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Tackling Crime From A Public Health Perspective – Symposium Planned For Trinidad & Tobago


by Michelle Nurse

Across the Region the screaming headlines make for sombre reading and reflection on the cheap value now placed on life; on the irrationality of the use of guns at the drop of a hat; at the ease with which guns have become more accessible to almost anyone with nefarious intentions.

Loss of life from gun violence is increasing in the region. Drugs and human trafficking are fuelling the upsurge in crime and violence.

Chair of CARICOM, the Hon. Philp Davis, Prime Minister of The Bahamas, addressed those matters pointedly as an area for priority action, when he addressed the opening of the Forty-Fourth Regular Meeting of the Conference of Heads of Government of CARICOM.

“We should seek to strengthen our collective response to end the smuggling of guns and drugs.
“And we must do all that we can to wipe out the misery of human trafficking,” he told his colleagues and other delegates.

Calling for a the Region to operate within a framework of “the interests of us all”, the Prime Minister warned “none of us will be safe until we are all safe. None of us will develop sustainably or securely, if we leave our neighbours behind. None of us will truly prosper if our resources are forever taxed by the poverty and instability of those nearby. Going it alone will not work.”

The crime and violence situation has galvanised regional security stakeholders to search for different approaches to confront the problem.

One such approach that is gaining traction is tackling the matter form a public health perspective. It is not the first time the link is being made between regional public health and crime and violence. Back in 2020, when Prime Minister of Barbados, the Hon. Mottley, was chairing the Conference of Heads of Government, she had announced that a multi-disciplinary summit on security was being convened.

She noted then that crime, violence and security were not issues that could “be believed to be simply the responsibility of governments”, particularly in the context of the Caribbean where they are “effectively public health disorders, public health diseases”.

At the conclusion of the 44th Heads of Government Meeting in The Bahamas, Prime Minister Davis announced that Trinidad and Tobago will host the high level multi-stakeholder meeting in April to address crime, particularly violent crime as a public health concern.

“The Heads of Government expressed deep concern at the current levels of violence being experienced in Member States. We recognise that to adequately address crime and violence, a holistic approach must be undertaken which addresses economic growth and prosperity, legislative judicial, police and education reform,” he said at the press conference at the conclusion of the Meeting.

In October last year, Institutions that participate in the CARICOM Security Cluster met in Trelawny, Jamaica, during a series of security-related meetings, including the 24th Meeting of the Council for National Security and Law Enforcement (CONSLE).

The CARICOM Security Cluster comprises the CARICOM Implementing Agency for Crime and Security (CARICOM-MPACS), the Caribbean Public Health Agency (CARPHA), Caribbean Disaster Emergency Management Agency (CDEMA) and the Regional Security System (RSS).

The October Security Cluster meeting focused on crime and violence as a public health issue preparatory to the 44th Regular Meeting of the Conference of Heads of Government of CARICOM on the matter.

After the CONLSE Meeting, CARICOM Today spoke with security and health experts including Dr. Joy St. John, Executive Director of the Caribbean Public Health Agency (CARPHA), and Lt. Col. Michael Jones, Head of the CARICOM Implementation Agency for Crime and Security (CARICOM IMPACS)

It makes a lot of sense

For Dr. St. John, the approach makes a lot of sense. She explained that the perspective considers what makes people behave in a way that allows crime and violence to thrive, because at the essence of health is behaviour. “So, the public health approach is therefore looking at how we can change that behaviour, so that when people are deciding on a way of life, they don’t decide on violence and crime”.

“From a purely public health perspective, it makes every bit of sense to link crime and violence with public health. In public health, we look at things that affect the health of the population and so the context, the national environment is going to affect the population. So, looking at crime and violence from a public health perspective is almost like a no-brainer. It’s the next step because we have been seeing since the COVID-19 lockdowns have stopped there’s been this resurgence in crime and there has been a lot of loss of life through shootings. We’ve seen that it has also affected the culture and the way in which especially young people are interacting with the whole of society, so it makes sense to have a public health perspective.”

“The other thing about the linkage between crime and violence and public health is that public health purists always approach health from the perspective of what are the determinants of health, and violence and health conditions, the traditional health conditions are also impacted by several things, so the causes of the causes for the health status of the region – poverty, access to social services, marginalisation in the society – all of those things affect people and how they live and how they take care of themselves and how they are able to access health services and those things also are also drivers of violence. So, it makes a lot of sense. It is not the usual connection, but it is not a new way of dealing with violence in the wider world.”

Acknowledging that the Caribbean “needs to do things differently”, she pointed out that the United Kingdom, and the Nordic countries have adopted the public health approach.

CARPHA sees its role in the approach through the lens of its membership in the security cluster of CARICOM, which was most recently fighting the COVID-19 health security threat as a unit.

“We’ve worked very closely with IMPACS, RSS, CDEMA and so now we’re looking at violence and crime… So I would be doing my work in the context of the Security Cluster… which is led by CARICOM IMPACS,” Dr. St. John said. She added that the activities that CARPHA will recommend will then be viewed by the Organs to which the Security Cluster reports such as CONSLE and the Council for Human and Social Development (COHSOD).

The message in music

Music has been suggested as one of the means through which the messaging against violence, particularly gun violence, is relayed. The suggestion is made even as the concern has been raised of music with lyrics and accompanying videos that glorify violence, guns and money, and which also objectify women.

While Dr. St. John agrees “it’s the message in the music,” she contends that the fact that music captures people’s imagination and directs people’s actions should be the point of focus. So, the music is the vehicle; the message for crime and violence can be replaced by other messages.

By way of example, she reflected on the use of ‘infotainment’ to work adolescents on sexual and reproductive health, HIV, and mental health.

She stressed that there is going to be a need for short- and long-term solutions to be found because public health approaches usually take a long time.

“We have had a change because of COVID. In the emergency of COVID, we saw the implementation of public health overmeasures, region-wide, within a very short time. This kind of response is not usual”.

She added that “we have to have resources for sustainability which means that we have to plug our interventions into our usual activities – at individual levels, at regional Americas, regional CARICOM, national and community levels. It also means that there has to be sustaining out of the box thinking for a long period of time which demands leadership and so in the upcoming conference with the Heads of Government on this matter it is going to be very important that the papers are taken, the decisions that are requested make it clear that there is a long-term commitment. In the same way that there was the Port-of-Spain Declaration in 2007 towards addressing non communicable diseases, which sets some frameworks which demanded long-term action, there will need to be papers that suggest this to the Heads, and suggested in a way that they like the idea and they commit in that way.”

Getting things done

“Because CARICOM functions very well for its members, it’s going to be important that the policy compact that comes out of the conference is then buttressed by some level of strategic planning with some level of monitoring and evaluation. In heath in CARICOM, there’s the Caribbean Cooperation on Health which is in its fourth iteration, and we have been using that as a way of ensuring regional development while there is national attainment of goals. And so, from the health perspective, we have a track record of getting things done over long periods of time and I am hoping that there will be similar vehicles, regional compacts, in other sectors, because a public health approach does not mean that health drives this: it means that there is a whole of society approach…”

She stressed the need to consider the issue as a developmental one and for a systemic approach to be undertaken as she is conscious of the challenge of resources, particularly in the context of the funding that was required to fight COVID-19.

Holistic approach

Lt. Col. Jones maintains that crime-fighting has to be tackled holistically, but sees the public health approach as another arrow in the quiver of responses that the Community can utilise to reduce crime in the Region.

Pointing to the range of impacts of crime and violence, he cites the impact the trafficking in cocaine, as an example.

“Yes, it has a street value of $20 000. But that brick of cocaine is equivalent to how many addicts that will develop as a consequence of (using the drug); how many visits it would mean going to hospitals; the loss in productivity hours? So …it’s not just $20 000 that its worth; it’s what can happen down the line. And I think once we start putting things like that into perspective, you’ll make a better argument at budget times as to the real worth that agencies such as ours contribute to the safety of the economy,” he said.

He pointed out that an approach “from cradle to grave” or a “mix of medicines” is essential as there is no “silver bullet” to confront the crime problem. There has to be a holistic approach, he stressed.


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  1. Finally people who get it….I have been shouting those interventions in post constero on this forum….now get on with it and implement these strategies.,.


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