SITUATIONAL ANALYSIS OF CHILDREN AND WOMEN IN TWELVE COUNTRIES OF THE CARIBBEAN

TABLE OF CONTENTS

List of Acronyms Executive Summary

CHILD DEVELOPMENT AND CHILDREN’S RIGHTS IN THE CARIBBEAN Economic Constraints, Poverty and Children’s Rights …………………… 1 Cultural Constraints to Child Development and Rights …………………. 2 Child Rights, the CRC and UNICEF……………………………………… 3 The Realisation of Children’s Rights ……………………………………... 4 UNICEF/CAO Situational Analysis……………………………………… 5

POPULATION, GOVERNMENT, ECONOMY AND SOCIETY Demographic Profile ……………………………………………………… 10 Assessment ………………………………………………………. 12 The State and Governance ………………………………………………… 13 Assessment ………………………………………………………. 14 Economy, Social Development and Poverty ……………………………… 14 Assessment ………………………………………………………. 23 Employment and Work …………………………………………………… 24 Assessment ………………………………………………………. 26

CHILDREN AND FAMILY LIFE The Image and Value of Children…………………………………………. 26 Patterns of Socialisation ………………………………………………….. 27 Family and Household Composition…………………………………….27 Assessment ……………………………………………………….. 30

THE CONVENTION ON THE RIGHTS OF THE CHILD (CRC) Ratification and Implementation ………………………………………….. 32 The CRC and UNICEF ……………………………………………………. 33 Assessment ………………………………………………………… 33

SURVIVAL, DEVELOPMENT, PROTECTION, PARTICIPATION

SURVIVAL: HEALTH, NUTRITION AND WELL-BEING………… 34 Water, Sanitation and Waste Disposal……………………………………. 34 Child and Adolescent Health……………………………………………… 35 HIV/AIDS Infection ……………………………………………………… 40 Adolescent Health, Sexuality and Well-being …………………………… 43 Assessment ……………………………………………………… 48

DEVELOPMENT: CHILDREN’S EDUCATION…………………… 50 Equal Educational Opportunity …………………………………………50 Early Childhood Education (ECE) ……………………………………… 51

i Primary Education ………………………………………………………55 The Common Entrance Examination (CEE) ……………………………58 Secondary Education ……………………………………………………59 Secondary School Examinations ……………………………………… 61 Tertiary Education ………………………………………………………62 Adult Literacy …………………………………………………………… 64 Inequalities in Education ………………………………………………… 64 - Rural/Urban Disparities ………………………………………… 64 - Gender Disparities ……………………………………………… 65 - The Feminisation of Education ………………………………… 67 Physical Conditions in Schools …………………………………………67 Special Education ………………………………………………………… 68 Assessment ………………………………………………………. 68

PROTECTION: CHILDREN ‘AT RISK’ ……………………………. 71 Child Labour …………………………………………………………….. 71 Street Children …………………………………………………………… 72 Children of Migrant Parents ……………………………………………… 73 Child Abuse and Neglect ………………………………………………… 74 Domestic Violence ………………………………………………………. 77 Pregnant Teenage Girls ………………………………………………….. 78 Children of Indigenous Minority Groups ………………………………… 80 Children with Disabilities ………………………………………………… 81 Children in Institutions ……………………………………………………. 82 Juvenile Offenders ………………………………………………………… 84 Assessment ……………………………………………………….. 86

PARTICIPATION: CHILDREN’S RIGHTS, THE LAW AND SOCIETY………………………………………………………….. 88 Children and the Law …………………………………………………….. 88 Children’s Rights and Participation ……………………………………… 93 Assessment ………………………………………………………………. 95

ANALYSIS ……………………………………………………………… 96

CONCLUSION………………………………………………………….. 107

APPENDICES I. Reported AIDS Cases …………………………………………… 111 II. The Ladder of Child Participation …………………………………….. 112

REFERENCES …………………………………………………………. 113

ii LIST OF ACRONYMS

ADP Adolescent Development Programme (Trinidad and Tobago) AIDS Acquired Immunodeficiency Virus Syndrome ARI Acute Respiratory Illness BVI British Virgin Islands CAREC Caribbean Epidemiology Centre CARICOM Caribbean Community CCA Common Country Assessment CEE Common Entrance Examination CDB Caribbean Development Bank CEDAW Convention on the Elimination of All Forms of Discrimination Against Women CFNI Caribbean Food and Nutrition Institute CRC Convention on the Rights of the Child CXC Caribbean Examination Council DPT Diptheria, Pertussis, Tetanus ECE Early Childhood Education EFA Education for All EU European Union GDP Gross Domestic Product GER Gross Enrolment Ratio HDI Human Development Index HFLE Health and Family Life Education IDB Inter-American Development Bank IMR Infant Mortality Rate MICS Multi-Indicator Cluster Survey MMR Maternal Mortality Rate MMR Measles, Mumps, Rubella NGO Non-Governmental Organisation OECS Organisation of Eastern Caribbean States PAHO Pan American Health Organisation PAM Programme for Adolescent Mothers (Grenada) PAREDOS Parent Education for Development in Barbados PQLI Physical Quality of Life Index PTA Parent Teacher Association SERVOL Service Volunteered for All (Trinidad and Tobago) SitAn Situational Analysis of Children and Women STI/STD Sexually Transmitted Illnesses / Diseases TCI Turks and Caicos Islands UNDAF United Nations Development Assistance Framework UNDP United Nations Development Programme UNICEF United Nations Children’s Fund UWI University of the West Indies VET Vocational Education and Training WHO World Health Organisation WSC World Summit for Children WTO World Trade Organisation YTEPP Youth Training Employment Partnership Programme (Trinidad and Tobago)

iii EXECUTIVE SUMMARY

1. This Situational Analysis of children and women in the twelve programme countries (Antigua and Barbuda, Barbados, British Virgin Islands, Dominica, Grenada, Montserrat, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Suriname, Trinidad and Tobago, Turks and Caicos) of the Caribbean Area Office of UNICEF has drawn on existing published data, qualitative and quantitative, to provide an assessment of the achievements and problems in four main areas: Survival (health, nutrition and wellbeing), Education and Development, the Protection of children in specially difficult circumstances, and Participation. It also presents an analysis which identifies the immediate and underlying causes of the major problems in these areas, preparing the groundwork for UNICEF’s strategic planning and programmatic interventions for the period 2003-2007.

2. The preparation of the Situational Analysis adopted a participatory methodology for data collection, but faced several challenges including  Time and resource constraints  Difficulties in accessing the data and delays in data retrieval and submission  The inadequacy of the databases in relation to children  The problem of balancing general regional perspectives with national specifics of the twelve participating countries.

3. The governments of the twelve Programme countries have taken many initiatives to maintain and improve children’s (and women’s) rights, including the ratification of the CRC and CEDAW, the establishment of national mechanisms to coordinate child rights issues, law reforms and improvements in the situation of children in terms of access to basic social services.

4. These include the following:

Survival  The expansion of water and sanitation services to the majority of the population including those in rural areas  Significant declines in infant and maternal mortality rates  Near universal immunisation  Control of communicable diseases  Virtual elimination of chronic malnutrition  Declines in adolescent fertility.

Education and Development  The achievement of near universal primary education  Investments in Early Childhood Education, Care and Development  Expansion in secondary school and tertiary educational provisions  Syllabus expansion to include technical and vocational education and Health and Family Life Education (HFLE)  Teacher training  Non-fee paying schooling and subsidies for children in need.

Protection  Provision of children’s homes and social work services for children in need of special care and protection  Legislation to protect children and women and initiatives to establish Family Courts  More sensitive and accurate data collection on child abuse and domestic violence

Participation

1  Reforms in family and employment laws to support the protection and rights of women and children  Some evidence of efforts by governments and civil society to facilitate the participation of youth in decision-making.

5. Although most Programme countries have achieved modest macro-economic gains:-  expenditure and investments in basic social services remains relatively unchanged  there are systemic weaknesses in social policy and planning and in social service delivery  there is relatively poor understanding and appreciation of the importance of social policy and development  and poverty and vulnerability are increasingly evident among ‘at risk’ groups of children and youths.

6. Four critical problem complexes concerning Caribbean children and youths have emerged from the Situational Analysis and must be targeted in research, policy and programmatic interventions:-  Early Childhood Education, Care and Development (ECECD)  Child Abuse, Exploitation and Violence  Adolescent Reproductive Health, Sexuality and HIV/AIDS  Adolescent Empowerment and Participation

7. The Situational Analysis revealed two major general areas of focus for the agenda for children in the Caribbean:-  To ensure that all children and youths are empowered as citizens and subjects of rights to participate fully and consistently in their own development  To ensure that those children and youths who are vulnerable and ‘at risk’, who are the principle victims of poverty and the disparities in the social system, are provided with the quality of life to which they have a right; to ensure that they have a future.

2 CHILD DEVELOPMENT AND CHILDREN’S RIGHTS IN THE CARIBBEAN

Economic constraints, poverty and children’s rights Despite progress The countries of the Caribbean region present a commendable record of political stability, and good governance, economic growth and social development. Basic indicators of health, development, nutrition, education and welfare reflect a level of progress that has, in general, been children are at maintained and improved. But children and their priorities and rights remain virtually risk invisible on the national agenda for development. Where they are mentioned it is as passive beneficiaries of social services and socialisation in preparation for adulthood. Children, as children, are not seen as subjects of human rights.

While basic indicators of child development in the Caribbean in terms of provision and protection are generally satisfactory, there are no grounds for complacency. The countries of The impact of the region have not been immune to the economic reverberations of the ‘lost decade’ of the economic 1980s. Several had no alternative but to implement stabilisation and structural adjustment recession on child programmes, with little in the way of a human face, cutting back drastically on State development provisions in health, education, housing and welfare (Jolly and Cornia 1984, Jolly and Mehrotra 1998, Girvan 1997). Recovery has been slow and constrained by the global environment of economic recession, the demands of debt servicing obligations, declines in ODA, and persisting poverty.

There is also emerging evidence of persistent poverty, a deterioration in the quality of life of children and adolescents, increased exposure to abuse and exploitation, and the violation of children’s rights especially among special groups of children ‘at risk’ and in need of special protection. Children bear the brunt of economic crisis: “it is the young child who is paying the highest of all prices, and who will bear the most recurring of all costs, for the mounting debt repayments, the drop in export earnings, the increase in food costs, the fall in family incomes, the run down of health services, the narrowing of educational opportunities” (UNICEF 1989:2).

Many countries of the region have not managed either to achieve or to reinstate budgetary provisions to match the 20/20 initiative. Public sector responsibility for social development and child welfare has been reduced. With unemployment rates relatively high and in some cases rising, especially among women and youth, family incomes have not kept pace with increasing costs of living. While civil society and NGOs, families and communities make every effort to spread scarce resources and to ensure social well-being, there is growing evidence of an impoverished quality of life for those persons most ‘at risk’ and vulnerable, children in particular.

Cultural constraints to child development and rights Fundamental barriers to the implementation of children’s rights are also evident at a country Perceptions of specific level in traditional ideologies of childhood and the accompanying resistant cultural ‘the Child’ practices which are, in turn, sanctioned in local legal, religious and political systems. Where children are perceived as dependent, incapable minors, as the property of their parents and as the passive beneficiaries of social protection and welfare provisions as they wait to grow up, then the implementation of children’s rights is invariably compromised.

The Western orthodox model which sentimentalises childhood has been exported world wide. It promotes the idea that children, as immature minors, have neither the capacity nor the need to express opinions or to participate in decisions affecting their lives. Children are to be seen and not heard and adults must assume responsibility as compassionate, altruistic role models who speak and act on their behalf. But, this model which juxtaposes childhood innocence and adult benevolence also assigns to parents, teachers and other adults the right to exercise authority and control beyond the level required to socialise and protect children. It also

1 silences children, limits their participation to token ceremonial activity and reinforces dependency and social exclusion.

This SitAn exposes a Caribbean environment in which there are few examples of projects and programmes that allow the voices of children to be heard and their participation to be realised. The silencing of If anything, the contrary practices of silencing and controlling children are reaffirmed. The children prevailing public perception of increasingly deviant and disruptive children in the home, school and community, an image sensationalised in media reports, provokes a reflex reaction which sanctions greater control and policing. This, in turn, reinforces authoritarian adult-child relations and conventional practices and policies of corporal punishment, institutionalisation and incarceration, rather than the empowerment and self-determination so central to the realisation of children’s rights. Other than an occasional token voice or appearance, Caribbean children continue to be excluded from active participation in shaping their own lives.

Children’s Rights, the CRC and UNICEF The UN Convention on the Rights of the Child (CRC) provides the vision and mandate for the advocacy and operational activities of UNICEF. The CRC stands as a landmark in the The CRC’s new international debate and platform of activities for the world’s children. Universally adopted by mandate for the UN General Assembly in November 1989, the ensuing enthusiastic ratification of the CRC children by UN member states was unprecedented in the history of international human rights instruments. All Caribbean countries included in this SitAn had signed and ratified by the end of 1993.

The children’s rights enshrined in the 54 articles of the CRC are comprehensive and represent internationally accepted minimum standards. They speak to four fundamental principles, namely non-discrimination, the best interest of the child, right to life, survival and The emphasis on development and respect for the views of the child. The articles have been summed up as the childrens’ rights ‘3 Ps’ of the CRC, namely provision, protection and participation. The innovative feature and participation of the CRC is the emphasis on the participation of children in decision-making concerning their own lives. Previous declarations focused attention on child welfare, summed up as the provision of health, education and various additional forms of welfare, and the protection of children from harm, abuse and exploitation. The CRC adds to this the promotion of children’s rights

 to express opinions freely and have these acknowledged (Article 12)  to freedom of expression and access to information (Article 13)  to freedom of association (Article 15).

It is these articles in particular that extend the mandate for children by acknowledging their autonomy and human worth and their rights to self-determination, social inclusion and empowerment. Child development is thereby redefined as an issue of justice and children become subjects of rights, rather than mere objects of charity.

The global mandate for children’s rights got off to a positive start in the almost universal endorsement of the CRC. But ratifying the Convention is the easy part and many of the States Parties had given little thought to tackling the problems of implementation in the light of this new and radical philosophy of childhood and children’s rights. Although the record of recent achievements is impressive, serious impediments have emerged to obstruct the realisation of children’s rights initiatives at country level. These constraints are both economic and cultural.

The Realisation of Children’s Rights As Caribbean countries proceed from CRC ratification to reality, in other words from signing and ratification on to the global movement for child development and rights to the process of Satisfaction of policy-making and implementation, real dilemmas and constraints emerge. While the basic needs but

2 evidence of countries of the region have maintained a reasonable level of resource allocation to social regression and development and achieved an impressive record of achievements in child health, nutrition, resistance to immunisation, education and welfare, there are deficiencies and signs of deterioration. As a children’s rights region the Caribbean has, in general, steered clear of the image and reality of ‘stolen childhoods’ and the extremes of child abuse and exploitation which have damaged the lives of many of the world’s children, but there is emerging evidence of regression in protection and provision, and also of resistance to the promotion of child participation.

This SitAn exposes a number of problems of paramount concern for the development and rights of children who have, hitherto, been either excluded or placed at the bottom of the Caribbean region’s agenda for social development. Countries in the region are concerned, but have been children ‘at risk’ slow to respond. Of principal concern is the plight of those children ‘at risk’ and in specially difficult circumstances for whom there is virtually no safety net or recovery:

 out-of-school children, working children and street children, mainly young boys who face danger, exploitation and abuse  adolescents and younger children who are exposed to sub-cultures of careless sex, drugs and violence  children who suffer physical and sexual abuse at home and elsewhere  sexually exploited and pregnant teenage girls  the children of minority indigenous groups who are socially isolated, stigmatised and experience a poor quality of life  disabled children who remain invisible and in need of resources and special programmes  children who are not parented, who are emotionally and economically deprived because their parents have died (increasingly as a result of the AIDs epidemic or violence), who have migrated or separated, who are imprisoned, or who through mental illness or drug and alcohol addiction do not fulfill their parental roles  institutionalised children and imprisoned youths who live in impoverished and degrading environments.

Children’s rights are integral to human rights but the realisation of children’s rights has to start with a fundamental re-definition of ‘the child’. Children must be perceived and promoted as The meaning of social actors and citizens with the same inherent value as adults and with the capacity and the children’s rights right to participate fully and consistently in decisions affecting their own lives. Children’s

rights do not give children the freedom to do as they like, for all rights must be balanced against responsibilities. But the rights of children are a special case of human rights since children are especially vulnerable and dependent and therefore also require interventions that promote their well-being and protect them from harm. These measures, which were previously perceived as a response to the ‘needs’ of children, are now re-defined as ‘rights’. They have become an issue of entitlement rather than one dependent on the charity and good will of governments and adults.

Caribbean and other Third World countries must not perceive and resist the CRC as an arrogant imperialist invasion of cultural sovereignty. The children’s rights enshrined therein The global must not be interpreted in opposition to adult authority and parental control. On the contrary, agenda of the global agenda for children and the accompanying change in cultures of childhood and child children’s rights development policy stands at the cornerstone of a sustainable and equitable future in all societies. Whether individual states welcome contemporary global realities or not, they are members of an emerging world-wide community and will therefore be subject to international scrutiny and comparison according to the moral and social codes of an international movement for human rights and social development that centres children.

UNICEF/CAO Situational Analysis A UNICEF Situational Analysis (SitAn) presents information on a comprehensive set of The Caribbean

3 Situational indicators documenting the quality of life and development of children (and also women) in a Analysis: particular country or region. This Report covers the following 12 Programme countries of the Caribbean area that fall within the mandate of the UNICEF Caribbean Area Office located in Barbados:  the Eastern Caribbean nations of Antigua and Barbuda, Barbados, Commonwealth of Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Coverage Trinidad and Tobago;  the British Overseas Territories of the British Virgin Islands (BVI), Montserrat and the Turks and Caicos Islands (TCI);  the South American mainland country of Suriname.

In addition to presenting basic indicators on the quality of life of Caribbean children, this SitAn also provides an assessment of the data, highlighting existing and potential problems … Content, and and the impact of these on the realisation of child development, participation and rights. It Focus, also assesses the impact of macro-economic trends, the contribution of social policy and services and the influence of family and community. The SitAn then proceeds to an analysis component which identifies priority problems and their immediate and underlying causes in determining the deprivation or progress of children (and women). This, in turn, leads to recommendations for programmatic interventions, advocacy and research priorities, paving the way for UNICEF’s broad strategic lines of action which, with detailed feedback from the 12 Programme countries will, ultimately, be carried forward to form the Multi-Country Programme (MCP) of Cooperation for the period 2003-2007. The MCP is guided by the four key principles identified in the CRC, namely the right to survival and development, the best interests of the child, non-discrimination, and participation. The overall goal of the Programme is to assist and support commitments and capacities of governments, families and communities to promote, protect and fulfill children’s and adolescent’s rights, meet children’s basic needs, and expand opportunities for them to reach their full potential.

In order for the SitAn to document the quality of life of children and women in the twelve countries that fall within the mandate of the UNICEF Caribbean Area Office, information had … and to be collected on a comprehensive set of indicators. Because of the extensive coverage of this Methodology SitAn and the vast volume of data that needed to be retrieved, it was imperative that this process be carried out as systematically as possible. However, there were serious time and resource constraints during the process.

The first step was the preparation of the list of indicators and relevant quantitative and qualitative data on which the assessment and analysis would be based. In order to collect the quantitative data for each country in a standardised format, a set of matrices was prepared. These covered the following areas and have been compiled as a separate document: i. Population ii. Economy and Social Development iii. Survival iv. Health and Education v. HIV/AIDS vi. Adolescent Sexuality vii. Household viii. Employment

Statistical data for the SitAn was initially extracted from relevant documents available in Barbados. These included Common Country Assessment (CCAs) / UN Development Assistance Frameworks (UNDAFs), End-Decade Assessment Reports, CRC Country Reports, Multi-Indicator Cluster Surveys (MICS) and other surveys, sectoral studies and programme evaluations.

4 Additional in-depth, qualitative data was captured from an extensive range of additional documents also available in Barbados and supplemented with information from a variety of sources including the UNICEF newsletter “Children in Focus”, studies on children ‘at risk’ completed by UNICEF consultants, sociological publications and newspaper reports. The papers and discussions presented at the recently held UNICEF (CAO) Symposium entitled “The Rights of the Child and the Caribbean Experience” held in Barbados in March 2000 also provided useful source.

The proposed methodology for this SitAn also included a third level of data collection which would involve travel by the consultants to those countries for which inadequate information had been retrieved during the data trawl in Barbados. Unfortunately, resource and time constraints did not permit this to happen before this first draft report. Although an effort was made to compensate for this by the collection of data and information during an initial round of country consultation meetings designed, in part, to obtain feedback on the Draft SitAn, gaps and inconsistencies remained. It is, inevitable, therefore, that the content of this report is biased towards those countries for which information on the provisions, protection and participation of children and adolescents was readily available in Barbados or was made available by the countries concerned. The intention is not to compare and rank the experience and record of individual Programme countries, but to expose for analysis and action the persistent and emerging problems in child development and the constraints to the realisation of children’s rights that all countries of the region have in common, albeit with some variation in nature and intensity. Most importantly, the participatory methodology of data collection and analysis was designed to ensure country and regional ownership of and commitment to the overall process of and policies for child rights realisation.

In the final analysis, the information included in the SitAn depended on the quality of data available in the Programme countries. In this regard, a number of problems emerged during the data collection phase. These included the following:

 Considerable variation between ministries, departments and agencies in the emphasis on and investment in data collection  A tendency to rely on ad hoc project-specific data collection  A lack of coordination and centralisation of data in central statistical offices  A tendency Trinidadto continue and with Tobago: outdated Databases indicators for rather Children than devise those relevant to new and emergent social problems and conditions The Government of Trinidad and Tobago, with technical and financial assistance from  A lack of standardisation of data with the result that data often appears contradictory UNICEF, is in the process of establishing two databases in respect of children. and of little use in the continuous monitoring of child development Child Indicator Monitoring System (C.I.M.S.): will transform the ad hoc updating of all  A tendency to target more conveniently accessible population samples concentrating, indicators relevant to the goals of the World Summit for Children into a standardised therefore, on children located within social institutions, schools in particular, rather system, which will facilitate the ongoing review and update of information and the goals. than search for those who are ‘at risk’, homeless or on the street The Children in Need of Special Protection Monitoring System: will initially apply to four groups The of reliance children: on traditionalabused and quantitative neglected, datainstitutionalised, relating to provision children and, with to disabilitiessome extent, and childrenprotection, in conflict and awith seeming the law. reluctance This systemto formulate is geared qualitative toward indicators data collected to measure on children inparticipation need of special and empowerment protection measures and the translation of this information into legislative, Absence preventive of assessments and remedial of the action. available Data data will and be analysis collected of the from causes Government of social agencies andproblems those non-governmental organisations which already collect data on children living in speciallyLack of forwarddifficult linkagescircumstances. between The the resulting database, data the willresearch also beagenda used andto guide policy advocacy formulation.and public education activities.

5 POPULATION, GOVERNMENT, ECONOMY AND SOCIETY

DEMOGRAPHIC PROFILE

Population size among the Caribbean Programme countries varies from the clustered-islands Population sizes of Turks and Caicos (TCI), the British Virgin Islands (BVI) and Montserrat where the range widely populations are under 5,000, to Trinidad and Tobago with a population of over 1 million. In between, are the island state populations, ranging from that of St. Kitts and Nevis with 39,000 to Barbados with just under 270,000, and the mainland country of Suriname with a population of over 400,000.

Population densities range from a high in the crowded island of Barbados (at approximately Population 600 per sq. km.) to the low level in Suriname at 2.5 per sq. km. Internal migration is evident densities vary in the relatively high proportions of the populations resident in the urban centres. In 2000, the proportion was estimated at over 35 percent in all Programme countries, with the highest urban populations recorded in Dominica (21.0%), Trinidad and Tobago (74.1%) and BVI (61.1%). In Suriname, over 70% of the population lives in the coastal region and population density in Paramaribo has been estimated to be as high as 2,761 per sq. km.

Several Programme countries have multi-ethnic and multi-cultural populations. Most diverse Ethnic and are those of Suriname and Trinidad and Tobago. In Suriname, roughly one third are cultural diversity descendants of African slaves, and another third descendants of Indian indentured labourers, and homogeneity approximately one sixth is of Javanese origin and there are also minorities of Maroons (10%), Amerindians (3%), Chinese (2%) and Europeans (1%). The population of Trinidad and Tobago is divided almost equally into those of Indian descent (40.3%) and African descent (39.6%). The remaining 20% of the population consists of persons who are white, Chinese, Syrian and of mixed descent. This ethnic and racial diversity has, on occasions, created tensions, but on the whole social interaction is relatively harmonious. Dominica and St. Vincent/Grenadines are also characterised by the presence of small groups of indigenous peoples. The populations of the remaining Programme countries are relatively homogeneous and consist of a majority of African descent with small minority proportions, particularly of Indians and Syrians who have arrived in recent generations.

Most Programme countries have entered the final phase of demographic transition from high Demographic to low birth and death rates and are experiencing modest population growth rates of under 1%. transition to St. Lucia is slightly higher at 1.15% while the BVI and TCI stand at 3.5% and 4.9% phase of slow respectively. In the BVI most of this increase, approximately 65% since 1980, is attributable growth to net immigration. This is also the case with the TCI with in migration from the Dominican Republic and Haiti, much of which is illegal. The exception to this pattern of demographic growth is Montserrat where the volcanic crisis precipitated the mass migration of two-thirds of the population, reducing it to just over 3000 by 1997, though return migration has rebuilt the population to between 4000 and 5000.

The general pattern of low and stable population growth in the majority of countries is Low fertility and attributable primarily to fertility control as all countries successfully implemented family mortality rates planning programmes and have cut crude birth rates to 25 per 1000 of the population or less. In 2000, Barbados showed the lowest rate at 12.8 per 1000 while those in St. Lucia and TCI remained relatively high at the 25 per 1000 mark (PAHO/WHO 2000). Mortality has also continued to decline and as crude death rates in all countries have fallen to below 11 per 1000 of the population.

The high migration rates of previous generations, which served as a safety valve against Varied migration population explosion, are no longer evident. The exceptions in this respect are Montserrat

6 patterns where the volcanic crisis precipitated mass migration leaving the country with less than 5,000 people. In other countries net out-migration persists, albeit at a lower rate. Over the last 30 years, migration has accounted for an estimated 55-60% of the current population in the prime working ages of 30-49 (Serow nd.:20). This age distribution indicates a movement of young adults which is economic and job related and also occurs for family reasons. The BVI and TCI, however, experienced net in-migration mainly from neighbouring islands and many countries of the region are experiencing the return migration of retiring nationals.

Correlating with this changing demographic profile are trends towards emergent aging Aging population populations and increasing longevity. In the three decades since 1960, the total number of the profiles elderly (aged 60 and over) in the region has approximately doubled and, furthermore, about one in three among them has attained the age of 75. With fertility rates predicted to remain low and the possible increase in the return migration of elderly nationals, this aging trend is likely to continue (Serow nd: 4-5, 78-85).

Life expectancy at birth compares favourably with that in developed countries and stands at Increasing life over 70 years in all countries except St. Kitts/Nevis where the level in the year 2000 was 67.6 expectancy years. Sex differentials persist favouring female longevity with an age gap of between 4 and 6 years. In all countries female life expectancy is over 70 years, while only in Grenada, St. Kitts/Nevis, St. Lucia and Suriname does that for males fall below this figure.

Concomitant with increased longevity is the declining proportion of youth in the populations. Declining In all Programme countries, the proportion of persons aged 19 and under fell from over 50% in proportions of the 1970s to an average of 41.8% by 1991 with the lowest proportions in Barbados (33.3%), children and Montserrat (34.5%) and the BVI (34.4%). The very young (aged under 5 years) also declined youth to an average of 10.6% of the total population with the lowest levels evident in Barbados (7.5%) and Montserrat (8.5%) and in both cases attributable to relatively low fertility rates. In Antigua/Barbuda and Grenada, however, the proportions of under five year olds in the population remained relatively high at 10.4% and 13.2% respectively (Suriname and TCI not included).

The changing age composition of the Programme country populations is also reflected in Increasing age increasing age dependency ratios which, by 1990 averaged 14.1, and declining youth dependency/ dependency ratios averaging 53.6, although in St. Kitts/Nevis, St. Lucia and St. declining youth Vincent/Grenadines the ratio is above 60 and in Grenada it stands at 71.8. Again the data for dependency Barbados and Montserrat indicate the relative progress of these two countries through the phases of demographic transition reaching relatively high age dependency ratios of 18.5 and 22.5 respectively, and low youth dependency ratios of 37.6 and 43.6 respectively (Suriname and TCI not included).

ASSESSMENT

Achievements: Slow population growth with declining fertility, low mortality. Out-migration has decreased.

Problem: Aging dependency with declining proportions of children and youth.

7 THE STATE AND GOVERNANCE

Political All of the Programme countries have gained political sovereignty apart from the BVI, sovereignty / Montserrat and the TCI which are British Overseas Territories. dependency Most Programme countries have achieved a level of political maturity characterised by stable parliamentary systems with two majority parties though other smaller parties occasionally Political maturity, field successful candidates during elections. At present, most governments have a clear but some parliamentary majority. There have, however, been instances of unrest and political conflict is instability evident along with allegations of corruption and nepotism.

The major organisational grouping of the region is the Caribbean Community (CARICOM) CARICOM, founded in 1973. All of the independent Programme countries are full members, together with OECS, CDB Montserrat. Suriname, though not a Commonwealth country also has full membership. The Membership and BVI and TCI have associate membership. functions CARICOM functions to promote closer political and economic integration among member states. Intra-regional trade has fluctuated particularly during the mid to late 1980s as a result of import restrictions and currency devaluations but has picked up since then. Progress has also been made with plans to establish the free movement of professional and skilled workers in the region and in harmonising reductions in the common external tariff. Also proposed are the establishment of a Single Market and Economy within which provision would be made for the free movement of skills, sports persons and cultural and media workers and a Caribbean Court of Justice.

The Windward and Leeward Islands along with Montserrat came together to form the subregional grouping, the Organisation of Eastern Caribbean States (OECS) in 1981. Members have pursued strategies and policies similar to those of CARICOM, leading to greater regional integration mainly by way of trade liberalisation, and are committed to full economic integration. In this respect, the OECS has established a Monetary Union and agreed to set up a Single Market facilitating the free movement of people, capital, goods and services. Several initiatives have been promoted to encourage joint programming in export, investment, natural resources management, agricultural diversification, fisheries and tourism development. The OECS also promotes expanded trade and other linkages within the larger Caribbean Community (CARICOM) market, although the absence of a common currency constitutes a significant obstacle to closer cooperation.

The Caribbean Development Bank (CDB) established in 1969 is also an important regional institution. All Programme countries are members and eligible for loans for economic growth and social development.

ASSESSMENT

Achievements: Political maturity and stability and the development of regional organisations.

Problems:  Politicial unrest and instability  Politico-racial factionalism  Marginalisation of smaller island economies

ECONOMY, SOCIAL DEVELOPMENT AND POVERTY

8 The countries included in this Caribbean (SitAn) comprise small, open economies that are Small open extremely vulnerable as a result of production and export which remains highly concentrated economies, primarily on mono-crop agriculture (though there is some evidence of diversification) and vulnerability and tourism, small domestic markets, weaknesses in public and private sectors, limited access to slow growth private investment, on-going efforts to their interests in recent international financial and trade negotiations in the new era of globalisation, and exposure to natural disasters.

However, the majority of the Programme country economies have grown slowly but relatively steadily in the last three to four decades. The 1980s is a period associated with economic decline, structural adjustment and increasing debt burdens as governments struggled to achieve macro-economic and fiscal balances. Most managed to maintain rates of growth of between 3.1% and 5.7% but, in the process incurred a large social debt as they were forced to make considerable cuts in expenditure on basic social development in health, education and social welfare.

The 1990s was a period of varying levels of economic recovery with the average real rate of growth in GDP for Programme countries at 5.1 (Caribbean Development Bank 1999:12). An exception to this general pattern of growth is Montserrat where the economy experienced a sharp downturn during the 1990s with GDP falling by 6.6% as a result of the volcanic crisis (Caribbean Development Bank 1999:12). The Suriname economy also faltered during the 1980s with a GDP of -3.07%, though it also recovered during the following decade to record slight growth with a GDP of 0.9%. In Trinidad and Tobago, a similar trend was evident with negative growth rates (GDP at -3.0%) during the 1980s, due mainly to falling oil prices, but recovery occurred to a GDP growth rate of 2.1 during the 1990s (Trinidad and Tobago National Report 2000:1) and 4.4% in 1998 (Caribbean Development Bank 1999:12). On the other hand, the BVI economy grew at a high rate of over 6% between 1994 and 1997, culminating in a real rate of growth in GDP of 13.9%, the highest among the Programme countries (Caribbean Development Bank 1999:12). The GNP per capita ranges from US$ 1,660 in Suriname to US$ 8,460 in Antigua and Barbuda.

All countries presently face problems consequent on the establishment of the World Trade Organisation (WTO). The new international economic environment of trade liberalisation threatens the preferential trading arrangements with the EU and the US on which Caribbean countries have traditionally depended and necessitates urgent preparations for survival in a competitive global arena. The banana industry of the OECS has been particularly hard hit.

Some Programme country societies and economies, particularly those in the Eastern Destruction by Caribbean, have suffered badly as a result natural disasters, volcanic eruptions, hurricanes and natural disasters: earthquakes in particular. Though there are few fatalities, agriculture and physical hurricanes infrastructure are often extensively damaged or destroyed. St. Kitts, for example, was hit by hurricanes Hugo in 1989, Louis in 1995 and Georges in 1998 and continues to implement a programme of recovery and reconstruction in agriculture and tourism. In 1998 an estimated 60,000 tons of sugar was destroyed and production declined by 20.4 percent. The economies of Antigua/Barbuda and the BVI have also been seriously disrupted by hurricanes, most recently by Georges which damaged hospitals, schools and other social infrastructure and also closed down hotels and other tourist plant on which these countries depend heavily. Also disruptive to economic and social life are the long-term effects of hurricanes, such as flooding. In the north east of Trinidad, for example, 15 families were evacuated as high tides associated with Hurricane Hugo flooded their homes (UNICEF Children in Focus 1989 (Oct):4).

More critical and devastating, however, is the damage to Montserrat as the Soufriere Hills … and volcanic Volcano erupted in 1995 and in 1998, and wreaked havoc on the island, rendering eruptions uninhabitable more than half of the land area, destroying the capital city of Plymouth, the port (Montserrat) and the airport and precipitating the migration of two-thirds of the island’s population.

9 Concomitant with the modernisation of Caribbean economies is the decline of agriculture. In Declining all countries the contribution of the agricultural sector has fallen during the last two decades contribution of and latest available figures reveal that only in Dominica (18.9%) and St. Vincent and the agriculture and Grenadines (10.4%) does agriculture contribute to over 10% of GDP. Sugar production and mining/ export from Barbados, St. Kitts and Trinidad has declined, and in St. Kitts is predicted to be quarrying shut down in the near future. In the Windward Islands, banana production is fluctuating and uncertain. In the TCI, commercial fishing exists but there is virtually no commercial agriculture. Nearly all food is imported, mainly from the US though small boats bring produce from the Dominican Republic and Haiti. The salt industry collapsed in 1972.

In all countries also the contribution of mining and quarrying to GDP ranks at less that 5%, Low contribution except in Trinidad and Tobago, where mainly crude oil and gas extraction contributes 21.5% of mining and and Suriname where bauxite, gold and crude oil contribute 14.7 %. The oil boom which quarrying Trinidad and Tobago enjoyed in the 10-year period between 1973 and 1983/4 was drastically affected by the collapse of oil prices and the economy experienced a rapid downward spiral. Public expenditure was drastically cut back, investment was reduced, the external debt mounted and unemployment escalated. Since then, however, the country has experienced recovery and growth.

In the Eastern Caribbean states agriculture, mainly in the form of the banana industry, Banana industry continues to function as the backbone of these economies and as a major revenue earner. in crisis However, the industry has been plagued by the new demands of trade liberalisation in a globalised world economy. The adverse rulings of the World Trade Organisation (WTO) have eroded preferential market access to the EU which played a major role in sustaining the banana industry. OECS states await the resolution of protracted negotiations between the EU and WTO. This, along with perennial problems of low rainfall and hurricane destruction and competition from the cheap ‘dollar bananas’ produced outside the region, are not easily resolved. However, there has been a positive response on the part of banana farmers to the crisis and the encouragement by governments to improve the quality and quantity of production. In 1998, this raised production by 3.2 percent, though in the previous year the industry had experienced a 28.2 percent contraction (UNDP 1998:24). Assistance from the EU’s Stabilisation of Export Earnings (Stabex) scheme and from banana recovery programmes are generating some stability. In St. Lucia, for example, the Banana Recovery Plan enhanced by the Certified Growers Programme has resulted in improved quality and increased returns to farmers (UNDP 1998:202). Nevertheless, the WTO mandate continues to threaten the livelihoods of large numbers of small farmers and their families and poses a serious problem for the quality of life and social fabric of rural communities in the Eastern Caribbean.

Several Programme countries, including Antigua/Barbuda, BVI, Barbados, Grenada, St. Lucia and TCI have turned their attention from agriculture to tourism as the potential mainstay of Tourism shows their economies. Success in this respect has been varied. At one extreme is the experience of promise Barbados in which tourism heads the list of growth areas. In 1998, the number of long-stay visitors exceeded 500,000 and was matched by the number of cruise ship passengers. The BVI also presents a record of economic growth in recent years due mainly to the promotion of luxury tourism and St. Lucia has experienced success, with visitor arrivals in 1998 increasing by 10.9 percent, while cruise ship passengers in the same year rose by 17.6 percent (UNDP 1998:201). The TCI has maintained a vibrant tourist industry since the boost in the 1980s due to the construction of the Club Med complex and the international airport. At the other end of the continuum is St. Vincent/Grenadines where tourism takes advantage of multiple small island destinations by promoting sailing. Approximately 40 percent of all visitors arrive by yacht and, in general, the number of visitors, totaling just over 200,000 in 1997, is small in comparison with other destinations in the region (UNDP 1998:222). Similarly, Dominica and Trinidad and Tobago also promote a specialist package, in this case eco-tourism, and the industry has remained relatively underdeveloped. In Montserrat, the nascent tourist industry has been almost totally eliminated with the destruction of the airport and hotel accommodation, though there are plans to rebuild and to use the volcanic experience as a

10 drawing card.

Construction continues to make a significant contribution to the economies of the Programme countries. In Barbados, in particular, construction has provided a main thrust for economic Construction development. However, the major construction booms are to be found in those countries booms but due which are recovering from hurricane damage, such as Antigua/Barbuda and St. Kitts/Nevis, as largely to residential, hotels and other tourist sectors undertake the process of rebuilding and renovation. recovery from In Montserrat, the volcanic crisis has initiated a massive re-construction programme in the safe natural disasters zone. While the contribution of other sectors of the economy including agriculture, manufacturing tourism and financial business services, declined markedly between 1994 and 1998, construction activity increased from 8.3 to 25.1 percent (UNDP 1998:168) and the upward trend is likely to continue as the economy and society are rebuilt. In effect, therefore, construction functions in these economies mainly as a temporary recovery and catching up activity in an effort to restore physical infrastructure, rather than as an on-going contributor to GDP, or indeed to employment.

A recent robust addition to certain Programme country economies is that of financial and business services. This is particularly evident in the more diversified economies of the region Financial and including Barbados, Antigua/Barbuda and the BVI. However, despite continuing reform to business services offshore regulatory regimes, this encouraging development has also been adversely affected by under threat the OECD protest to the WTO about what they perceive as unfair tax advantages gained by companies that do business through Caribbean offshore IBCs. Caribbean countries have contested the OECD black-listing but the implications for the future development of these sectors of regional economies remain uncertain.

The Programme countries have, in general, made reasonable progress in social development as estimated in the Human Development Index (HDI) and the Physical Quality of Life Index Maintaining (PQLI) (Table I) but only Barbados and Antigua/Barbuda have achieved HDI rankings within social the high category. Within the Programme country group, Barbados has the highest ranking at development 30 (out of a total of 178 countries). These rankings are an indication of the recognition among the respective governments of the critical importance of social development and a commitment on their part to investments in social capital and human resources.

However, social policy and planning capacity continues to be weak in most Programme countries. There is poor appreciation and understanding of the importance of social policy in Systemic general and in relation to the wellbeing of children and families in particular. The prevailing weaknesses in view is that social services consist of unproductive charitable handouts that can no longer be social policy justified in the context of increasingly severe resource constraints. Weaknesses are notably evident in the areas of implementation, where delays are common, and evaluation, which is generally confined to financial monitoring. Those involved in social policy are often preoccupied with practical issues of resource acquisition and expenditure, within overly centralised structures in which Ministries of finance have assumed a dominant role in determining priorities for budgeting. Personnel trained in social policy and planning are scarce and the database is weak (Thomas nd.).

Several weaknesses have been identified in social service delivery. Highlighted are the following: Weak social service delivery  ‘segmentation, fragmentation and duplication in the delivery of social services (Thomas nd.)  some deviation from the principle of ‘universality’ in service delivery to the detriment of the needy  reliable indicators for social policy have only recently begun to be developed with the result that social expenditure levels may not be a reliable indicator of social development.

11 There are delays in budgetary allocation and much may end up in staff salaries, and may be wasted, leaked or poorly targeted.  Resistance to change in terms, for example, of eliminating ineffective programmes and projects or failing to incorporate customer choice  The disadvantaged position of social sector ministries in the allocation of resources  Low returns for investment in partnerships, with NGOs for example, which continue to have a peripheral role in social development  High level of external donor input into social policy  Erratic and inconsistent political commitment to social policy  Absence of a clear and coherent vision of, and meaning and value of social policy  Lack of accountability in social service delivery (Thomas nd.).

Programme countries’ governments agreed to the 20/20 initiative of the World Summit for Social Social Development in 1995 which committed them to providing a minimum of 20% of their development budgets which, along with 20% of donor resources, was to be allocated to basic social expenditure services. But, related to the systemic and social service delivery weaknesses mentioned above, there is evidence that in some Programme countries, expenditure allocated to basic services has been misdirected or inadequate for basic needs provisions, for example in pre-primary and primary education, primary health care and low-cost water and sanitation services especially in isolated rural areas and depressed urban communities.

In some countries, real expenditures in health and education have declined over the last decade. Physical structures have deteriorated, and there is evidence of a persistent brain drain as trained and skilled personnel have migrated. Some governments have been unable to maintain expenditure at levels required to sustain health, educational and social services in relation to rising costs. This contraction was implemented through reductions in salaries, textbooks, and other general supplies and goods for teachers and pupils. This, in turn, contributed to low test scores in key subject areas, limited access to secondary schooling and deficient curriculum programmes and an alarmingly high number of reported cases of students unable to read and write. However, in Trinidad and Tobago, government was able to restore teachers’ salaries, granting an overall increase of about 35 percent in 2001.

Although the Programme countries have implemented National Insurance and Social Security National schemes, major gaps and inadequacies exist in social protection. In the majority of cases insurance and neither the income ceilings nor the payment benefits have been adjusted to keep pace with social security wages and inflation. In addition, benefits for the unemployed are often non-existent, apart schemes do not from severance payments and these are not assured in cases of employer insolvency. Public reach all assistance schemes do not adequately reach low income families with children and injustices persist as a result of unclear criteria and contradictory practices of payment. A major cause for concern throughout the region is the escalating drain on these social security schemes by demands for pensions in the context of aging populations. Private companies are beginning to fill the gap, but their schemes are costly and the gap between those who can and those who cannot afford additional contributions is widening.

Table I: Social Development Indicators in the SitAn Caribbean Countries

Country HDI Ranking (2000) HDI (1998) (max = 0.999) PQLI (1990) (max = 100) Antigua/Barbuda 37 0.833 85 Barbados 30 0.858 91 BVI - 0.800 85 Dominica 51 0.793 85 Grenada 54 0.785 86 Montserrat - - 84 St. Kitts/Nevis 47 0.798 80

12 St. Lucia 88 0.728 82 St.Vincent/Grenadines 79 0.738 81 Suriname 67 0.766 - Trinidad/Tobago 50 0.793 - TCI - - -

Source: UNDP Human Development Report, 2000; UNDP 1998; Smith-James 2001. Note: The HDI is based on three indicators: longevity, as measured by life expectancy at birth; educational attainment, as measured by a combination of the adult literacy rate and the combined gross primary, secondary and tertiary enrolment ratio; and standard of living, as measured by GDP per capita (PPP US$).

There is little indication in the Programme countries of any significant reduction in poverty, Persistent poverty despite the general economic recovery during the 1990s and the implementation of Poverty Eradication Programmes in several countries of the region. Between 12% and 60% of the populations continue to live below the poverty line with 60% in Suriname and 21% in Trinidad and Tobago. In the OECS countries, poverty has re-emerged in those communities affected by the disruption of the banana industry and the consequent unemployment and impoverishment. The population living below the poverty line has been estimated at 27.6% in Dominica, 25% in St. Lucia, and 32.1% in Grenada. The national survey of 4293 households in Suriname revealed high levels of poverty, at 52% in the urban areas, 61%in rural area and 91% in the interior. Caution was urged in interpreting the data however, since over-estimation was likely due to the use of an income poverty measure among interior populations that depend on subsistence farming (Suriname (MICS) 2000:21). In those countries whose economies are more diversified and better cushioned against economic recession, poverty levels are somewhat lower. In the BVI, for example, 17.7% of the population is estimated to be below the poverty line (Smith-James 2001:8).

Trinidad and Tobago: Measurements of Poverty

A World Bank Study (November 1995) showed that 21.2% or 265,000 people subsisted below the poverty line of TT$2,430 per year. Among these, 10% were categorised as ‘extremely poor’, that is unable to afford a nutritionally balanced food basket. A 1996 study conducted by the Ministry of Social Development, using a poverty line of TT$623 per month, identified 35.9% as poor. The actualSt. Vincent measurement and the of Grenadines: poverty remains The aBanana challenge. Crisis UNECLAC/ISER and Impoverishment recommended more ‘methodological rigour in both the conceptualisation and measurement of poverty’ and the “Bananas UNDP emphasised constituted thatthe largestthe psychological single item impact in viable and exports. coping mechanismsThe change inof theindividuals banana regimeare difficult has tohurt measure, the country but need and to impacted be taken intodirectly consideration on its macro-economic in designing interventions performance. to Drasticeradicate action poverty has (CCA been taken(Trinidad to bring and Tobago)farmers up1998:48-49). to the levels appropriate for the exports of fruit through the certification programme. There has been a significant fall-out effect with implications for poverty given that possible one-half of all farmers could not achieve such levels in the short-to-medium term… The decline in banana production and the reorganisation of the industry have apparently led to the shedding of labour, especially of women workers who were employed in boxing plants. In the absence of alternative employment opportunities in manufacturing, and given the continuing segmentation of the labour market, women would have been particular hard done by the decline in banana production In the absence of a coherent diversification programme… marginal banana farmers have had little institutional support in entering other forms of agriculture. As banana and other agriculture shed labour, more workers have been forced into informal actitity. .. One area of response on the part of some of the poor to the declining activity has been the recourse to non-legal activity. The growing of marijuana has been conducted in some cases, very openly in the Northwest of the island of St. Vincent… Tell-tale signs of increase in poverty are revealed in the limited data generated by the Ministry of Health. There has been an increase in mothers presenting with anemia. More children are reportedly going to school without meals or are being kept from school since their parents cannot provide them with meals to take to school. The infant mortality rate has almost doubled since 1994. The authorities responsible for Social Welfare are also sensitive to a major increase in the numbers13 of people who put aside their pride and approach the department in search of public assistance” (Henry 2000:30-34). In many countries, partnerships are being forged between governments and civil society, the The role of civil private sector and NGOs in particular, in an effort to promote social development and maintain society and NGOs human resource development programmes. However, NGOs in particular often lack the resources and the capacity to fill the gaps for services provision in social development, especially in health and education, and many rural populations are deprived of social services.

A critical challenge facing the economies and societies of the Programme countries is the Deviant emergence of new sub-cultures characterised by escalating trends towards organised crime, subcultures violence and drug abuse. The geographical characteristics of Caribbean islands with threaten progress unprotected coastlines makes them especially vulnerable to drug transshipment and and stability trafficking. Marijuana trafficking has permeated the informal sectors. This drug scourge threatens to undermine economic development and social stability. In countries such as Barbados and St. Lucia that rely heavily on tourism, the industry is threatened by increasing incidents of violence specifically targeted against tourists. Even political systems appear to be under threat. The high and increasing levels of crime and violence have stretched legal and political resources to the limit, overcrowded the prisons, disrupted community life and impoverished families. The most direct impact is evident among the youth, young males in particular, who are attracted by the promise of quick financial rewards and elaborate life styles.

The disproportionate impact of poverty and violence on children is well known. Among Poverty, violence Programme countries it is children who have borne the brunt of economic recession and social and children fragmentation. It is they who suffer from the long-term effects of malnutrition and neglect that may be with them for the rest of their lives. While adults may overcome periods of poverty, it is children who miss significant periods of schooling, who suffer injuries during hazardous income-generating activity, or who have to grow up fast taking on burdensome responsibility at home for housework and the care of their younger siblings. Children are for the most part powerless within their households. They therefore have little influence over psychological and social costs of poverty and are helpless in the face of increased depression, alcoholism, abuse and violence within their families.

In general then, Programme countries persist with a model of development that privileges Children, social economic growth and has failed to break the cycles of poverty, inequality and violence that development and continue to marginalise large proportions of their populations. So-called social development economic growth programmes are no more than survival strategies rather than development initiatives and have failed to recognise the critical fact that investments in social development are vital if economic progress is to be sustained. Newman-Williams and Sabatini (1997:52) add to this the importance of investment in children as they contend: “Economic sustainability requires the full development of human resource potential… social development, starting with children is the conditio sine qua non of economic development (and not vice versa), and that by investing in children and keenly monitoring their situation, Caribbean countries will be able to achieve

14 the progress in human development which is needed to foster technological and economic growth in this direction.

ASSESSMENT

Achievements: Modest economic growth and recovery, and evidence of diversification to service industry (tourism and financial/business). And reasonable progress in social and human development, the maintenance of adequate levels of social expenditure, the delivery of social services and provision of social security for the poor.

Problems:  economic vulnerability exacerbated by globalisation  massive infra-structural damage by natural disasters and resources devoted to reconstruction rather than development  little evidence that macro-economic growth has led to social development and poverty reduction  systemic weaknesses in social policy  weaknesses in social service delivery  weak civil society and NGO capacity, and limited contribution to social development  organised crime and escalating violence at all levels of society  absence of a development model that gives priority to social development as critical to sustained economic growth  disproportionate impact of poverty and violence on children

EMPLOYMENT AND WORK

The size of the economically active population has increased in the Programme countries since Expanding the 1970s and, in the case of the BVI, has more than doubled. During the same period, there labour force has also been a sizeable increase of 80% in St. Vincent/Grenadines, while elsewhere the increase has been more modest.

The shift to service economies in the Caribbean appears to be favouring the participation of Male labour force women. In virtually all Programme countries, the female rate of increase in the labour force larger, but gap has been more rapid than the male. Exception is Grenada where, as indicated, agriculture closing continues to be the major employer of labour. However, the male labour force participation rate continues to be relatively higher, averaging 75.8 percent 1990/1 compared with 49.2 percent for women (Brown-Chen nd.:6). In Trinidad and Tobago, the gap has closed with males constituting 61.8% of the labour force in 1999.

Agriculture has traditionally constituted the backbone of Caribbean economies and the major Declining source of employment. In recent decades, however, there has been a move to service-based agricultural activity concurrent with the processes of internal migration, urbanisation and industrialisation. employment Employment in agriculture has declined significantly and in all Programme countries absorbs no more than 30 percent of the economically active population. The banana crisis in the Windward Islands has displaced over 16,000 farmers since 1993. Further reductions are expected with serious implications for the quality of life of communities and families. At the other end of the continuum are Antigua/Barbuda, Barbados, BVI and Trinidad and Tobago and TCI where agriculture employs less than 10% of the economically active population.

Disappointing Employment in industry, which never lived up to expectations during the early years of employment in modernisation, has declined recently and absorbs between 10 and 30% of the total labour force industry in the Programme countries.

15 The diversification to service employment is evident in the relatively high and rising Rising service proportions of the labour employed in this sector, varying between 60 and 70%. Barbados at sector 77% shows one of the highest rates and this correlates with marked growth in financial and employment business services along with the maintenance of relatively high levels of employment in government service, wholesale/retail, construction and tourism sectors.

But much of this service activity is located in the informal sector and is small-scale, unstable, High levels of economically marginal and falls outside the formal protective provisions for unemployment informal sector and other social benefits. Many people are self-employed in basic survival activity, often in activity illegal trading and hustling, and much of this is not counted in official statistics. Among the poor of the region are many women who head their households, are sole breadwinners for their dependent children and elderly or infirm family members, and who scratch a living in informal service and trading. The small business sector has not reached its full potential. Women who make up a large portion of this sector have more difficulties accessing bank loans than do men and face problems in the areas of marketing and information (CCA (Trinidad and Tobago) 1998:4).

In many countries, economic growth rates have failed to make a significant impact on Unemploy-ment unemployment rates and double-digit figures persiSt. Overall, unemployment rates remain persists especially high, though there has been evidence of fluctuation and a recent gradual decline. Among the among women Programme countries, relatively high rates were evident in 1990 in Trinidad and Tobago (21.8%), St. Vincent/Granadines (18.0%) and Barbados (17.2%). In Trinidad and Tobago, however, the rate had declined to 13.1% by 1999. Barbados also experienced a decline, to 9.2% by the end of 2000, and the BVI imports labour and enjoys almost full employment. However, recent studies conducted in rural communities, for example in Grenada, reveal unemployment figures that have escalated to between 52% and 63% (Charles 1998). Furthermore, official statistics indicate that although female employment is rising more rapidly than male, unemployment rates for women have traditionally been and continue to be significantly higher than for males and in several countries are nearly double.

However, unemployment rates are highest among young people suggesting that “the High levels of ‘unemployment problem’ is essentially a problem of youth unemployment” (Brown-Chen youth nd.:7). Among countries of the region, the 15-24 age group was worst affected with 49.9 unemployment percent unemployment in 1990/1. The corresponding rate for the school leaving 15-19 age group was 23.0 percent. In Trinidad and Tobago and the BVI, the proportion of total unemployment falling within the 15-24 age range is particularly high, at 42.3 and 40.9 percent respectively. In both age categories the female population continued to suffer higher rates of unemployment. As one commentator puts it: “The dim employment prospects for young people is manifestly a failure of development performance, contributing to social alienation and its attendant problems of crime and other anti-social behaviour” (Brown-Chen nd.:9). And according to the recent West Indian Commission, “Many of the concerns being raised by Caribbean youth, therefore, derive from the frustration, alienation and marginalisation resulting from the disparity between educational attainment and appropriate job content” (West Indian Commission 1992:375).

ASSESSMENT

Achievements: The labour force is expanding in size and occupational opportunities are diversifying, especially for women.

Problems:  reductions in mainstay rural employment in agriculture, especially bananas

16  high levels of informal sector employment (menial, insecure, marginal) especially among women  high unemployment rates among school leavers, young people and women

CHILDREN AND FAMILY LIFE

The image and value of children ‘The child’ in Children are universally desired and valued in Caribbean society. Men and women are Caribbean incomplete as adults unless they have children and a home is considered empty without them. culture Very few choose to remain childless and those that do not have children of their own will invariably ‘adopt’ or give a home to the children of others. But there is recent evidence to suggest that the intrinsic value of children is balanced against their usefulness to adults in that children are seen as the property of their parents, as an investment in old age and as a means of accessing money from men. In other words, they are also viewed as giving meaning in various ways to their parents’ lives (Brown 2000).

Patterns of socialisation Cultural practices of childhood socialisation tend to reinforce adult authority. Children are Socialisation generally seen as vulnerable and incompetent and parents perceive their role to be that of emphasises providing guidance and control, as well as security and basic needs. At an early age, children obedience, are taught the value of obedience and good manners. They are frequently told to ‘keep quiet’ academic success and left to watch television rather than encouraged to play and express creativity. There is and conformity evidence of gender distinctions in patterns of socialisation in that boys are encouraged to be outside, involved in physical activity, while girls are kept at home in activities more likely to facilitate cognitive development. Parents tend to place great emphasis on doing well at school and show great pride in a child’s academic achievements. A failure at the Common Entrance Examination tends to mark a child indelibly.

Punishment in the form of loud scolding, slapping and ‘flogging’ is preferred to positive encouragement and correction. The prevailing view is that children must be molded into Physical responsible adulthood. In general, adolescents, young men in particular, feel that they are punishment negatively stereotyped by adults as indecisive, unsociable, deviant, irresponsible and even as preferred ‘a threat’, as a ‘lost generation’ with ‘no sense of direction’ (Danns et al. 1997:6,105). Within this general climate of opinion, children’s rights have little place and are perceived as undermining the authority of parents, teachers and other adults. If anything, the view expressed is that children already have too many rights and have, as a result, got out of control.

Family and Household Composition Caribbean populations have a heritage of extensive internal and external migration. The search for work, along with other economic and social contingencies, has separated Matrifocal generations of family members, dispersing them between different households and across household national boundaries. The recent extensive literature on Caribbean kinship has reversed the structures image of Caribbean family fragmentation, breakdown and dysfunction by highlighting functioning and supportive extended family networks despite residential and geographical separation. Having said that, however, if family life is assessed from the perspectives young children, co-residence with both parents is likely to be more positively viewed for practical daily family functions such as child care and socialisation. But Caribbean conjugal patterns and household structures generally favour mother-child bonding while fathers often live elsewhere and may play a marginal role in the day to day lives of their children. There is, however, evidence from in-depth research to suggest that the younger generation of fathers have increased their commitment and expanded their roles as fathers, although the problems of fatherless ‘outside’ children persist, that is those who were born often to young men who subsequently settled down and formed a co-residential family (Barrow 1998).

17 The 1990/1 Census returns for the Programme countries indicate that a high proportion of households (between 25% and 45%) are female-headed. Female household headship is associated with poverty and vulnerability, in turn due to high unemployment, low wages, High rates of irregular and uncertain employment concentrated in the informal sector and the double burden female household of employment and child care (Massiah 1984). According to a 1997 UNECLAC study headship, focusing on poverty eradication and female headed households (FHHs) in the Caribbean, associated with “women and men experience poverty differently and therefore require different policies and poverty programmes to eradicate poverty. The FHHs are the strongest direct link between poverty and gender; gender has to be integrated into all stages of the process of poverty alleviation, from planning to programming through to evaluation” (CCA (Trinidad and Tobago) 1998:49).

If household composition is examined from the perspectives of children, specifically by examining with whom these children live, the results confirm the image of paternal marginality. As Table II indicates, between 31% and 59% of children aged 0-14 years live in homes headed by women, which generally signifies the absence of an adult male and his Many children economic and fathering contribution. In addition, as many as 40% of children of up to 14 living without years of age live in homes headed by an adult who is not involved in a co-residential conjugal fathers or father union (Table III). This effectively means that either their mother or father, and in the great figures majority of cases the father, is absent from the home. It also means that there is no substitute father or mother, a step-parent for example, resident in the home. In Suriname, due mainly to heavy migration of males, 37.8% of children aged 0-14 live with only one parent (Suriname (MICS) 2000:34).

The breakdown of figures in Table III shows that in St. Kitts/Nevis a higher proportion of children, though still a relatively low total number, live in households without one or the other biological (or ‘adoptive’) parent. It must be remembered that, because of the frequency of conjugal separation, even those children living in homes headed by an adult involved in a common law or marital union, do not necessarily live with both biological parents. However, substitute parents are often committed to raising their step-children, and in many cases extended family members play an important role in child care and socialisation.

Also contributing to parent-child separation are the escalating rates of divorce being experienced in the majority of countries of the Caribbean. Although only a minority of couples actually enter maritalBarbados: unions, it Divorce is marriage and thatChildren is believed to provide the parental commitment and family stability and the most appropriate home environment for child care Escalating and “Divorces socialisation. in Barbados When marriages have been end increasing in divorce steadily and couples over the separate, years. childrenThe escalation more often is divorce rates thanevident not from remain 1991, with when their 10 mothers. divorces Theirwere recorded,experience up of to fathering 1994 when is invariably the number compromised, of decrees impacting on especiallyabsolute awarded in cases peakedwhere theirat 278. fathers Since remarry then, thereand start has abeen second some family, decline, and though where it there is too are children problemsearly to tell of if adjustment this is a permanent in relationships trend. In with considering stepfathers. these The statistics, emotional it is trauma,important social to disruptionremember andthat oftenthe figures economic for divorceproblems reveal suffered only by a childrenproportion when of thetheir problem parents of divorce marital are well-known,dissolution. butThere virtually are many unresearched. spouses who separate without recourse to the law or who remain together in the same household in empty shell marriages. There can be no denying the impact of divorce on the children involved, both in terms of emotional trauma and social dislocation. As the incidence of divorce rises, a growing number of children, dependent children in particular, is involved. For adults and children alike, divorce is associated with psychological shock and problems of social and economic adjustment. As Carter (1994:36) reports: ‘the major reactions among children of divorce in Barbados vary with age and level of maturity. They run the full range from guilt to anxiety, fear of abandonment, sleeping problems, eating disorders, hyperactivity, withdrawal and physical development regression. These problems are exacerbated by the fact that children are often used as pawns in divorce proceedings such as when parents take opposite sides in relation to them and refuse to compromise in their interest’. However, the Family Law Act, 1981 gives priority to the interests of children during divorce proceedings by stating that, ‘[t]he court shall regard the welfare of the children as the first and paramount consideration’ and by granting the decree absolute only when satisfied with proposed guardianship, residential, financial and other arrangements for the children involved. It is also clear that remaining within a conflictual and dysfunctional marital and home environment may18 promote equally traumatic effects on children as well as their parents” (Barrow forthcoming). Reflecting the general conclusions concerning the absence of one parent from the home, a WHO/PAHO survey conducted among Caribbean school children aged 10-18 years, reported that less than half of the adolescent participants lived with both parents, while one third lived with their mothers only. Feelings of family insecurity and lack of support were identified in Adolescent the survey as students reported their concerns about parents leaving them (19.8%), violence in perceptions and the home (12.4%) parental problems with mental health, drinking, drugs or violence, a lack of experiences of care and understanding from parents and family members, and the desire to or experience of problems in running away from home. Although the majority felt cared for by their mothers (91.9%) and family life by their fathers (86%), up to 30% reported that they could not discuss their problems with parents (WHO/PAHO 2000:23-24). Reports from Suriname reveal an increasing incidence of gambling among parents with the result that financial resources are diverted from the support of children and that children are left alone at home.

ASSESSMENT

Achievements: Children are universally desired and highly valued in family life. They bring joy to parents and are cared for within extended family networks.

Problems:  patterns of socialisation emphasise good manners, social control and academic achievement only  physical punishment and negative reinforcement are the favoured methods of discipline  extensive migration has separated children from parents and extended family members  high proportions of children live in female-headed households and these homes are associated with poverty  family life centres on the mother-child bond and marginalises fatherhood  escalating divorce rates have a negative emotional and social impact on children and tend to reduce their contact with fathers  adolescents report problems of insecurity, non-communication and violence in family life.

Table II: Percentage Distribution of Children (0-14 years) by Sex of Household Head for Selected Caribbean Countries

Children in male-headed Children in female- Country Total Children households (%) headed households (%)

19 Antigua/Barbuda 018,076 50 50 Barbados 059,587 52 48 BVI 004,385 69 31 Dominica 023,138 59 41 Grenada 032,269 50 50 Montserrat 002,790 51 49 St. Lucia 048,945 57 43 St. Kitts/Nevis 013,920 41 59 St. Vincent/Grenadines 039,626 51 49 TOTAL/AVERAGE 242,736 53.3 46.6

Source: Camejo nd.: 4

Table III: Percentage Distribution of Children (0-14 years) by Union Status (Single) and Sex of Household Head in Selected Caribbean Countries

Country Total Children Total (%) Male (%) Female (%) Antigua/Barbuda 08,172 45 4 41 Dominica 08,795 38 5 33 Grenada 13,781 42 5 37 Montserrat 01,232 44 4 40 St. Lucia 16,296 33 4 29 St. Kitts/Nevis 07,341 53 5 48 St. Vincent/Grenadines 06,356 41 5 36 TOTAL/AVERAGE 71,973 40 4 36

Source: Camejo nd.:6

20 THE CONVENTION ON THE RIGHTS OF THE CHILD (CRC)

Ratification and Implementation CRC and All Programme countries had ratified the CRC by the end of 1993 and committed themselves CEDAW to the protection and promotion of children’s rights. In addition, to date, all Programme ratification countries, apart from Suriname, have also ratified the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). In all cases, BVI, Montserrat and TCI as British Overseas Territories, the ratification on the Convention was extended through the United Kingdom.

In terms of the CRC, although ratification was rapid initially, the resources and mechanisms … but little for follow-up has generally been slow. As a result, members of the public as well as many cultural persons in strategic positions to facilitate the realisation of children’s rights, including awareness magistrates, teachers, social workers and parents, have either remained unaware of the message and mandate of the CRC, or the limited messages have not internalised and impacted on. They have formed strong resistant positions to those rights which challenge prevailing cultural norms of parenting styles and socialization, or have not fully translated the spirit and intent of the CRC provisions into their daily course of development.

BVI: The Absence of Public Awareness and Understanding of the CRC

“Since our ascension to the CRC in 1995, the BVI Government has not demonstrated any concerted efforts to make the Convention itself or the Territory’s report to the Geneva Committee widely available. Furthermore, the CRC does not seem to be explicitly included in the consideration of policies affecting children As a result, the population, including key Government Officials, is generally unfamiliar with its principles. For example, Senior Social Workers and Officers in the Criminal Justice System systematically operate in violation of the ‘best interest of the child’ principle, and seem surprised to learn that that should be their ‘primary consideration’. The first report to the Geneva Committee was submitted in March 1999 and examined in September 2000. Neither the report nor the response of the Committee again, has been widely disseminated. Plans are underway, however, for a National Conference on the CRC, to be conducted under the auspices of the Inter-sectoral Social Services Committee later this year. Additionally, the Human Rights Reporting Coordinating committee will be publishing brochures in the coming months on the territory’s obligations with respect to the various conventions extended to it, including the CRC. These will be published in a form that children can readily understand, and distributed in schools” (Smith-James 2001:15-16).

But the countries of the region have begun to undertake the administrative, legal and other Monitoring and measures required for the implementation of the CRC. The NGOs, in particular the Save the reporting Children Alliance in the Windward Islands, played a leading role in social and political progress activism, strengthening social networks, communicating new ideas and information and lobbying for children’s equality and rights. Nevertheless, the increased momentum towards public education has been sporadic in nature, an event dinner, be it during the celebration of child month or the child rights month. States Parties are required to report regularly to the Committee on the Rights of the Child on their progress in the implementation of the CRC, initially 2 years after ratification and every 5 years thereafter. The majority has established local committees to facilitate the process of public education, monitoring and reporting. To date, Barbados, BVI, Grenada, Montserrat, St. Kitts/Nevis, St. Vincent and the Grenadines, Suriname, Trinidad and Tobago, and Turks and Caicos have submitted their initial national reports.

The CRC and UNICEF The UNICEF agenda for children has traditionally focused on the provision of basic needs in

21 The changing health care, nutrition and education and the protection from harm and danger. Although these mandate of remain critical to UNICEF’s programme, the agenda has moved on to embrace the new UNICEF mandate of children’s rights and participation as articulated in the CRC. Globally and within the Caribbean region, UNICEF has been promoting a change in the perception of children’s rights as privileges and advocated for the integration of children’s rights into overall development.

ASSESSMENT

Achievements: All Programme countries were among the early CRC signatories and have initiated monitoring and reporting procedures to varying degrees.

Problems:  there has been limited sustained public discussion or media exposure of the CRC philosophy and principles  there is strong cultural resistance to the full implementation of children’s rights by government officials concerned with child development or by parents and the general public.

22 SURVIVAL, DEVELOPMENT, PROTECTION AND PARTICIPATION

SURVIVAL: CHILD HEALTH, NUTRITION AND WELL-BEING

The health and survival prospects of the populations of Programme countries are reasonably Modern health good and improving. Health profiles show that many of the communicable diseases profiles attributable to underdevelopment and poverty have been brought under control and Caribbean populations are increasingly faced with new health problems associated with modern life styles.

Caribbean: Changing Health Profile

The Caribbean Regional Health Study (1994) identifies the following key changes in the health profile of the region:  a resurgence of some communicable diseases thought to have been virtually eradicated…cases of malaria were reported in many countries of the region... There has been marked success, however, in the control of measles, polio and smallpox.  a shift to non-communicable diseases (NCCDs) with vascular disease, diabetes and hypertension accounting for up to 40 percent of deaths. Heart disease and malignant neoplasms also ranked high.  new and increasing health problems attributable to aging, dietary habits, sedentary lifestyles, mental and emotional disturbance, stress and environmental factors (responsible, for example, for pneumonia and asthma).  sharp increases in domestic and non-domestic violence apparent in the increasing proportion of hospital admissions for accidents and injuries.  the HIV/AIDS epidemic - the escalating incidence and mortality rates, increasing infection among the female and younger sectors of the population, the need for improved laboratory and medical practices, and the urgency of developing a strategy to curtail the spread of the disease (IDB/PAHO/WHO 1996) (Note: Among the Programme Countries, only BVI and TCI were not included in the report)

Water, Sanitation and Waste Disposal High rates of Within the Programme countries there has been significant improvement in environmental access to water health conditions. Over 90% of the populations have access to safe drinking water supply and sanitation services, with the exception of Suriname where, although the 93.0% of the urban population is supplied, this is the case with only 66.0% of those in the rural areas and 20% of those in the interior (Suriname (MICS) 2000:24). In addition, the majority of countries have provided over 90% access to sewage and excreta disposal services by way of a house connection, public network of easy access facilities. In Suriname, however, while over 98% of the urban population is supplied, there are marked regional disparities and only 30.5% of those living in the interior are supplied (Suriname (MICS) 2000:24). Country size and distances combined with difficult mountainous terrain are clearly influential in the supply of water and sanitation services. Little information is available on refuse collection, though in Trinidad and Tobago it has been estimated that at least 60% of the population is supplied with adequate collection services by local authorities (National Report (Trinidad and Tobago) 2000:9).

There are however problems, many of which are related to deteriorating plant and equipment. But problems In terms of water supply, there are problems of leaking and out-dated cast iron pipes. Water persist shortages due to inadequate distribution and irregular supply often necessitate the storage of water by households which poses a health hazard particularly when containers such as tanks, buckets and drums, become breeding grounds for mosquitoes (CCA (Trinidad and Tobago) 1998:28). There is also evidence of population pressure on systems, particularly in urban and tourist areas (IDB/PAHO/WHO 1996:42). Problems of sewage disposal occur in, for example

23 Paramaribo, where part of the system is in the form of open canals that overflow in the rainy season. In the rural hinterland also, pit latrine sludge is often dumped without treatment into rivers and canals (CCA (Suriname) 1998:21). In the western coastal area of Dominica sewage is often indiscriminately dumped into water systems and open ground (Government of Dominica 2000:9). In several other Programme countries the discharge of untreated effluent into marine and river areas has been reported.

Child and Adolescent Health Declining infant The Infant Mortality Rate (IMR) which hovered at between 40 and 60 per 1000 live births in mortality the 1970s, has declined markedly, in most cases to 20 per 1000 live births or below. Only St. Kitts/Nevis and Suriname are higher, with rates of 24 and 23 per 1000 respectively. Countries of the region have achieved success in the control of diarrhoeal diseases, malnutrition and infectious diseases which were once the leading causes of child morbidity and mortality. A closer examination, however, reveals some fluctuation in recent years, especially between the mid and late 1980s (IDB/PAHO/WHO 1996:37) and a recent report states that the IMR in St. Vincent/Grenadines has doubled since 1994, linking this with impoverishment as a result of the banana crisis (Henry 2000:34). The major causes of death in infancy are essentially preventable and constitute cause for considerable concern. In Trinidad and Tobago, for example, 49.6 percent of deaths during the first month of life were due to asphyxia (respiratory distress syndrome) and 28 percent to hypoxia (a deficiency of oxygen). Most disturbing of all was the finding which reported for that country “a small but increasing number of infanticides involving new-borns and infants has been noted in recent times” (CCA (Trinidad and Tobago) 1998:24-25).

Also preventable are the major causes of death in children under 5 years. In the age group 1-4 Major causes of years, the main reasons for hospital admissions in the Caribbean region are acute respiratory child mortality illnesses (ARI) diarrhoeal diseases and accidents (including injury, drowning and poisoning). preventable Recent trends indicate that mortality rates due to gastro-enteritis are declining in relation to those attributable to ARI, asthma in particular (Proceedings (Caribbean Cooperation in Health Project)1995:8,11). In Trinidad and Tobago, major causes of child death in 1995 were injury (27.5% male, 37.0% female) and infectious diseases (13.8% male, 14.8% female) (CCA (Trinidad and Tobago) 1998:24-25). In Barbados and Trinidad and Tobago in particular, a new challenge in child mortality at ages 1-4 years concerns the increasing number of babies born with AIDS (Proceedings (Caribbean Cooperation in Health Project) 1995:26,79). The governments of Barbados and Trinidad and Tobago have implemented a policy of making available drug therapy to pregnant women who have tested positive for the HIV virus.

Maternal mortality rates have also fallen below 100 per 100,000 live births in all Programme Declining countries except Antigua/Barbuda and St. Kitts/Nevis. Due to the smallness of population in maternal the programme countries, the statistical sampling requirements for calculation of the Maternal mortality mortality rate are always a challenge. However, there is some indication of fluctuations. In Trinidad and Tobago, for example, maternal mortality rose between 1996 and 1997 from 38.9 to 70.4 per 100,000 live births and, although no specific explanation has been given, the under-utilisation of prenatal services has been suggested. However, in 1997 only 1% of births was attended by persons other than a doctor or midwife and only 1.7% took place at private homes or places other than hospitals or nursing homes (CCA (Trinidad and Tobago) 1998:10- 11). Additional interventions include the promotion of early attendance at antenatal clinics, the early diagnosis and management of complications, nutrition counseling and the training of health professionals.

All Programme countries have maintained high levels of immunisation coverage. Virtually all countries of the region have legislation which is enforced requiring immunisation prior to High school admission. The success story is evident in the following average percentage for 2000 immunisation for the vaccination of infants under one year of age: coverage DPT 93.6

24 Polio 94.0 Measles 93.3 (PAHO/WHO 2000)

In 1994, Suriname was ranked relatively low in terms of immunisation but, by 1998 the situation had improved with DPT and Polio coverage up to 90 percent, and Measles at 82 percent (PAHO/WHO 2000). However, throughout the region there is concern that, while high proportions of children are receiving first doses of vaccines, the proportion of those returning for the additional required dosages is low. In Suriname, for example, only 84.4% are estimated to return for the second DPT dose and 79.1% for the third (Suriname (MICS) 2000:27).

Despite high rates of immunisation and consistent declines in the prevalence of disease, Outbreaks of outbreaks still occur. An epidemic of measles broke out in 1989, resulting in a five-fold infectious increase in cases and occurring mainly in the BVI and Trinidad and Tobago (also in Jamaica). diseases occur Though detailed epidemiological data are not available, reports suggest that a large proportion of cases occurred among children over 5 years of age who had been vaccinated. (Children in Focus June 1990:7-8). However, the disease was brought under control by the so-called ‘big bang’ catch-up measles vaccination campaign with an average coverage of over 92%. It was conducted during 1991 throughout the English-speaking Caribbean and Suriname (PAHO/WHO 1997:6). Cases of rubella and dengue fever also fluctuate. Sizeable outbreaks occurred in Barbados and Trinidad and Tobago between 1995 and 1997, and the rate in the region reached 10.3 cases per 100,000 of the population in 1996 (PAHO/WHO 1997:4). In Suriname, an increase in malaria cases has been confirmed in the interior, especially among children (CCA (Suriname) 1998:17) and, although an estimated 72.2% of under five year olds sleep under a bed net, only 5% of these nets are impregnated with insecticide (Suriname (MICS) 2000:29). No cases of polio have been reported in the last years.

The chronic malnutrition associated with poverty has all but disappeared in the Programme Chronic countries which, despite economic recession, have generally maintained a satisfactory malnutrition rare, nutritional profile. Although information is patchy and unavailable for most countries, there is but pockets of general evidence that cases of chronic malnutrition, ‘wasting’ and stunted growth are rare. hunger and The percentage of newborns with low birth weight (under 2500 g) in 1990 was 12 or less in all nutritional countries for which this information was available. In the BVI, however, low birth weight due deficiency persist to the pre-maturity of babies born to teenage mothers has been noted (Smith-James 2001:23). In Suriname school children aged 4-11 suffer with acute malnutrition with the average ‘wasting’ (low weight for height) for boys and girls estimated at 16% (CCA (Suriname) 1998:18). And in rural villages in Grenada, there is evidence of hunger as significant proportions of mothers admit that there are times when they have nothing to feed their children (Charles 1998).

Antigua, Dominica, St. Vincent/Grenadines: Micronutrient Study Hunger among School Children in Suriname “The project assessed the status of iron, vitamins A and E in Antigua, Dominica and St. Vincent “ All and but the twoGrenadines schools targeting mentioned three the vulnerable problem population of ‘hungry groups: children’… children Inaged some 1-4 neighbourhoodsyears, school-age many children parents 5-19 have years more old, than and one pregnantjob, sometimes women…In at a far Antigua, distance only(French the Guyana),children aged and 1-4have years little were time surveyed…”for their children. They leave money for their children to buy food “The and summary these children results have show to that take in care these of threethemselves. countries One the teacher prevalence said: ‘Don’tof deficiency pay too of muchvitamin attention A is 1% to or the less fact in that the some target children populations. take money It is totherefore school. not It is surprising not enough that to buyovert a decentsigns of bread. the deficiency It is cheaper are notfor aobserved. parent to Thegive surveythe child confirms a little bitthat of current money fortificationthan to buy food.programmes and consumption levels are appropriate to avert the clinical signs which result from A teacher vitamin who A deficiency.talked regularly We note, with however,pupils said that that up children to 10% ofsometimes some groups only had marginaltwo good mealsdeficiency a week but thisat home. was more And in for children the other 1-4 yearsdays theyold…” had to eat ‘what they found’. Some children “ For vitamin mentioned E, apartbeing fromhungry, some but elevated according values to the in teachers, young children many are in ashamed.Antigua and They St. sometimesVincent the just levels hang fall around in the normalthe office ranges and hope for the to targetdraw attention populations…” to their problem. “…A diversityiron deficiency of signs continues were named to be bya cause the teachers of major as public signs health of hunger: concern sleepiness, particularly angular in stomatitis,pregnant women, fainting, young bad childrenschool performance, and to a lesser non-attendance extent school-aged (sometimes children. because The extendthere was of nothingthe deficiency to eat isthat also day) serious. headache, More 25dizziness, than 30 percent nausea, of concentration the target populations problems, showed hanging over (theirevidence desks), of iron skin deficiency. diseases, vomiting, The results and of abdominalearlier studies, pain although(which could not strictly also be comparable, symptoms of anaemiashow that and the helminths”prevalence (Prohealth1994:18-19).of anemia is not declining rapidly…” (CFNI/PAHO/WHO 1997) There have also been outbreaks of gastroenteritis and pockets of nutritional deficiency and food insecurity persiSt. This is manifested, for example in Trinidad and Tobago, in protein- energy malnutrition and iron-deficiency anaemia among lactating mothers, children under five years, school children and the elderly (CCA (Trinidad and Tobago) 1998:51). An assessment of the meals consumed in four rural communities in Grenada, concluded that there was little variety and that diets were deficient in Vitimins B and C, Carotene and some minerals (Charles 1998). A micro-nutrient study conducted in Antigua, Dominica and St. Vincent/Grenadines reported serious levels of iron deficiency (CFNI/PAHO/WHO 1997; see also Government of St. Vincent and the Grenadines 2000:9-10).

Breast-feeding Information on breast-feeding is generally scarce and somewhat inconsistent. The Ministries discontinued of Health in Grenada and St. Kitts/Nevis report that only 39% and 55.6% of mothers early respectively breast-fed exclusively for over 4 months in 1998, while the rate of exclusive breast feeding for the first three months of life in Antigua has been estimated at 75% of all infants (Proceedings (Caribbean Cooperation in Health Project) 1995:19). In Suriname, only 13% of children under 4 months are exclusively breast-fed (Suriname (MICS) 2000:26). In general, what data there is available suggest relatively high rates of exclusive breast-feeding in the early weeks of life followed by a marked decline subsequently. Women in the BVI decided not to breast-feed or to discontinue doing so for the following reasons: “inconvenience/ embarrassment, pain and discomfort, fear that breasts would stretch and eventually sag unattractively, fear that breast milk was insufficient in quantity/nutrients;

26 weaning had to take place before their return to work” (Smith-James 2001:38). On the other hand, a base-line survey of 4 impoverished rural communities in Grenada, indicates high levels of breast-feeding with an average of 92.8% of babies breast-fed. For 83.3% this continued for 6 months or more (Charles 1998).

Modern nutritional problems have emerged in Caribbean populations. Obesity, among women Emerging in particular, has been a problem for some time now and appears to be spreading to childhood obesity adolescents and children. The 1995 meeting of Coordinators of Maternal and Child Health and lack of Programmes in the Caribbean concluded that “childhood obesity needs our attention and fitness education needs to focus on healthy eating habits” (Proceedings (Caribbean Cooperation in Health Project) 1995:8). More specifically, in the BVI obesity has been identified as the main nutritional problem facing children and has been attributed both to a poor diet of convenience foods with a high starch, sugar and grease content, and to lack of exercise (Smith-James 2001:39).

HIV/AIDS Infection HIV/AIDS With over 2% of the population in the wider Caribbean region already infected with reaching HIV/AIDS and numbers rising rapidly (see Appendix I), the epidemic constitutes the number epidemic one health concern in the region and is rapidly becoming a developmental problem. The proportions devastating spread of the HIV virus since 1983, the year in which it is thought to have been first detected in Trinidad and Tobago and Suriname, is generating much official concern throughout the region. By 1996, the total number of cases reported in the Programme countries had risen to a total of 4033 and the number of deaths attributable to HIV/AIDS to 2841 (Table IV). HIV/AIDS related morbidity is becoming a leading cause of death and in St. Vincent/Grenadines in 1999 is estimated to have been responsible for 40% of deaths among young men and women (UNICEF/CAO Mid-Term Review 2000:ii). Adding to the human and personal catastrophe are the social problems which might result in the future from high mortality among teachers, nurses, parents and others playing critical roles in the economy and society, the threat to political stability and the economic costs. The World Bank estimated that by 2000 the total cost of the AIDS epidemic would be equivalent to 6% of the region’s GDP, threatening the economic gains of the last two to three decades.

The highest absolute number of cases was reported from Trinidad and Tobago where in 1996, Country 2,492 cases were identified, representing a rate of 198 per 100,000 of the population (See variations in Table IV), and that by 1997, the estimated number of persons infected by the virus has risen to HIV/AIDS 6,800. However, the highest incidence rate was in Barbados with 762 cases (and a rate of infection 285), which according to the latest figures had escalated to 1,250 cases by February 2001, representing a rate of 289 per 100,000. The lowest incidence was reported from Montserrat (2 cases) and BVI (12 cases) where the disease was not identified until after 1987. By 2000, however, 53 cases of HIV and 21 cases of AIDS had been reported from BVI (Smith-James 2001:32). Adding to the alarm, it is well recognised that for each case of HIV/AIDS identified there are many which remain invisible to official statistics, largely because this is not a notifiable disease and medical practitioners are under no obligation to report cases. This and the rapid spread of the disease supports the prediction that in all countries of the region, the incidence will inevitably escalate and rapidly.

HIV/AIDS continues to affect mainly the male working adult population. The ratio of male to The spread of female cases averaged 2.3:1‘ Sugarin the ProgrammeDaddies’ Passing countries on AIDSin 1997 (PAHO/WHO 2000). But infection to there is some evidence that this profile is changing. With women accounting for an estimated women and 35% “’Sugar of cases Daddy in Syndrome’,the region, thethey practice are increasingly of older men at riskfinancing and the young gender girls gap in exchangeis closing. for In children Suriname,sex, is contributing a 1993 National to the rise AIDS in cases Programme of Acquired survey Immune of 67 commercial Deficiency Syndromesex workers (AIDS) indicated in thatthe Caribbean,condom use an was anti irregular. HIV/AIDS The seminar women for reported journalists that andmen pastors offer 2-3 has times been more informed. money for unprotected ‘We are very sex. concerned. They revealedThere are general these older feelings men who of hopelessness can afford to andfinance low young self-esteem girls (Antonius-Smitsand get sexual favours et al. in 1994:56). return. Some There of isthese also men increasing who are evidenceinfected withof transmission HIV/AIDS then from mothergo on toto infectunborn the child girls which and bycontribute 2000 accounted to the spread for 6% of of theall reporteddisease incases the (UNICEF/CAOregion,’ said Mid-TermCheryl O’Neil, Review communication 2000: Annex adviser 1). toInfection the Trinidad- is concentrated among persons in the main based Caribbean Epidemiology Centre (CAREC) which is hosting the seminar. O’Neil who did not name specific countries, said the ‘Sugar Daddy Syndrome’ which was a growing one, was driven by the fact27 that young people wanted ‘brand name things to wear; a box of chicken and chips; outfits to wear out on dates; or free rides in the taxi’ (Daily Nation, Barbados, May 28, 2001:12). childbearing years of 25-44 years and, in all of the Programme countries except Montserrat and TCI, there are cases of children under the age of 4 years who are infected. In Trinidad and Tobago reported pediatric cases had risen from 5 in 1985 to 28 in 1996, resulting in a cumulative total of 177 (CCA (Trinidad and Tobago) 1998:55), while, in Barbados, the total pediatric cases amounted to 57 by 2000 (since 1981). These represented 7.0% and 4.7% of all cases respectively (Ministry of Health, Barbados).

Given the relatively long incubation period of the virus before it develops into full-blown AIDS, estimated at anywhere between 7 and 15 years, it is clear that many Caribbean persons Adolescent risk of are becoming infected during their teenage years as a result of unprotected sexual activity. infection Adolescent girls are particularly at risk. Evidence from Trinidad and Tobago shows that, although males carry a higher rate of infection in the general population, the reverse is apparent among adolescents. Teenage girls outnumber boys 5:1 for new HIV infections and 4.5:1 for AIDS cases reported in 1996. The need to assess the link between this incidence and a cultural pattern of sexual relationships between adolescent girls and adult males has been identified (CCA (Trinidad and Tobago) 1998:24). At particular risk are the women and girls of indigenous peoples in Suriname who live in mining communities and those resident in tourist destinations in Caribbean islands. In TCI, the increase in HIV/AIDS has been attributed in large measure to the influx of illegal immigrants from the Dominican Republic and Haiti (Situational Analysis (TCI) 1996:3).

In general, public attitudes towards persons suffering with HIV/AIDS infections continue to be Negative attitudes a challenge. to persons with AIDS

28 Suriname: Attitudes to persons with HIV/AIDS

“ The MICS survey also attempted to measure discriminatory attitudes towards people living with HIV/AIDS. To this end, respondents were asked whether they agreed with two questions. The first asked whether a teacher who has the AIDS virus but is not sick should be allowed to continue teaching in school. The second question asked whether the respondent would buy food from a shopkeeper or food seller who the respondent knew to be infected with AIDS. Almost half of the respondents believe that a teacher with HIV/AIDS should not be allowed to work. This percentage is highest in the urban region at 58.7 percent and lowest in the interior at 25.8 percent. Urban women and those with secondary or higher education are more likely to express this discriminatory attitude than rural women and those with no Table IV: HIV/AIDSprimary ineducation. the Programme About 14 Countries, percent of 1982-1996 women would not buy food from a person infected with AIDS… Overall, about 49.3 percent of women agree with at least one of the Country discriminatoryNo. of cases statements” reported (SurinameMale (MICS) 2000:30).Female Sex unknown No. of deaths Antigua/Barbuda 079 056 0014 09 0064 Barbados 0762 0583 0179 00 0637 BVI 0012 0007 0005 00 0007 Dominica 0088 0069 0019 00 0070 Grenada 0095 0065 0026 04 0067 Montserrat 0002 0000 0001 01 0000 St. Kitts/Nevis 0,058 0038 0020 00 0032 St. Lucia 0,090 0054 0036 00 0074 St. Vincent/Grenadines 0,098 0066 0032 00 0094 Suriname 0,215 0151 0064 00 0182 Trinidad/Tobago 2,492 1,755 0726 08 1,854 TCI 0,042 0,029 0013 00 0030 TOTALS 4,033 2,873 1,135 22 2,841

Source: CAREC (Courtesy Uli Wagner,GTZ Advisor, CAREC)

Adolescent Health, Sexuality and Well-being

A recent study of adolescent health was conducted among a sample of secondary school Overall children across the Caribbean region. Among the Programme countries included were perception of Antigua/Barbuda, Barbados, the BVI, Dominica, Grenada, and St. Lucia. The survey was good health conducted in schools and a total of 15,695 children and adolescents aged 10 to 18 years of age among youths participated. The majority (80.2%) of young persons who participated considered themselves to be healthy and the major problems identified were headaches and problems in relation to physical development and sleep.

However, although virtually all (85.9%) indicated their awareness of where to go to receive Limited health medical attention, few (36.3%) had done so either with a doctor, dentist or other medical care, personnel in the two year period prior to the survey. An important deterrent is the perception confidentiality among young persons that adults, including physicians, nurses, teachers, guidance counselors, problems peer counselors and parents, cannot be trusted to maintain confidentiality (WHO/PAHO 2000:10-11). For the BVI Situational Analysis, interviews with children about their health and health care revealed the following: “While many considered themselves to be in good health and value the services provided by health care professionals, the contemplation of physician- patient interaction stimulated pronounced fear and resistance. This is partly attributable to the lack of child friendly health care facilities in both the public and private sectors. Conditions at the hospitalBarbados: children’s Adolescent ward Fitness for example and Nutrition are stark, cramped and not accommodating of parents who wish to spend the night with a sick child” (Smith-James 2001:25). A preliminary report of the Barbados Schools Adolescent Health and Fitness Study (1999) conducted using a random sample of 380 secondary school students reveals that 86.7 percent Alsofailed contesting the fitness prevailing test, only public 20.3 opinion percent concerning passed the adolescentcardio-respiratory behaviour unit were of theresponses mile Low levels of concerningrun/walk test, the and low 20.8 rate percent of use failed of tobacco the Body and Mass illegal Index drugs, teSt. although alcohol consumption substance abuse, amongThe study adolescents concluded is that relatively high, with 45.5% of those in the sample reporting use. Over but disturbing one fifththere identified was a “negative problems attitude relating to physicalto alcohol activity or drug by abusesome ofand the several students”, mentioned parental signs of drinking that “a problems considerable (WHO/PAHO number of 2000:12-13). young Barbadians In a recentare in sampledanger ofof 71succumbing youths fromto chronic disease in their adult years” and  that “if nothing was done to improve their health and fitness status adult obesity was a distinct possibility for this group” . (Study conducted by B. Griffith and29 J. Douglass in conjunction with the Chronic Disease Research Centre and the School of Clinical Medicine and Research, University of the West Indies, Barbados and reported in Barbados Advocate, March 21, 2001). marijuana and throughout the Caribbean region, 19.7% of respondents reported using marijuana, 23.9% cocaine use reported using cocaine and 35.1% reported using alcohol (Danns et al. 1997:99) And in Trinidad and Tobago, an increasing number of young people, young men in particular, have been arrested for marijuana possession and trafficking. A Rapid Assessment Survey conducted there in 1997 also stated that most cocaine and marijuana users reported taking the drug every day, and that unlike the marijuana users, those using cocaine felt that their health was being affected. An increasing number of persons chronically addicted to cocaine was reported (CCA (Trinidad and Tobago) 1998:59-60).

The survey also reported a high level of satisfaction among the youths in the sample with their Adolescent weight (69.2%) and general appearance (88.4%). However there are problems, though the dietary and information available on these is scanty. The survey revealed that about one sixth of the fitness problems students in the sample have taken measures to lose weight including laxatives, diuretics, diet pills and induced vomiting as well as diet and exercise (WHO/PAHO 2000:8). There is minimal information on adolescent nutrition and physical fitness, though it is known that eating disorders are also making an appearance among adolescent girls and young women in the Caribbean. In addition, significant numbers of students reported that they never exercise (WHO/PAHO 2000: 6-7).

Also contrary to public perceptions concerning adolescent sexuality, most respondents Lower incidence (65.9%) aged 10 to 18 years involved in the PAHO/WHO survey indicated that they had not of adolescent sex experienced sexual intercourse. Among the reasons given were “wanting to wait until than generally married, wanting to wait until older, not wanting to risk pregnancy, fear of disease, and not believed being emotionally ready” (WHO/PAHO 2000:14). However, had the sample included out-of- school youth or even those who were not attending for the day of the survey, these proportions are likely to have been significantly altered.

Other surveys indicate that among those adolescents who are sexually active, this practice But early sexual began at an early age especially for boys, many of whom were active at age 14 with some initiation and initiating sexual intercourse from as early as 9 years of age. Reasons given include “to show careless practice love for partner, peer pressureTrinidad from and Tobago:both friends Adolescent and adults, Sexuality to be natural and enjoy one’s self, and to feel grown up and independent” (Proceedings (Caribbean Cooperation in Health Project) A national 1995:98). survey of Inknowledge, the WHO/PAHO perceptions school and practices survey, conducted a high proportion among 1,500 (77%) youths had experiencedfound that among sex before those agewho 13. had However,previously the engaged results in also sexual revealed intercourse, the following 51.5% ofcauses males for seriousand 53.1% concern: of females felt that they were not at risk. Approximately 50% of these had initiated sexual activity by age 16. Among the females, 28.5% reported having sexual intercourse with older men, while 23.9% admitted to being with more than one partner. A total of 31.5% said that they would30 take a chance to have sex without protection. Of those who were sexually active, 12.7% had never used condoms, and another 12.2% reported sporadic use (CCA (Trinidad and Tobago) 1998:57).  that for nearly 40% of this group, their first experience was forced  that over 60% of the boys in this group had experienced sex with more than two partners  that only 26.3% always used some form of birth control  that only 30.3% worry about causing a pregnancy or becoming pregnant  that a minority (38.7%) worry about AIDS (WHO/PAHO 2000:14-16).

A survey conducted in Barbados, also among school children echoed these findings. Among a random sample of 1,791 children in secondary schools 33% had been sexually active. Of these, 50% claimed that sexual intercourse had first occurred before the age of 13 years, 25% had been active with more than one partner, and 63 % had engaged in sexual activity without the use of condoms (Ellis et. al. 1990:7-9). In the BVI a 1999 survey reported that, among student who have had sex, a quarter said that it happened against their will the first time. Additionally, the age of first sexual encounter for 20% of the sexually active was at less than 11 years old, with about 28% reporting having had 6 or more partners. Early sexual activity and multiple partners were particular pronounced in boys. Local laws do not protect boys against sexual exploitation, except in cases of homosexual contact, so that unlawful carnal knowledge and statutory rape legislation are still only applicable to girl children (Smith-James 2001:23).

There has also been some suggestion of a lack of knowledge and awareness among Lack of adolescents who do not make the link between intercourse, the menstrual cycle, contraception Knowledge and pregnancy and who may still believe that pregnancy cannot occur with first sexual intercourse or with the withdrawal method. Although sex education is on the secondary school curriculum in most secondary schools of the region, the onus is still on parents to provide information and this they continue to find embarrassing and difficult.

BVI: Adolescent Contraceptive Use

“The 1999 Adolescent Health Study Survey indicated that among respondents, ‘four in ten who have had sex (39%) indicated that they never use contraceptives. A quarter (25%) used them every time they have sex, while 19% use them sometimes. With reference to their most recent encounter, a quarter (25%) said they had used nothing, while over half (58%) had used a condom. Smaller groups (13%) had used withdrawal or rhythm, 2% had used douches, 7% had used the pill or injections or IUD, 4% had used a sponge, cream or diaphragm and 1% had used the morning after pill. Students were asked about their reasons for non-use of birth control or protection. One fifth of the sub-sample (21%) said they just do not think of it, 4% want to have a baby, 10% don’t think that a pregnancy or STD will result, 18% have no time to prepare because it is spontaneous. Other small groups (4%) do not want to use a method, while 4% think it is wrong to use a method, 3% find it too embarrassing or difficult to get a method, 3% cannot afford it, 4% worry about side effects. Other small groups of students leave it up to the partner’ (Smith-James 2001:33).

31 Declining Adolescent fertility has, however, been generally declining in the Caribbean region though adolescent there is still some evidence of fluctuations. In Barbados, in 1980 births to teenage girls were fertility, but high high, constituting 28.6% of total births. Since then, there has been a significant decline to the abortion rates 1999 figure 14.1%. But much of this is due to a relatively high rate of teenage abortions, amounting to between 16% and 23% of the total performed at the island’s central hospital. From the BVI, however, comes the report that births to teenage mothers increased from 18 in 1990 to 41 in 1999 (i.e. from 6.3% to 13% of deliveries) and that the “trend has become a manner of major concern and, indeed, alarm”. The report continues by stating that “[T]hese occurrences are particularly troubling in light of the fact that girls who become pregnant are subsequently denied an opportunity to complete their studies at public schools (except when very close to completion)” (Smith-James 2001:31). It has also been noted that most adolescent pregnancies in the Caribbean region are unintended (Proceedings (Caribbean Cooperation in Health Project) 1995:98-99). The picture presented here, therefore, is one of premature, careless, unprotected sexual activity often resulting in unwanted pregnancies, but not necessarily in child birth. Declining adolescent fertility rates might therefore be due not so much to controlled sexuality and contraceptive use as to high rates of abortion. Few Programme countries have legalised abortion and the conditions under which these are conducted may be unsafe.

Pervasive Many of the young persons in the WHO/PAHO survey reported having experienced violence violence in one form or another. For one sixth of the students this was in the form of physical abuse at home while one tenth were victims of sexual abuse though most frequently by other teenagers or adults outside the home. Violence is very much a part of the lives of many young persons. Nearly a third of the sample indicated concern about violence in their communities and their desire to move elsewhere. (WHO/PAHO 2000:27-8). They also reported direct involvement in violent behaviour in the form of carrying weapons to school or elsewhere, being stabbed, shot or knocked unconscious, belonging to a gang, or contemplating hurting or killing another person or committing suicide. One female respondent aged 16 responded by stating “[I]n my own neighbourhood I know 12,13, 14 year olds who own guns. They shoot them off as a symbol of their manhood”. The results also revealed that as many as one in six of the young participants in the survey felt that they would not live to the age of 25 (WHO/PAHO 2000:17- 19).

ASSESSMENT

Achievements: Health and nutrition profiles reflect significant achievements in that access to water and sanitation services has expanded and spread to rural populations, Infant Mortality Rates (IMR) and Maternal Mortality Rates (MMR) have declined and are relatively low, immunisation is nearly universal, water-borne and communicable diseases are virtually under control, chronic malnutrition is a thing of the past and adolescent fertility is declining. The majority of adolescents are satisfied with their health and physical well-being.

Problems:  An increase in opportunistic infectious diseases primarily related to weakened body immunity such as HIV/AIDS  some reluctance on the part of women to prolong breast-feeding beyond 3-4 months  pockets of malnutrition and vitamin/iron deficiency among young children and women, and occasional hunger in poor, rural communities  the emergence of environmental health problems of Acute Respiratory Infections, mainly asthma, and accidental deaths

32  the emergence of modern problems of obesity, over-weight and unfitness among children and adolescents  the HIV/AIDS epidemic which is spreading to women, adolescents especially teenage girls, and infants (perinatal transmission)  adolescent reluctance to access health care and lack of trust in health professionals  teenage alcohol and drug abuse  early initiation, careless and unprotected practices and a lack of knowledge in relation to sexuality and reproductive health  high teenage abortion rates (including illegal unsafe terminations), and isolated cases of infanticide  pervasive violence affecting children of all ages at home and in the wider community.

33 DEVELOPMENT: CHILDREN’S EDUCATION

Equal Educational Opportunity for All Guiding ideology Since the achievement of varying levels of political sovereignty, the governments of the of equal Programme countries have placed great emphasis on education as the principal social educational institution for the achievement of social and racial equality and main avenue for social opportunity for mobility for the poor and working classes. The guiding ideological principle is that of equal all educational opportunity for all. Initially, the target was inequalities on the basis of race, class and rural/urban residence with these variables centered in policies implemented to reduce elitism in educational systems. But by the late 1970s, the disparities in the schooling provided for boys and that for girls became the major focus. The central policy designed to eliminate discrimination against girls and to equalise educational opportunities by gender was co- education.

In all Programme countries, the law stipulates compulsory education for children between the ages of 5 and 15/16 years. In Suriname, children are admitted to primary school at age 6 and Achievements in education is compulsory by law between ages 7 and 13. Provisions for primary education are education virtually universal and the emphasis in many countries of the region, those of the OECS in particular, has shifted to the expansion of secondary schooling, as well as to provisions for Early Childhood Education (ECE). The achievements of the decade of the 1990s are described as follows:

 “significant improvements in Early Childhood Education, Care and Development in several countries;  the maintenance of universal primary education;  significant progress towards universal secondary education;  the implementation of several initiatives addressing behavioural issues for students, youths and adult learners; and  an increase in the use of the media in education, especially in the training of teachers” (CARICOM (Plan of Action, 2000-2015) 2000:63).

Governments of the region have also joined the global Education for All (EFA) movement and most have initiated action on the following additional improvements in schools:

 textbook schemes  school meal services  subsidised transport  guidance and counselling  library resources  school equipment - computers, photocopiers, sewing machines, furniture and other materials  curriculum expansion to include HFLE (HFLE), information technology and visual and performing arts  parental involvement as teacher’s aids and members of active PTAs  protection and safety from abuse, drugs and violence in schools.

While enrolment statistics indicate significant progress, there is mounting evidence indicating Problems in that the quality of education delivered is less than satisfactory. Student performance is poor educational particularly in reading, writing and numeracy and levels of attrition are high. Moreover, quality and information pointing to significant inequalities has emerged showing that children from urban performance schools do better than those in rural schools and girls do better than boys. Overall, there is clear evidence that Article 29.1 of the CRC which states that “… the education of the child shall be directed to the development of the child’s personality, talents, and mental and physical abilities to their fullest potential” is being violated for many of the children of the Programme countries.

34 Early Childhood Education, Care and Development (ECECD) Among the Programme countries, there is evidence in the low priority given to education for Relatively low young children (aged under 5 years) and that governments and the public at large are still to priority to ECE recognise the significance of recent research pointing to its importance as the critical foundation for all subsequent learning. From Suriname, for example, it was reported that early childhood education is considered as covering the pre-school period and therefore misses the important early period up to age 3. It was also noted that government, parents and caretakers are not aware of the significance of early childhood education and do not consider play and stimulation, communication and space for exploration important to young children (Personal Communication, Drs. Lilian Ferrier, Foundation for Human Development). In general, the budgetary allocation per child for Early Childhood Education (ECE) is miniscule, less than half that for primary education. For countries for which estimates are available, the highest reported expenditure for 1998 is for Barbados at 1.52% of the national budget, and Dominica as low as 0.06% in 1999/2000. In St. Lucia, pre-school expenditure accounts for a low proportion of the national budget at 0.05% in 1999, although this represents a marginal increase in the expenditure over the decade. Provisions have been gradually expanding, but continue to be concentrated mainly in private hands, that is in centres run by churches, NGOs, voluntary organisations and private individuals. In Trinidad and Tobago, for example, there are currently 858 Early Childhood Care and Education Centres, of which only 156 are government funded and operated. Throughout the region, many of the initiatives are voluntary and the main focus tends to be on custodial care in facilities variously named as nurseries, play-groups and day care centres. Many constitute little more than baby-sitting services in a neighbour’s home. They operate with little official regulation, though licensing is a requirement in Barbados, St. Kitts/Nevis and TCI. Governments in the region may offer supplementary support in the form of guidance, teacher training, supervision and financing.

In the majority of Caribbean countries a distinction is made between Day-Care for the under 3 year olds, and pre-primary provisions for children aged 3-5 years. Pre-primary schools are considerably more developed than the day care for the younger groups. They usually fall within the mandate of Ministries of Education, while day care for younger children is generally overseen by the Ministries of Social Services, Community Development or Health (Charles 1999, Jules and Panneflek 2000). Towards the end of the decade, a Caribbean initiative in the form of a plan of action for ECE was launched and there has been considerable effort on the part of Programme country governments to follow through by laying the ground work in programme planning, teacher training and establishing requisite legislative frameworks (Implementation of Caribbean Plan of Action for Early Childhood Education, Care and Development 2000). However, pre-primary enrolment continues to fall far short of desirable levels, except in the TCI. As a result, large proportions of children enter the formal primary system with no pre-primary preparation and are at considerable disadvantage.

The Caribbean Plan of Action for Early Childhood Education, Care and Development, 1997-2002

“ The Caribbean Plan of Action focused on the need for mechanisms and strategies to achieve nine (9) specified objectives within the 1997-2002 time frame, viz: 1. Legislative framework for coordinated provision of services and monitoring of standards in the sector 2. Integrated social planning and implementation of initiatives 3. Adequate financing 4. Equitable access to quality provisions to minimise the plight of the large percentage of children in high risk situations 5. Education and training for all providers of early childhood education and development 6. Appropriate curriculum development and materials development towards improving quality of ECECD provisions 7. Increased parent, community and media awareness and involvement 8. Coordinated action at both national and regional levels and multi-sectoral participation 35 (government, NGO and private sector) 9. Increased research to inform development of the sector”(Charles 1999:14). In 1998, the Gross Enrolment Ratio (GER) for Day Care in the Caribbean region was estimated at only 5% and had in fact decreased by 2% since 1990 (Charles 1999:22). The Low enrolment in exceptions were Barbados where enrollment increased by more than 50% (Ministry of day care and pre- Education, Barbados) and St. Kitts/Nevis by 8% over the same period. The Barbados increase primary is due in large measure to the establishment of the Child Care Board which deals specifically schooling with day care and other child welfare matters. The maximum GER for Day Care was at 33% in Barbados (Charles 1999:22).

Pre-primary GERs in 1997 were more promising, varying in those countries in which information was available from 68.1% to 95.5%, generally representing a modest increase over the decade though there was some sign of fluctuation and even decline since 1995 (Jules and Panneflek 2000).

The attendance of children at pre-schools is closely related to the level of education of the head of the household in which they live, this more so than either the marital status or employment status of these heads. In other words, the higher the level of education of Correlates of pre- household head, which in most cases is the mother or father, the greater the chances of a child primary being enrolled at pre-school. The exceptions are BVI where the pre-school attendance of enrolment… children of household heads with primary and tertiary education was equivalent, and Montserrat where children of heads with tertiary education showed lower enrollment levels (Camejo nd.:14). From a more practical perspective, the non-participation of young children is also due to problems of access, including a lack of finance for transportation, and the absence of information on these facilities, particularly in the larger countries of the region (Jules and Panneflek 2000). There is, however, some evidence that a higher enrolment rate is related to the location of pre-schools on the same site as primary schools. In Suriname, for example, where this is the case, enrolment of 4-5 year olds is 70% and promotion from pre- primary to primary is automatic (CCA (Suriname) 1998:22).

However, most significant of all in determining enrolment rates is affordability. Since most pre-schools are privately owned and operated, there are fees to be paid and these, for the majority of the poor, are beyond their means (Camejo nd.:21). A report from Trinidad and …affordability is Tobago, for example, indicates that “The facility costs more than those who need it can afford the critical to pay for it. The main cause of this is the high rate of unemployment, especially along the determinant East West corridor, but also throughout both islands. There is also the attendant poverty that unemployment engenders. One notices, for instance, a pattern of January rather than September registration of children… The reason the parents give for this late registration is lack of money. Many state that they have to hold back pre-schoolers so that they could deal with the cost of sending the older ones to primary school in September when the new school year begins. In county Caroni, specifically, the reason given is that there is more money available or expected in January when the cane season begins” (Jules and Panneflek 1998).

36 In Suriname, the cost of pre-primary education at US$5.75 per child per year is considered high (CCA (Suriname) 1998:24).

Of major concern also is the parental perception which reflects a misunderstanding of the purpose and value of the social, emotional and cognitive development emphasised in early childhood education. On the one hand, parents tend to have a limited, academic view of Parental education, and pre-schooling is deemed unnecessary and, indeed, as a waste of time and perceptions of money if children are not being taught to read and write. On the other hand, parental needs early childhood may reinforce a custodial emphasis. Enrolment may therefore increase during periods of education higher employment, not merely because parents can afford to send their children, but also because it is then that they require a baby-sitting service. The prevalence and, in some countries and localities, increasing numbers of female headed households and teenage mothers is likely to reinforce this trend.

Pupil-teacher ratios averaged out at a relatively high rate of 30:1 but also varied from centre to centre, indicating limited achievement of the objective of smaller classes and more individual attention. Major constraints relate to limited training and insufficient staff, in turn linked to a Pre-school rapid turnover and low salary levels. Staff also lack training in management and accounting staffing problems skills which would enable them to run their centres as viable business enterprises.

Primary Education Primary education begins at age 5 in most Programme countries (in Montserrat the equivalent age is 4.5 years). There is, however, increasing evidence of over-aged pupils, mainly boys, Governmental enrolling for the first grade, an indication of a lack of early childhood preparation. In those responsibility for countries in which sufficient secondary school places allow for the graduation of all primary primary school children, this phase of education ends at age 11, while in others children may remain in education the all-age primary schools until, for example, as late as 17 years of age in St. Lucia (Jules and Panneflek 2000).

Primary education is compulsory, is generally offered free of charge in public schools under the responsibility of the Ministries of Education of the various countries. The majority of children are enrolled in public schools. Private fee-paying primary schools are also operational. In TCI, there are 24 privately owned primary schools compared with 10 run by government, but there are 3.3 children in public schools for every one in a private school. In general terms, improvements in the education offered in government schools have closed the gap between them and the private schools, although the syllabus in the former tends to be more heavily concentrated on academic work.

Indicative of government involvement in the provision of primary education and the importance attached to this level of schooling, primary education averages between 3% and 4% of GNP, and ranges from 15.3% and 65.5% of current expenditure on education. In some Governmental countries, however, the falling primary school intake coupled with an increasing emphasis on expenditure on and the shift of expenditure to the expansion of secondary education has reduced the relative primary allocation to primary schooling. education All Programme countries are close to achieving universal primary education. Enrollment rates have surpassed World Summit for Children goals (UNICEF 1994) and, by 1990/1 for children aged 5-14 years ranged from 92% in Trinidad and Tobago to 99% in Grenada, Montserrat and St. Kitts/Nevis (Camejo nd.:23). In Suriname the overall rate of enrollment was 78%, although in the interior the rate was lower at 61.2% (Suriname (MICS) 2000:23). These rates Near universal are generally stable though there is some evidence of decline. A decline in the numbers of primary school students, and even teaching staff has been noted and attributed to declining fertility rates and enrollment migration. In Dominica, for example, between 1985/6 and 1998/9 the number of primary school students declined from 16,102 to 13,418, two primary schools were phased out and, although the number of teachers remained constant, the pupil-teacher ratio fell from 26.3 to 21.9 (Andrew 1999:22). Other countries of the region have experienced similar declines and

37 expect this trend to continue.

However, declining enrollment rates are also a reflection of increasing proportions of children not attending school. In Trinidad and Tobago alone, it is estimated that about 10% of the primary school age group was out-of-school, totaling 19,927 children in 1995 (CCA (Trinidad and Tobago 1998:20). The reasons are complex and varied, but the inability to meet the costs But evidence of of education ranks high. Though exempt from paying fees, other costs such as transportation, children excluded books, lunch and uniforms are beyond the budget of many poor families. In addition, the from primary disabled and mentally challenged are deterred from attending school because their special school needs are not being catered for. In Suriname, an additional constraint is the remoteness of the rural and interior populations from primary school locations.

When attention is directed beyond formal enrolment rates to focus on what is happening within schools, then additional problems emerge. Many primary schools systems have adopted the practice of automatic promotion and this masks underachievement by lowering Evidence of repetition rates. In others, repetition is relatively high, between 6% and 26%. In Suriname, under- for example, during the past decade 25% of students at every level (Grades 1-6) repeated the achievement and grade the following year (CCA (Suriname) 1998:23). In general, male repeat rates attrition considerably higher, reaching twice that of girls in some educational districts. Major reasons include poor reading and writing abilities as well as problems in multi-lingual areas where the language of instruction is not the first language of the child, such as the Surinamese interior (Jules and Panneflek 2000).

Pupil survival rates are also a cause for concern. In 1996, up to 28% of pupils did not complete primary school. There is also evidence here that boys have done better than girls in this respect in Barbados, St. Lucia and Suriname in particular years of the decade of the 1990s. In Suriname, drop-out rates averaged 4% each year for grades 1-5. However, in 1992/3 there was a sharp increase in the rate to nearly 20% at Grade 1 which was interpreted as a reflection of the parental and student disillusionment at the low prospects ultimately at Grade 6 (CCA Suriname 1998:23) as well as to the general problems related to structural adjustment and poverty.

Dominica: Primary School Drop-out and Repeat Rates

In 1997/98 a total of 51 pupils dropped out of school. Of these, 37 were boys and 14 were girls. In 1998 the differential was much greater between the sexes with 18 boys and only 2 girls dropping out. This gives a drop out rate of 0.51% for boys and 0.21% for girls. Although these figures are small they do indicate that some children did not complete the primary cycle of education which is likely to lead to disadvantages in employment prospects and prosperity in their adult lives. It is very likely though that these ‘dropouts’ are really migrants who have left to join families overseas. Nationally, the repetition rate has fallen from 779 in 1996 to 330 in 1997/98. The overall percentage of repeaters of the total numbers of pupils in the primary sector has fallen from 5.4% to 2.4%. As with drop out rates the boys significantly outnumber the girls… However, there are no fixed (standard) criteria for success or failure which leads to inequities in the system. In addition,38 there do not appear to be any programmes in place for pupils who do repeat - they merely do the same again which leads to further demotivation and little success” (Andrew 1999:28). The quality of teachers and teachin`g have been identified as critical in the determination of high survival and low repetition rates. Teacher qualification levels are good and there is evidence of improvement in most countries (Jules and Panneflek 2000). And teacher-pupil Teaching staff ratios have declined to a median value of 1:22 by 1999, although in Suriname, the ratio in issues public schools is approximately 1:35 to 42. In addition, the overall decline experienced has been due more to declining fertility and continuing migration than to a deliberate policy and some countries, Dominica for example, have been implementing measures to reduce primary teaching staff. However, there is also evidence that primary teacher salaries are relatively low and non-competitive with the result that teacher turnover is quite high, and ‘ghost teaching’ occurs as many teachers are involved in additional jobs to supplement earnings (World Bank 1993:69, CCA (Suriname) 1998:23). In addition, schooling is frequently interrupted by teachers’ strikes (Antonius-Smits 1994:23). Compounding the problem is the contemporary decline in the level of respect which was accorded to teachers in previous generations and the prevailing high levels of stress associated with the profession as a result of disciplinary problems in the classroom.

The Common Entrance Examination (CEE) Most countries administer a standardised test, generally known as the Common Entrance Examination (CEE) for graduation from primary to secondary school, though there is some Poor CEE variation in terms of the age at which this is taken and the number of tests given (Jules and performance and Panneflek 2000). The emphasis of the CEE is on language arts, mathematics and social low rates of sciences/general knowledge. In Trinidad and Tobago, however, the CEE has been abolished assignment to and replaced with a Secondary Entrance Examination (SEA) Programme, introduced for the secondary first time in the 2000/1 academic year and guaranteeing all students a place in secondary schools schools.

Elsewhere, CEE ‘passes’ are a reflection of the numbers of children for whom secondary school places are available and assigned, and therefore give little indication of academic performance. In those countries where adequate places exist in secondary schools, the ‘pass’ rate is 100%. In others, those who ‘pass’ the CEE move on to secondary schools, while others remain in the Junior Secondary Programme (JSP) of the all-age primary schools generally until age 15 or 16 years. In the former, students who are considered unsuccessful gain entry to the lower grade secondary schools; in the latter those who remain in all-age primary schools are labeled as having failed.

In the OECS countries, CEE ‘passes’ are generally low. In St. Lucia, for example, just over half (54.8%) of the students writing the CEE in 1999 were assigned to secondary school places. While this represented a slight increase during the decade, concern was expressed over poor performance in Reading and Essay Writing (Education for all Assessment: St. Lucia Report 1999:68-9). In Suriname, an investigation which tracked students through primary school between the years 1988 and 1994, revealed that a high proportion (48%) did not receive that country’s equivalent to the CEE, that is a primary school leaving certificate (CCA (Suriname) 1998:23). A review of the Education System conduced in BVI in 1988 reported that: “It is evident that with one in three children failing to achieve primary school leaving certificates after seven or more years of schooling, the quality of primary education needs to be improved. The poor quality of teachers in the primary schools is seen as the main reason that the primary system fails to produce children with the necessary skills to enable them to

39 progress to secondary education” (Smith-James 2001: 50).

There is increasing recognition of the many disadvantages of CEE, not least of which is the heavy pressure on young pupils whose future success or failure is determined by one day’s exam. The CEE also tends to reinforce a narrow academic curriculum and teaching emphasis. This has lead many governments of the region to at least consider the abolition of the CEE and Alternatives to to implement some form of automatic promotion. In Dominica, the plan is to replace the CEE the CEE with National Testing in 2001 and to eliminate the entry of 12 and 13 year olds into the JSP sections of the primary schools (Andrew 1999:23). Whether or not this policy will reduce inequalities in the educational system and the negative stereotyping of pupils as ‘failures’ at an early age, remains to be seen.

Secondary Education Secondary education in the Caribbean has generally been offered in three streams namely, academic, vocational-technical and primary school teacher training. Provisions at secondary level still have some way to go to reach universal enrolment. In Trinidad and Tobago, the Varied secondary education is universal since 2000 but the majority of countries have not, as yet, opportunities for managed to provide sufficient places for all students. Education after age 11 years is generally secondary determined by performance in the CEE after which students tend to be divided into three education groups:

 The highest grade performers generally graduate to the elite secondary schools, virtually all of which are located in urban centres and many of which are distinguished by having sixth forms  Below these are other students gaining places in secondary schools, but in the less prestigious schools  At the bottom are those with the lowest marks who remain in the all-age primary schools or junior secondary schools generally for a two to three year period.

Statistical information on secondary school enrollment is inconsistent and inaccurate. Data may include all those who remain in primary schools after the CEE or only those who move on to secondary schools. Different schools also cater to different age groups so that a blanket definition of secondary education by age, for example, age 12 to 16 years, can be misleading Secondary (World Bank 1993:84). As indicated, however, the proportion of primary school graduates education who actually move on to secondary schools remains low in the majority of Programme enrolment countries for which this information is available. This, in effect, means that most children are not enrolled in those schools, which allow them to culminate their education by obtaining CXC passes for entry into the labour market.

Taking a broad, all embracing view, Census data (1990/1) indicates that within CARICOM countries, the majority of males (67%) aged 15-19 years received secondary education with the corresponding figure for females being higher (75%). Only in Barbados and St. Kitts/Nevis did the male youth exceed their female counterparts, albeit minimally, in secondary education. Highest levels of secondary educational enrolment were recorded for St. Kitts/Nevis (91.2%), Barbados (90.0%), Montserrat (86.6%), and BVI (83.7%). There is, however, a marked difference between these countries and others, particularly those of the OECS sub-region where secondary enrolment rates vary between 33% and 63% primarily because of an inadequate expansion in the number of secondary school places (Camejo nd.:51).

During the decade of the 1990s, rapid strides have been made in the provision of secondary education in some countries of the region, notably Dominica where a significant expansion in plant, material and human resources increased access. By 1998, 60.5% of students were admitted to secondary school compared with 31% between 1984 and 1992 (Andrew 1999:14). In Trinidad and Tobago, as of September 2000, all children who sat the CEE were placed in a

40 secondary school (National Report (Trinidad and Tobago) 2000:19-20) and plans are underway to provide places for all students in state secondary schools by the year 2002 and to make schooling at this level mandatory. However, in Suriname a decline in enrolment at both junior and senior secondary school levels has been recorded, for example from 21,204 in 1993/4 to 19,907 in 1994/5. The main reason given was the cost of schooling estimated at US$25.63 per child per year. Another reason for low enrolment, in Suriname and also in Dominica, is the problem of access in terms of time and transportation costs incurred in reaching distant secondary schools (CCA (Suriname) 1998:24, Andrew 1999:39).

These figures show promising improvements, but there are problems in the quality of education which are reflected in relatively high rates of repetition and attrition. In Suriname, repetition rates are estimated at 22-28% and drop-out rates at 17% each year (CCA (Suriname) But problems in 1998:25). In Trinidad, the corresponding figure for drop-outs is estimated to be between 0.2 student and 0.7%. Those identified as being ‘at risk’ in this regard are girls of African descent, girls performance from rural areas, boys mainly up to Form 3, children from single parent/father-headed households, children who live some distance from the nearest school and those from low or no income households (CCA (Trinidad and Tobago) 1998:30). These figures represent a disturbing sign, particularly since the completion of secondary education is considered necessary for effective functioning in the modern formal sectors of Caribbean economies. In addition, from an economic perspective the low levels of pupil achievement, are also of concern in light of the relatively high investment that governments put into secondary education, approximately double that allocated per child for primary education.

While student-teacher ratios are relatively low, for example in Dominica (17.6:1), TCI (14:1), there are reports of secondary school teachers who are simultaneously employed in other jobs or income-generating activities, who move on to other occupations when the opportunity Deteriorating arises and of a decline in the morale of the teaching profession. These developments are due school not only to the poor salary levels and terms and conditions of employment compared with environments alternative occupational opportunities, but also to the deteriorating environment at school. In the BVI, for example, it was reported that “[a]nother feature gaining prominence across the entire educational system is the escalation of aggressive, violent and other anti-social behaviour being exhibited by students” and that “school violence had become a very real part of the environment in which the children of the BVI receive their education” (Smith-James 2001:47). This conclusion can be echoed in most other Programme countries as disciplinary problems have escalated, outbreaks of violence occur in some countries and there is increasing stress and pressure on teachers and heads. Many schools can no longer be considered safe environments, for students and teachers alike.

Secondary school examinations Poor overall student performance in examinations also indicates that all is not well with the educational system. Only a minority of secondary school students attain any certificates. According to Census data, in 1990/1 percentages of the population without certificates ranged from 52.9% in St. Lucia to 81.5% in St. Vincent/Grenadines with an average of 65.8% for all Students Programme countries excluding Suriname. However, there have been improvements over the graduating with past three decades, for example an impressive 33.8% decline in proportions without no exam passes certificates between 1970 and 1990/1 in St. Lucia. Except in the BVI, this improvement has been due mainly to declines in the proportion of girls without certificates, while in Grenada and St. Vincent/Grenadines the proportion of boys without certificates has actually increased. Achievement at the lowest level of attainment, the school leaving certificate, is correspondingly low. Proportions of the population with school leaving certificates ranged from 2.9% in Grenada in 1990/1 to 20.1% in St. Lucia with an average of 7.9% for all Programme countries (excluding Suriname). While girls still out-perform boys in all countries except the BVI, the differential is small ranging from 0.1% to 2.1% with an average of 0.75%. Similarly, increases in the proportions with school leaving certificates have been small between 1970 and 1990/1, suggesting that improvements have been attained at higher levels.

41 Secondary schooling in the region is focused on CXC examinations, though some countries still continue with ‘O’ levels conducted by various examination boards in Britain. CXC examinations have been administered across the Caribbean region for several years (and are The CXC expanding their scope to include a Caribbean equivalent to the British ‘A’ level exams). examination Initially a CXC pass at Grades I and II was considered equivalent to the original ‘O’ levels and system constituted the requirement for entry to post-secondary courses as well as government employment. Recently, however, the view that CXC standards have been pitched relatively high led, in 1997, to the extension of this to include Grade III passes. Despite the fact that only between one-quarter and two thirds of the secondary school cohort take these exams (World Bank 1993:88), they constitute the major goal of secondary schooling in the minds of teachers and parents alike. Performance in these examinations provides the main indicator of the success or failure of secondary education in the region. The 1990/1 Census indicates that, overall, only 3.3% passed CXC Basic Exams (2% female and 1.3% male) and 11.4% passed GCE ‘O’ Levels and CXC General Examinations (6.7% female and 4.7% male) (Camejo nd.:54-55).

Tertiary education Tertiary education in the Caribbean region continues to improve but remains under-resourced. On the more academic side, several countries, those in the OECS in particular, have Tertiary established Tertiary Learning Institutes (TLIs) which provide a variety of programmes. Most education are linked to the University of the West Indies (UWI) and offer a range of Level I courses so provisions that students can move directly into Level II of their degree programmes on arrival in the (academic and Campus countries of Trinidad, Barbados and Jamaica. The Centres for Continuing Studies run vocational) by the UWI are located in various countries of the region and operate an extra-mural service and Distance Teaching programmes are being established.

There are also Vocational Education and Training (VET) courses. The importance of VET has been emphasised for a variety of reasons including high rates of academic failure at secondary level, high rates of youth unemployment, the need for a pool of skilled labour, the need to alter attitudes and motivations in local economies and the desire to reduce technological dependency (World Bank 1993:94). Secondary school curricula in schools and community colleges have been diversified to include vocational subjects and the national training boards operated by the ministries of education are generally involved in vocational training with an emphasis on skills for young people. For example, the government of Antigua/Barbuda has instituted vocational training programmes to “equip young people with skills and training” for setting up micro-enterprises, becoming self-employed or working within the public or private sector. As a poverty alleviation strategy, the government also created a Job-programme targeting youths by paying their salaries while training through job placements in schools, local industry, government and private agencies (National Report (Antigua and Barbuda)). NGOs also provide training, notably the Caribbean Life Centre of Service Volunteered for All (SERVOL) which provides training mainly for pre-school teachers across the region and also runs a Youth Training, Partnership and Employment Programme (YTEPP) and an Adolescent Development Programme (ADP)(National Report (Trinidad and Tobago) 2000:21-22).

Enrolment at tertiary levels has grown considerably during the last 3 decades or so with student numbers tripling in some countries (World Bank 1993:111). However, overall rates continue to be low. According to data from the 1990/1 Census, enrolment ratios in tertiary education among the 20-24 year age group vary from 2.9% in St. Vincent and the Grenadines Tertiary to 19.7% in Barbados. The average among the Programme countries (not including Suriname educational and TCI) is 8.7% (Camejo nd.:54). Major constraints to tertiary enrolment have been enrolment identified as the inability to meet entry requirements in the light of generally poor secondary examination performances, and the costs which often include tuition fees as well as examination fees, books and transportation (World Bank 1993:117). Access is also problematic, especially for rural populations since virtually all tertiary institutions and educational opportunities are heavily concentrated in urban areas. Another deterrent to enrolment which has been suggested is the absence of articulation between the training offered

42 and employment opportunities. It has been reported for Suriname that there has been no labour market analysis of employer needs to inform training programmes (CCA (Suriname) 1998:25). With governments according priority to the expansion of secondary schools in many Programme countries, the infrastructure and materials for tertiary education have been affected. In Dominica, the neglect of tertiary education during past decades has been reported: “Even the most modest development has been denied the sector due to lack of finances. As a result many of the buildings are run down and dilapidated, equipment is old and sometimes obsolete and staff have been unable to maintain contact with modern training methodologies” (Andrew 1999:75).

Low proportions with degrees Except for the BVI where the percentage is 11.4% (1990/91), the proportion of the population possessing degrees is very small in all Programme countries. Although there have been improvements over the period 1970 to 1990/1, with some countries tripling this proportion, 5 countries have percentages below 2% while the average is only 2.3% if the BVI is excluded. Females have not yet caught up in this area: in 1990/1, the average was 1.6% for males and 1.2% for females.

Adult Literacy Adult literacy rates are variously defined and measured. Very few surveys specifically designed to assess literacy have been conducted and often rates are estimated according to the number of years spent at primary school. The prevailing view, however, is that levels of literacy are relatively high. In those countries for which information is available the rate is officially estimated at between 82% in Antigua/Barbuda and St. Vincent/Grenadines and 98% in BVI and TCI, with marginal differences between men and women. In Suriname, the overall national rate is 86.2%, though it declines increasingly with age to 62.8% among those over 65 years of age (Suriname (MICS) 2000: 24).

This perception is not only reflected in the view that the conduct of literacy surveys is not a priority, but also in the limited provisions allocated to literacy projects and programmes by Caribbean governments. However, there is also a perception that reading, language and oral communication skills are declining and that Caribbean countries cannot afford to be Adult literacy complacent in this regard. In the absence of standardised measurements and literacy surveys, estimates however, the need tends to be met by NGOs and voluntary groups though in some countries relatively high such as St. Lucia, government has taken over responsibility. Media (print and electronic) involvement is also evident in the programmes to encourage reading and facilitate oral expression.

Inequalities in educational provision Significant differences exist between the secondary education offered at the three levels with teaching skills, facilities and equipment concentrated in the elite schools while those who Evidence of remain at the upper levels of all-age primary schools are accordingly deprived. inequalities in secondary Rural/urban distinctions education There is a heavy concentration of educational facilities at all levels, from pre-school to tertiary, in the urban centres of Programme countries. In Dominica, it has been noted that pre-schools are not within easy reach of all of the population and it is the poorer families that suffer … in rural/ disproportionately in this regard (Andrew 1999:19). Similarly, although primary schools in urban urban areas are more overcrowded with higher pupil-teacher ratios, they produce the best CEE distinctions results. In 1998, 5 schools located in the Roseau District obtained 84.6% of the awards granted to CEE students (Andrew 1999:30). In Suriname, distinctions are clearly evident. A 1998 UNICEF study conducted in the interior, on the Upper Suriname River, concluded that 70% of 4-5 year olds were out of school along with 57% of 6-10 year olds and 61% of 11-14 year olds (CCA (Suriname) 1998:24). At tertiary levels, virtually all opportunities for academic and vocational training are located in the capital cities and the immediate environs.

43 Gender disparities A marked gender disparity in education, with girls outperforming boys at tertiary, secondary and even primary levels, has become clearly evident throughout the region and so-called “male under-achievement” constitutes a major preoccupation among governments, educationalists, parents and the general public. As information presented in this report has indicated, the disparity is clearly evident in enrolment statistics, examination performance, repeat rates and … in gender drop-outs at all levels of the educational system. It has also been noted in attitudes and disparities behaviours with boys having lower levels of self-esteem and motivation, less sense of purpose, poorer attention spans and study habits, and displaying more frequent episodes of disruptive behaviour at school. The nature of this disparity in the Caribbean goes against the trend in many other developing countries where the education of girls lags behind that of boys. The problem in Programme countries has received some attention in research, but the output of these studies has tended to be country specific, taking the form of statistical investigations of the nature and extent of the problem, rather than the causes.

Gender disparities are evident even at primary levels. Although overall enrolment levels are high and generally equal for boys and girls, girls perform better than boys in both maths and English, boys show higher attrition rates, there are consistently more girls than boys entered for the CEE and girls do better in this exam and gain more places in secondary schools (UNICEF 1998). In the absence of mechanisms to maintain a balanced sex ratio in secondary school selection, girls numerically dominate secondary school places at a ratio of 3:2. Enrolment at tertiary levels is even more unbalanced. Statistical information from nine selected colleges of the English-speaking Caribbean indicated that female enrolment significantly outstripped that of males except in technical institutions. In Trinidad and Tobago, a mechanism is in place to maintain a balanced gender ratio in secondary school placement. This approach, however, tends to work against disadvantage for some girls who may earn higher scores than boys on the exam.

At the University of the West Indies, female enrolment surpassed that of males in 1982/3 and has increased to approximately 64%. At the Barbados Campus the ratio of female to male enrolment among undergraduates is 2:1 (2,604 females and 1,334 males) (University of the West Indies 2001:4). Broken down by faculty gives the following proportions, indicating that only in Science and Technology do male students outnumber females: Male Female Social Sciences 386 948 Science and Technology 425 371 Humanities 157 511 Law 74 255

At the Trinidad campus, there is less disparity with 51.6% female students, and only in the Faculty of Engineering is male enrolment (79%) significantly higher than female. However, as indicated males are still ahead of females in terms of the proportions who have degrees.

Gender differentials in CXC performance have also been assessed. More females enter for CXC examinations at General level than males. In all Programme countries (except Suriname) the proportion of female entrants exceeded 60% with an average percentage at 61.8%. Females also out-performed males in the CXC examination in June 2000. For all Programme countries (excluding Suriname) the percentage of female entrants attaining the highest levels (Grades I and II) averaged 21.4% compared to 11.8% of male entrants, almost a 2:1 ratio. Males did perform a little better at Grade III level, where the averages were 12.5% of male entrants compared to 19.6% of females. A poor reflection on the quality of education being received is the small proportion of entrants for CXC examinations who enter for what would be considered the basic subjects of English and Mathematics. In June 2000, an average of

44 15.8% of the entrants entered for English while the average for Mathematics was 13.0%. While females far out-performed males in English, males held their own in Mathematics. An average of 10.5% of the male entrants in English received Grades I or II compared to 24.0% of the females, more than a 2:1 ratio. In Mathematics, the percentages receiving Grades I or II were generally lower in all territories, with an average of 9.8% for the male entrants compared to 9.5% for the females. The general conclusion reached from this and other more in-depth studies is that, while the gender disparity is evident and increasing, boys continue to do better in traditionally ‘male’ subjects.

The feminisation of education Educational systems in the region are becoming female domains, not only in terms of student enrolment and performance. PTAs are mainly female, both in terms of general membership and active supporters. Most noted, however, is the feminisation of the teaching profession, at all levels of the system. In Suriname all 517 teachers at pre-primary schools are female. In St. The feminisation Kitts/Nevis only 22.5% of primary school teachers are male. In Dominica, where it has been of teaching and noted that girls in primary school are outperforming boys in all subjects of the CEE, the education conclusion was reached that the feminisation of education has a detrimental effect on the male student. Noting the low proportion of male teachers (22% in primary and 32% in secondary schools in 1998/99) and the marginalisation of males in the school and wider society, it was recommended that the issue “should be addressed with due urgency” (Andrew 1999:15). Teaching at secondary school level is also becoming a female profession in TCI where 78% of all teachers in government secondary schools are women (End of Decade Assessment (TCI) ).

The preoccupation with ‘male under-achievement’ has led to some sensationalism in the press (and a call for a return to single-sex education at secondary level in those countries where co- education was introduced). There is an urgent need to investigate more precisely the nature of gender differentiation in education and to identify the sources and causes of the problem whether these lie in socialisation practices and gender sub-cultures in the wider social The rhetoric of environment of home and community or in the educational system, in for example, teacher- ‘male under- pupil interaction, disciplinary methods, teaching, curriculum and testing biases. achievement’ Physical Conditions in schools In several programme countries, economic recession and adjustment policies have led to reduced public spending on the maintenance and construction of school infrastructure and there is evidence of poor and deteriorating physical conditions especially in many primary schools of the region. Some, notably those in rural areas, continue to be without electricity and piped water. In Suriname, for example, it has been estimated that 60% of government Deteriorating primary schools are in need of repair and the Ministry of Education, unable to assume this school infra- responsibility in total, has been encouraging community participation and support (CCA structure (Suriname) 1998:23). Elsewhere in the region, in St. Kitts/Nevis for example, hurricane damage has diverted funding to school buildings, textbooks, materials and equipment that would otherwise have been spent on programmes to ensure the EFA targets.

In some countries, the physical plant is little changed since the Caribbean Development Bank reported the following for the OECS countries in 1990: “Because of overcrowding and deteriorating school facilities, generally in rural areas, the physical environment in many primary and government secondary schools is not conducive to effective teaching or learning, and capital investment requirements have increased. In most of these schools, individual classes are separated only by moveable partitions and the noise level is high. There is an acute shortage of school furniture in many schools and very little maintenance has been carried out on existing buildings (Caribbean Development Bank 1990). In the case of Trinidad and Tobago, the Ministry of Education has implemented a school maintenance grant funded mostly through a loan from an international funding agency.

Special education In most countries of the region, special needs education has always been and continues to be a

45 low priority. Provisions are often the responsibility of churches and NGOs with minor financial assistance from government and there is significant reliance on voluntary contributions. There is, however, evidence of increasing government involvement in some Programme countries. In Trinidad and Tobago, for example, where an estimated 27,000 The neglect of students with special needs attend school, all new schools have been equipped with ramps, special education special toilet facilities and access to specialist rooms. Diagnostic units have been established to assess special education needs and teachers have been trained in special needs methodologies (National Report (Trinidad and Tobago) 2000:20).

ASSESSMENT

Achievements: All governments and peoples of Programme countries acknowledge the critical importance of education for children’s development and, as the following achievements indicate, have accordingly concentrated resources in the expansion and improvement of schooling for all:

 the laws stipulate compulsory education for all children aged 5 to 15/16 except in St. Vincent  governments are committed to and have invested in Early Childhood Education, Care and Development (ECECD)  near universal primary education has been achieved throughout the region for some time now and this is reflected throughout the generations, in high adult literacy rates and also in primary enrolment rates of over 90%  school construction, at least at primary level, has generally been planned to ensure access for all children of the relevant age group based in the more isolated rural areas  the quality of public primary education in some countries is at least equal to that of private schools

 the provision of universal secondary education has been achieved in several Programme countries while others are moving successfully in this direction by phasing out all-age primary schooling  equal educational opportunity has also been facilitated by the non-payment of tuition fees at primary schools and increasingly at secondary levels.  there is evidence of growth in tertiary education, both academic and vocational  the diversification of syllabuses at secondary level in particular is evident in the addition of vocational and technical education, computer studies and Health and Family Life Education (HFLE)  teacher training has been provided locally and the proportion of trained teachers in public schools is relatively good  relatively low pupil-teacher ratios have been maintained especially at secondary levels  subsidies have been provided either generally or specifically for poorer families for books, uniforms, school meals, and transportation  parental attitudes towards the education of their children, both boys and girls, are positive.

Problems:  levels of enrolment appear to be declining, even at primary levels, and although much of this may be accounted for by migration and declining fertility, there is also evidence of an increasing number of out-of-school children, especially boys  non-enrolment as a result of the inability of parents to pay the additional costs  problems of access evident in isolated rural areas especially in the larger and more mountainous Programme countries  disturbing levels of exam failure, along with repetition and drop-out rates, especially among boys  relatively low budgetary allocations to pre-primary and tertiary education, and evidence of

46 proportional reductions to primary schools education as governments give priority to secondary education  deteriorating infrastructure in some schools  inability to attract and retain teachers especially males, ‘ghost’ teaching and low status and morale in the teaching profession  unsafe school environments -- disciplinary problems, disruptive student behaviour and occasional outbursts of violence  continuing emphasis on corporal punishment and ambiguity concerning alternative methods of discipline  limited parental involvement in schooling especially among fathers, and inactive PTAs.

47 PROTECTION: CHILDREN ‘AT RISK’ AND IN NEED OF SPECIAL PROTECTION

Child Labour Rough estimates Statistical information on child labour is virtually non-existent, though there has been some of working attempt to provide an indirect assessment of the proportion of children that might be working children by examining school truancy rates. On this basis, a rough estimate suggests that in the Caribbean region, between 10% and 25% of children over the age of 12 are economically active (UNICEF(CAO) nd.:23).

Problems in the measurement of child labour relate to the informal and often invisible nature The work that of the work in which children engage. Boys, for example, work alongside their parents on children do family farms or operate as street vendors or car windscreen wipers, while girls take care of younger siblings while parents are at work, or undertake domestic chores either at home or in the households of others. The intention of the CRC mandate on child labour is not to totally prevent children from working, but to ensure that the work they do does not exploit and endanger them or keep them from attending school. However, the truancy rate estimate of the problem quoted above is a reflection of child labour which interferes with schooling. In addition, the labour in which they are involved may endanger their health and lives. As agricultural workers children may be exposed to dangerous machinery and chemicals, on the street they are exposed to traffic hazards and fumes, and in domestic work to mistreatment and occasionally to sexual abuse.

Suriname: Child Labour

“ Many children of poor families are engaged in street work as newspaper vendors, attendants of parked cars in the city (mostly street children) and as vendors of snacks and fruits. A number of children, mostly between 12 and 14 also work in market places, supermarkets and other enterprises. …There have also been increasing numbers of street children that offer their services in the streets of Paramaribo…boys are more engaged in child labour in the street and in enterprises than girls. Girls are more often in the company of their mothers. There have been several registered cases in which girls were forced into the sex business, particularly by mothers who have the same profession. Some women were literally forced into sex business by family members, abusive or addicted partners or by others… In some particular cases, sex work of daughters was viewed as a normal affair… which … focuses light on women’s sexual subordination which has for decades been the cause of the degradation and sexual abuse of women and girls. There are, however, many disguised forms of child prostitution. Studies indicate that young girls also prostitute to earn money. A 1998 study conducted in the gold mining areas of Suriname revealed that for 75% of adult Surinamese/Guyanese sex workers poverty had been the main reason to engage in sex work and that 70% of the teenagers engaged in sex work for the purchase of luxurious goods such as brand-name sneakers and designer jeans or because they loved gold” (Mid-Term Review Preparatory Meeting (Report for Suriname) 2000:9-10). St. Lucia: Child ‘Waste Pickers’

“A small number of children, as well as adults, living near Solid Waste Disposal sites in Ciceron and Vieux Fort regularly engage in waste picking, sorting through garbage for glass bottles and other materials that they can sell, and for discarded food. The largest number of waste pickers turn out on Wednesdays when cruise ship garbage is dumped. Generally, the children engaged in waste picking are not registered in school. There are numerous hazards associated with this type of activity including disease from contact with the garbage and from eating contaminated food salvaged from it, and injury from shifting objects in waste piles. The risk of injury is exacerbated by the fact that in order to get to the freshest refuse, many waste pickers will begin shifting though the garbage even as it is being dumped. The St. Lucia Solid Waste Management Authority (S.L.S.W.M.A.) initiated a study of this problem, working closely with community health48 authorities in the communities where most of the waste pickers live. S.L.S.W.M.A. has proposed measures to improve the situation, though the problem has not yet been eliminated” (Wells 2000:15). Street Children Rough estimates Children living on the streets in the Caribbean are also neglected in research and data of street children collection, though they are clearly visible in increasing numbers in some of the Programme countries and have attracted media attention. Some tentative estimates have been made. For example, numbers of homeless youths in Port-of-Spain, Trinidad have been estimated at approximately 300 of which an estimated one third are under 18 years of age. Most are male, not because young girls do not become homeless, but because they tend subsequently to become involved in sexual relationships with men who provide them with shelter.

The scattered and sparse information that is available indicates that children are pushed out of Reasons for child their homes by domestic violence, parental substance abuse, and other problems exacerbated homelessness by poverty. These children may also be left abandoned by the migration or death of a parent or other care-giver. Others were rejected because of their homosexuality, a physical or mental disability or previous involvement in criminal activity (Sharpe and Bishop 1993:50-53). There are also children who do not live on the street, but who spend time there because “parents come home late, housing conditions are very poor, or because nobody bothers where they spend their time” (UNICEF Mid-Term Review Preparatory Meeting (Report for Suriname) 2000:9).

An investigation of lifestyles of boys in Trinidad who had lived on the street but who Lifestyles on the subsequently found a home at Marion House, a facility catering for young men in the 15-25 street age group, revealed the following: “On the streets they usually identify somewhere to sleep - an abandoned house, under the eaves, under old wooden buildings, abandoned motor-cars. They would ‘hustle’ for money for food - a combination of begging, petty theft and sometimes work… brief tasks like washing cars or ‘hustling maxis’ in Independence Square (‘Hustling maxis’ means corralling passengers and herding them towards a particular taxi for a pittance from the driver)” (Sharpe and Bishop 1993:51).

Many had tried cigarettes, marijuana or alcohol and most had been victims of physical abuse and all were at risk of sexual abuse or had already been abused on the streets. They were often picked up by the police and occasionally beaten before being returned to the streets. Most were reluctant to talk of their experiences on the street and felt ashamed of what they had done to survive. (Sharpe and Bishop 1993:51).

Children of migrant parents The quality of life The long tradition of migration from the Caribbean has left many children behind, without of ‘barrel their parents, to be raised by other family members. Anecdotal evidence suggests that at best children’ they are often left with an aging grandmother, too old to cope with an active child or a

49 teenager going through the problems of puberty. At worst, they become victims in abusive home situations. They spend their days waiting for that all important call to go and join their parents abroad or for the clothing and toys that arrive in barrels - hence the epithet ‘barrel children’. A clear link has been made between deteriorating macro-economic conditions, declining employment, migration the numbers of children left behind and their poor educational and life prospects. In Trinidad and Tobago, for example, “macro-economic conditions created by impositions such as structural adjustment do seem to take a severe toll on primary school enrolment…The data paint a picture of synchrony between GDP, unemployment rates, parent migration and primary school enrolment rates… as unemployment increased in the society, so did migration rates. As migration rates increased, given a short lag time of approximately one year, school enrolment fell. The wider society tells of the increases in grandparent-headed families and ‘barrel’ children” (Jules and Panneflek 2000).

Child Abuse and Neglect Under-reporting There is little in the way of reliable information and statistics on the incidence and trends in of child abuse child abuse and neglect for the Caribbean region, though some individual Programme countries keep a register of cases. The absence of laws to enforce mandatory reporting is one reason. Lack of legislative and official national management protocols contribute to the mismanagement of child abuse and its prevention. It appears, however, that there is an increase in reporting due, in turn, to increased awareness, a growing recognition of child abuse as a social problem and the knowledge in some countries that those who report incidents can do so anonymously. However, most countries still depend on voluntary action on the part of relatives and neighbours, along with teachers and those in the medical profession. Child abuse is a source of shame to immediate family members and the tendency is to cover up rather than report. The child victim will also tend to hide the problem fearing the power of the perpetrator and the consequences of reporting. What information there is available suggests an increase in child abuse, though this may, at least in part, reflect the change in social response to the problem as indicated above. Whatever the case, the high rates of abuse reported in the figures are unacceptable.

In St. Lucia, the Crisis Centre recorded 46 cases of child abuse in 2000 down from 52 and 60 Patterns of child in 1999 and 1998 respectively. However, the majority of these cases abuse related to lack of abuse maintenance. In 2000, there was, however, an increase in the incidence of physical abuse to 13 compared with 6 and 5 in the previous two years and instances of child neglect rose to 5 in 2000 from 1 and 2 in the previous two years (St. Lucia Crisis Centre 2001). In Barbados, the Child Care Department in Barbados also keeps relatively thorough records of child abuse and neglect (Table V), which might reflect the nature of the problem in other Programme countries, at least in part. The Barbados data indicate some changes in the pattern of child abuse and neglect over time. Cases of abandonment which, in the past, were often due to the migration of parents who neglected to make provisions for the children they left behind, have declined to virtual insignificance. On the other hand, cases of neglect have increased and continue to be the most prevalent problem. Officials at the Barbados Child Care Department report that many parents do not perceive that leaving their children alone at home for extended periods of time constitutes neglect. In 1993, Barbados added the category of Emotional Abuse, extending the definition of child abuse to include cases in which children are victims of threats, cursing, broken promises and constant belittling. However, there is likely to be significant under-reporting in this category since this behaviour is not generally defined as abuse in local culture and public consciousness.

Table V: Child Abuse in Barbados, 1981-1999

Year Physical abuse Sexual Abuse Neglect Emotional Abuse Abandonment Total 1981/2-4/5 0,440 146 0,945 - 109 1,701 1985/6-9/0 1,076 604 1,873 - 148 3,701

50 1990/1-4/5 1,315 694 2,487 34 031 4,561 1995-6 0,251 142 0,447 60 008 0,910 1996-7 0,218 181 0,473 78 001 0,951 1997-8 0,278 185 0,606 63 000 1,132 1998-9 0,224 212 0,350 34 004 0,824 1999 (Jan-Feb) 0,050 036 0,083 07 001 0,177

Source: Child Care Board, Barbados.

A similar pattern was reported from the BVI where “[C]hildren for the most part, suffer in silence as speaking out may lead to them being labeled ‘rude’ and ‘disrespectful’, and ‘out of place’, and may precipitate an escalation in the severity of the abuse being perpetrated against them. Amazingly, a parent heard threatening to ‘knock down’, ‘knock out’, or ‘knock a child into next week’ is often greeted with acceptance or mild amusement, but the notion that a child should ‘call the police on their parents’ to report such abuse is strongly disapproved of, even among law enforcement officers” (Smith-James 2001:64).

Physical Abuse is endemic in the Caribbean. Traditional disciplinary methods for children in Physical the home, at school and in other social institutions, have depended heavily on physical punishment is punishment, sanctioned by biblical quotes to the effect that to ‘spare the rod’ is to ‘spoil the culturally child’, and by convictions on the part of parents that the punishments they received as children condoned did them no harm. Furthermore, the prevailing perception that this generation of children and adolescents, especially boys and young men, is becoming increasingly disruptive and delinquent at school, in the home and on the street has reinforced the opinion in the minds of parents, teachers and other authority figures that strict corporal punishment is needed.

Parent education programmes have been established in some Programme countries, mainly by Parenting NGOs operating at community level. For example, Parent Education for Development in education Barbados (PAREDOS) and SERVOL in Trinidad and Tobago teach parents about alternative methods of socialisation and discipline. Elsewhere there have been programmes to improve the care of abused children, for example in Suriname where the Home for Abused Children was opened in 1994.

Of grave concern is the prevalence and apparent continuous increase in the number of cases of Changing nature Sexual Abuse. Traditionally the incidence of sexual abuse has been attributed to the new co- of sexual abuse residential or visiting partners of the mothers of adolescent girls. The pattern of conjugal instability, separation and serial partnering in the region means that women often have children with more than one man and that their present partners may not be the fathers of their teenage daughters who live at home. Public opinion also concludes that because these mothers rely heavily on the financial support provided by their new male partners, they turn a blind eye to the sexual abuse of their teenage daughters.

But the statistical breakdown of child sexual abuse cases in Barbados refutes this stereotype, though not fully. The figures for 1994/5 and 1995/6 indicate that, of a total of 248 reported cases in which virtually all of the victims were female (93.5%), a relatively low proportion (16.5%) were perpetrated by a “stepfather” or “mother’s boyfriend”. In the majority of cases the abusers were other men, not part of the family. Officials of the Child Care Department in Barbados report a disturbing patternSt. Lucia: in the Child form Prostitutionof the abuse of school girls, under the age of consent (16 years) who are said to be voluntarily entering and often actively seeking relationships “ There is no with data older collected men on (‘minibusmen’ the incidence in of particular)prostitution who in St. they Lucia, identify but credible as their “boyfriends”anecdotal evidence and who suggests provide that them there with has money been an and increase material over goods. the past The decade, disturbing especially trend of sexualin child abuse prostitution, of young involving girls by botholder boys men, and often girls. not Some exposed individuals until pregnancy working results,close to has those also beenpopulations reported indicate from the that BVI the and problem Trinidad centres and Tobago around (Smith-James children engaged 2001:38, in CCA ‘free-lance’ (Trinidad andprostitution, Tobago) often1998:24). targeting Little bus is known drivers, of a these group liaisons generally other perceived than rumour to haveand anecdotal money. evidenceOthers, however, but this patternpoint to reiterates an increasing the earlier number mentioned of brothels information being established, on adolescent and sexuality say that in otheryoung Programme girls are recruited countries. as ‘models’ and then end up in strip-tease bars, or engaging in sex-tourism. Probation officers working with juvenile delinquents report that virtually all of the girls as well as a small number of the boys on their caseloads say that they have sex in exchange for money, food, clothing51 or shelter. The situation is exacerbated by the fact that there is no residential facility for girls who are in trouble with the law or in need of care and protection, so many of them are on the streets” (Wells 2000:11). As indicated earlier, there is also evidence of the commercial sexual exploitation of children Commercial especially among those street children who have left home, very often to escape physical and sexual sexual abuse there. Life on the streets exposes them to prostitution by both local residents and exploitation of tourists. Their plight has been highlighted with news from Trinidad and Tobago of their use in children the making of child pornographic films.

Domestic violence The wider The abuse of children is part of a wider problem of domestic violence which is also prevalent problem of in the Caribbean region. It exists mainly in the form of abuse which occurs within the home domestic violence environment, mainly perpetrated by men against women who are their partners or ex-partners. Small-scale studies provide the little information that exists and indicate that as many as 30% of women interviewed in, for example, Barbados and the BVI admit to having been physically abused. These studies also refer to violence against women as a culturally accepted means of resolving conflict and maintaining dominance and control (Clarke 1998, Jordan 1989, Haniff 1998).

Under-reporting is also prevalent in these cases of domestic and spousal violence. In Under-reporting Dominica, for example, a 1991 study revealed that only 13.9% of those who indicated that they had been victims of domestic violence reported incidents to the police (Clarke 1998). A study conducted in Suriname, showed that those women who did finally make official reports, had often been subject to abuse for many years (ProHealth 1994) Reasons for low reporting levels are varied and include the following:

 police insensitivity in dealing with victims  feelings of shame on the part of the victim and the notion that they were in some way responsible  persistent notion that men are entitled to control women by beating  economic and social dependence on men who are abusive  lack of protection for victims after reporting  absence of action taken against the perpetrator and low rates of conviction.

Despite low levels of reporting and the absence of research and systematic data collection, Domestic anecdotal evidence indicates that domestic violence is endemic in Caribbean culture. It has violence persisted over the generations and may be on the increase in response to the social mobility of privatised and women and the trend towards greater gender equality. In general, domestic violence continues trivialised to be treated as a private matter and is therefore trivialised by the police and legal systems of the region. There is evidence that the preservation of family cohesion takes precedence and cases of domestic violence are perceived as matters that require conciliation, rather than as

52 criminal offences requiring prosecution. However, there is also some evidence on the part of women in particular of a change in attitude towards spousal violence which has, in turn, led to increased reporting (Clarke 1998:6-7, 9).

CEDAW does not speak directly to violence against women. This deficiency was corrected in International 1989 when the Committee on the Elimination of All Forms of Discrimination against Women, conventions and to which all States Parties are obliged to submit reports, required that these reports should local policy include information on violence against women. In addition to indicating progress on the eradication of this form of violence, governments are also obliged to implement measures to ensure protection for women. The OAS General Assembly adopted the Inter-American Convention on the Prevention, Punishment, and Eradication of Violence in June 1994, and although not all Programme countries have signed individually, support of the Convention at least in principle by the majority can be assumed by virtue of the fact that all independent CARICOM countries are also members of the OAS (Clarke 1998:15). With this framework in place, the Women’s Desks and Bureaux in the region have been forging links with women’s rights groups and activists to eliminate all forms of violence against women and children.

Pregnant teenage girls Culture, A few small-scale surveys conducted recently in the Caribbean have addressed the cultural, psychology and socio-economic and psychological dimensions of teenage pregnancy and the quality of life of life chances the girls involved. Reference has been made to contradictions in prevailing cultural attitudes. There is, for instance, disapproval of adolescent and pre-marital sex but also the need for proof of fertility as a pre-condition for marriage (Russell-Brown 1987) and child-bearing is valued in general and particularlyTrinidad within Romanand Tobago: Catholic Pregnant and Hindu Teenage belief Girlssystems (Sharpe and Bishop 1993:8). Several studies also report a lack of knowledge among adolescents about contraception, A study conducted reproductive in Trinidad processes among and health 54 pregnant risks, while girls others attending provide ante-natal details clinics on the povertyrevealed and that: conflict which characterise the family backgrounds of the pregnant teenage girls and the rejection of daughters when the pregnancy becomes visible. Shame and a desire to hide the pregnancy from parents and other family members also deters the girls from seeking  only 22.2% had completed secondary education the necessary ante-natal care (Russell-Brown 1988, Sharpe and Bishop 1993). Many  48.8% were unemployed, and those that were employed were engaged in menial low- adolescent mothers will not have completed their education and official educational policy paying jobs may deny them the opportunity to do so. They therefore struggle to support themselves on a  they came from families who were not financially well off with 26.8% of household low income, are at risk of additional pregnancies and child-bearing and of being submerged in a persistentincomes cycle at less of thanintergenerational $600 per month poverty.  household sizes were large averaging 7 persons  the majority (70.4%) were not using contraception regularly  they lacked accurate information about their bodies and about contraception  75.9% did not think that they were at risk of HIV infection  43.9% felt that their feelings were not respected within the family  26.5% reported incidents of abuse within the family  21% lived in homes where quarreling was frequent  48.1% had themselves been abused or neglected  only 58.5% were living with their mothers although the majority (75%) maintained contact with them  their fathers were identified as the main parenting male in only 34.1% of cases  only 43% of mothers and 13% of fathers were seen as supportive during the pregnancy  66.7% of the babies’ fathers were seen as actively supportive in caring and planning for the birth  the majority of these fathers were not adolescents themselves: 80% were over 20 years of age

The study makes clear the correlation between teenage pregnancy a complex of other socio- economic and psychological factors. While not denying the variety and complexity in the life circumstances of the girls in the sample, the pattern that emerges links pregnancy with early school-leaving, unemployment and poverty; with a lack of knowledge of reproduction, contraception and health risks; and with family conflict and neglect. It would appear that these circumstances combine to encourage teenage girls to search for emotional support in early sexual activity often with older males. As one of the participants in the survey is quoted as saying “I thought he loved53 me…I only slept with him because of that, and as soon as he knew I was pregnant he left me… I want my baby, I need someone to love me.” (Sharpe and Bishop 1993:13-31). In some countries, programmes have been started, for example, the Programme for Adolescent Programmes and Mothers (PAM) in Grenada, the Golden Opportunity Programme in Antigua/Barbuda and a projects centre for teenage mothers in Suriname. Concern has, however, been expressed about the sustainability of such programmes and whether or not they have adopted rights-based perspectives. Also special attention is given to adolescent sexuality and reproductive health in the programmes of the various family planning associations in the region and in HFLE initiatives.

54 The poor quality Children of minority indigenousSuriname: groups Centre for Teenage Mothers of life, poverty The populations of Programme countries include indigenous groups, namely the Maroons and and social Amerindians “Because of inthe Suriname, negative consequences and the Carib of Indianspregnancy of Dominicafor girls, the and Youth St. Vincent/Grenadines.Department of the isolation of TheseMinistry peoples of Education are deprived started of ahealth teenage-mother and educational project provisions in 1989, and which opportunities, in 1992 resulted and suffer in indigenous marginalisationthe establishment because of the JOVROCEof ethnicity (Young and isolated Woman ruralCentral) residence. Foundation. More The specifically, Foundation the groups qualityaims at ofcreating life of indigenousconditions forchildren early ismothers characterised to finish by their the following: education and take proper care of their children. Reproductive health education and building self-esteem of teenage motherspoor is nutrition part of JOVROCE’s programme. Girls could also attend courses in making baby clothing.high fertility, In 1999, and infant the Foundation and maternal opened mortality a day care centre for teenage mothers. Accordinglack of toECE the coordinator of JOVROCE, most girls got pregnant during a relationship but amonghigh illiteracy the girls rates younger and poor than academic 15 years, performance many were sexuallyin reading abused. and writing, Programmes due in part and to actionslanguage aimed difficulties at prevention of teenage pregnancy should therefore include issues of sexual abusehigh of girlslevels (UNICEF of absenteeism Mid-Term from Review school duePreparatory to labour Meeting in agriculture (Report for Suriname 2000: 11). early initiation into sexual activity, commercial sexual abuse in mining communities and high risk of HIV/AIDS infection (Suriname)  high levels of domestic violence  extreme poverty and social isolation (Joseph 2000, Terborg 2000).

The situation in Suriname has been compounded by internal war which devastated the economy, undermined social development and forced many indigenous peoples to migrate to Paramaribo when they form an ‘internally displaced’ group (UNICEF 2000).

Children with disabilities The neglect of Children with disabilities also remain virtually invisible in the statistical record and on the children with agenda for development. In most Programme countries there is no coherent, coordinated disabilities system of collecting data to assess the number of chidren affected by disabilities, their nature and seriousness or the facilities and services available. What information there is, tends to be collected in a sporadic ad hoc manner and is of little value in an effective evaluation of the situation of disabled childrren. In addition, until recently disabled children have been considered as the responsibility of their parents and families who manage as best they can. Many, therefore, remain hidden in homes, marginalised from mainstream society and, as a result, their needs are overlooked.

A recent study of the situation of disabled children in the region (UNICEF 1999), has The nature of estimated the proportion of disadvantaged children at between 1.15% and 2.75%, with the child disability incidence somewhat higher in Dominica (6.25%) and St. Kitts/Nevis (3.95%). The most prevalent form of disability was learning difficulty followed by hearing and speech difficulties and then visual problems. Over 14% of those affected were under 5 years of age, and more boys than girls were identified as disabled. Trinidad: Children with Disabilities

The findings of a study of 406 children seen at a Child Guidance Clinic in Trinidad arrived at the following conclusions:

“It is anticipated that 10-15% of the population will be learning disabled and of these a significant number will develop conduct disorders if their special educational needs are not met. Children with conduct disorders frequently go on to delinquency and criminal behaviours in adulthood. Children with disabilities are at increased risk of being abused, particularly in situations where their basic educational needs are not met; they may either remain at home to be perceived as burdens by their parents, or may be inappropriately situated in school and thus constantly set up to fail, and end up with severely damaged self- esteem” (Sharpe and Bishop 1993:124).

55 The inadequacy Those services that are provided by the State are concentrated in certain urban areas and are of provisions and therefore unavailable to the majority of disabled children, especially those of the poor that lack services transportation. The UNICEF study estimated that only 20.4% of disabled children are receiving any form of special assistance (UNICEF 1999). The more severely affected who are not toilet trained inevitably remain at home. In addition, there are often long waiting lists and the staff are generally overloaded with cases, often comprising an increasing number of children with severe psychological and psychiatric problems in addition to those with mental retardation and learning difficulties for which many of these centres were originally set up (Sharpe and Bishop 1993:121). Some Governments in the Programme countries have made some provisions, for example, in 1975 in Trinidad the Child Guidance Clinic was set up in the Ministry of Health to provide psychiatric services to children and adolescents. There are also on-going policies to integrate the disabled into mainstream society, in relation to children, for example, by including them in the school system and providing appropriate teaching aids and support. In the BVI, 1978 government took full responsibility for the Eslyn Henley-Richiez Centre for Children with Special Needs which had been established by the Red Cross six years previously. Pioneering NGOs have filled the gap to some extent. The Trinidad and Tobago Association for Retarded Children administers two homes and four schools catering to children with special needs. However, the majority of children who receive remedial education are those whose parents can afford to pay for it. In general then, the services available are grossly inadequate in addressing the need for early detection, intervention and treatment and, as a result, the disabled remain at home, the responsibility of their parents, and socially excluded from mainstream society.

Dominica: Special Needs Education

The Alpha Centre (AC) “caters to 31 pupils with mental disabilities on a daily basis. There are four classes with four teachers, a US Peace Corps helper and one or two volunteers. The centre was established in 1974 by the Catholics. In 1996, the Centre moved to a new building funded by varied sources. The Centre is run by a private non-profit organisation, the Dominica Association for the Mentally Handicapped with some assistance from the Ministry of Education. The salaries are paid through the Association’s fund- raising efforts. The Ministry of Education has provided one trained teacher and a subvention of EC$1000 towards the salary of another teacher. The principal/coordinator has given up half her salary so that the centre can pay for much needed administrative support and she teaches part-time in another school to support herself. The Centre continues to struggle to survive. So far the AC and its outreach programme has been able to assist a total of 156 children in some form. However, 57 of these children … are of school age, capable of learning at school but do not have access. Many of them have a physical disability and would need to be transported, while others have been excluded from school because the already busy and overworked teachers are unable to manage their behaviour…” (Andrew 1999:36).

56 Institutional Children in Institutions provisions and Caribbean countries have a long history of State care for children who are for one reason or cultural practices anther left without a family. The policy has been one of institutionalisation in what were of child care referred to as orphanages but are now called Children’s Homes. Only gradually is there a change in formal policy approach to fostering and adoption, though there is a Caribbean cultural tradition of informal adoption (‘child-sharing’ or ‘child-shifting’) whereby young children are moved from parental homes to those of other relatives, maternal grandmothers and aunts in particular. Child rearing then was perceived as the shared responsibility of the extended family with neighbours and community members also playing a role in the socialisation of children. Informal adoption occurred for economic reasons, to spread the costs of raising children, but also for social reasons, for example, when a woman with no children of her own took in the child of a sister or other relative.

For several reasons, however, this cultural tradition has not provided for all children and those left homeless have been taken into care in Children’s Homes. Most of these Homes are in reasonable condition though there is evidence of overcrowding and understaffing. Children Conditions in attend neighbouring primary and secondary schools, and some skills training and recreational Children’s activities may be provided in the Home. There are, however, often staffing problems of Homes inadequate training, high levels of absenteeism and high turnover rates. There is also evidence of child malnutrition, poor health, and psychological disorders which are neglected. Of major concern is the future of the children as they reach 16 or 18, the age at which they are abruptly required to leave the Home. Little in the way of an alternative is provided for them though some half-way houses have been established. However, at the St. Mary’s Home in Trinidad “many discharged over-age boys present a menace to the Home as they live on an empty lot adjoining the back of the home, ‘over the wall’ of the institution and enter to steal and abuse residents” (Sharpe and Bishop 1993:92).

BVI:The Rainbow Children’s Home

“ In 1996 the Rainbow Children’s Home was established by the Social Development Department to meet the needs of children (up to age 14) requiring special provisions for care and protection. The Home is now operating at full capacity with 26 children (16 girls, 11 boys); some having been in residence since its inception four and a half years ago. Most placements result from severe physical abuse and neglect, sexual abuse, abandonment or ‘child dumping’ at the Home. The current practice of having children warehoused for years at a time with no exposure to a normal family environment is contributing to the re-victimisation of children in the most difficult circumstances. Some residents of the Home have been in residence since birth and have been denied the right to bond with one significant parental figure. They are instead raised by a series of ‘staff’ with little formal training or experience beyond having raised their own children and grandchildren. The special emotional/psychological and developmental needs of each resident is lost in the shuffle as the limited and over-taxed ‘House Parents’ concentrate their time and energy towards the completion of endless domestic chores. In 1999 the death of a baby boy resident in the Home occurred subsequent to a fall sustained on the premises. This case remains unresolved” (Smith-James 2001:66).

57 Juvenile offenders Variations in the The Programme countries vary as regards the age of criminal responsibility. Some, such as age of criminal Grenada, TCI and Trinidad and Tobago have retained the common law age of 7 or 8 years, responsibility while others have raised it. In Dominica and St. Lucia the age of criminal responsibility is 12. In between are St. Vincent/Grenadines (8 years), Suriname (10 years) and Barbados (11 years, but at the discretion of the judge) (Thompson-Ahye 2000:9). Generally, children of the Caribbean over the age of 14 years are assumed to have developed a reasoning capacity sufficient to know right from wrong and to be held criminally responsible for their actions (McDowell 2000:17-18).

The most common offences of which juveniles are accused are the more minor ones of theft, Juvenile offences vandalism and bad language and behavior. Occasionally, however, they are brought before the courts on charges of drug possession and trafficking and indecent assault. In Trinidad and Tobago between the years 1994-1999, 76% of the offences for which juveniles (aged 11-17 years) were charged were Robbery, Breakings or Larceny, while a further 19.8% were drug offences (Thompson-Ahye 2000:15). Of considerable concern is evidence of the use of children by adults in criminal activity. In Trinidad and Tobago, most of this occurs in drug trafficking, armed robbery, house breaking, larceny, shop-lifting, prostitution and the encouragement of children in begging on the street and, where the children concerned come before the courts, rarely is action taken against the adults involved (Thompson-Ahye 2000:16, Children in Focus 2000:5). Juvenile statistics in Trinidad also reveal problems of destitution and vagrancy (Sharpe and Bishop 1993:67). Also of concern in Suriname, is the high incidence of sexual offence including rape committed by male youths aged 14-17 years.

The involvement of youths, young men in particular, in criminal activity has been linked to a Correlates of number of background social environmental factors including: juvenile delinquency  the poor quality of parent/child relationships  mothers who began child-bearing in their teens  an home environment of neglect and abuse  poverty and overcrowding at home  previous experience with children homes  learning difficulties creating problems at school  an educational system which gives priority to exam success rather than life skills  high levels of youth unemployment  perceptions of inequality of opportunity  low sense of self-worth manifested in varying degrees of personality disorders (Sharpe and Bishop 1993:64-65).

Juvenile justice Caribbean legal systems have attempted to upgrade their juvenile justice systems, in particular and court by establishing family courts. These have been set up in St. Vincent/Grenadines and St. Lucia. procedures In Trinidad and Tobago there has been prolonged discussion on the establishment of a family court. The Family Court Bill is currently in the process of being drafted and the plan is to have the court fully operational in just over 2 years. In Grenada, the Family Court Act, 1994 was passed only to be repealed two years later. Even where family courts exist, they lack personnel trained in counseling and social work and the necessary social service infrastructure. Juveniles usually face trials in public and their right to a speedy trial is not generally honoured. In addition, the attempts to provide special treatment for children involved in criminal activity by implementing restrictions on persons allowed to attend court proceedings and the preservation of anonymity are often breached. However, lower levels of punishment are generally meted out to juveniles. The death sentence is not pronounced against persons under the age of 18 years in any of the SitAn states.

58 Incarceration In the absence of any consistent policy and provisions for rehabilitation, incarceration in and corporal prisons, in detention centres and in industrial schools continues to be preferred option, punishment especially for boys. The common mode of discipline is ‘flogging’. These practices of persist physical punishment are reinforced by public perceptions of rampant delinquency and crime among young persons, in turn, fueled by media sensationalism and court reporting. But these get-tough measures are out-dated and contravene the CRC mandate against the physical punishment of children and the recommendation that insitutionalisation should be a last resort and avoided in favour of counseling, probation, community service, educational and skills training programmes, and foster care. Children leave these penal institutions with low self- esteem, a social stigma and negative attitudes towards the police and legal system. After-care programmes are either non-existent or under-developed, re-integration into society is problematic and rates of recidivism are high.

Some evidence of There are however, some positive signs of initiatives to abolish corporal punishment, including rehabilitation a move towards community service and supervised probation as an alternative to custodial programmes sentencing with laws for this purpose enacted in Barbados, Dominica, St. Lucia and Trinidad and Tobago. Projects to assist juveniles have also been established, for example, the Juvenile Liaison Scheme set up by the police in Barbados and the work of the Community Police and Police Youth Clubs in Trinidad and Tobago. Some countries have also adopted a policy of training in conflict resolution in schools and the training of peer counsellors.

ASSESSMENT

Achievements:  The majority of the children of Programme countries are protected within functional and caring families, while those that are not are generally cared for in Children’s Homes or by social workers, counsellors and probation officers employed by the State in social services departments. In some countries, priests, teachers and the police also play an important role in the care and protection of children and young persons themselves, are acquiring peer group counselling skills.  A general body of legislation to protect women and children is in place and family courts exist in a few countries

 Official attitudes, administrative practices and recording procedures have also become more conscious of and effective in dealing with of the problems of domestic violence and child abuse.  There is also evidence of a cultural change in attitudes towards the acts of and the victims of violence and abuse, and members of the public are coming forward more readily to volunteer information on specific cases.

Problems:  Children who are out of school, working, and living on or spending time on the streets are exposed to danger, drugs and alcohol, physical abuse, and sexual exploitation  Young children are exposed to physical and emotional abuse and neglect within a culture that continues to condone or turn a blind eye to these practices  Children live in home and community environments increasingly characterised by conflict and violence  Children in Children’s Homes and those whose parents have migrated or died suffer emotional, social and material deprivations. Generally no alternative residential arrangements are made for adolescents when they reach the age at which they have to leave the Homes.  Children, teenage girls in particular, are sexually ‘at risk’. They are sexually abused at home; they actively seek liaisons with older men in return for ‘love’, money and material

59 goods; they become involved in prostitution; they are exposed to infections (STDs and HIV/AIDS); and they become pregnant and confront the realities of survival as adolescent mothers  Adolescent boys and young men are increasingly involved in sub-cultures of drug trafficking and abuse, organised crime and violence  Juvenile justice systems are not youth friendly and young offenders face corporal punishment, incarceration and long-term alienation from society  Social services are over-burdened and NGOs, churches and voluntary groups lack the capacity and resources to do more than implement small-scale projects and deal with a few cases  Family problems continue to be seen as private matters to be hidden and dealt with behind closed doors. Levels of reporting and action continue to be low because victims are ashamed, they fear reprisals from their abusers, they are treated with disrespect and disdain by officials and often no action is taken against the perpetrators.

60 PARTICIPATION: CHILDREN’S RIGHTS, THE LAW AND SOCIETY

Children and the Law Legal reforms The CRC has no automatic force in law within the jurisdictions of the countries that have and provisions ratified it and a general realisation of the inadequacy of legal provisions for national level for children follow up to and enforcement of the CRC recommendations has emerged in the Caribbean (UNICEF 2000:25). However, virtually all countries of the Caribbean had already implemented legal provisions relating to the welfare of children. In terms of birth registration levels of compliance are high. Even in Suriname where geographical size and isolation present problems, a high proportion (94.9%) of births are registered. The reform of family law has been particularly relevant. Some Programme countries also had legislation specifically relating to the status of children which predates the CRC of 1989:

Antigua/Barbuda Status of Children Act, 1986 Barbados Status of Children (Reform) Act, 1979 Grenada Children Born Out of Wedlock (Removal of Discrimination) Act, 1983 St. Kitts/Nevis Status of Children Act, 1983 St. Vincent/Grenadines Status of Children Act, 1980 Trinidad/Tobago Status of Children Act, 1981

During the decade following the CRC, a considerable number of Acts came into effect to protect the rights of children. Among Programme countries these included:

Antigua and Barbuda:  1994 amendment to the Civil Service Regulations for maternity leave for 13 weeks with full pay  1995 Sexual Offences Act raising the age of consent from 14 to 16 years.

Barbados:  1990 Barbados Protection of Children Act imposing limits re. sexual exploitation, and involvement in pornography and prostitution  1992 Sexual Offences Act fixes 14 years as the age below which a girl cannot legally consent to sexual intercourse  1992 Domestic Violence (Protection Orders) Act widens the definition of a child to include any child who resides in a household on a regular basis  1999 Juvenile Justice Act raises age of criminal responsibility from 7 to 11 years  Signatory in August 2000 to the Declaration and Agenda for Action on the Commercial Sexual Exploitation of Children

British Virgin Islands:  1995 Domestic Violence Act provides for State removal of children from affected homes

Dominica:  1998 Sexual Offences Act increasing the penalty for sexual abuse especially in relation to minors and for the rehabilitation of offenders

Grenada:  1991 Status of Children Act removing legal differences between children born in and out of wedlock in relation to inheritance  1993 Criminal Code amended to include protection against sexual abuse for boys  1994 Adoption Act amended to strengthen safeguards in adoption cases

 1998 Child Protection Act strengthens the powers of the court in cases where children are in need of protection

61 Montserrat:  1995 Family Act providing for a mixed panel of judicial officer, priest, teacher and probation officer to review cases involving juveniles

St. Lucia  1994 Domestic Violence Act providing for parental lodging of a complaint in matters affecting children  1995 revoking the Teaching Service regulation concerning pregnancy of unmarried female teachers  1997 Family Court Act providing special setting for family matters

St. Kitts and Nevis  1994 Probation and Child Welfare Board Act standardising age for employment and consent at 16 years, and providing for child’s privacy in court cases

St. Vincent and the Grenadines  1992 Family Court Act providing for special setting for family matters  1992 Employment of Women, Young Persons and Children Act restrictions on employment to protect women and children, prevents employment of children under 14 years of age  1995 Domestic Violence Act ensures that ‘the best interests of the child’ applies in making orders

Suriname:  1996 Status of the Children Act removing distinctions between children born in and out of wedlock in relation to inheritance

Trinidad and Tobago:  1997 Domestic Violence Act and recognition of family courts  2000 Children’s Authority Act establishes national authority to act as guardian of children  2000 Children’s Community Residences, Foster Homes and Nurseries Act makes provision for licensing and regulation these establishments  2000 Miscellaneous Provisions (Children) Act amends certain laws affecting children  2000 Children (Amendment) Act defining a child and young person as under 18 years of age and makes other provisions  2000 Adoption of Children Act regulates adoption procedures BVI : The Status of Children Born out of Wedlock

One blatant form of discrimination is the unequal treatment under the law of children born out of wedlock, who are categorised as ‘illegitimate’ and face legal barriers as a result. . . nearly two-thirds of children in the BVI are illegitimate …[T]hese laws therefore affect the majority of the territory’s children. The Human Rights Coordinating Committee concluded in their recent report that the sole areas of discrimination is in the area of inheritance. Also affected, however, are children’s citizenship rights, Belonger status, and the right to have a father on their birth certificate…. [T]he father of an illegitimate child would have to voluntarily sign for the child or later swear an affidavit that he is the father in order for paternity to be legally established. Citizenship problems may arise if the child is born to a BVIslander father, but her mother is a non-national. The most glaring inequality between legitimate and illegitimate children is, indeed, in the area of inheritance laws. According to the Legitimacy Act, a child born out of wedlock can inherit his mother’s assets only if he has no legitimate siblings. If one child is born to a couple prior to marriage and a second born after, for instance, the first child would not be able to inherit assets from her parents. Similarly, the intestate Estates Act stipulates that if a parent dies [without having made a will], the illegitimate child has no legal right to his or her estate. Amidst fears that repealing such discriminatory legislation would somehow sanction 62 immoral behaviour, innocent children are ‘scapegoated’ and made to suffer for the ‘sins of their parents’, behaviour over which they have no control” (Smith-James 2001:12). Abolishing The essential emphasis of many of the earlier reform Acts was to equate the rights of children illegitimacy whether born in or out of wedlock, in effect to eliminate the status of illegitimacy. Prior to the passage of these Acts, the majority of Caribbean children had no rights before or protection by the law. Although there was little stigma attached to illegitimacy in daily social life, these children also suffered discrimination in formal social institutions, education and religion in particular. The Status of the Children Acts facilitate conformity with the CRC which, in Article 2, specifies birth status as one of several criteria for the elimination of discrimination against children. For example, the Barbados Act at Section 3 states as follows:

“ the distinction at common law between the status of children born within or outside of marriage is abolished, and all children shall be of equal status; and a person is the child of his or her natural parents and his or her status as their child is independent of whether the child is born within or outside of marriage”.

And Section 6 of this Act provides that:

“This act applies to all children whether born before or after the commencement of this act and to all dispositions and instruments made after such commencement”.

In a region where approximately 70% of children are born out of wedlock, this legislation has far-reaching effects. However, not all Programme countries have, as yet, introduced legislation specifically concerning the status of children and abolishing illegitimacy.

Age at marriage Problems persist in relation to age at marriage, in Suriname for example. There the Civil Code stipulates that a male and female must be age 18 and 15 respectively to contract a marriage. The Asian Marriage Act of that country stipulates the legal marriage age for boys at 15 years and for girls at age 13. In May 2000 the Suriname Committee on the Implementation of the CRC reported that: “No measures have been taken or are envisioned to increase the legal minimum age for the marriage of girls (15 years) to the equivalent of boys (18 years). There are also no measures taken for amending the Asian Marriage Act to increase the legal minimum ages for marriage of both boys and girls. It is important to note that the prevalence of Asian marriage at very young age is rapidly reducing as a consequence of changes in society. However, this remains a sensitive area for formal intervention since it regards customs based on cultural-religious values. However, the Government recognises the need to

63 address this issue” (Suriname Committee on the Implementation of the CRC 2000:9)

More legal New legislation concerning the status of children has, however, not gone far enough and until reform required established family law is also overhauled in accordance with these new provisions, for CRC discriminations against the illegitimate child will continue, particularly in relation to compliance maintenance, succession, custody and contact with fathers (McDowell 2000). Moreover, law reform has been slow. In Trinidad and Tobago, it was mentioned that “effective implementation at the national level is delayed as a result of slow legislative drafting and updating as evidenced in conformity to the CRC with respect to protection from abuse and neglect, marriage, employment and corporal punishment”. The following areas were highlighted for attention: the administration of juvenile justice; the minimum age of employment and the minimum age of marriage; the absence of monitoring mechanisms particularly to register the violation of children; the use of corporal punishment in institutions and in the family; health issues affecting women; the high maternal mortality rate; the impact of HIV/AIDS on children; and the rate of early pregnancy (National Report (Trinidad and Tobago) 2000:5).

In general terms, despite widespread legal reforms in Programme countries, the established body of law dealing with children has not kept pace with social and economic changes or with the new global mandate on children’s rights. The following areas of non-compliance between existing legislation and the CRC have been identified:

 age of majority  responsibility of parents and guardians  preservation of identity  affiliation and birth status  inter-country adoptions  children with disabilities  social security  education  sexual abuse and exploitation  deprivation of liberty  administration of juvenile justice (UNICEF/CAO (Mid-Term Review) (Annex III) 2000:4).

However, the majority of Programme countries are engaged in a process of legal reform to comply with the principles of the CRC, and in this regard, have chosen to amend specific pieces of legislation rather than go the route of a single omnibus act which consolidates all legislation on the protection and rights of children.

Children/Family Law & Domestic Violence Legal and Judicial Reform (Organisation of Eastern Caribbean States)

The family law and domestic violence legal and judicial reform project has as its goal the reform of the justice system and legislation thereby assisting the promotion of a fair, efficient and effective delivery of justice by an independent and competent judiciary. One important result of this will be the elimination of discrimination against men, women and children in the Caribbean. For the most part the legislation in the OECS countries and Turks and Caicos is archaic and does not reflect the social and economic realities of the present day Caribbean. It is true that countries have amended various aspects of their legislation from time to time, but much more now needs to be done to bring it in line with the provisions of the Convention and to improve the conditions under which children and their families must live. The need therefore arises for the countries of the Caribbean to urgently undertake a programme of legal reform with the purpose of modernising, rationalising and consolidating the law affecting children, bringing it in line with the UN Conventions of which they are signatories. Furthermore, countries64 need to ensure that the black letter law can be effectively implemented through supportive and adequately resourced social services to the families it is designed to benefit. Re-imaging Children’s Rights and Participation children as The CRC advances the agenda for children’s development from welfare to rights, by subjects of rights advocating for children the right to express opinions and to be heard, the right to freedom of expression and access to information, and the right to freedom of association. In this respect, the CRC replaces the classical image of children as incapable, passive and dependent and elevates them to the status of social actors. From being silent objects of concern, the property of their parents, the beneficiaries of adult benevolence and in need of guidance and control, children have become re-imaged as active subjects with a critical voice in their own development. But very few societies and cultures have advanced to embrace this new image of children and childhood. From Suriname it has been reported that: “Our youth rarely gets the opportunity to participate in family decisions. They also have little or no say in politics and in the development of youth programmes. Even in youth organisations young people aren’t allowed to fully participate. So young people in Suriname are in many ways being held unemancipated. They are too little involved in working with and thinking about matters that concern them” (Suriname, Bureau for Educational Guidance and Training 2000:47). This sentiment could be echoed throughout the Programme countries

Resistance to Among the Programme countries as elsewhere, the concept of children’s rights remains alien children’s rights and there is evidence of resistance to the realisation of children’s participation. At best, adults, including parents, teachers, social workers and officials, cling to the image of childhood incapacity and dependency. At worst, there is a growing perception of childhood deviance and delinquency, especially among male youths, which provokes a response favouring increased controls and sanctions. Within this climate of opinion, the voices and active participation of children is interpreted as a threat to the rightful authority of adults. But whether children are sentimentalised as innocent minors or criminalised as deviants, the end result is to reinforce adult control and to deny them the right to participate in decisions which shape their own lives. The recent West Indian CommissionSuriname: National(1992:378) Institute concluded for Youththat “many Caribbean youth feel powerless in a world dominated by adults in which they are not listened to and over which they In Novemberhave no control. 1999, the They two-chamber feel alienated National from theInstitute normative for Youth patterns was whichofficially are established supposed to guideby the theirthen behaviourPresident ofand Suriname. on the basis The ofInstitute which comprisesthey are judged. a Youth They Council call (upfor toa greater18 years) say inand the a decision-makingCouncil for Young process Adults especially (19-31 Years) as it relateswhose membersto issues wereimpacting elected directly by their on peersthem”. Thefor a point 2-year is tenure.echoed by Carter in the concept of ‘extended subordinacy’ which emerged from his The study Youth of Council youth in is Barbados.the more active He identifieschamber, and“two in of the the first defining year of characteristicsits functioning, ofhad the generalits own socio-economicgovernment-financed condition TV ofprogramme youth – economic in which and the politicalyouth themselves powerlessness, chose lack and of controlpresented over issues their that economic reflected life the chances situation by ofvirtue children of their in Suriname.weak labour Representatives market position of and the a conditionYouth Council of extended further participatedsubordinacy inin national their social and regionalrelations youth within meetings, an adult-defined and helped world to (Carterformulate 1993:8) the draft. youth policy. In May 2001, the Youth Council helped to organise an information fair, which aimed at Whatproviding little youthevidence with there information is of children’s on possibilities participation for furthertends, therefore, study or employmentto be token inand confinedSuriname, to andthe following:held a survey during the fair to gain an insight what the general public symbolicthought of participation: the Youth Council’s when children tasks. takeMost part of thein activitiespeople commented organised thatby adults although by merely they knew of the Youth Council, more information was needed on what it actually did, and some recommendations were received to give more body to its function. The Youth Council is now in the process of self-evaluation. It65 needs to discuss how to give shape to its role – which should be independent from Government or civil service structures – and how administrative support and organisational capacity can be improved. symbolising the social participation of children in honourific or ceremonial acts decorative participation: which takes place when children are called upon to adorn events by publicly display their talents manipulated participation: during which children become the mouthpieces for adults and, as puppets, represent their ideas, attitudes and practices, while adults maintain control from behind (Hart 1992) (See Appendix II).

A small start to Small beginnings in the fuller participation of children are evident in for example, research children’s rights which has begun to hear and record the voices of children (UNICEF 2000) and in media realisation presentations that which highlight contemporary issues and concerns affecting children and youth. More formally, are the Youth Parliaments which have focused attention on healthy lifestyles, and on governance and democracy, and the Caribbean Youth Summit which discussed adolescent health rights.

ASSESSMENT

Achievements: There is an established body of family and employment law and recent legislative reforms have occurred to extend recognition and support for the rights of children and women.

Problems:  slow and incomplete legal reform to ensure full conformity with the CRC and CEDAW  children’s rights and participation in decision-making concerning their own lives continues to be an alien concept  children’s participation tends to be limited to token, ceremonial involvement

66 ANALYSIS

The analysis constitutes the central component of the SitAn. It examines the causes which lie The link between behind the priority problems identified during the assessment and the relationships between assessment, them. The analysis is intended to lead on to recommendations for strategic planning analysis and culminating ultimately in the formulation of the UNICEF/CAO Multi-Country Programme recommend- (MCP) of Cooperation for the period 2003-2007. The assessment component which has been ations included at the end of each section of this report has identified a comprehensive range of problems, all of which, it could be argued, require attention. However, the limited resources of UNICEF and Programme country governments and civil society make it imperative that these are prioritised for analysis and action. The criteria which inform this order of priority and the selection of the most critical problems for analysis and action include for example, the number of children affected by the problem, the impact on the poorest and most marginal groups, the severity of the problem, evidence of change such as a sharp deterioration, and overall impact of specified problems on the realisation of children’s development and rights. There are other problems, which according to these criteria, might fall within the priority list, but for which in-depth information necessary for analysis is not immediately available. These are earmarked for research, and subsequent assessment and analysis once the necessary information has been collected.

The analysis investigates the immediate and underlying causes of priority problems. From Format for the the viewpoint of UNICEF programming it provides the information on which programme analysis objectives are based and according to which strategies and priority interventions are identified during the process of design and formulation of the new programme of co-operation. At this stage, however, this report constitutes a draft document for preliminary discussion with all SitAn governments, NGOs/CBOs, civil society and where possible children themselves, so as to ensure that it reflects their concerns and priorities. This discussion process is considered to be a critical stage in the formulation of the SitAn and subsequent UNICEF programme.

This analysis brings forward priority problems from those identified during the assessment component of earlier sections of this report and asks Why? Though it is not the intention here to exaggerate the negative aspects of child development in the SitAn, the analysis component of the SitAn is, by definition, problem focused. In identifying the causes, a distinction is made between immediate and underlying causes and links are made between them. The analysis will pay particular attention to the following conditions and variables:

 the socio-economic context  the social institutional framework  the environment of home, family and community  changes during the life-cycle  distinctions of gender, socio-economic status and rural/urban residence.

The analysis is also guided by the emphasis of the CRC on provision, protection and participation. In other words, priority problems for analysis relate to those which clearly undermine or violate children’s rights in terms of provisions in basic health, education and welfare, protection from danger, abuse and violence, and participation in decisions affecting their lives. These, in turn, are linked to the human rights philosophy enshrined in the CRC and expressed in the four founding principles of non-discrimination, the best interests of the child, the right to life, survival and development, and respect for the views of the child.

Priority problems for analysis have been grouped into four major areas. Each tends to speak to a particular stage in the life cycle of the child and will therefore highlight variations in quality of life, problems and vulnerabilities as children grow from infancy to adolescence.

1. EARLY CHILDHOOD EDUCATION, CARE AND DEVELOPMENT (ECECD)

67 In all Programme countries, great strides have been made during recent decades to ensure the survival and development of infants and young children. Some countries, however, still have some catching up to do while in others there is evidence of some regression. At a macro-level, the underlying causes include internal war, political instability and poor governance; economic recession, especially as a result of the crisis in the banana industry, and poverty; rural isolation; and deteriorating environmental conditions. While governments have made significant investments in the health and nutrition of young children and women, their contribution to early childhood education has been very limited. More specifically, the increasing incidence of AIR, especially asthma, reflects a deterioration in environmental conditions.

Unemployment and family poverty have also contributed directly to problems in early childhood development. While health care for children is generally accessible and affordable or provided free of charge, this is not the case with either day care or pre-schooling which is generally in private hands. Rural families have particular problems in accessing these facilities. The HIV/AIDS epidemic also affects early childhood development both by direct pediatric infection and also by orphaning those children whose parents have succumbed to the disease.

More immediate causes of early childhood deprivation lie in family patterns and the link between these and poverty. Poverty can be seen as both the cause and consequence of family and household patterns which impact directly on children. These include female headed households, single parent families, and teenage motherhood. The neglect of children who are left unattended at home is evident in the proportion of ‘accidents’ among children admitted to hospital and is linked to patterns of female employment, the double burden of work and child care, and the unavailability of day care. Teenage pregnancy and childbearing also correlates with low attendance at ante-natal clinics and low birth weight, and possibly also neglect as adolescents may be unprepared for motherhood. In addition, parental migration, which is directly linked to unemployment and poverty, often causes children to suffer disproportionately as they may live in households where they are neglected or abused, or end up in the deprived conditions of Children’s Homes.

Matrifocal family structures, conjugal instability and escalating divorce rates often mean that children grow up from a young age with little or no contact with their fathers and substitute father-figures may not take on this responsibility. ‘Outside’ children suffer more in this respect and, although illegitimate children may live with and bond closely with their fathers, the law in some countries continues deprive them of their rights.

Patterns of parenting tend to reinforce adult control and to emphasise good manners, silence and academic achievement from an early age. Little emphasis is placed on play and creativity either in the home or in early childhood education centres. The emotional and physical abuse of children in the home and at school is a direct result of cultural patterns of discipline which continue to favour and accept as normal verbal sanctions and physical punishment. Domestic conflict and violence has made the home environments of children unsafe and there is a prevailing view from officialdom that the home and family are private domains. Intervention by the State therefore occurs only as a last resort. From the perspectives of health and nutrition, there is a emergent tendency also to rely on purchased fast food, for convenience and as a treat for children, with consequences of over-weight and obesity.

68 1. EARLY CHILDHOOD EDUCATION, CARE AND DEVELOPMENT (ECECD): PROBLEMS AND CAUSES

PROBLEMS IMMEDIATE CAUSES UNDERLYING CAUSES

- nutritional deficiencies and hunger - low ante-natal attendance by - macro-economic model that teenage mothers marginalises social development - low birth weight - shortened period of breast-feeding - economic recession, structural - obesity and overweight adjustment - dependence on fast-food - poor preparation for primary - unemployment education - low awareness of importance of ECE by parents and governments - poverty - parentless/fatherless children - non-appreciation of ‘play’ and - rural isolation - abuse and neglect confidence-building in ECD - deteriorating environmental - accidents in the home - inaccessability and unaffordability conditions of day care and pre-school facilities - children in Children’s Homes - internal war - female headed households, single parenting and teenage motherhood - political instability

- women’s double burden of work - low governmental expenditure on and child care and involvement in ECE

- conjugal instability and escalating - laws discriminating against divorce rates children born out of wedlock

- neglect of ‘outside’ and - privatisation of home and family illegitimate children and state non-interference

- absent/marginal fathers

- migration/mortality (AIDS) of parents

- poor parenting skills

- preference for verbal abuse and physical punishment

- domestic conflict and violence

69 2. ABUSE, EXPLOITATION AND VIOLENCE

Economic recession, unemployment and the consequent increasing impoverishment among families in rural communities and poor urban areas has impacted negatively on the quality of life of children. There is increasing evidence of children becoming victims of abuse, exploitation and violence. Poor families are unable to pay the costs of education and also depend on the income earned by their working children. Increasing numbers of children are falling through the cracks in the formal institutional system. Families, schools, churches, the legal system and social services fail to protect these children or to provide the necessary safety net when they fall on hard times. There is little evidence that children ‘at risk’ are rescued and rehabilitated within the system.

Success at school is the major determinant of a child’s future and the principle avenue for an escape from poverty. But the system is biased against the children of the poor. These young children enter the formal educational systems lacking the preparation provided by supportive home environments and pre-primary schooling. Despite governmental efforts to reduce elitism in the system, schools continue to be hierarchically ranked with inequalities in teaching and facilities, particularly between rural and urban schools. Educational success is defined as academic and is measured by exam results at CEE and CXC which only a minority of students ‘pass’. The others who are technically oriented or late developers are labeled ‘failures’ at school and at home from a very early age, and there is little opportunity provided for them to catch up. The feminisation of the school system and the poor performance of boys functions as a strong disincentive for them. The social environment in schools is deteriorating as boys in particular exhibit low levels of motivation and concentration with increasing numbers engaging in disruptive, violent behaviour. From as early as primary school age, boys in particular are dropping out of school. This constitutes a critical turning point in their lives, exposing them to the subculture of the street, exploitative labour, and physical and sexual abuse, and little chance of any future escape from deprivation and poverty.

Social institutions other than education, also fail to protect young children ‘at risk’ or to rescue them from abusive, exploitative situations. There is a lack of outreach, early intervention and follow up care as social services personnel are overburdened with case work, tend to operate from offices and to deal with cases that are referred to them. Social workers and NGOs, CBOs, Churches and other voluntary organisations lack the capacity to do more than deal with a small part of the problem. There seems also to be a lower level of informal community participation in child care and welfare than was the case in previous generations. The invisibility of many children who are ‘at risk’, whether in the home, at work or on the street reinforces their neglect and marginalisation in official social policy. Little is known of their lives or of what they have go through on a daily basis to survive.

The family constitutes the other critical social institution in the lives of children but more immediate causes of child abuse and exploitation are to be found there. Domestic violence against women and children is widespread. Intervention and reporting are limited by the prevailing notion that the family is a private domain and the unsympathetic and ineffective response from the legal and social welfare systems. Few societies provide alternative safe accommodation for victims. Parental pressures of unemployment and poverty may lead to drug abuse and alcoholism or stress and depression which have a profound effect on children. The vast majority of children on the street have run away from conflict, abuse and violence at home. If and when they are picked up the preferred solution is transfer to a Children’s Home rather than adoption and fostering.

An early exit from the educational system and dysfunctional family backgrounds also characterise the experiences of many young men who become juvenile offenders. Their

70 situation is exacerbated by exposure to a juvenile justice system which is not youth friendly and which emphasises imprisonment with hardened criminals. This generally results in further alienation from society rather than rehabilitation.

Indigenous children are among the most disadvantaged as rural isolation, social exclusion and ethnic discrimination add to their plight.

The life chances of children with disabilities depends primarily on the economic status of their parents. Those with money are able to pay for and enrol their children in special needs educational facilities. Poor disabled children, especially those living in rural areas where special needs education is lacking, tend to survive at home. As an extra burden on already over-burdened parents, they may become targets of abuse.

2. ABUSE, EXPLOITATION AND VIOLENCE

PROBLEMS IMMEDIATE CAUSES UNDERLYING CAUSES

- working children - lack of preparation at pre-primary and - macro-economic development primary levels model that marginalises social - street children development - educational emphasis on academically - sexual abuse successful children - poverty and unemployment

- physical abuse and violence - poor educational success rates and high - economic marginalisation and against children and women drop out rates, among boys social exclusion and ethnic discrimination against indigenous - neglect of indigenous - early stigma of ‘failure’ in education peoples children - lack of catch up and rehabilitation facilities - children at risk not on policy - neglect of disabled children agendas - parental stress and pressure - juvenile repeat offenders - educational inequality, poor - parental migration, alcoholism, drug abuse quality and inaccessible schooling in rural areas - parental non-involvement in children’s schooling -irrelevant and unattractive school curricula - poor parenting skills - feminisation of schooling - declining community involvement in child care and welfare - overloaded social services

- no social safety net for children ‘at risk’ - lack of capacity in NGOs, CBOs

- preference for institutionalisation in homes - privatisation of family life to adoption and fostering - increasing conflict and violence - incarceration of juvenile offenders in in children’s environment at home, preference to probation and rehabilitation school and community

71 3. ADOLESCENT REPRODUCTIVE HEALTH, SEXUALITY AND HIV/AIDS

The sexual problems of adolescence are manifesting themselves in the sexual abuse mainly of teenage girls, though boys are also among the victims, in the persistence of relatively high rates of teenage pregnancy and abortion, and in the spread of HIV/AIDS to the adolescent population, particularly girls. The underlying causes are to be found in the socio-cultural environment of contradictory attitudes concerning pregnancy and fertility. At the same time sex is dominantly featured in youth culture, in the media, television and films, and in the increasing focus on material goods such as brand-name gear. Sexual problems are also likely to correlate with high rates of unemployment among youth and ‘failure’ at school, with large proportions of school leavers entering the labour force with no certification or qualifications and high rates of youth unemployment. There is also evidence that youths leave school ill- prepared for the world of work and adulthood, despite the recent introduction of HFLE in the curriculum.

A home and family life characterised by emotional deprivation, non-communication, a lack of security, domestic violence and sexual abuse is also a contributory factor. There is evidence of an inter-generational cycle of teenage pregnancy correlating either with compulsory withdrawal from school and limited opportunities in the labour market, or with unsafe abortions.

More immediate causes relate to the lack of knowledge and unawareness among adolescents of the critical facts of contraception and reproductive health. In the absence of effective public educational campaigns, myths and ignorance, along with shame and covering up, are prevalent in relation to HIV/AIDS and other STDs. There is a general lack of concern among adolescents about the consequences of unprotected sex. In this respect, the systems of education, family and social services are failing them. Health services are also perceived by adolescents to be places where they are not respected and where confidentiality is not maintained. This, in turn, is likely to lead to careless, unprotected sexual practice with more than one partner. Reports of forced sex among from adolescents are also disturbing. Adults, men in particular, who dominate and sexually abuse young girls, especially in tourist and mining areas but also in the wider society, are responsible especially for the disturbing trends towards commercial sexual exploitation among adolescent girls. The mothers of these young girls are also believed to be leading them into prostitution.

72 3. ADOLESCENT REPRODUCTIVE HEALTH, SEXUALITY AND HIV/AIDS

PROBLEMS IMMEDIATE CAUSES UNDERLYING CAUSES

- HIV/AIDS spread to women and - early sexual initiation - high levels of unemployment youths (teenage girls in particular) among youth and school leavers - unprotected sex with multiple - teenage pregnancy and (unsafe) partners - high levels of ‘failure’ at school abortions - adolescent ignorance about - school system that does not prepare - sexual abuse and forced sex contraception, reproductive health youth for work and adulthood

- commercial sexual exploitation - adolescent lack of concern about - ineffective public HIV/AIDS consequences of unprotected sex campaigns, not targeting youth

- shame and ignorance about - ineffectiveness of HFLE and HIV/AIDS parental incapacity and reluctance to inform children about sexuality - sex for emotional and material and reproductive health benefit - youth avoidance of health care, - adult (male) abusers in perceived lack of respect and tourist/mining areas and in society confidentiality in by officials generally - non-legalisation of abortion

- emphasis on materialism and sexuality in youth culture

- advertising promotion of materialism and sex

- contradictory cultural attitudes regarding adolescent fertility and pregnancy

73 4. ADOLESCENT EMPOWERMENT AND PARTICIPATION

A child’s right to participate in decisions affecting his or her life is the most innovative and critical dimension of recent thinking on child development. Unfortunately, this concept remains alien to Caribbean culture. There is neither the awareness nor the inclination to implement strategies for participation. The omission constitutes a violation of the human rights of all children, but is particularly critical in the lives of adolescents.

The main obstacle lies in the cultural norms which have traditionally silenced and suppressed children. Youths report that within the family and school there is little guidance and direction, and that their voices and ideas are not heard. In recent years adult authority has been reaffirmed by the negative stereotyping of young people, ‘boys on the block’ in particular, as disruptive, deviant and dangerous. Media portrayals of juvenile offenders have reinforced this image. The trend therefore is towards adult control, sanctions and incarceration rather than youth empowerment and self-determination. Very few opportunities are provided for adolescents to express their opinions and to be heard, and then only for those who have been successful, who are fully integrated in society and whose opinions are safe. Even then there is a tendency for participation to be ceremonial and symbolic rather than integrated into social policy.

Poor school performance and disempowerment are likely to be instrumental in reinforcing a subaltern youth culture and peer group activity in which young men can express themselves and feel a sense of self-esteem and belonging. But these groups becoming increasingly penetrated by the global culture of organised crime, drug trafficking and abuse, and violence. The promise of get-rich-quick rewards along with high unemployment rates and disillusionment in relation to prospects for occupational success and mobility, further deters young people’s investment in education. The result is that young men in particular become marginalised and alienated from mainstream society.

4. ADOLESCENT EMPOWERMENT AND PARTICIPATION

PROBLEMS IMMEDIATE CAUSES UNDERLYING CAUSES

- lack of awareness of - few opportunities provided for youth - macro-economic development model human rights among participation that marginalises social development adolescents and children - perceived need for greater parental and adult - CRC and children’s rights not - non-participation of authority publicised youth in national and community development - lack of family guidance, communication and - basic rights of children alien to and respect resisted in Caribbean culture - involvement of youth in deviant and dangerous - devaluation of education and disillusionment - high unemployment and social sub-cultures over occupational prospects among youth marginalisation of youth

- youth lack of self- - culture which silences, supresses, - negative stereotyping of youth esteem and self- criminalises and incarcerates youth confidence - age dependency on young working - youth social and economic subcultures population emphasising get-rich-quick activities, drug abuse, organised crime, and violence - domestic conflict and violence

74 CONCLUSION

The United Nations Convention on the Rights of the Child (CRC) provides the guiding philosophy for this Situational Analysis and for the UNICEF agenda for child development. Attention has shifted from ‘needs’ to ‘rights’, from policies and programmes that emphasised goodwill and charity to a mandate based on the fundamental principles of justice, entitlement and empowerment. In addition to the traditional welfare perspectives which were based on the protection of children from harm and danger and the provision of basic needs in health, education and social services, the new agenda adds a third right, that of participation which gives children and youths the right to a voice in their own development. The level of participation envisioned in the CRC moves beyond the ceremonial and symbolic involvement of children to according them a full and continuous right to participate in all decisions affecting their lives. From this comprehensive perspective, therefore, the rights of children become an integral component of Human Rights.

This may be relatively clear and simple in principle, but the translation of child rights into practice has confronted much resistance and many sources of constraint, not least of which is the reaction of adults, whether as parents, teachers or others concerned with child welfare. At a time when children appear to be ‘getting out of hand’ and youths increasingly involved in deviant, violent sub-cultures, adults are even more reluctant to let go of authority and provide the space for the younger generation to exercise the right to participate and make decisions. The realisation of child rights, therefore, is premised on a fundamental philosophical change in the meaning of ‘the child’. Children must no longer be seen as ‘adults in waiting’, as incapable, dependent minors who are the property of their parents, but as autonomous citizens and social actors.

The Programme countries which fall within the mandate of the UNICEF Caribbean Area Office have a commendable record of achievements in the relation to child wellbeing. Basic indicators in health, educational and social services reveal that provisions have been maintained and, in general, continue to improve, despite macro- economic set backs and fluctuations. There has been a tendency in some countries to become complacent and to pay less than the required attention to social policies for community development, the enhancement of family life and the wellbeing of children and women. In the lives of children, in particular, there is evidence of old problems reappearing in terms, for example, of diseases thought to be under control and of children living and working on the streets; of the persistence of other problems such as early sexual initiation and teenage pregnancy; and of the emergence of new problems such as drug abuse, violence and scourge of HIV/AIDS among the youth.

Many of the critical problems for children and youths uncovered and highlighted in this Situational Analysis can be summarised under two headings: disparities and vulnerabilities.

Disparities: The slave plantation heritage of Caribbean countries gave rise to rigid social hierarchies and entrenched social inequalities on the basis of race, ethnicity, class and rural/urban residence. During the 1960s in particular, social structures changed with the achievement of increased political sovereignty, economic development and occupational diversification, greater equality of access to educational opportunity and social mobility. But the new era of globalisation and neo-liberalisation threatens to reverse social progress and development. Within the Caribbean there are signs that poverty and violence are re-emerging. Not all children have been protected from these global and national developments and in several Programme countries disparities are reappearing. Evidence of this is clear in the distinctions:

 between children who are sheltered in homes and those who are homeless and on the street  between children who are in school and those who have dropped out and engage in income-generating work as part of the child labour force  between children who are parented and supported by close-knit families and those who are without parental and family care and protection  between those who are well fed and those who are hungry  between those who live in safety and those who live with violence and danger.

Vulnerabilities: There is increasing evidence of children, albeit a minority of them, who are ‘at risk’. This Situational Analysis has exposed the following groups of children as those who live in especially difficult circumstances:

75  out-of-school children, working children and street children, mainly young boys who face danger, exploitation and abuse  adolescents and younger children who are exposed to sub-cultures of careless sex, drugs and violence  children who suffer physical and sexual abuse at home and elsewhere  sexually exploited and pregnant teenage girls  the children of minority indigenous groups who are socially isolated, stigmatised and experience a poor quality of life  disabled children who remain invisible and in need of resources and special programmes  children who are not parented, who are emotionally and economically deprived because their parents have died (increasingly as a result of the AIDs epidemic or violence), who have migrated or separated, who are imprisoned, or who through mental illness or drug and alcohol addiction do not fulfill their parental roles  institutionalised children and imprisoned youths who live in impoverished and degrading environments.

As this Situational Analysis reveals, these groups of children survive without the care and protection of the social institutions of primary importance in most children’s lives, namely the family, the school, the church and the State. They have, as it were, fallen through the cracks in the formal institutional system and live in poverty and danger. Caribbean countries provide little in the way of a safety net to pick them up and return them to mainstream society.

The mandate, therefore, for UNICEF, governments, NGOs and civil society and for all those involved in the realisation of child rights in the Caribbean can be summed up as follows:

 to ensure that all children and youths are empowered as citizens and subjects of rights to participate fully and consistently in their own development  to ensure that those children and youths who are vulnerable and ‘at risk’, who are the principle victims of poverty, violence and the disparities in the social system, are accorded the quality of life to which they have a right; to ensure that they have a future.

76 APPENDIX I: REPORTED AIDS CASES, 1984-1998

77 APPENDIX II

78 REFERENCES

Andrew, M. EFA 2000 Country Report: The Commonwealth of Dominica. Education Planning Unit, 1999.

Antigua and Barbuda Antigua and Barbuda National Report on Follow up to the World Summit for Children and Lima Accord. Ministry of Planning and Ministry of Education, Culture and Technology, nd.

Antonius-Smits, C., Malmberg-Guicherit, H., del Prado, R. Situational Analysis of Children and Women in Suriname, 1995. UNICEF, 1995.

Barrow, C. Caribbean Masculinity and Family: Revisiting ‘Marginality’ and ‘Reputation’. In C. Barrow (ed) Caribbean Portraits: Essays on Gender Ideologies and Identities. Jamaica, Ian Randle Publishers, 1998.

Barrow, C. Contesting the Rhetoric of ‘Black Family Breakdown’ from Barbados. Forthcoming.

Brown-Chen, C. The Employment Problem in CARICOM Countries. 1990-1991 Population and Housing Census of the Commonwealth Caribbean. CARICOM, nd.

Caribbean Development Bank Annual Report, 1999. Barbados, 2000.

Caribbean Development Bank “Education Finance in the OECS Region: Grenada, St. Kitts-Nevis, St. Lucia, Dominica and St. Vincent- Grenadines”. Barbados, 1990.

Caribbean Food and Nutrition Institute (CFNI/PAHO/WHO) Micronutrient Study Report - A Three Country Survey: Vitamin A,E, Beta-Carotene and Iron Status in the Caribbean. In collaboration with the Ministries of Health and Education of Antigua and Barbuda, Dominica and St. Vincent and the Grenadines. Sponsored by UNICEF. Jamaica, Kingston, 1997.

Camejo, A. Socio-Economic conditions of Children and Youth in CARICOM Countries. 1990-1991 Population and Housing Census of the Commonwealth Caribbean. CARICOM, nd.

Carter, R. Attitudes and Perceptions among Barbadian Youth. Institute of Social and Economic Research, University of the West Indies, Barbados, 1993.

Charles, L. Grenada Community Baseline Surveys: Final Report. Barbados, UNICEF/CAO, 1998.

Charles, L. Measuring the Impact. An Assessment of the Progress made in achieving the Objectives of Education for All, 1999.

Clarke, R. Violence Against Women in the Caribbean: State and Non-State Responses. UNIFEM/CIM, 1998.

Danns, G., Henry, I. and Lafleur, P.

79 Tomorrow’s Adults: A Situational Analysis of Youth in the Commonwealth Caribbean. London, Commonwealth Secretariat, Commonwealth Youth Programme, 1997.

Dominica Dominica Country Report: Report on the Achievement of the World Summit Goals for Children, 2000.

Ellis, H., M. Hoyos, F. Jones, M. Sounder and E. Walrond “A Knowledge, Attitude, Belief and Practice Survey in Relation to AIDS amongst Children ages 11-16 Years Old in Barbados”, Bulletin of Eastern Caribbean Affairs, 16 (4-5), 1-12.

Girvan, N. Poverty, Empowerment and Social Development in the Caribbean. UWI, Canoe Press, 1997.

Government of St. Vincent and the Grenadines Country Report on Achievement of the Goals of the World Summit for Children and the Santiago and Lima Accords. October 2000.

Hart, R. Children’s Participation: From Tokenism to Citizenship. Innocenti Essays, No. 4, UNICEF/ICDC, 1992.

Henry, R. “Poverty, Labour Market and Labour Policies in Selected Eastern Caribbean Countries: A Situational Overview and Recommendations”, UNDAF, 2000.

IDB/PAHO/WHO Caribbean Regional Health Study, 1996.

Implementation of Caribbean Plan of Action for Early Childhood Education, Care and Development. Conference 2000, Jamaica.

Jordan, M. Physical Violence Against Women in Barbados, 1977-1985. Bridgetown, Bureau of Women’s Affairs, nd.

Joseph, F. Contravention of the CRC and the Carib Indian Children” Paper presented to UNICEF/UWI Symposium. Barbados, March 2000.

Jules, V. and Panneflek, A. Education for All in the Caribbean: Assessment 2000. Subregional Synthesis Report. Vol. I: Summary, January 2000.

McDowell, Z. Elements of Child Law in the Commonwealth Caribbean. UWI, Canoe Press, 2000.

Newman-Williams, M. and Sabatini, F. Child-Centred Development and Social Progress in the Caribbean” in N. Girvan (ed) Poverty, Empowerment and Social Development in the Caribbean. UWI, Canoe Press, 1997.

PAHO/WHO A Portrait of Adolescent Health in the Caribbean, 2000. Minneapolis, University of Minnesota, WHO Collaborating Centre on Adolescent Health, 2000.

PAHO/WHO Health Situation in the Americas.Basic Indictors 2000. Special Programme for Health Analysis.

Pence, A.

80 Overview of the Situation of Children, Women and ECCD in Suriname. October 1999.

Proceedings of the Sixth Meeting of Coordinators of Maternal and Child Health Programmes in the Caribbean. (Grafton Beach Resort, Tobago, 18-20 October 1995).

ProHealth Violence Against Women in Suriname: A Study of Reported Cases. Paramaribo, Prohealth, 1994.

Prohealth The Nutritional Status of School Children in Suriname. Paramaribo, ProHealth, 1994.

Russell-Brown, P. Teenage Sexuality: Perceptions and Attidudes of the Youth of Tobago. Family Planning Association of Trinidad and Tobago.

Serow, W. Aging in the Commonwealth Caribbean. 1990-1991 Population and Housing Census of the Commonwealth Caribbean. CARICOM, nd.

Sharpe J. and Bishop J. Situation Analysis of Children in Especially Difficult Circumstances in Trinidad and Tobago. Barbados, UNICEF Regional Office of the Eastern Caribbean, 1993.

Smith-James, P. Situation Analysis of Children and their Families: British Virgin Islands, 2001.

St. Kitts and Nevis Education for All in the Caribbean: Assessment 2000. (Prepared by J. Matthew), September 2000.

St. Lucia Education for All (EFA) Assessment: St Lucia Report. Corporate Planning Unit, August 2000.

St. Lucia Crisis Centre Submission: St Lucia Crisis Centre, July 2001.

Suriname Report: Basic Life Skills Assessment. Bureau for Educational Guidance and Training , Basic Life Skills Committee, Suriname, 2000.

Suriname Common Country Assessment (CCA)

Suriname Implementation of the Convention on the Rights of the Child: List of Issues to be Taken up in Connection with the Consideration of the Initial Report of Suriname. Paramaribo, May 2000.

Suriname Multiple Indicator Cluster Survey (MICS) 2000. Government of Suriname and UNICEF, 2001.

Terborg, J. “The Impact of Recent Social Changes on Sexual Socialisation of Maroon Children in Suriname”. Paper presented to UNICEF/UWI Symposium, Barbados, March 2000.

Thomas C.Y. OECS Social Policy Document (Draft), nd.

81 Thompson-Ahye, H. “Juvenile Justice: An Oxymoron in the Caribbean?” Paper presented to UNICEF/UWI Symposium, Barbados, March 2000.

Trinidad and Tobago National Report on Follow-up to the Lima Accord Towards World Summit for Children. October 2000.

Trinidad and Tobago Common Country Assessment (CCA)

Turks and Caicos Islands End Decade Assessment Report: World Summit Goals for Children, nd.

Turks and Caicos Islands Situational Analysis of Children. UNICEF, 1996.

UNDP Eastern Caribbean Development Co-operation Report. UNDP Barbados and the OECS, 1998.

UNDP Human Development Report 2000. Oxford University Press, 2000.

UNICEF The State of the World’s Children. New York, UNICEF, 1989.

UNICEF The Rights of the Child in the Caribbean: Questions and Answers. UNICEF and CARICOM, nd.

UNICEF Voices of Children and Adolescents in Latin America and the Caribbean: Regional Survey. UNICEF, Regional Office for Latin America and the Caribbean, 2000.

UNICEF/CAO Mid-Term Review of the Multi-Country Programme of Cooperation 1998-2002. Barbados, 2000.

UNICEF/CAO Amazon Programme in Suriname: Progress Report No. 2. UNICEF/CAO 2000.

UNICEF/CAO CAO Annual Report, 2000. Barbados.

UWI Statistics 2000-2001. Barbados, University of the West Indies, 2001.

Wells, M. St. Lucia: End-Decade Assessment of Progress on the 1990 World Summit Goals for Children. St. Lucia, 2000.

West Indian Commission Time for Action: the Report of the West Indian Commission. 1992.

World Bank Caribbean Region: Access, Quality and Efficiency in Education. Washington, The World Bank, 1993.

82 Newspapers and other periodicals

Daily Nation, Barbados

The Barbados Advocate

Trinidad Express Newspapers (Sunday Express)

UNICEF, Children in Focus.

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