ACTIVITIES OF TH% CARIBBEAN FIELD OFFICE OF THE PAN AMERICAN SANITARY BUREAU”

BY DR. P. F. DE CAIRES Chief, Pield Ojice for the Caribbean

After a tour of inspection to study the Aedes aegypti problems in the Caribbean, a PASB staff member visited Jamaica in January 1950. The purpose of this visit was not only to observe the work being done against Aedes aegypti, but also to investigate the possibility of setting up a Field Office for the Area to facilitate closer contacts with the various governments. While the sum of individual land masses to be served did not amount to a large area, and while the total population was not in excess of seven million, the scattered nature of the territories and the long distances between them-aggravated by poor transportation facilities--made it necessary to have a central location from which to work. As shown in Fig. 1, Jamaica was not only one of the larger islands but offered rela- tively good air connections with the other territories. With the collabora- tion of the Government of Jamaica an Office was set up in the Health Department itself in January 1950. Altogether thirty-nine territorial governments are served by the Field Office for the Caribbean at this time, made up as follows: France (3): Guadeloupe, Martinique and French Guiana. Netherlands (7): One Group Government (The Netherlands Antilles in Curac;ao) ; five insular Governments in Curacao, Aruba, Bonaire, St. Martin and St. Eustatius; and one territorial Government in Suri- nam. United Kingdom (25) : Four “Group” Governments (The Windwards in Grenada; the Leewards and Virgin Islands in Antigua; Trinidad and Tobago in Trinidad; and Jamaica and Dependencies in Jamaica); twenty insular Governments in Bermuda, the Bahamas, Turks Is., Caicos Is., Jamaica, Cayman Is., St. Kitts-Nevis, Antigua, Anguilla, Barbuda, Montserrat, Tortola (for the Virgin Is.), Dominica, St. Vin- cent, St. Lucia, Grenada, Barbados, Trinidad and Tobago; and one territorial Government in British Guiana. United States (4): The Commonwealth of Puerto Rico (responsible also for the islands of Culebra and Vieques); the Virgin Islands, insular Government in St. Croix, St. John and St. Thomas. The Office in Kingston, Jamaica, is now located in a separate building at the Department of Medical Services, with the usual Office facilities provided. Al1 the other Governments served have been most coopera- tive and have given every assistance to this Office in the field. Figure 2 shows the various projects completed, in operation and planned. * Received for publication February 1954. 532 May 18641 CARIBBEAN FIELD OFFICE 533

Fra. I.-Map showing territories covered by the Caribbean Field O$ice of the Pan . Ameritan Sanilary Bureau.

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PROJECTS COMPLETED Insect control programs have been completed with PASB technical assistance in Bermuda, the Cayman Islands and French Guiana, which are free of Aedes aegypti. The mass phase of a TB/BCG project was completed in Jamaica in May 1953, the final BCG figures being:

Tested ...... 629,168 Positive ...... 234,380 Negative and vaccinated...... 343,950 Negative and not vaccinated...... 2,069 Notread...... 48,347 534 BOLETIN DE LA OFICINA BANITARIA PANAMERICANA

PROJECTS IN OPERATION Insect Control..-The Regional Insect Control Program in the Carib- bean (AARO-8) is operating in eight territories: Bahamas, Jamaica, Netherlands Antilles, Grenada, St. Lucia, Trinidad, Barbados and Suri- nam. In Grenada and St. Lucia the projects are assisted by WHO-TA

FIG. 2.-Map showing differenl projects of the urea covered by the Carabbean Field Oficc of lhe Pan Ameritan Sanitary Bureau.

r 10’

l Insect Control- Completed 0 Iwect Control- Operating AARO-B @ Insect Control- Others @ hsect Control- Planned

0 Yows-VD - Planned \ a Leprosy * Planned + Survey of Public Heolth Serwces

staff and are far advanced, as is the program in Trinidad. This regional project is served by one Public Health Officer, one Insect Control Adviser and two Sanitarians-al1 working out from Jamaica-in addi- tion to staff in Grenada and St. Lucia. Additions to this regional project are planned in the Leeward Islands, St. Vincent and Dominica. Muy 19541 CARIBBEAN FIELD OFFICE 535

Projects are in operation in Puerto Rico, British Guiana and Tobago, with this oflice providing consultation as necessary. It is interesting to note that four members of the international staff attached to this project have been drawn from the Caribbean. TB/BCG.-A TB/BCG project is far advanced in Trinidad and Tobago and in St. Kitts-Nevis and Anguilla. The most recent figures on the BCG phase of these projects are: Cumulative total.3 (from inception up I’olals in to and includ- December ing December 1953 1953) Trinidad and Tobago Tested...... 9,184 291,149 Positive. . . . , ...... 2,458 91,105 Negative and vaccinated ...... , . 6,206 184,859 Negative and not vaccinated...... 5 271 Notread...... 515 14,931

Nov. i6-Dec. Si, 1963 St. KGB-Ne& and Anguilla Tested...... , ...... 12,715 Positive...... 7,240 Negative and vaccinated...... 5,074 Negative and not vaccinated...... 0 Notread...... 401 A BCG project in Grenada is now in progress and the BCG part of a TB/BCG program is due to start in British Guiana very shortly. The Government of Jamaica made available to the Organization, on salary, the BCG Adviser for the projects in St. Kitts-Nevis, Anguilla, Grenada and British Guiana. Reorganization of Public Health Services.-A request from Barbados was received, and acted on, to make a survey of the island’s public health problems and resources. A report is in preparation, which will contain the broad principles along which recommendations for the reorganization of the health services might proceed. This report mill be further dis- cussed with the Government. Other Governments have indicated that they will request similar consultation and advice. SUMMARY The extent and nature of the work of the Field Office for the Carib- bean has been described, showing its development from initial Aedes aegyptir work to more general activities. A pleasing feature of this development has been the fact that Govern- ments now turn to the Organization through the Field Office for advice 536 BOLETIN DE LA OFICINA SANITARIA PANAMERICANA and consultation on a wide range of problems, with more and more attention being given to long range planning and integration of health activities.

-- - ACTIVIDADES DE LA OFICINA DE CAMPO DEL CARIBE DE LA OFICINA SANITARIA PANAMERICANA (Resumen) En este trabajo el autor describe la extensión y naturaleza de las actividades de la Oficina de Campo del Caribe, mostrando el desarrollo de la misma a partir de la campaña contra el Aedes aegypti. Los programas terminados, en ejecución o proyectados, comprenden: control de insectos, vacunación BCG, frambesia, enfermedades venéreas, lepra, y estudio de la organización sanitaria de los territorios bajo la jurisdicción de esta Oficina de Campo.

CORRECTION YELLOW FEVER IN THE CARIBBEAN” Monkeys tested in 1953 under ideal conditions failed to confirm the previous recent existence of yellow fever in Mexico within the lifetime of the monkeys tested; therefore, the statements which appear in above article (maps on pages 199 and 201, and the first sentence of the second paragraph on pages 203) are not justified. It is believed at the present time that the entire monkey population of Mexico is probably susceptible to yellow fever. * Bulletin of the Pan Ameritan Xanitary Bureau, Vol. 32, No. 3, March 1952, p. 197.