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Both countries regard healthcare in a holistic
Motherhood and childbirth
light and view it as a universal right. Services are free or affordable. Per capita health spending is
The basic indicators of child survival show that
creditable by Caribbean standards, at US$ 523
infant and child mortality have been reduced.
per annum in Trinidad and Tobago, and US$ 309
Maternal deaths during childbirth are also rare.
in Dominica, in 2004.
Ante-natal care is generally available, although it may not reach specific individuals such as
But there are problems with healthcare in both
teenagers who are hiding their pregnancies.
countries. It can be inefficient and delivery can
Almost all babies are born in hospital and their
be poor. Where preventative measures have been
births are attended by qualified professionals.
neglected, there can be demand for expensive
There continue to be some problems with
curative measures instead. An unregulated private
mothers and babies who are harmed by
sector has started to grow up and this can mean
traditional practices, such as the drinking of
low-quality services, especially for the poor.
bush tea to hasten birth.
It is unlikely that these populations can become
As we saw in Chapter 3, young children spend
much healthier while they remain poor. Rural
most of their time indoors and at home, and
and poor people have persistent bad health and
the hazards they face are those of home life.
are least likely to receive primary care.
Accident and injuries at home – for example from drinking kerosene stored in soft drink
Of special concern are the Carib people of
bottles – are the most common danger for the
Dominica. Their numbers have dwindled to
very young, along with infectious disease. Other
about 1,700 and intermarriage and migration
concerns are a small but growing number of
threaten their future as a separate group. While
infanticides. The highly disadvantaged Carib
they tend to live in the Carib Territory, they
community has its own more severe problems,
do not have a distinct culture or language
such as respiratory disease caused by sleeping on
apart from some traditional handicrafts. Their
old rags, and fungus infections exacerbated by
health, education and welfare are well below
overcrowding.
the national average. Attempts to revive the Carib language and culture have been slow to
Some aspects of early child care are highly
get going. This community is subject to many
developed in both countries. This is true of
health concerns including violence, alleged
immunisation against polio, diphtheria, TB and
incest, sexually transmitted disease, and the
measles, which has become effectively universal.
health effects of poor water supplies and
Parents generally know that immunisation
dangerous waste disposal practices.
is important even when they do not know the