By Jeanna Pearson in Grenada
Guyana was placed under the microscope yesterday at the opening of the 60th Caribbean Public Health Agency Research Conference in Grenada, when several health researchers who presented on the prevalence of violence and injury in the Caribbean, ranked this country as one of the top distressed countries.
Researchers revealed data gathered from almost all of the 24 Caribbean Public Health Agency (CARPHA) member countries pertaining to violence and injury and offered recommendations to tackle these issues.
Besides being ranked as having the highest suicide rate in the world, Guyana was listed as one of the Caribbean countries with an above-average injury death rate per every 100,000 population and with a high ratio of adolescent alcohol consumption.
CARPHA representative, Dr Sara Crooks said that 10% of the world’s deaths are caused by injuries, and 90% are estimated to occur in lower-middle income countries. Crooks, who was making presentations on the CARPHA Injuries and Violence in the Caribbean project, stated that the objective of the project was to partially determine the magnitude of the burden of injuries in the Caribbean because they only focused on cause of death in the region.
She said that violence accounted for 26.1% of deaths in a vulnerable age group of 1-44 years. It is closely followed by traffic accidents, suicide and drowning. Guyana, she said, has a ratio of 100 deaths per 100,000 population as compared to the Cayman Islands which has 27.3 per 100,000 population.
She stated further that injury deaths per every 100,000 population among males exceed the regional average in countries with larger populations. Guyana was cited as one of the countries which exceeds the average injury-death rate, along with Jamaica and Trinidad and Tobago. She said in English and Dutch-speaking Caribbean countries’ deaths due to injuries in males far exceed deaths in females.
She said intentional injuries including violence and self-inflicted injuries are significant contributors to injury-related deaths for many countries in the region, with deaths resulting from self-inflicting injuries accounting for over 40% of injury-related deaths in Suriname and 25 % of injury-related deaths in Guyana.
Crooks gathered her data using the CARPHA regional mortality database for the period of 2007-2013. An analysis of regional causes of deaths by age and gender was completed along with a crude injury death rate for each country, by gender, followed by a descriptive analysis of the type of injuries contributing to death in each country. The information was taken from medical cause-of-death certificates.
Crook stated that an understanding of the current mortality profile of injury and violence in the region is critical for the development of effective and efficient interventions to address this problem.
Alcohol consumption
Priti Singh from the Pan American Health Organization (PAHO) in Guyana also shared data on alcohol consumption among youths, raising concerns from participants about what is causing Guyana to be high on the lists for almost all health issues.
She stated that on average Guyanese have consumed more than 8 L of pure alcohol in 2010 compared to the global figure of 6.2 L—indicating consumption to be 8.1L per person age 15 years or older.
“About 15.2% of male drinkers (10% of the population aged 15+) engaged in heavy episodic drinking, that is, consumed at least 60g of pure alcohol at least once per month,” she said, adding that the Global School-based Student Health Survey (GSHS), which was developed by WHO and CDC in collaboration with UNICEF, UNESCO and UNAIDS, was reviewed and there seemed to be a scarcity of statistics on the consumption of alcohol in youths and violent behaviour.
She stated that the PAHO in Guyana focused its research on early youths, aged 13 to 15 years, and a two-stage cluster sample design was used to produce data representative of all students in Forms 2, 3, 4, and “other” in Guyana. She stated that a total of 2,392 students participated in the Guyana GSHS and the prevalence for alcohol consumption in males in schools was rated at 44.10%, while females trailed behind with 34.30%.
Prevalence of males involved in fights was 51.30% and 25% for females; while 80.50% of male students had their first drink before the age of 14 and 77.10% of females.
“Young people who begin to drink in early teens are more likely to become dependent on alcohol within 10 years as compared to those who begin to drink in late teens and early 20s,” she said, adding that intentional injuries resulting from violence are another public health problem that account for high loss of life and disability among young people in the region with a great proportion from effects of drinking.
She noted that Guyana has, “No written policy adopted or revised pertaining to the fight against alcoholism, no legally binding regulations on alcohol advertising and product placement, as well as no legal regulations on alcohol sponsorship sales. A national legal minimum age limit for purchase of alcohol exists however it is not enforced.”
She stated that the organization was looking to strengthen data collection to reveal the true extent of the problem and strengthen support for outcome evaluation studies. She stated that it is focused on building capacity for violence prevention and developing comprehensive and data-driven national action plans while incorporating violence prevention into other health platforms.
Participants at the CARPHA conference questioned why in every analysis of Caribbean countries Guyana keeps popping up on the extreme end of the spectrum.
Weakness
Chief Medical Officer Shamdeo Persaud responded that even though there seems to be weakness in Guyana’s health care system, the issues raised were complex ones.
He stated that Guyana is developing a National Mental Health Strategy which will focus on the root causes of violence and suicide. He, nevertheless, accepted that Guyana was “consistently” one of the countries with a high distress rate for such issues. “Even if we have more data we will see the same trend…it’s consistent,” he said.
According to the WHO, Guyana had the highest estimated suicide rate for 2012 in the world, and Suriname has the sixth-highest. Data from the Americas revealed that suicide rates first peak among young people, remain at the same level for other age groups, and rise again among older men. Pesticide poisoning and hanging are the most common forms of suicide in Guyana, with most of the cases originating in Essequibo and Berbice.
Health Minister Dr George Norton had told Stabroek News that there is also a large number of suicide cases arising from the small Amerindian community, Baramita in Region One.
