Vulnerability and Adaptation to Dengue Fever in Jamaica A Socioeconomic Scenario

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Vulnerability and Adaptation to Dengue Fever in
Jamaica A Socioeconomic Scenario

• Charmaine Heslop-Thomas and Wilma-Bailey

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AIM

• To analyze the vulnerability of communities in
  Jamaica to possible increase in the transmission
  of dengue fever and to propose effective and
  feasible mitigating strategies.

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RESEARCH QUESTIONS

• What areas of the country are vulnerable to
  dengue fever?
• What are the socioeconomic characteristics of the
  communities and groups that are vulnerable to
  dengue fever?
• What are the socioeconomic factors associated
  with vulnerability?
• What are the historic trends in these
  socioeconomic variables?
• How might these variables change in the future?

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VULNERABLE AREAS

• 1.Review present conditions in order to target
  vulnerable area what areas are vulnerable to
  dengue fever?
• Obtained data from the Ministry of Health on the
  last two epidemics 1995 and 1998.
• Difficulties experienced in assessing geographic
  distribution of dengue cases
• -not all cases seen are reported to the MOH.
• When cases are reported, home addresses are not
  always recorded in one of the largest outbreaks
  affecting the KMA in 1995, only the reporting
  hospital was recorded.
• Reported cases are those who were affected or who
  had developed complications.
• Unsatisfactory data made it difficult to come to
  grips with the geographic distribution of the
  disease research not possible for all of
  Jamaica

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Contd

• In the absence of complete date we decided to see
  if data for any one year formed a recognizable
  spatial pattern.
• We plotted the home addresses on a map and the
  only year in which we saw a recognizable trend
  was in 1998 in St. James.
• In 1998 there were 224 reported cases in the
  island and 88 in St. James.
• There were more males than females especially in
  the age group 20 -34 years.

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Communities

• Granville/ Pitfour is a suburb of the parish
  capital, Montego Bay. It has a population of
  6359, slightly less than in 1991.
  Granville/Pitfour has an average of four persons
  per household but many of these households
  consist of one roomed informal as well as formal
  structures. Public standpipes and pipes in the
  yard together provide water to the majority of
  persons, pit latrines are most common.
• Retirement is found immediately beyond the
  boundaries of the urban area. It has a
  population of 1783 and experienced slight growth
  between 1991 and 2001. Based on access to social
  amenities, Retirement is the best endowed of the
  three communities.
• Johns Hall is in rural St. James and has a
  population of 2, 332-also showed a decline in
  population. A segment of the community resembles
  the squatter (informal) community of
  Granville/Pitfour. Many are not involved in
  typical rural pursuits.

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Sample

• 10 per cent sample of 257 heads of households.
• 151-Granville/Pitfour
• 57-Johns Hall
• 49-Retirement

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Vulnerability Framework

• Adopted from Liverpool School of Tropical
  Medicine on vulnerability assessment for
  infectious disease-malaria, TB and HIV.
• Proposal of vulnerability assessment at various
  scales-individual, household and community,
  environmental and institutional.

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Framework for identifying factors that influence
vulnerability to infectious diseases (LSTM)
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Measuring Vulnerabilityof communities and groups

• Questionnaire was used to establish vulnerability
  of communities and groups to dengue fever.
• 257 questionnaires were administered to 257 heads
  of households in three communities
  Granville/Pitfour, Retirement and Johns Hall.
• Selection of indicators based on supporting
  literature.
• Ranking of indicators

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Identification of adaptive capacity at the
Institutional Level

• Interviews with experts from governmental and
  Non-governmental organizations.

Mrs. Clarke Allwood-Director, Programme,
Budgeting and Financial Management Drs. Erica
Edmann and Karen Webster-Medical Officers Mr.
Peter Knight-Environmental Health Officer Mr.
Desmond Clarke-Chief Public Health
Inspector Mrs. Zoe Hamilton-Health Educator,
Kingston and St. Andrew
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Other Public Sector Institutions

• Mr. Franklyn McDonald CEO, NEPA
• Mr. Paul Saunders, Deputy Director General, ODPEM
• Mr. Jeffery Spooner, Head of the Climate Branch,
  Meteorological Service of Jamaica.

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Non-Governmental Organizations

• Jamaica Environment Trust-Kerry Ann Curtis,
  Project Coordinator
• Mr. Wellington Taylor, Jamaica Conservation and
  Development Trust
• Professor Anthony Clayton-University of the West
  Indies Centre for Environment and Development
• Professor Elizabeth Thomas- Hope, Environmental
  Management Unit, UWI

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University of the West Indies

• Climate Studies Group, Mona
• Professor Anthony Chen
• Dr. Michael Taylor
• Dr. Dharmaratne Amarakoon

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Vulnerability at the institutional Level

• Resource problem limits the ability of the MOH to
  respond adequately to present conditions.
• No long term planning to meet the possibility of
  increased transmission.
• Little routine surveillance but rather knee-jerk
  responses to outbreaks and citizens complaints.
• Expressed view was that communities must take the
  responsibility for vector control

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Vulnerability of Communities and Groups

• Community vulnerability
• - vulnerability increased with increasing
  distance from the city of Montego Bay.
• - overall Johns Hall, the rural community was
  most vulnerable.
• Vulnerable group
• -the most vulnerable group accounted for 14 per
  cent of the sample.
• -most were found in the rural community of Johns
  Hall (49 per cent) but the urban community of
  Granville/Pitfour accounted for 40 per cent.
• -this group consisted mainly of households
  headed by unskilled females who were earning
  below minimum wage

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Future Trends

• Historic trends and future projections.
• a. Examine the trends in socioeconomic
  variables associated with the most vulnerable
  community and groups over the past few decades.
• b. make projections based on these trends

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Poverty

• Declining trends over the past few decades but
  still not at an acceptable level.

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Poverty contd

• Urban and rural disparities in poverty

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• Thank You