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High Prevalence of Non-communicable Diseases (NCDs)

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High Prevalence of Non-communicable Diseases (NCDs)

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The Caribbean is currently experiencing a crisis of non-communicable diseases (NCDs). Three quarters of all premature deaths in the region are attributed to NCDs. Rates of obesity among Caribbean women are some of the world's highest. Rates of diabetes are also double the global average, and ". . .diabetes mortality in Trinidad [alone] is eight times higher than in North America" (One Caribbean Health, n.d.).

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1. Brainstorm one additional approach to provide culturally congruent care for the people of Trinidad and Tobago.
2. How is healthcare funded in Trinidad and Tobago?
3. What condition(s) would a public health education program in Trinidad most likely focus on?
4. What herbal supplements or functional foods might a patient from Trinidad and Tobago use when practicing self-care?

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Wheatgrass (Triticum aestivum L.)

Saffron (Crocus sativus L.)

Aloe vera (L.) Burm. f.

Beetroot (Beta vulgaris L.)

Carrots (Daucus carata L.)

Papaya (Carica papaya L.)

(Clement et al., 2016)

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There is an acknowledged gap in literature on Caribbean culture that influences how effective care interventions can be.  However, some predominant commonalities have been identified in nearly every Caribbean country, including the Republic of Trinidad and Tobago:

a history involving European colonialism and slavery

collectivist over individualistic values

social emphasis on spirituality, community/family, and education

(Greenidge, 2016).
While these statements may appear vague, they offer a baseline for which to begin meaningful discussions about health.  Perhaps in the future, better documentation and increased research on health and illness in the Caribbean will enable healthcare professionals to provide better, more culturally competent care.

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35.4% East Indians

34.2% Africans

23.0% mixed races

8.4% of other ethnic groups (Asian, European, and Middle Eastern)

(World Health Organization, 2017)

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Intra-Caribbean migration  to Trinidad and Tobago is very popular.  However, the republic is facing a crisis of emigration of skilled professionals (particularly nurses and other healthcare workers) to countries such as the USA
(UN Migration, 2018).

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The Republic of Trinidad and Tobago is an extremely diverse country. It is inhabited by people of many ethnicities speaking a variety of languages and practicing a variety of religions. It is the melting pot of the Caribbean in terms of immigration and migration. Nurses working in this environment must have excellent cultural competency skills when providing care in any type of setting. Cultural competency skills enable nurses to provide care that is considerate to the health beliefs, values, and practices of diverse populations (Perry et al., 2017). Here are some principles any nurse can practice to improve cultural competency:

conducting a cultural awareness self-assessment to identify bias

asking patients and community members how they define illness and health

learning about the different subcultures present in a given region to build cultural knowledge

using interpreters when needed

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Use of traditional alternative medicine and natural products is strongly ingrained in the culture of Trinidad and Tobago. There are a variety of plants species used to create herbal treatments.  One of the most used herbal remedies involves the leaves, bark, fruit, and seeds of the soursop tree (Annona muricata L.) [pictured right]
(Clement et al., 2016).

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All healthcare services in the country are managed by the Ministry of Health, which is an organization of national authority that is responsible for supervising all of the health care systems in Trinidad and Tobago
(Government of the Republic of Trinidad and Tobago Ministry of Health, n.d.).

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The healthcare systems in Trinidad and Tobago include the private sector, the public sector, and nongovernmental organizations (NGOs).
Most of the residents of Trinidad and Tobago utilize the public sector for their healthcare needs, such as District Health Facilities (DHF) (UN Volunteers, 2018).

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The Republic of Trinidad and Tobago is the southernmost island country in the Caribbean region.  It is composed of the main islands of Trinidad and Tobago and numerous other smaller islands.

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Official Language:

English

Main Spoken Language:

English-based Creole

"First Foreign Language" :

Spanish

Other Languages:

Caribbean Hindustani

French/Creole French

Chinese

(CIA, n.d.)

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                                                                             References

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                                                                             References

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(2015, November 16). [Map depicting the Republic Trinidad and Tobago] [Map]. 32 Flags. http://thecomeback.com/32flags/fifa/know-your-usmnt-opponent-trinidad-and-tobago.html/attachment/trin-lmap-md

Central Intelligence Agency. (n.d.). Central America :: Trinidad and Tobago — The World Factbook. Retrieved June 1, 2020, from https://www.cia.gov/library/publications/the-world-factbook/geos/td.html#cntryLocatorModal

Central Intelligence Agency. (n.d.). [Flag of Trinidad and Tobago] [Flag]. Retrieved June 1, 2020, from https://www.cia.gov/library/publications/the-world-factbook/geos/td.html#cntryLocatorModal

Clement, Y. N., Mahase, V., Jagroop, A., Kissoon, K., Maharaj, A., Mathura, P., McQuan, C., Ramadhin, D., & Mohammed, C. (2016). Herbal remedies and functional foods used by cancer patients attending specialty oncology clinics in Trinidad. BMC Complementary and Alternative Medicine, 16(399). https://doi.org/10.1186/s12906-016-1380-x

Government of the Republic of Trinidad and Tobago Ministry of Health. (n.d.). Ministry of Health. Retrieved June 1, 2020, from https://www.health.gov.tt/sitepages/default.aspx?id=38

Greenidge, W. L. (2016.). Help-seeking attitudes and behaviors of English-speaking Caribbean college students: a review of the literature and implications for clinical practice. American Counseling Association. https://www.counseling.org/docs/default-source/vistas/article_5858f227f16116603abcacff0000bee5e7.pdf?sfvrsn=4

Morton, J. F. (1987). Plate 10: SOURSOP, Annona muricata [Photograph]. NewCROP. https://www.hort.purdue.edu/newcrop/morton/soursop.html

One Caribbean Health. (n.d.). Social determinants of health: inequality is a mass killer. https://onecaribbeanhealth.org/social-determinants-of-health-inequality-is-a-mass-killer/

Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2017). Fundamentals of Nursing (9th ed.). Elsevier.

UN Migration. (2018, February 26). Trinidad and Tobago. International Organization for Migration. https://www.iom.int/countries/trinidad-and-tobago

UN Volunteers. (2018, April 8). Providing primary healthcare in Trinidad and Tobago. https://www.unv.org/Success-stories/Providing-primary-healthcare-Trinidad-and-Tobago

World Health Organization. (2017). WHO country collaboration report: Trinidad and Tobago. https://apps.who.int/iris/bitstream/handle/10665/272475/ccs-tto-2017-2021-eng.pdf

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53.7% Christian

18.2% Hindu

5.0% Muslim

8.4% Other

(Central Intelligence Agency [CIA], n.d.)