop prevention strategies. As health officials, it is pertinent that we are aware of the cultural stigma attached to a pandemic such as HIV/AIDS in order for us to design appropriate strategies to overcome this challenge. For instance, the major mode of transmission of HIV/AIDS was heterosexual contact between young adults so, it would be wise to promote safe sex amongst teens by addressing the issue with the Barbadian youth and adolescents. Implementing AIDS awareness educational campaigns at secondary schools, broadcasting promotional advertisements on television, the radio, the Internet, in public gathering places and especially at public events that attract young people such as parades, parties and concerts is a great way of addressing this issue. Furthermore, having condoms and anti-retroviral drugs readily available is also useful. The MOH should also enable optimal use of global, regional, and subregional collective agreements for national health development by building alliances and partnerships with neighboring countries to design cost- and labour- effective strategies and campaigns.
3. How has your country addressed Pandemics in the past? What would you have done differently?
As a response to pandemic influenza, Barbados has developed a National Influenza Pandemic Preparedness Plan (NIPPP) along with other Caribbean countries. Several preparedness activities were instituted to respond timely to a pandemic event. For example, the MOH has built capacities in early detection, investigation and response including strengthening health service preparedness to execute health sector interventions and containment activities. In fact, Barbados hosted a “Sub-Regional Workshop on Pandemic Influenza Preparedness and Response: Caribbean Experience and Less” in September 2009. This workshop was primarily directed to national health and disaster officers involved in the planning and implementation of preparedness and response activities of the country.
The MOH also initiated campaign to eradicate rubella by immunizing all men & women in age group 21-35. This campaign was 51% complete by 2000. Also, in 2000, Barbados had achieved 97% coverage for DPT, 96% for polio, and 92% for Measles, Mumps, and Rubella.
Furthermore, Barbadian law requires notification of all cases of communicable diseases listed in the Health Services Regulations to the MOH. The surveillance of communicable diseases is the responsibility of a team led by the national epidemiologist and integrated by environmental health officers and public health nurses working in collaboration with public health and private laboratories.
More generally, Barbados has introduced “Health and Family Life Education” within the curriculum of primary & secondary schools. This has been a major achievement in improving community health. A healthy community allows for a smoother and more effective way to deal with a pandemic.
4. Which countries do you see yourself becoming allies or rivals with? Why?
Barbados is already a member of numerous regional organizations and alliances which include the Caribbean Community (CARICOM), the Association of Caribbean States (ACS), the Organization of Eastern Caribbean States (OECS) etc. It seeks to maintain these relations so as to pool resources together to develop training programs, technical assistance, development and use of information systems.