Organisation Of Eastern Caribbean States Research Articles

‘A Somewhat Lethargic Approach’: Britain and the Grenada Crisis, 1983

ABSTRACT In October 1983 the small Eastern Caribbean island of Grenada, a member of the Commonwealth with the Queen as Head of State, dominated the headlines in Britain. The US had invaded Grenada to restore order after the violent implosion of the Marxist-Leninist government. It is well established that the US misled the UK as to their intentions until the eleventh hour and that this resulted in a disproportionate amount of discord between the allies. This article departs from that aspect by examining how policymakers in London handled the crisis. Using recently declassified documents and interviews with participants, it demonstrates firstly that the British High Commission in Barbados read the signs of military action correctly but were side-lined by London after the request for assistance was received from the Organisation of Eastern Caribbean States. Secondly, it reveals that the idea of taking the initiative and consulting with Washington after the murder of Grenada’s Prime Minister never arose and that government claims that they communicated their opposition to a military solution from the start were wrong as this only happened on the afternoon before the invasion.

Central bank digital currencies: An innovative tool for enhancing domestic and cross-border payments and settlements

“Central Bank Digital Currencies (CBDCs)” is a relatively new but very fast developing story. The rush of central banks all over the world toward CBDCs proof-of-concept studying and piloting in recent years, as well as somewhere already the practical implementation of their own digital currencies have been motivated by a number of factors that are analyzed in this study. The potential gains of CBDC domestic issue and application can be distinctly outlined today. But, the leading central banks, following to the basic principle “do no harm!”, are acting as carefully and slowly as possible in order to avoid the negative consequences of an abrupt shifts in the contemporary financial landscape. However, successful progress of the People’s Bank of China in piloting the digital yuan, as well as the launch of CBDCs in the Bahamas, Nigeria, Jamaica and the countries of the Organization of Eastern Caribbean States, not only stimulate other states to intensify their own research developments for CBDC, but also raise the question of future implementation of CBDCs for international settlements. The study’s key hypothesis, put forward by the author, is that the inevitable approaching issue of central bank digital currencies will create unique opportunities to enhance significantly the quality of settlement and payment systems not only domestically, but, and especially, internationally. CBDCs’ implementation for cross-border transactions will help to overcome the long-known but still unresolved hurdles of the existing archaic infrastructure of international settlements: low speed, high costs, limited access and insufficient transparency.

Marine spatial planning in the Eastern Caribbean: Trends and progress

Within the last decade, several members of the Organization of Eastern Caribbean States (OECS) have initiated marine spatial planning (MSP) processes. Through a literature review and document analysis, this paper traces the evolution of MSP policy in the region and analyses the plans focusing on the drivers, scale, legislation, authority and spatial outputs. A developing policy framework, increasing political will, the growing Blue Economy development agenda and strong leadership by the OECS Commission have provided the impetus for progress. Further advancement however is threatened by ongoing capacity constraints and questions over plan implementation and the delivery of subsequent planning cycles, with uncertainty over the future direction of MSP in the region. The experiences of these Small Island Developing States (SIDS) provide valuable lessons for others just embarking on MSP.

New Bottle, Old Wine? Implications of the World Bank's Systematic Diagnostic Reports for the Rise of Noncommunicable Diseases in the Organization of Eastern Caribbean States.

Since its foundation in 1944, the International Bank for Reconstruction and Development, soon renamed the World Bank (hereafter, “the Bank”), has shifted its initial goal of reconstructing post-World War II Europe to promoting economic development and alleviating poverty in Africa, Asia, Latin America, and the Caribbean. Bank assistance is provided through loans awarded to countries that agree to policy changes that the Bank deems necessary to achieve its stated goals. Bank policies—dubbed Structural Adjustment Programs (SAPs) and, over time, superseded by Poverty Reduction Strategy Papers—have been criticized for not only failing to ameliorate underdevelopment and poverty, but for exacerbating both. The most recent Bank approach to development and poverty alleviation, the Systematic Diagnostic Reports (SDR), attempts to address these criticisms. We appraise the SDR for six Organization of Eastern Caribbean States (OECS). All share daunting economic and social challenges, including an ongoing epidemic of noncommunicable diseases (NCDs). We argue that, contrary to the Bank's claims, these challenges will continue under, and may even be exacerbated by, the policies the Report demands, and we elaborate on their implications for NCDs in the OECS and for social and health equity in the region.

Turning to Rabat: Explaining the Elevation of Moroccan Relations with Caribbean Countries

ABSTRACT Diplomatic relations between Caribbean and African countries are a driving force behind their respective contributions to the conduct of international politics, as the past decade-plus of little-known Organisation of Eastern Caribbean States (OECS)-Moroccan relations attests. An analysis of the latter sheds new light on two, interlinked sets of dynamics. First, there is an interplay between those enhanced relations and OECS members’ status-seeking behaviour – through recognition as pro-Rabat, Western Sahara agenda influencers – in a hierarchical system of sovereign states. Second, having regard to the subsequent benefits, the OECS bloc is taking a hard-nosed approach to aligning itself with and diplomatically backing Rabat, which could conflict with some long-established foreign policy tenets of these states.

How context influences the Continuing Professional Development of Teacher Educators within the ecological environment of the island territories of the Organisation of Eastern Caribbean States

The continuing professional development (CPD) of teacher educators has been receiving more attention over the past two decades globally. Reportedly, teacher educators (TEs) have transitioned directly to teaching in higher education (HE) as school teachers without formal preparation or support in some cases. My study aims to understand issues that promote and or hinder the CPD of the TEs within the ecological environment of the OECS and identify policy areas as a response to issues raised. The Ecological Systems Theory of Human Development was used as the theoretical framework. A Mixed Method, exploratory, sequential QUAL-quan design, is used. Data was collected in Phase 1 through semi-structured interviews from six teacher educators and eight other participants who occupy different levels of the ecological context. In Phase 2, an online survey which was informed from the interview responses was developed and administered to the population (n=53) of the TEs. Data analysis was conducted using thematic analysis and simple descriptive statistics for the Phases respectively. Integration occurred at reporting and discussion of findings. Findings revealed that participants value CPD but a weak CPD culture exists. Findings indicate lack of financial support and recognition for CPD efforts, heavy workload, family commitments, costs, time and appropriate support from the various systems within the ecological environment hindered more than promoted their development. A consensus emerged among participants, that proper systems and policies are needed to systematically address the CPD of the TEs. Recommendations are made in light of the findings.

Effets potentiels du covid-19 sur l’activité touristique dans les pays membres de l’Organisation des États de la Caraïbe orientale et détermination du seuil optimal de recettes touristiques qui maximise leur croissance économique

Cette étude analyse et évalue les effets potentiels du COVID-19 sur l’activité touristique dans les pays membres de l’organisation des Etats de la Caraïbe orientale (OECO), en se fixant deux objectifs : (i) évaluer à l’aide d’un modèle de régression standard, l’impact du déclin de la demande touristique mondiale sur les économies de cette zone, et (ii) déterminer grâce à un modèle de régression en données de panel, de type Threshold Auto Regressive (TAR), à la Hansen 1999, le seuil optimal de recettes touristiques/PIB à partir duquel son efficacité devient effective en termes de croissance économique. D’une part, les résultats montrent qu’en raison de la pandémie, le PIB de la zone OECO reculerait de 11.8 % en 2020, et nécessiterait une aide internationale immédiate de 810 millions de dollars. D’autre part, l’estimation du modèle à effet de seuils révèle que la relation entre les recettes touristiques/PIB et la croissance économique est non linéaire dans les pays de l’OECO. Elle montre également qu’il existe pour l’ensemble de ces pays, une relation positive et significative entre tourisme et croissance économique dans deux régimes : un régime avec un degré de spécialisation touristique inférieur ou égal à 25.27 % (régime 1), et un régime avec un degré de spécialisation touristique compris entre 12.97 % et 25.27 % (régime 2). En conséquence, le seuil optimal de recettes touristiques qui maximise la croissance économique dans cette zone s’établit à 25.27 % du PIB. Son effet marginal est de 0.17 point de pourcentage, suggérant qu’une augmentation de 1 % des recettes touristiques, améliorerait, toutes choses égales par ailleurs de 0.17 % la croissance économique dans la zone OECO.

Food system and social reproduction realities for women in agriculture across the Caribbean: Evidence from Grenada, St. Lucia, and St. Vincent and the Grenadines

AbstractThis article provides evidence of the food system challenges and structural barriers faced by women farmers and food producers in the Organisation of Eastern Caribbean States. The aim of the piece is to add to critical literatures on political economy, development and food systems in the Majority World via recognizing the political agency of rural grassroots women in the Caribbean. To do so, we focus on the role that social reproduction has in the lives of working Caribbean women who are engaged in agricultural production. The analysis we offer was generated via a mix‐method project that included 111 farmers and agro‐processors from Grenada, St. Lucia, and St. Vincent and the Grenadines. We deliberately centre the perspectives of Afrodescendant rural women. Our study reveals the main barriers faced by women in agriculture are lack of access to land, concessions and capital; non‐gender responsive Agricultural Extension Services; an absence of national and sectorial gender policies; and ongoing dismissals of the time and effort that goes into unwaged socially reproductive labour. In illustrating these realities, we cast light on how the barriers faced by women food producers in the OECS are inextricably linked to persistent colonial‐plantation relations, patriarchal social norms and liberal‐capitalist logics.

New Bottle, Old Wine? The Bank’s Systematic Country Diagnostic Reports and the Rise of Noncommunicable Diseases in the Organization of Eastern Caribbean States

New Bottle, Old Wine? The Bank’s Systematic Country Diagnostic Reports and the Rise of Noncommunicable Diseases in the Organization of Eastern Caribbean States

Civil Society Organisations, Governance and the Caribbean Community by Kristina Hinds

Reviewed by: Civil Society Organisations, Governance and the Caribbean Community by Kristina Hinds Mayra Vélez Serrano Kristina Hinds. 2019. Civil Society Organisations, Governance and the Caribbean Community. London: Palgrave Macmillan. 200 pp. ISBN: 978-3030043957. The literature of regional integration and multilevel governance has mostly focused its attention on the case of the European Union. The process of societal cross-regional interactions is less studied in areas which have a long history of regionalization without formal regional organizations, or what Hettne and Söderbaum (2000) call the Regional Complex. The book Civil Society Organisations, Governance & the Caribbean Community by Kristina Hinds provides a much-needed analysis of the role that civil society has in the processes of regional integration in the Caribbean. This book is divided into eight chapters and three themes. First, the author introduces the concept of civil society for the Caribbean and a description of the Caribbean political culture, governance, and participation. The book later delves deeper into the areas in which civil society has been involved in regional governance in two regional organizations: the Caribbean Community (CARICOM) and the Organization of Eastern Caribbean States (OECS). Finally, Hinds uses two countries as a case studies to draw insights from the connection between civil society and governance in the countries of Barbados and the Republic of Trinidad and Tobago. In chapter two, Hinds provides a clear conceptualization of what the term Civil Society Organizations (CSO) means, especially in the context of the Caribbean. She clarifies that civil society organizations must be treated separately from those organizations that lie between the state, the market and civil society, such as organizations that receive funding from corporations or the state. Hinds explains the historical development of civil society in the Caribbean at the end of the Cold War. While civil society has been seen as the key to bringing about democracy, she argues that what we have observed is the “NGO-ization” of civil society. It is precisely these organizations that become the focus of the international development efforts in the 1990s. Organizations such as the United States Agency for International Development, the World Bank and the United Nations focused on providing assistance to these NGOs as a way of supporting economic development and good governance. However, such NGO-ization [End Page 176] requires the professionalization of civil society into highly technical and bureaucratic entities, undermining other manifestations of civil society. Caribbean civil society tends to lack the high degree of technical expertise that international agencies expect. One reason lies behind the development of society in the Caribbean, where the majority of the population was enslaved, and thus excluded from membership in “civil society.” However, other forms of less formal but vibrant expressions of civil society date back to resistance movements against slavery. Hinds explains that civil society in the Caribbean has challenged the notion of formal organizations or even “polite-civil” expectations. Meanwhile, formal CSOs represented the white planters and merchants’ interests. Hinds explains that during the colonial era, civil society functioned as a community-based organization to support formerly enslaved people. Labor unions were prescribed during colonial rule and trade unions did not emerge until early 20th century. However, early on, local movements engaged with wider international movements, such has the Garveyite Movement (which expanded from Jamaica, through the Caribbean and later Latin America), the United Negros Improvement Association, Pan-Africanism, and Black Power in United States. In the same vein, there was a development between local women organizations and regional organizations, such as the Caribbean Women’s Association. Hinds clarifies that civil society in the Caribbean varies greatly among the region’s countries. However, these descriptions apply mostly to the English-speaking Caribbean. In chapter three, Hinds provides a theoretical framework by which we can analyze the involvement of CSO in decision-making. Furthermore, she explains the historical context in which the incorporation of CSOs into governance has evolved. Hinds argues that CSOs are fundamental for a participative and collaborative style of governance. Since the 1990s, the international community has equated good governance with broader inclusion of civil society. For example, she posits that there are four stages of participation of CSOs in governance. The...

Abstract 3343: The Florida women’s cancer study: Breast cancer presentation among African American and Afro Caribbean women in south Florida, a 10-year cohort

Abstract Introduction: The Black population in the US constitutes about 4 million immigrants. Of this, 50% is from the Caribbean region. Jamaica is the largest contributing country, followed by Haiti and Trinidad and Tobago. Florida has the second largest Caribbean population in the USA. Breast cancer is the main cause of cancer death among females responsible for 14%-30% of cancer deaths in the Caribbean; this is up to two times higher than the USA. Little is known about the molecular subtypes of breast cancer and the demographics of Black Caribbean Immigrants. Objectives: Study the demographics of BC patients in the African diaspora, determine similarities and differences in cause, subtype and outcome of women with breast cancers in African American (AA) and Afro-Caribbean (AC) immigrants. Methods: Approved by the Ethics Committee of the University of Miami IRB. Patients treated for breast cancer between 2006 to 2016 were included. Abstracted data included sociodemographic factors, genetic testing results, and treatment histories. Results: A retrospective US-based cohort of 1369 women (self-identified as black), diagnosed with BC - the Florida Women’s Cancer Study (FLWCS), at Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital in Florida. This cohort contains data from 624 (46%) African-American (AA) women and 507 (37%) AC women diagnosed with breast cancer between 2006-2016. Ninety per cent (n=1232) of the cohort is of non-Hispanic ethnicity.FLWCS country distribution includes is composed of Haiti (18.3%), Jamaica (6.5%), Bahamas (3.1%), Cuba and Dominica Republic (2.8% each), Trinidad and Tobago (1%) and other nationalities from the Organization of Eastern Caribbean States (Antigua, St. Kitts and Nevis, Anguilla, Dominica, St. Lucia and Grenada) at 2.5%. ACwomen living in Miami were diagnosed at a younger age (53.7 years versus 54.9 years), than AA women.Twenty-eight percent of the AA women were premenopausal compared with 32% of the AC women. The AA women had a higher BMI, 32.1 vs 29.8 (p=0.0001), a lower proportion of HER2 positive breast cancer of 17.6% versus 23% (p=0.027), and more children 3.1 versus 2.8 (p=0.023), than the AC women. The rate of HER2 overexpression in the Caucasian population is12% while HER2 positivity was seen in 26.2% Jamaican women, 25.8% in Haitian women and 26.5% in Cuban women (p=0.043) respectively. Less than 5% of the cohort underwent genetic testing with less than 1% having a pathogenic germline mutation. Conclusion: African American (AA) and AC women have many similarities there are significant differences in terms of ancestral diversity, inherited genetic mutations, environmental exposures and access to medical care. Thus, it is imperative to gain an understanding of the causes of cancer in AC women in their own countries in order to better serve those immigrant populations once they reach the US. Citation Format: Priscila Barreto Coelho, Matthew Schlumbrecht, Danielle Cerbon, Carlos Parra, Judith Hurley, Sophia George. The Florida women’s cancer study: Breast cancer presentation among African American and Afro Caribbean women in south Florida, a 10-year cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3343.

Differences in breast cancer outcomes amongst Black United States-born and Caribbean-born immigrants.

1088 Background: The Black population in the US constitutes of 4 million immigrants, with 50% from the Caribbean. It has been shown that breast cancer is responsible for 14%-30% of cancer deaths in the Caribbean; this is up to two times higher than the USA. Methods: Retrospective cohort of 1369 self-identified Black women with breast cancer. Data was obtained from Jackson Memorial Health Systems and University of Miami Health System Tumor Registry. Individual-level data from 1132 cases was used to estimate hazard rations (HRs) of women born in the Caribbean (CB) or in the USA (USB) using Cox proportional hazards regression analysis for overall survival. Median follow-up was 115 months (interquartile range, 91.9-138.1 months) per participant. Results: Data from 622 (54.9%) USB women and 507 (45%) CB women diagnosed with breast cancer between 2006-2017. 90% (n = 1232) of the cohort is of non-Hispanic ethnicity. Caribbean immigrants from Haiti (18.3%), Jamaica (6.5%), Bahamas (3.1%), Cuba and Dominica Republic (2.8% each), Trinidad and Tobago (1%) and other nationalities from the Organization of Eastern Caribbean States were included, mean age 55.7 [95% CI, 54.7-56.8]; USB mean age 57.6 [95% CI, 56.4-58.7] (P = 0.02). Compared to USB, CB had lower BMI at diagnosis 29.6 [95% CI, 28.9-30.3] versus 30.9 [95% CI, 30.1-31.7, P = 0.015]. Compared to CB patients, USB patients had more ER- [31.4% vs 39.1 %, P = 0.018] and triple negative breast cancers [19.6% vs 27.9%, P = 0.003]. Compared to USB patients, CB presented at more advanced stage, III and IV [44.2% vs 35.2%], p = 0.016. In spite of higher advanced stage at diagnoses, CB patients had a better breast cancer overall survival [HR = 0.75; 95%CI, 0.59-0.96; P = 0.024]. Black Hispanic patients had a better overall survival [HR = 0.51; 95%CI, 0.28-0.93; p = 0.028] compared to non-Hispanic Blacks. Compared to Hispanic Caribbean, non-Hispanic Caribbean had a worse overall survival [HR = 1.98; 95%CI, 1.00-3.94; P = 0.048]. The distribution of patients treated at the private cancer center and the safety net hospital were the same, differences in outcomes observed are due to intrinsic differences. Conclusions: This is the largest analysis to date of self-identified Black breast cancer patients in the context of nativity, race, ethnic identity and overall survival with clinico-pathologic characteristics. CB immigrants diagnosed with breast cancer have a better overall survival than US born Black patients. This finding suggests that within the African diaspora in the USA, additional factors beyond race contribute to the outcomes.

Interpretation of the Meaning of ‘Direct Effect’ in the Revised Treaty of Basseterre

Abstract The article utilises the Vienna Convention on the Law of Treaties (VCLT) rules of interpretation to determine the meaning of ‘direct effect’ within the Revised Treaty of Basseterre (RTB). The RTB is the constituent treaty of the Organisation of Eastern Caribbean States (OECS). Despite the RTB having been in force since 2011 there has not been a single contentious case regarding the interpretation of the RTB. While the RTB and the OECS gained some inspiration from the European Union (EU), the Commonwealth Caribbean adheres to the dualist doctrine in the practical relationship between international and domestic law. As such, the meaning of ‘direct effect’ has been the subject of controversy. Therefore, this article shall discern the meaning of ‘direct effect’ within the RTB, including delineating possible practical application. The evaluation shall reveal that the definition is the same, however, due to the Caribbean context the application differs in slight ways.

Foreign direct investment and growth in developing countries: Evidence from the countries of the Organisation of Eastern Caribbean States

This paper empirically explores the relationship between foreign direct investment (FDI) and economic growth in the countries of the Organisation of Eastern Caribbean States (OECS). To reach that goal, the paper utilizes panel data consisting of annual data covering the period 1988-2013 from 34 countries, including the six OECS economies, and estimates a dynamic panel growth model using the generalized method of moments (GMM). The empirical results show that although FDI positively affects growth, its impact is minimal when considered in isolation. In other words, its significant effect is rather indirect. There is also a strong and positive interaction between infrastructural development and FDI in enhancing economic growth, but FDI crowds out domestic investment. These findings have policy implications.

Martinique’s Accession to the Organisation of Eastern Caribbean States: A New Chapter in Caribbean Regionalism?

ABSTRACTThe admission of Martinique as an associate member of the Organisation of Eastern Caribbean States in 2015 has been seen as an event of significance in the Caribbean region for a number of reasons. Among other things, it was the first example of a non-Anglophone country being accorded that status, and it was the first French territory allowed to join one of the core regional groupings of the Commonwealth Caribbean. This article argues that the deepening of Martinique’s relationship with its neighbours within a multilateral framework may offer new practical possibilities for regional integration.

Achieving quality in early childhood education in the Eastern Caribbean depends on teacher preparation

ABSTRACTTeachers’ knowledge and use of developmentally appropriate strategies are vital for creating the enabling early learning environments that foster the development of the ideal Caribbean Community (CARICOM) citizen who is ready to face the challenges of living in the twenty-first century. Early childhood education in the Eastern Caribbean refers to pre-primary education [EDMU – OECS. (2012). The Organisation of Eastern Caribbean States (OECS) Education Sector Strategy 2012–2021, Retrieved July 5, 2015, from http://www.oecs.org/edmu-resources/oecs-education-strategy; EDMU – OECS. (2014). OECS education statistical digest 2012/2013]. Thus five to seven year old children, during the first three years at the primary education level, are being denied their rights to developmentally appropriate learning since their teachers are seldom trained in early childhood philosophy. Teacher competence is needed to ‘get things to happen on the ground level’ [Fullan, M. (1996). Professional culture and educational change. School Psychology Review, 25(4), 496–500, p. 496]. Thus, Quality Early Childhood Education in the Eastern Caribbean can be achieved if teachers of young children have knowledge of early childhood pedagogy.

Key challenges and outcomes of piloting the STDM in the Caribbean

The Organisation of Eastern Caribbean States (OECS) was assisted by the Australian government's aid agency, AusAID, with technical input from UNHabitat and the University of the West Indies, St. Augustine, in the developing of regional land policy guidelines that will address the most critical land issues being faced by the countries. A key aspect of this project was to evaluate pro-poor land tools that would provide comprehensive land administration and thus facilitate the equitable use and allocation of the limited land resource in the sub-region. This initiative provided for and included an opportunity for introducing the Social Tenure Domain Model (STDM) to support economic, social or environmental land policy goals. The individual member states of the OECS committed to participate in the project notwithstanding existing institutional shortcomings that may affect implementation.This paper reviews the major characteristics in land administration shared by most of the OECS countries that will affect the implementation of the STDM which is based on the LADM international standard ISO 19152:2012. It then presents a proposed STDM profile that will address the land issues common to most of the OECS states. Lastly, it presents the preliminary results of pilot testing of an implementation of the STDM, software version 0.9.5, developed by the Global Land Tool Network (GLTN). The pilot was conducted in Saint Lucia, and St. Vincent and the Grenadines. The primary aim was to examine the practical and social implications of implementing the recording process for informal tenures using the STDM software developed by the GLTN. It was found that some of the technical process went smoothly but middle and lower middle income groups are resistant to the idea of recognising informality because they perceive difficulties in differentiating between legitimate land tenure rights and illegal occupation and use, and because they anticipate impacts on their own legal tenure.

Governance, management and accountability: The experience of the school system in the English-speaking Caribbean countries

This paper seeks to explore the implementation of three of the critical elements required to improve performance in the education system: governance, accountability and management. The paper examines the education reform processes conducted by five Caribbean countries: Jamaica, Cayman Islands, Guyana, Belize, Trinidad and Tobago, along with those represented by the Organization of Eastern Caribbean States. The individual countries along with the Organization of Eastern Caribbean States have all embraced and implemented at some level the elements of governance, accountability and management as a part of their strategic planning arrangements between 1990 and 2010. The review shows that clear efforts were made by these countries to address the issue of governance, accountability and management although with varying levels of success. The most notable achievement was that the democratization and decentralization of the education process in these countries seemed to be a central strategy being used to strengthen governance, management and accountability. However, the implementation needs to be deepened so that stakeholders, especially at the school level, can have a greater say and make a more worthwhile and meaningful contribution to the process.

Farmers’ Satisfaction with Extension Services in the Organization of Eastern Caribbean States

Farmers’ Satisfaction with Extension Services in the Organization of Eastern Caribbean States

English

Recently, Martinique was accepted as an associate member by the Council of Ministers of the Organization of Eastern Caribbean States. This membership constitutes a major asset in bringing Martiniquais closer to the other Caribbean populations and should play a key role as it relates to regional cooperation especially in the domain of healthcare. It is urgent for