Title: Vulnerability and Adaptation to Dengue Fever in Jamaica A Socioeconomic Scenario
1Vulnerability and Adaptation to Dengue Fever in
Jamaica A Socioeconomic Scenario
- Charmaine Heslop-Thomas and Wilma-Bailey
2AIM
- 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.
3RESEARCH 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?
4VULNERABLE 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
5Contd
- 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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7Communities
- 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.
8Sample
- 10 per cent sample of 257 heads of households.
- 151-Granville/Pitfour
- 57-Johns Hall
- 49-Retirement
9Vulnerability 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.
10Framework for identifying factors that influence
vulnerability to infectious diseases (LSTM)
11Measuring 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
12Identification 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
13Other 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.
14Non-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
15University of the West Indies
- Climate Studies Group, Mona
- Professor Anthony Chen
- Dr. Michael Taylor
- Dr. Dharmaratne Amarakoon
16Vulnerability 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
17Vulnerability 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
18Future 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
19Poverty
- Declining trends over the past few decades but
still not at an acceptable level.
20Poverty contd
- Urban and rural disparities in poverty
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