Healthcare and the Caribbean

I have been off on vacation at the beautiful island of St Lucia for a week and made my best attempt at not thinking about my job during that time. Everyone needs a break here and there and I am no exception to that rule.


I must say that as flawed as I find our health care system, it could be far worse. I looked through the phone book, which is a habit I have when I travel. It gives me a feel for the country and what life is like there. St Lucia had more physicians listed than attorneys, which is a positive sign, but they have precious few of either, and the physicians listed were almost exclusively listed as primary care providers. There are only two hospitals on the island, one public with only limited services, and one private with more extensive services, but obviously, at a cost. That hospital actually had listed two psychiatrists on staff. A tour guide said that at one time there was an effort to build a psychiatric hospital on the island, but the funding dried up and the project came to a halt. Many other specialized services appear to be fairly limited on the island of St Lucia, a situation that appears to be pretty much more the rule than the exception in Caribbean islands.


St Lucia, if anything, appeared to be economically more stable than other islands I have visited, although poverty is still quite rampant. Health insurance is provided for the elderly by the government, but not for younger persons and it is not generally provided by employers. A tour guide told us that if one wanted health insurance, it was the responsibility of the individual to buy it oneself. He did not say how much it cost but from the appearance of the homes on the island, it could be safely inferred that this was a luxury that not everyone could afford. It did not have the feel of desperation and utter hopelessness that one sees from the images in Haiti, even the ones prior to that tragic earthquake. I did not get the impression that most people were living "high on the hog" either and money was probably pretty tight.




In Caribbean islands I have visited, and Mexico also, people who work at resorts work six days a week, twelve hours a day or more and despite this, somehow always seem to have a positive attitude. It never seems to amaze me how they can maintain spending their lives catering to wealthy people who they know work many fewer hours, for much more money and with many more luxuries in their lives and still be so pleasant. Of course a good attitude gets tips, but these are all inclusive resorts and the guests are told tipping is included in the cost so employees do not expect to be tipped. That said, resort employees probably are much better paid than many of their peers. One would hope that most of the guests treat them with a fair degree of respect. Personally for myself, when I am on vacation I am in a pretty good mood and am not likely to be giving an employee a lot of trouble, but there are always outliers who do overindulge and can get pretty nasty.



It is inspiring to see such a positive attitude in people despite such harsh conditions. Things do tend to run more slowly and we learned on this vacation that five minutes in Caribbean time was a lot longer than American time, but considering how much people endured in their lives, it was easy to be forgiving if things did not show up as quickly as one would expect in the USA. And we could guarantee when it did show up, it would be delivered with a smile.



Caribbean drivers are the exception to the Caribbean time rule, and drive with an alacrity that makes even me nervous on curvy roads that are certain to cause motion sickness without a hefty dose of Dramamine for other nausea medicine of choice on board. Returning to the snail's pace I endure in a community heavily populated with retired persons stressed me more than the shock of the temperature drop. At least they appreciate a good thrill.



I do not feel bad for visiting the Caribbean islands although I know some do, feeling that we are exploiting a poor country. If they did not want us there, they would not treat us with such open arms. Tourism is a significant money generator for small islands that have few resources to exploit without destroying natural resources such as the rainforests, pristine beaches and mountains. Many areas have found a balance between allowing some development and too much, and improved their standard of living in the process. I hate to see this level of poverty so close to our own home and feel that people deserve better.

I wish them well.