Dutch-speaking Caribbean Research Articles

A review of immunization legislation for children in English- and Dutch-speaking Caribbean countries.

To assess the legislative frameworks concerning childhood vaccination in the English- and Dutch-speaking Caribbean and propose a model legislative framework for Caribbean countries. This study included a survey of 22 countries and territories in the Caribbean regarding legal vaccination mandates for school entry, budget allocations, sanctions, or exemptions. A legal consultant conducted a comprehensive search and analysis of legislation regarding vaccination among 13 Caribbean countries/territories. A comparative analysis of the legislation under five themes-legislative structure, mandatory vaccination, national immunization schedule, sanctions, and exemptions-formed the basis for the proposed model legislation. Among the 22 Caribbean countries/territories, 17 (77%) had legislation mandating vaccination, 16 (94%) mandated vaccination for school entry, 8 (47%) had a dedicated budget for immunization programs, and 13 (76%) had no legislated national schedules. The source of legislation includes six (35%) using the Education Act, eight (47%) the Public Health Act, and five (29%) a free-standing Vaccination Act. Three countries/territories-Jamaica, Montserrat, and Saint Lucia-had immunization regulations. In 12 (71%) of the 17 countries with legislation, sanctions were included, and 10 (59%) permitted exemptions for medical or religious/philosophical beliefs. Several countries in the Caribbean have made failure to vaccinate a child an offense. By summarizing the existing legislative frameworks and approaches to immunization in the Caribbean, the analysis guides policymakers in making effective changes to immunization legislation in their own countries.

10-year trends in noncommunicable disease mortality in the Caribbean region.

ABSTRACTObjective.Between 2006 and 2016, 70% of all deaths worldwide were due to noncommunicable diseases (NCDs). NCDs kill nearly 40 million people a year globally, with almost three-quarters of NCD deaths occurring in low- and middle-income countries. The objective of this study was to assess mortality rates and trends due to deaths from NCDs in the Caribbean region.Methods.The study examines age-standardized mortality rates and 10-year trends due to death from cancer, heart disease, cerebrovascular disease, and diabetes in two territories of the United States of America (Puerto Rico and the U.S. Virgin Islands) and in 20 other English- or Dutch-speaking Caribbean countries or territories, for the most recent, available 10 years of data ranging from 1999 to 2014. For the analysis, the SEER*Stat and Joinpoint software packages were used.Results.These four NCDs accounted for 39% to 67% of all deaths in these 22 countries and territories, and more than half of the deaths in 17 of them. Heart disease accounted for higher percentages of deaths in most of the Caribbean countries and territories (13%-25%), followed by cancer (8%-25%), diabetes (4%-21%), and cerebrovascular disease (1%-13%). Age-standardized mortality rates due to cancer and heart disease were higher for males than for females, but there were no significant mortality trends in the region for any of the NCDs.Conclusions.The reasons for the high mortality of NCDs in these Caribbean countries and territories remain a critical public health issue that warrants further investigation.

Zika virus outbreak in 19 English- and Dutch-speaking Caribbean countries and territories, 2015-2016

Background: Surveillance for zika virus was enhanced in the English- and Dutch-speaking Caribbean following emergence of zika virus in Brazil in May 2015. The first autochthonous case of zika in the Caribbean was reported by Suriname in November 2015 and since then, the virus rapidly spread throughout the region. Zika shares similar epidemiology, clinical presentation, and transmission cycle to chikungunya and dengue. However, the emergence of this new virus presented some challenges to public health professionals throughout the region. The epidemiology of laboratory-confirmed zika cases reported to the Caribbean Public Health Agency (CARPHA) for 19 English- and Dutch-speaking Caribbean countries during November 1, 2015–December 29, 2016 was documented. Methods & Materials: CARPHA Member States reported clinically suspected cases of zika and submitted serum specimens to the Agency for laboratory investigation. Real-time-polymerase-chain-reaction (RT-qPCR) was used to detect zika virus in samples taken 1 - 5 days of onset of illness. Samples taken ≥6 days of onset of illness were tested by RT-qPCR or neutralization by plaque reduction and IgM ELISA (for dengue and chikungunya virus). Due to the documented link between zika virus and congenital syndrome and zika virus and Guillain-Barré Syndrome (GBS), data on these disease outcomes were extracted and presented. Results: During the epidemic period, October 1, 2015 to December 29, 2016, 5,614 cases from 19 English- and Dutch-speaking Caribbean countries and territories were tested for arboviruses. Of these, 1,447 cases tested positive for zika virus. The majority of cases were female (83%), of which 614 (51%) were pregnant. Sixty-five percent of cases were between ages 20-44 (median 30 years, range: 5 days to 90 years). Rash, fever and arthralgia affected 87%, 63% and 60% of all reported cases, respectively. Four confirmed cases of congenital syndrome associated with zika virus infection were reported from three countries during the period. One hundred and twenty-one cases of GBS were reported from ten countries with 13 reported cases laboratory confirmed for zika virus. Conclusion: The emergence of zika virus in the English- and Dutch-speaking Caribbean underscores the threats to regional health security, the need for enhanced surveillance systems and innovative prevention and control strategies.

Zika virus outbreak in 19 English- and Dutch-speaking Caribbean countries and territories, 2015-2016.

ABSTRACTSurveillance for Zika virus was enhanced in the English- and Dutch-speaking Caribbean following emergence of the virus in Brazil in May 2015. The first autochthonous case of Zika in the Caribbean was reported by Suriname in November 2015, and the virus subsequently spread rapidly throughout the region. Caribbean Public Health Agency (CARPHA) member states (CMS) reported clinically suspected cases of Zika and submitted serum specimens to the agency for laboratory investigation. A patient was considered a confirmed case if Zika virus was detected by real-time reverse transcription–polymerase chain reaction (RT-PCR) assay or serological test. Due to the documented link between 1) Zika virus and congenital syndrome, and 2) Zika virus and Guillain–Barré syndrome (GBS), data on both of these disease outcomes were extracted from country and regional reports. This special report describes the epidemiology of laboratory-confirmed Zika cases reported to CARPHA, including links with both congenital syndrome and GBS, for 19 English- and Dutch-speaking Caribbean countries during the epidemic period (1 October 2015–29 December 2016).

The Expanded Program on Immunization in the English- and Dutch-speaking Caribbean (1977-2016): reasons for its success.

ABSTRACTThe year 2017 marks the 40th year of the establishment of the Expanded Program on Immunization (EPI) by the Pan American Health Organization (PAHO), the regional office of the World Health Organization (WHO) in the Americas, the first WHO region certified as eliminating poliomyelitis (1994), measles (2016), and rubella and congenital rubella syndrome (CRS) (2015). The English- and Dutch-speaking Caribbean subregion of the Americas paved the way in eliminating these diseases. This report highlights the innovative strategies used in this subregion that helped make the EPI a success.A review of published/unpublished reports and written and oral accounts of the experiences of Immunization Advisors and national EPI managers was conducted to identify the strategies used to strengthen the Immunization program in the subregion since its implementation by countries in 1977. The results show that these include strong collective political commitment, country-specific immunization legislation, joint use of a standard coverage monitoring chart, annual meetings of national EPI managers, collaborative development of annual national Plans of Action for Immunization, coordinated implementation of vaccination campaigns, subregional oversight of surveillance and laboratory support, a performance award system for countries, and subregional standardized templates for immunization manuals and procedural guidelines. Political will and support for immunization has been particularly strong in this subregion, where 99% of EPI costs are borne by governments. Dedicated health staff and multi-country agreement and application of strategies have led to high sustained coverage and good-quality surveillance, resulting in the absence of wild polio for 34 years, measles for 25 years, CRS for 17 years, and rubella for 15 years.

Leading Causes of Cancer Mortality - Caribbean Region, 2003-2013.

Cancer is one of the leading causes of deaths worldwide (1); in 2012, an estimated 65% of all cancer deaths occurred in the less developed regions of the world (2). In the Caribbean region, cancer is the second leading cause of mortality, with an estimated 87,430 cancer-related deaths reported in 2012 (3). The Pan American Health Organization defines the Caribbean region as a group of 27 countries that vary in size, geography, resources, and surveillance systems.* CDC calculated site- and sex-specific proportions of cancer deaths and age-standardized mortality rates (ASMR) for 21 English- and Dutch-speaking Caribbean countries, the United States, and two U.S. territories (Puerto Rico and the U.S. Virgin Islands [USVI]), using the most recent 5 years of mortality data available from each jurisdiction during 2003-2013. The selection of years varied by availability of the data from the countries and territories in 2015. ASMR for all cancers combined ranged from 46.1 to 139.3 per 100,000. Among males, prostate cancers were the leading cause of cancer deaths, followed by lung cancers; the percentage of cancer deaths attributable to prostate cancer ranged from 18.4% in Suriname to 47.4% in Dominica, and the percentage of cancer deaths attributable to lung cancer ranged from 5.6% in Barbados to 24.4% in Bermuda. Among females, breast cancer was the most common cause of cancer deaths, ranging from 14.0% of cancer deaths in Belize to 29.7% in the Cayman Islands, followed by cervical cancer. Several of the leading causes of cancer deaths in the Caribbean can be reduced through primary and secondary preventions, including prevention of exposure to risk factors, screening, early detection, and timely and effective treatment.

Depicting Caribbean Theological Libraries

Theological libraries in the Caribbean have suffered from invisibility, so this study aims to bring these libraries to the fore. It presents key features of the libraries and seeks to determine if these are influenced by the libraries’ denominational affiliation, geographic location, and size. Geographically speaking, the target area was twenty-nine Caribbean territories. Data was gathered using a questionnaire containing mainly open-ended questions in English and Spanish, which was mostly administered face-to-face. The general results are offered first: the number of libraries found, their geographic location—whether in the English, Spanish and Dutch-speaking Caribbean—their denominations, and their size. These results are followed by a more detailed presentation focusing on classification schemes, subject headings, automation, and staffing at the supervisory level. The findings are then analyzed by denomination, location, and size. The article ends with a discussion of the results, comparing theological libraries in the Caribbean with theological libraries in the United States, Asia, and Europe. The study concludes that denomination and location have not affected the findings; but size has to some extent. Also, in some areas, Caribbean theological libraries resemble those in North America, while in others they resemble those in Asia and Europe.

Distribution of influenza and other acute respiratory viruses during the first year after the 2009-2010 influenza pandemic in the English- and Dutch-speaking Caribbean countries.

Limited specimen collection and testing for influenza occurred in the English and Dutch-speaking Caribbean countries prior to the 2009/2010 influenza pandemic. Caribbean Epidemiology Centre (CAREC) member countries rapidly mobilized to collect specimens during the pandemic and a vast majority of confirmed cases during the pandemic period were influenza A(H1N1)pdm09. To describe the aetiology and distribution of acute respiratory illness (ARI) among laboratory confirmed cases during the first year after the 2009/2010 influenza pandemic in the English- and Dutch-speaking Caribbean. In total, 774 specimens were tested and 394 (52.7%) cases had positive laboratory confirmation. Respiratory syncytial virus (RSV) (28.4%) and influenza A(H3N2) (23.1%) were most frequently detected. RSV activity peaked in July 2011 while influenza A(H3N2) peaked in October 2010. Influenza was responsible for illness in greater numbers in persons 15-64 years while RSV was seen in primarily in children<5 years and adults>65 years. Other agents confirmed include rhinovirus (12.9%), influenza B (10.9%) and influenza A(H1N1)pdm09 (9.4%). RSV and influenza A(H3N2) were the most common viruses identified during the first year after the influenza A(H1N1)pdm09 pandemic. Influenza was detected every month with peak activity corresponding to that typically seen in North America (October to March). In order to determine the seasonality of influenza and RSV, laboratory data from subsequent years and increased specimen submission is needed.

Pandemic influenza A (H1N1) 2009 in the English- and Dutch-speaking Caribbean: an epidemiological overview.

To describe epidemiological trends of pandemic influenza A (H1N1) in the English and Dutch-speaking Caribbean during the pandemic period. Data on laboratory-confirmed cases and deaths associated with pandemic influenza A (H1N1) contained in two regional databases at the Caribbean Epidemiology Centre (CAREC) were analysed. The data sources were epidemiological and laboratory reports from English and Dutch-speaking countries and the CAREC laboratory information system (LABIS). In the English- and Dutch-speaking Caribbean, pandemic influenza A (H1N1) was the predominant circulating influenza virus type during the pandemic period. There were three distinct phases: a first pandemic wave during mid-April to end of August 2009 (734 cases), a second pandemic wave during September-December 2009 (570 cases) and a phase of low transmission during January to mid-August 2010 (55 cases). The majority of cases (76%) were aged less than 30 years, with children of school age being most affected. Most cases (89%) presented with symptoms of the respiratory tract and smaller proportions (20-40%) presented with gastrointestinal and other symptoms. No cases tested were resistant to oseltamivir. A quarter of cases required hospitalization and the case fatality rate was 1.8%. The epidemiological characteristics of the pandemic in the English- and Dutch-speaking Caribbean were consistent with that in other parts of the world. It is important that post pandemic surveillance (epidemiological and virological) for respiratory illnesses continues to be enhanced in order to give a better understanding of seasonality and changing trends in respiratory illnesses and their aetiologic agents.

Juanita de Barros, Steven Palmer and David Wright (eds), Health and Medicine in the Circum-Caribbean, 1800–1968, Routledge Studies in the Social History of Medicine, No. 33 (New York: Routledge, 2009), pp xi + 309, $125.00, paperback, ISBN: 978-0-415-96290-2.

Juanita de Barros, Steven Palmer and David Wright (eds), Health and Medicine in the Circum-Caribbean, 1800–1968, Routledge Studies in the Social History of Medicine, No. 33 (New York: Routledge, 2009), pp xi + 309, $125.00, paperback, ISBN: 978-0-415-96290-2. - Volume 56 Issue 1

Curaçao and the Folding Diaspora: Contesting the Party Tambú in the Netherlands

General diasporic discourse informs the definition of immigrant minority groups as residing and acting in countries but maintaining strong sentimental and material links with their countries of origin--their homelands (Sheffer 2986, 3). Yet for Curacaoans in the Netherlands, the distinction between the ideas of host country and homeland becomes hazy at best. Curacao, the largest of the Dutch-speaking Caribbean islands, boasts strong social and political ties with the Netherlands. The Dutch language, for example, is the official language of Curacao, and on the island, the Dutch educational system reigns supreme. Curacaoans hold Dutch passports and are legally Dutch citizens; therefore, there is a tendency to gravitate to the Netherlands, and Curacaoans who do emigrate typically expect their integration into Dutch society to be problem free. The reality, however, is decidedly different. Curacaoans who make the move are likely to find themselves treated as ethnic migrants in the Netherlands and considered foreigners with a Dutch passport by the general Dutch public (Sharpe 2005, 292). always thought of myself as Dutch, said one Curacaoan gentleman in 2009, a man who migrated to Amsterdam nearly twelve years ago. That is until I came to Holland. His Curacaoan friend, in the Netherlands for over seven years, said the same year that growing up on Curacao, you are told you have two homes: here and there. And you believe your destiny is to move to Holland.... It was very traumatic for me when I got here and I discovered [that] none of this was true. (1) For Curacaoans in the Netherlands, the notions of and homeland quickly lose their former meaning. Concepts of self dissolve into experiences of otherness as feelings of belonging are replaced with uneasiness. A simultaneous feeling of disconnect to Curacao inevitably accompanies the Curacaoans trying to make their way in the Netherlands, and they become into and hidden within the larger, culturally diverse immigrant society surrounding them, composed of Moroccans, Congolese and Turks, to name a few. As their histories and experiences connect, a folded emerges. Born of disjunction and struggle, the diaspora represents a venue for global and local coexistence: a place where a multitudinous terrain of belonging and unbelonging, sameness and difference, converge. For displaced Curacaoans specifically, entrance into the diaspora is less the result of their leaving home than it is the result of being cast as a stranger within what had heretofore been considered home territory. And yet the diaspora affords Curacaoans a place of perceived safety and strength--an arena in which (borrowing from James Clifford) to construct public spheres, forms of community consciousness and solidarity that maintain identifications outside the national time/space [of the Netherlands] in order to live inside, with a difference (Clifford 1994, 308). At the center of the diaspora, a new, alternative consciousness begins to emerge. Tambu parties--the commercialized ritual music popular on Curaqao's mainland--helps many Curacaoans in the Netherlands resolve feelings of contradiction and conflict and creates within the diaspora a creative means of control. Tambu parties transcend ambiguity and ambivalence and offer meaningfulness in their place; and as the self becomes reestablished, new identities emerge. Tambu parties in the Netherlands have widened in scope in recent years, with the result that numerous other displaced genealogies have joined Curacaoans in enjoying a renewed sense of belonging. Put another way, Tambu parties provide the diaspora a means of living inside, with a difference. At Dutch Tambu parties, youths join with elders, and Afro-Curacaoans dance alongside African and other Afro-Caribbean migrants. In this way, strong transgenerational and transcultural bonds are forged as solidarity emerges out of difference, and a new sense of belonging is born. …

Caribbean economies in the twenty-first century

Part I. Introduction 1. Prospects for the Caribbean in the Twenty-first Century: An Introduction, by Irma T. Alonso Part II. The Caribbean: Economic and Social Characteristics 2. Economic Geography of the Caribbean, by David R. Hicks 3. Social Conditions in the Caribbean, by Irma T. Alonso 4. The Economic Structure of the Northern Caribbean: Cuba, the Dominican Republic, Haiti, and Puerto Rico, by Irma T. Alonso and David R. Hicks 5. The Economic Structure of the English-Speaking Caribbean Islands, by Irma T. Alonso and David R. Hicks 6. The Economic Structure of the French- and Dutch-Speaking Caribbean Islands, by Irma T. Alonso and David R. Hicks 7. Small Size and the Transformation of the Countries of the Organization of Eastern Caribbean States, by Noel Gray Part III. Special Caribbean Issues 8. U.S.-Caribbean Trade Relations: The First Fifteen Years of the Caribbean Basin Initiative, by Gregory K. Schoepfle 9. Industrialization and Trade in the Caribbean, by Irma T. Alonso 10. Drugs and Economics in the Caribbean, by Ivelaw L. Griffith Part IV. Prospects for the Future 11. The Caribbean in the Twenty-first Century: Challenges and Opportunities, by Claire Nelson

Making modernity in the hinterlands: new Maroon musics in the Black Atlantic

IntroductionBorn in mortal opposition to the peculiarly modern forms of slavery that helped to usher in a new era of European world domination, the Maroon societies of the Americas have long provided theorists of identity operating in the realm that has come to be known as the Black Atlantic with a potent symbolic currency. Nowhere has this currency acquired higher value than in the Caribbean region, where questions of identity are so fundamentally bound up with histories of plantation slavery.The runaway slave has had a special place in the literature of the anglophone Caribbean; and francophone, hispanophone and Dutch-speaking Caribbean writers have all displayed a similar fascination with the Maroon epic. In more recent times, popular music – a medium that has played a primary role in the constitution of a truly diasporic sense of identity spanning the Black Atlantic – has helped to carry consciousness of a heroic Maroon past across the globe. Both practitioners of Caribbean (or other Afro-American) popular musics and those who write about them continue to reference the Maroons of yore, often tracing the rebellious thrust of much of today's music to these original Black warriors, whose defiant spirit, it is felt, continues to inhabit and motivate the collective memory (Aly 1988, pp. 55–7, 65; Zips 1993, 1994; Leymarie 1994).

Caribbean Creolization: Reflections on the Cultural Dynamics of Language, Literature, and Identity

Brings together prominent writers from the English, French, Spanish and Dutch-speaking Caribbean in an examination of creolization and its impact upon the region's literary production. The collection seeks to redefine Caribbean identity and aesthetics.

THE UMH CONTRIBUTION TO THE ENGLISH, FRENCH, AND DUTCH-SPEAKING CARIBBEAN

The UMH project has made a significant contribution to music schol arship in the English, French, and Dutch-speaking Caribbean. It has stim ulated new research as well as new ideas for further research and docu mentation. From these will flow programmes and activities that will strengthen national and regional development and increase understand ing both within the region and further afield. This can best be recogni zed and appreciated in the social and historical context of the region, and against the background of certain global concerns.