1 REPORT ON
NATIONAL FOLLOW-UP
TO
The Regional Strategy to the Brasilia
Declarations
OF THE MADRID INTERNATIONAL
PLAN OF ACTION ON AGEING
(MIPAA)
MARTIN G WEEKES
SAINT LUCIA
JANUARY 2012
1 2 ACRONYMS
CBO
COMMUNITY BASED ORGANISATION
GOSL
GOVERNMENT OF ST LUCIA
MIPPA
MADRID INTERNATIONAL PLAN OF ACTION
MOH
MINISTRY OF HEALTH
MOST
MINISTRY OF SOCIAL TRANSFORMATION
NCPD
NATIONAL COUNCIL OF AND FOR PERSONS WITH
DISABILITIES
NGO
NON-GOVERNMENTAL ORGANISATION
NELU
NATIONAL ENRICHMENT LEARNING UNIT
NIC
NATIONAL INSURANCE CORPORATION
NCF
NATIONAL COMMUNITY FOUNDATION
SLBWA
SAINT LUCIA BLIND WELFARE ASSOCIATION
SSDF
SAINT LUCIA SOCIAL DEVELOPMENT FUND
2 3 TABLE OF CONTENTS
Background
5
Executive Summary
5
Situation analysis
7
Population dynamics
7
Social &Economic Indicators
12
Current Socio-economic & Political Situation
14
Methodology
14
Review &Assessment of Actions aimed at older persons in Saint Lucia
Overview
17
Action Prority One: Protection of Human Services
18
-National Policy for older persons
18
Access to Credit Opportunities
18
-Banking and financial institutions
18
Access to Decent Employment
18
-National Insurance Corporation & the Retirement Age
21
-Increased coverage of persons (contributory & non contributory)
21
Promoting the participation
21
- Club 60’s groups
21
- Mechanisms to take the view of older persons
22
- Division of Human Services
22
-National Enrichment Learning Unit
23
Action Priority Two- Health and Well Being in Old age
23
Universal Access to comprehensive Health Care
23
-Promotion of Healthy Lifestyle behavior
23
-Regulation of long term care services & environments
24
-Human Resources training in geriatrics and gerontology
25
3 4 -Monitoring the health of older people
25
Priority Area Three: Enabling the Supportive Environment
26
Accessibility of the physical environment
26
Sustainability and adequacy of social support system
26
Promoting a positive image in old age
28
Economic security
29
- Access to decent work
29
- Increase coverage of social security systems
30
-Care of older persons
31
-Equitable access to health services
32
-Monitoring of long term stay institutions
32
-Creation of palliative care economy
33
-Access to health care for older persons with HIV
33
Health
Environment
34
Promotion of continuing education
34
Recognition of contribution of older persons in care economy
35
Housing for older persons
35
CONCLUSIONS AND PRIORITIES FOR THE FUTURE
36
Legislative/Policy
36
Programmatic
37
Administrative
39
Institutional Development
42
Conclusion
43
References/Bibliography
4 5 1. BACKGROUND COUNTRY
SAINT LUCIA
Ministry of Health, Human Services and
Gender Relations
Martin Gregory WEEKES
Consultant
Morne Fortune
PO Box CP 5831,Conway Post Office
Castries
Saint Lucia
Telephone 1-758-452-6139;1-758-723-7169
e-mail
address:[email protected]
Institution Coordinating report
Person in Charge
Contact Information
2. EXECUTIVE SUMMARY 2.1
Saint Lucia is a part of the Windward Island chain located in the Eastern Caribbean. Its
neighboring islands include Saint Vincent and the Grenadines to the southwest, Barbados to the
southeast, and the French territory of Martinique to the north. The 238 square-mile island of
Saint Lucia is known for its volcanic peaks and lush tropical climate.
Saint Lucia is the most populous of the countries in the Organization of Eastern Caribbean
States (OECS), a political and economic body joining the small developing islands in the Eastern
Caribbean. Most of the population lives along the coast in the less mountainous regions of the
north and south. Saint Lucians are predominantly of African or mixed African-European descent
and largely Roman Catholic in faith. While English is the national language, French patois is
also commonly heard, a reflection of France’s early influence on the island.
5 6 Despite the many strides made in the socio-economic lives of Saint Lucians over the years since
it became an in dependent country in 1979 the island like most of its sister islands is faced with
many challenges to provide for its growing population particularly the young and the elderly.
At present Saint Lucia does not have an official national policy for older persons (Ageing) and as
a result poses a myriad of challenges to those organizations and individuals mandated or
interested in the development of these persons. One of the major ones is the lack of leadership to
guide that national agenda resulting in much duplication of effort, the inconsistency in standards
of care and by extension the inability to maximize use of scarce resources.
In the past five years Saint Lucia has been able to make some progress as it sought to implement
policies and programmes along with activities all geared as mandated by the Madrid Plan of
Action on Ageing( MIPPA) and reinforced by the Brasillia Declaration, to the improvement of
the quality of life of older persons. There is no doubt a high level of interest in the development
of programmes for the elderly however as mentioned a major hindrance is the lack of a
coordinated and structure approach.
Significant strides have been made in many areas one of which is the area of public sensitization
on the major issues surrounding an ageing population but much more needs to be done so in this
regard so it becomes each St. Lucian’s business.
There has been a great improvement in the quality of elderly care administered by both public
and private organizations and increased respect for the human rights of the elderly overall.
Of major priority going forward is the development of programmes that will focus energies and
resources on the provision of assistance in areas of health care, decent (work) employment,
improvement in physical environment and increased personal financial assistance where
appropriate for older persons.
At the end of this report a list of recommendations distinctly indicates the direction Saint Lucia
should go as outlined in the areas of legislative/policy; administrative, programmatic and
institutional(development) as these relate to ageing. However prudent attention must be paid to
6 7 the current economic situation that exists in whatever strategic planning efforts are made or
action plans implemented.
3. SITUATION ANALYSIS 3.1 Population Dynamics
Findings from the 2010 Housing and Population Census indicate a 5 percent growth in the Saint
Lucia population over the ten-year period between 2001- 2010, with an estimated area household
population of 166,526. Of that population 82, 926 are men and 83600 are women.
Overall the district of Castries which accounted for 40 percent of the estimated population of
Saint Lucia in 2010 saw virtually no change in its share of the total population from 2001.
However, in 2010, there were only 1,312 more persons living in the Castries District
than in 2001. This represents a 2% increase in population of Castries.
While nearly three-quarters of the population lives in rural areas, there has been a consistent
movement of people toward urban areas over the last twenty years. The population has also been
aging over time as the fertility rate has dropped. Out of this sum, there were 165,595 individuals
residing in private households, 931 persons living in institutions. It is estimated that 151 persons
are residents of Relief houses, Poor houses and Elderly homes.
Ageing There was an average population growth of .05% growth recorded over the period 20012010(see graph below) . At a glance the population of persons 65 years and over was recorded at 8.62 % a total of over 14627 persons and following closely is 5484 persons between the ages of 60‐64. St Lucia for the first time has fifty one (51) centenarians. 7 8 Transposed % Cumulative Frequency
(i.e % of Population that is On and Above
the Age Interval of Interest)
Transposed Cumulative Frequency
(i.e. # in Population who are On and Above the Age Interval of Interest)
SAINT LUCIA 2010
SAINT LUCIA 2010
105 and Over
100 to 104
95 to 99
90 to 94
85 to 89
80 to 84
75 to 79
70 to 74
65 to 69
60 to 64
55 to 59
50 to 54
45 to 49
40 to 44
35 to 39
30 to 34
25 to 29
20 to 24
15 to 19
10 to 14
5 to 9
0 to 4
0,01%
0,02%
0,13%
105 and Over
15
100 to 104
36
95 to 99
212
90 to 94
657
85 to 89
1.827
80 to 84
3.731
75 to 79
6.296
70 to 74
9.887
65 to 69
14.267
60 to 64
19.751
55 to 59
26.241
50 to 54
35.167
0,40%
1,10%
2,25%
3,80%
5,97%
8,62%
11,93%
15,85%
21,24%
27,86%
35,24%
42,65%
50,05%
58,08%
45 to 49
40 to 44
35 to 39
66,30%
75,92%
84,93%
92,87%
100,00%
Graphs are based on Saint Lucia’s 2010 Population Census 8 30 to 34
25 to 29
20 to 24
15 to 19
10 to 14
5 to 9
0 to 4
46.130
58.348
70.633
82.886
96.175
109.795
125.716
140.634
153.784
165.594
9 Frequency Distribution of Saint Lucia's Population By Age
105 and Over
15
100 to 104
21
95 to 99
176
90 to 94
445
85 to 89
1.170
80 to 84
1.904
75 to 79
2.565
70 to 74
3.591
65 to 69
60 to 64
55 to 59
50 to 54
45 to 49
4.380
5.484
6.490
8.926
10.963
40 to 44
12.218
35 to 39
12.285
30 to 34
12.253
25 to 29
20 to 24
13.620
15.921
10 to 14
0 to 4
13.289
15 to 19
5 to 9
14.918
13.150
11.810
9 10 As indicated in the following graphs the population of Saint Lucia is ageing at a fairly quick rate
with projections indicating that in ten years time the number of persons 65 years and over may
reach twenty thousand( 20,000 ) with a doubling of that number to over forty thousand by the
year 2050.
10 Year Projected Growth of the Population as a whole compared to Projected Growth of Population aged 65+
(Based on the projections of the National Insurance Corporation)
200000
180000
160000
140000
120000
100000
80000
60000
40000
20000
0
65+
YR 2012
YR 2013
YR 2014
YR 2015
YR 2016
YR 2017
YR 2018
YR 2019
YR 2020
YR 2021
YR 2022
14675 14893 14972 15329 15564 15858 16099 16432 16918 17465 18037
Tot. Pop. 167454 168437 169434 170443 171458 172478 173499 174514 175513 176488 177442
10 11 The graph below indicates that the population of St Lucia is ageing at a fairly quick rate with
projections indicating that in ten years time the number of persons 65 years and over may reach
20,000 doubling to over forty thousand by the year 2050.
Long Term Projected Growth of General Population Compared to that of Population aged 65+
(Based on projections of the National Insurance Corporation)
200000
180000
160000
140000
120000
100000
65+
80000
Tot. Pop.
60000
40000
20000
11 YR 2064
YR 2061
YR 2058
YR 2055
YR 2052
YR 2049
YR 2046
YR 2043
YR 2040
YR 2037
YR 2034
YR 2031
YR 2028
YR 2025
YR 2022
YR 2019
YR 2016
YR 2013
YR 2010
0
12 3.2 Social and Economic Indicators
Like most small-island developing economies, Saint Lucia’s economy is extremely vulnerable.
The main sources of revenue are highly susceptible to fluctuating exchange rates. Natural
disasters like hurricanes threaten both the agriculture and tourism industries and, as an island
with limited manufacturing, importation increases the expense of doing business in the country.
The effects of the global financial crisis that began in 2008 continue to hurt Saint Lucia and the
rest of the Caribbean. While Saint Lucia experienced a decrease in economic growth in 2009,
preliminary reports in the 2010 Economic and Social Review shows an increase in real gross
domestic product (GDP) growth in 2010. In 2011 the GOSL reported economic growth of 4.5%.
The national economy remains vulnerable to natural disasters, which is evidenced by the
substantial damage and loss incurred following the passage of Hurricane Tomas struck the island
in October of 2010, causing severe damage to roads, crops, and many parts of the country’s
infrastructure. Saint Lucia anticipates growth throughout 2012 partially driven by ongoing
reconstruction.
In Saint Lucia poverty is defined in terms of its chief characteristic -deprivation. Poverty
refers to any situation in which an individual, or group possesses less than some standard of
living that has generally been defined as acceptable. This standard may be determined either on
the basis of the material condition of other persons or groups in the society, or on the basis of a
measure of the gap between what is possessed and some objective indicator of elementary human
need. Poverty is thus a complex of multiple deprivations. The poor are those in society who
suffer disadvantage with regard to the possession of goods, or facilities deemed to be necessary
according to some generally accepted social standard, or some fundamental physical need. KEY
FINDINGS
The results of the 2005/2006 Country Poverty Assessment indicates that the poverty, as
measured by the headcount, increased from 25.1 percent in 1995 to 28.8 percent in 2005, but
indigence fell substantially from 7.1 percent to 1.6 percent over the same period. The indigent
are persons whose daily average consumption is too low to guarantee adequate nutrition to
maintain good bodily health. The Gini coefficient of inequality also fell over the period; in other
words, while measured poverty increased, overall inequality in the society fell. It should be noted
that the finding of increased poverty in 2005/06 does not mean that the poor were necessarily
12 13 worse off in terms of material conditions: indeed, comparisons of indigence are ‘purer’, in so far
as they ignore relative factors that intervene in poverty comparisons.
Assessment data from this intervention also reveals, as has been found in most Caribbean
countries, that those persons living below the poverty line are disproportionately young. Children
aged 0-14 represented 39 percent of all poor persons, while the elderly aged 65 years and above,
represented 7 percent of the poor population. In many of the communities expressed concern
about the plight of the elderly. Moreover, those who were totally reliant on public
assistance would have been among the poorest having regard to the fact that public
assistance payments were lower than the indigence line. A fair percentage of the poor
elderly population have cited the following reasons for their situation ; age and inability to
work, ill health or sickness, responsibility for supporting children, including children with
disabilities, or grandchildren, lack of support by adult children and lack of access to
resources. In addition a number of these are still responsible for the welfare of children and
grandchildren with many totally dependent on pensions and assistance from the
government, and from neighbours, and friends for their survival.
St Lucia’s Social Safety net is made up of a number of social assistance programmes of which
the main one is the Public Assistance programme which is targeted to the “needy” and reaches
approximately 25% of poor households. Other interventions in this regards are some Student
support systems, Community dare care Programme and Rovings caregivers programme, labour
market programmes and social care programmes . In recent years the St Lucia Social
Development Fund (SSDF) has implemented a significant number of community infrastructure
and development projects with some also targeting individuals and households where necessary.
Active consideration is again being given to a national health scheme which will seek to
broaden the scope of the current limited assistance given to older persons on a needs
assessment basis.
The Government of Saint Lucia is continuously working on ways to improve the health systems
to mitigate an increase in many communicable and healthy lifestyle diseases. A brand new
modern and well equipped multi-dollar hospital is scheduled for completion in the second half of
13 14 2012 to complement the recently built and commissioned Mental and Wellness Centre
(Psychiatric Hospital). Upgrade of rural and sub urban “wellness centres” aim to increase
persons particularly older persons’ timely access to primary health care at no costs or in some
instances subsidized rates. Recent discussions with the National Insurance Scheme (NIS)
indicate that they are seriously considering including all their pensioners in their social
insurance programmes a service currently enjoyed by the rest of their contributors.
3.3 Current Socio-economic and Political situation
Saint Lucia recently saw a change in government; elected to office in late November 2011 to
replace one which governed the country since 2006. At the top of the governments agenda is the
urgent need to create employment for its nationals. Unemployment as at the end of 2010 stood at
22% with 52 % of our young persons (20-29) years unemployed. The GOSL has promised to
inject EC$100 million in the short and medium term to jump start the economy and create those
badly needed jobs.
A short term employment programme (STEP) commenced immediately (December) to build on
some of the initiatives started by the previous administration which is expected to inject EC$ 5
million immediately providing badly needed income to mostly unskilled persons in the labour
force. There is no doubt that many older persons will benefit directly or indirectly from these
government initiatives.
BACKGROUND
4. METHODOLOGY
Most persons interviewed whether face-to-face or over the telephone were more than willing to
share experiences and opinions. There was no clear plan of action at the national level identified
since the MIPPA however the main stakeholder sought to implement programmes and projects
that had some genesis in the recommendations coming out of the MIPPA.
14 15 The consultant used a combination of desk research, interviews, web browsing to obtain the
material informing most of the report. The data collected was resourced mainly from the files of
a number of Local NGO’s and the government ministries with a fair share coming from national
and international publications cited wherever possible referenced in the bibliography at the end
of this report.
The first part of the report in earnest reflects the findings of the efforts of these stakeholders and
the second part the gaps existing and a reflection of the respondents’ vision and
recommendations for the future and along with those of the consultant.
15 16 REVIEW AND ASSESSMENT OF ACTIONS AIMED AT OLDER
PERSONS IN SAINT LUCIA
16 17 Overview
Nearly two-thirds of older persons live in developing countries, yet older persons are still largely
excluded from the wider global, regional and national development agendas. At a time when the
international community is preparing to take stock of sustainable development and is looking to
forge a development agenda for the future, it is important that the needs and contributions of
older persons become a bigger part of the picture. Older persons are vibrant and essential
contributors to the development and stability of society, and more can and should be done to
utilize their potential.
In the context of the St Lucia which does not have a culture of retirement, a closer examination
of the situation indicates that despite this obvious recognition and admission by the leaders and
drivers of the Saint Lucian society there is still much that has to be done to accomplish some of
the above objectives.
Immediately following the Madrid intervention in 2002 St Lucia recognized the need for urgent
action in developing a national agenda with regards to older persons and the first ever national
Symposium on the Rights of older persons was held under the theme “Towards a Society for All
Ages”. The symposium’s main objectives were to bring into sharp focus the plight of older
persons and the need for greater attention to be paid at the policy, institutional and programmatic
levels as these related to some of the recommendations coming out of the Madrid International
Plan of Action. Of significance resulting from the above was the commitment to develop a “St
Lucia National Policy for Older Persons” (2003) which up to the time of writing remains
unfortunately in the drafting stage.
In the following comments it will be noted that despite some significant strides being made in the
areas of institutional and programmatic development the policy definition and agenda continues
to fall below expectations.
17 18 Action priority One: Older Persons and Development
The Helpage Saint Lucia National Council of and for Older persons which was set up in 1980
has continued to be the driving force in increasing the opportunities for the involvement and
participation of older persons in all aspects of Saint Lucian life. From 2003 with the initial
attempt to develop a national policy for older persons to the current success of the acquisition of
a brand new building housing a elderly day care and administrative offices( through the
assistance of Government), this organization has been steadfast in its endeavours to improve the
lives of the elderly.
Protection of Human Rights
National Policy for older Persons.
Older persons by virtue of the St Lucia Constitution enjoy the rights and freedoms like any other
person. St Lucia in its draft policy also makes mention of the intent that any ratified policy must
be grounded in the United Nations Principles for Older persons (1991) which sets out the rights
and entitlements of older persons in critical everyday living areas and situations.
The Saint Lucian government through its Social assistance programme continues to strengthen
its commitment to older persons and making a contribution to the improvement of the quality of
life. Since 2007 many of the organizations ( mainly NGO’s) of older persons have sought to
sensitize their members and volunteers to the many human rights issues. These have been done
through the development of several capacity building initiatives e.g. training programmes for
caregivers, public awareness statements, self- development programmes for the older persons.
Access to Credit Opportunities
Banking /Financial Institutions
The banking and financial system has over the last few years been more appreciative of older
persons in its provision of credit facilities. A few of them have extended the repayment period
for long term and mortgage loan to 70 years (from 60 and 65) and some insurance companies
are less rigid in their acceptance of older persons applying for policies.
18 19 Access to Decent Employment
National Insurance Corporation (NIC) and Retirement Age
There are a few challenges facing Saint Lucia in its quest to provide decent employment for
older persons. The major ones are 1) the increasing unemployment rate throughout the entire
population but extremely high among the youth and 2) the mandatory retirement age in the
Public Service of 55 years. Recently we have seen a ray of light as the Government of St Lucia
through its National Insurance Scheme has raised the national retirement age from 60 to 65 with
the option to do so between 60-65 over a period of years. This has given some persons the option
to continue to work for a longer period and helped increase the NIC’s income base for the future.
There has been an increase in awareness generally on the question of self-employment and
entrepreneurship and in recent times there is a marked increase in older professionals and semiprofessionals opening their own businesses. The NIC through a policy change which now allows
a pensioner to continue to receive has pension even when he/she has returned to work has
encouraged many older persons to re-enter the workforce (employment) or create their own
enterprise and employ others.
Two fairly successful enterprising projects started by the Helpage St.Lucia National Council of
and for older persons, namely: 1) flower growing project, corsage making and flower arranging
along with 2) cake making and cake decorating were established mainly to promote work but
these have presented the added value of improving the quality of life of older persons. In
addition these initiatives have been able to get the older persons actively involved in ventures
where their skills are highlighted and rewarded. This also addresses in some way the right to
develop projects which would benefit older persons and ensure that these have the support of the
local private sector. The charts below indicate the unemployment situation as it relates aeging
Unemployment Rate by Age 19 20 Unemployment Rate by Age Group
SAINT LUCIA 2010
70%
60%
50%
40%
30%
20%
10%
0%
65 15‐19 20‐24 25‐29 30‐34 35‐39 40‐44 45‐49 50‐54 55‐59 60‐64 Years Years Years Years Years Years Years Years Years Years Years and Over
Unemployment Rate 63% 32% 20% 15% 13% 13% 13% 12% 13% 16% 30%
Trend in Unemployment Rates Across Age Categories
(Fitted with parabolic trendline)
SAINT LUCIA 2010
70%
60%
50%
40%
30%
y = 0,0131x2 ‐ 0,1806x + 0,699
20%
10%
0%
15‐19 20‐24 25‐29 30‐34 35‐39 40‐44 45‐49 50‐54 55‐59 60‐64 65 Years Years Years Years Years Years Years Years Years Years Years and Over
20 21 Increased coverage of pensioners (contributory and non Contributory)
As previously mentioned the NIC in 2003 has increased the retirement age to 65 years and this
has created an opportunity for many older persons to work for longer periods. Of worthy mention
is that the NIC has been able to do this without any increase in the basic contributions (10%)
from income.
The GOSL has strategically decided to move all persons newly employed effective 2003 from
their own pension scheme to the national scheme managed by the NIC. This of course will
drastically reduce the government’s pension bill which continues to grow astronomically and has
to be met through its recurrent expenditure (est. $32Million annually.)
There are still a few private entities that offer coverage to some of their employees (contributory
or non contributory). Additionally many persons are applying to some local and international
financial institutions for retirement/pension plans that are expected to complement those of the
NIC and GOSL.
Promoting the participation of older Persons
Club 60’s Groups
The Helpage Saint Lucia National Council of and for Older Persons have continuously promoted
the full integration and participation of older persons in the St Lucian Society. Very early in the
1980’s and continuing (although to a lesser extent now) Club 60’s groups were developed in
almost every community on the island focused at allowing older persons to get involved in the
development of their communities and the country as a whole. These groups were extremely
successful as they provided an avenue for building awareness on the Rights of older persons and
allowed them to effectively present their views. There is need for a revitalization of the Club
60’s effort which could improve the social interaction and support
to older persons and
supported the work and programmes of the Helpage Saint Lucia National Council of and for
21 22 older Persons. At one stage there were over twenty of these all over the island which has
withered down to a handful of active ones.
Mechanisms to take the view of Older persons on matters concerning them and of national
importance .
Two of the other associations on the island…1) the Government Pensioners Association and the
2) Ex police men League have continuously represented their membership in matters of national
importance. On closer examination these groups are a repository of tremendous experience and
knowledge and should be called upon to increase their participation and contribution to the
decision making process on national policies in a more meaningful and structured manner by the
powers that be.
Division of Human Services
This arm of the Ministry of Health on a daily basis implements services aimed at meeting the
needs of older persons in Saint Lucia either directly or in close collaboration with other NGO’s.
By virtue of its direct contact with the beneficiaries through its social workers either in the field
or through interaction within its established institutions there is always great awareness of the
expressed needs and the level at which these are being met by the Division and other players.
There is need however for ongoing organized monitoring and evaluation. The department
remains faced with serious human resource challenges to better serve the beneficiaries. With an
increase in staff compliment the department will also be able to change its focus from just public
assistance implementation to a more diversified service geared to meet more of the needs of
older persons.
The newly built institution home aptly named “Comfort Zone Senior Citizens Home” in the
south of the island for older persons through its programmes and processes is determined to
encourage full participation of its residents in all activities to encourage their holistic
development and satisfactory quality of life.
22 23 National Enrichment and Learning Unit (NELU)
This unit which is part of the Ministry of Education although not specifically mandated to
provide services directly to older persons has integrated some in their programme of training and
education. The NELU through its education and training programme has provided older persons
with the opportunity to not only improve their basic literacy and numeracy skills but also offers
training (and certification) in a number of technical skills including cake decorating, plumbing,
tiling, motor mechanics. In the absence of any empirical data, Information from the unit indicate
that at least 10% of the participants in this programme are over the age of 50 years. It is the
intention of the management of that unit to begin constructive dialogue with the Division of
human Services of the MOH and the Helpage St Lucia National Council of and for Older
Persons to examine further means/areas of collaboration.
Action Priority Two: Health and Well being in Old Age
Universal access to comprehensive health Services
The health sector in St Lucia is a mix of public and private facilities/ entities. It is estimated that
the public sector provides only half of the primary health care but 90% of secondary health care
on the island. Access to health care for a long time has been uneven with the distribution of
services skewed toward urban areas. In the early 2000s the GOSL began pursuing some form of
Universal Health Care (UHC) as a means to ensuring all people have access to services
regardless of age or ability to pay and to ensure the quality of service. There is now renewed
hope that the UHC will be back on the Government’s priority list.
Currently the Ministry of Health provides as part of its safety net programmes, a medical
assistance initiative whose main objective is to increase access to medical care and beneficiaries
are able to obtain these through the mechanism of means testing. The two facets of this
assistance are 1) Fee waivers for medical care at public institutions for a year, subsequent
renewal annually is an option and 2) A grant for possible accessing to medical services overseas
23 24 if necessary; a onetime benefit. A significant number of older persons have and continue to
make use of this facility despite the number of complaints about the bureaucratic nature of the
processes.
A few other organizations like the National Community Foundation (NCF) and the St Lucia
Blind Welfare Association (SLBWA) also provide targeted assistance and services to older
persons at no costs or subsidized rates. These benefits are accessed by formal application to the
relevant organization. It is anticipated that Saint Lucia will during the course of 2012 get a brand
New National Hospital (NNH) which generally should open up new access areas however to
many St Lucians this new initiative does pose some serious financial and human resource
challenges before it becomes a reality and meets that objective.
Promotion of healthy life styles behaviours and environments
In the past five years or so St Lucia has witnessed an increased effort to sensitize the populace to
the benefits associated with switching to and maintaining healthy life styles and maintaining a
healthy environment. Recent information from studies conducted by recognized and reputable
international bodies (WHO; PAHO) have indicated abnormal increases in persons affected with
non-communicable diseases particularly cancer, diabetes, hypertension and heart related
illnesses.
The MOH through its Division of Human Services and the Ministry of Sports have
led the charge in this regard ably supported by Helpage St Lucia National Council of and for
Older persons, the NCF and the several private sector organizations. The most popular means of
selling the message are health fairs, organized sponsored walks/races, television and radio panel
discussions and popular theatre (drama presentations).
Regulation of long term care services
In this regard the MOH has commenced the development of an operations manual for use by all
day care services provider (draft copy available) and is to extend that to now include, all persons
and institutions who are involved in providing services for older persons.
It is hoped that after adoption and regularization of the National Policy for Older Persons (Draft
available) and the adoption of the operations manual there will be a better means to regulate
overall service provision.
24 25 The Division of Human Services is also in the process along with other stakeholders of
developing standards for the industry to create more operational efficiencies and effectiveness.
Human Resources training in geriatrics and gerontology
As mentioned before Saint Lucia like most other Caribbean countries has an increasing ageing
population and there is a need to ensure that their needs are met. This realization has brought into
sharp focus the need for trained personnel to provide the optimum levels of service to meet the
present and developing demand.
There has in recent times been an increase in the number of retired nurses and other health
professions providing personal geriatric care to private households and one or two institutions.
The arrival and fair successes of Liberty Nursing a private sector company attests to this growing
phenomenon.
The Helpage St Lucia National Council of and for Older Persons in conjunction with the St
Lucia Social Development Fund (SSDF) and the Ministry of Education’s NELU have
successfully conducted training programmes in elderly (geriatric) care which targets not only the
older persons themselves but the younger(potential) caregivers.
In discussions with the management of the institutions (both privately and publicly owned) that
provide formal care to older persons there was a strong indication that professional training for
their staff is a top priority. Efforts are underway to determine ways in which this training could
be extended to all levels of staff.
Monitoring the health of the older population
This is an area that needs serious development both at the data collection and analysis levels.
The MOH has access to information available in the institutions under its purview however no
arrangement currently exists for the ability to access that which exists through private doctors’
consultations. Recently (2011) the government announced the development of a new
Management Information System expected to link up both public and private sector institutions
including private doctors’ offices (databases) to capture in real time medical information/records
of all persons in the Country. Questions of the right to privacy, ethics and human rights
25 26 violations have already being raised and discussed vis -a- vis the obvious overall value of such
an initiative.
Priority Area Three: Enabling and Supportive Environments
Accessibility of the physical environment
There has been increased awareness of the challenges and constraints faced by older persons as
they sought to get on with everyday businesses activity particularly in the capital Castries and the
other town Gros Islet in the north. For years now older persons through Helpage St Lucia
Council of and for older Persons have solicited the government of the day to make access to
public buildings, offices, institutions and recreational areas easier accessible to older persons.
Significant support to their requests has come from other associations like Saint Lucia Blind
Welfare Association (SLBWA) and the National Council of and for persons with Disabilities
(NCPD).
There are notable improvements as are quite noticeable in certain parts of the capital Castries.
These improvements allow for better ability to traverse streets, as ramps have been placed on
almost all the main and side streets. Entrances/exits to some public buildings (e.g. the General
Post Office) have been modified to accommodate comfortable use by older persons. In recent
times all new or renovated buildings have been served by elevators for easier access to upper
floors.
The lobbying continues by the stakeholders to ensure that at the policy level the GOSL ensures
architects and designers incorporate new and adequate means of access that addresses the needs
of older persons, persons with disabilities etc. Preliminary responses have been favourable in this
regard. There is need however for a much better appreciation of older persons who use the public
transportation. More public education and awareness must be undertaken to ensure bus drivers
and (younger) passengers are more respectable and cordial to older passengers.
In the end older persons should be given every opportunity to pursue their interests and take care
of their own personal businesses/concerns. It is therefore imperative that public places are easily
26 27 accessible and safe for use. Older persons should feel comfortable in venturing outside their
homes, private or residential whether for business or recreational purposes.
Sustainability and adequacy of social support systems
St Lucia’s social support landscape for older persons is very much like that of most other
Caribbean islands. Most of what exists is created and sustained by the public sector with able
assistance from quasi-government institutions, and NGO’s, however a fair percentage is still not
adequately served.
According to a 2009 World Bank report : the Government of St Lucia has a number of social
assistance programme that could address critical vulnerabilities, however programmes suffer
from a number of constraints. St Lucia faces significant challenges in providing a sustainable
safety net that protects the most vulnerable.”
A few of these challenges are as follows: 1)
Absence of a clearly articulated social protection strategy making approaches haphazard with no
clearly defined priorities. 2) safety net does not adequately among others things, protect children,
single parents(predominantly women) or working age poor and 3) Division of Human Services
(responsible for most direct support to older persons) should be moved from the Ministry of
Health to the Ministry of Social Transformation, Youth and Sports to facilitate synergies and
obtain economies of scale in programming for its targeted beneficiaries and information
management.
Although some strides have been made in this regard recently there is still need for the Division
to strengthen the Social Assistance programme geared specifically at the older persons. There is
need to amend the public Assistance Act to better reflect the current realities. The construction of
modern, well equipped home for older persons “Comfort Zone Senior Citizens Home (2011)”
has brought a ray of hope to those involved in the provision of support to older persons.
Two day care centers for older persons, one in La Clery Castries, north of the island and the
other in Mongouge Choiseul, South west coast of the island are now available to enhance the
social support landscape. There is need however to optimize use of these facilities to meet a
higher number of older persons. The general public and particularly older persons must be made
more aware of the services offered through a sustained programme of education, sensitization
27 28 and awareness. A minimum standards regime for all day-care centers was drafted in November
2009 should be moved to completion and adoption in the short or medium term.
The Government of St Lucia continues to provide both financial (annual subvention) and
technical assistance to the private residential homes. However there is a dire need to increase this
effort to assist in the quality and sustainability of services provided by the homes.
Promoting a positive image of old age and ageing.
Several private sector firms have opted to use older persons in their advertising particularly for
services targeted at that market. Some of the banks and other financial institutions have taken the
lead in this regard. The NIC has used pensioners in their advertising paraphernalia also showing
a very positive image. The NIC’s issuance of “gold cards” to all pensioners that allows for
identification in a special way along with special discounts at many of the main shopping centers
and shops covering a very wide range of products and services.
Most major financial institutions, utility companies and other corporate entities have in recent
times introduced special areas/queues for older persons to obtain special service. Some have
provided chairs/seats to make the waiting more comfortable for these older customers.
The management teams of the homes on the island have attempted to increase the image of their
residents positively by encouraging outdoor tours to places of recreation or interest around the
island and allowing the electronic media to cover these. They have encouraged well organized,
sustained visits to the residential homes, by younger persons, social and cultural groups and
employees of local companies where the residents are engaged and entertained along with social
interaction.
Since 2004 short hiatus last two year (venue problems) the Helpage St Lucia National Council of
and for older persons have staged annual Senior Games which have attracted significant support
from the public and feature as a major event on the sporting calendar. These events are usually
supported and attended by the Governor General of St Lucia with the ability to attract significant
corporate sponsorship and support. Participation from older persons has immense resulting in
some of them representing the country overseas in International Senior Games.
28 29 Recent recognition and observances of international days such as Elder Abuse Prevention (June
15th) and International Day of Older Persons (October 1st) have added a special dimension to the
positive way in which the society views ageing. The mobilization of support for these
observances have been spearheaded by Helpage National Council of and for older persons
however, there is still a need for the government of St Lucia to provide more support to increase
the overall impact.
Cognizant of the productivity of older persons in the workforce, the islands two tertiary
institutions namely the Sir Arthur Community College and Monroe College, continue to offer
opportunities to older persons (retired professionals) to work as lecturers and trainers in their
programmes.
On the social scene some of the existing Club 60’s and the National Council itself have been able
to successfully stage beauty and talent shows/ competition(mostly annually) where women and
men showcase their attributes in a positive to very appreciative audiences. Coverage either live
coverage or recordings of these events is typically provided by national media houses. Through
the staging and broadcasting of these interventions younger persons it is envisaged obtain a much
better appreciation of the importance of an ageing population. Several of these are usually held
under the patronage of His Excellency the Governor General of St Lucia Dame Pearlette Louisy
who in her own way exudes a very positive image of ageing.
Dialogue must be commenced in earnest with the newly established Media Association to
discover means/strategies by which the local media can be used as a means of portraying old age
and ageing in a positive manner. Programmes can be developed that highlight the abundant
knowledge and experience of older persons and the benefits that can be derived as a result for the
development of younger persons and the creation of a positive nexus between these generations.
Economic Security
Access to decent work
Traditionally the family assumed responsibility in providing care for older persons (relatives);
however recent changes in family structure and functions as well as the impact of recent social
and economic challenges have resulted in many older persons being neglected and left to fend
29 30 for themselves. For many of the elderly, the Government monthly allowance is the only regular
source of income. For many retired professionals who receive pensions the amount received
monthly is often inadequate to meet their basic daily needs. As a result for those older persons
involved they view this situation as a great source of concern as this determines the quality of
life they will live.
Many older persons however continue to rely heavily on children and other relatives for
economic support. Other sources of income for older persons include overseas pensions, self
employment, remittances, return on assets/investments (interest; rentals etc.).
The above means that a significant number of older persons are therefore challenged to provide
adequately for themselves (and sometimes dependants) .
In the absence of any formal strategy or policy, access to decent work for older persons is left to
the individual. To help meet those challenges, Helpage Saint Lucia National Council Of and For
Older persons has been able to develop one or two projects that provide some work for a few
individuals.
In addition, the recent increase in the retirement age to 65 years, now enables older persons to
work for a little longer period and receive additional normal income before pensions set in.
The inclusion of Adult Day Care Centers opens up an opportunity for self employment creation
and income generation however there is need for organized strategic training and programming if
this is to materialize.
Increased coverage of social security systems
There is need for a high percentage of older persons in St Lucia to be covered by the existing and
potential social security systems. The NIC has recognized this and there are active considerations
being given to proposals that will bring all their pensioners into medical and health care
insurance like the remainder of the contributors at no costs.
30 31 Public discussions have resurfaced surrounding the Universal Health Care which has as its main
objective the access by everyone including older persons to health care at no cost or at subsidized
costs in some instances. This intervention has taken even more urgency in terms of adoption and
implementation with the imminent commissioning of the New National Hospital due sometime
in 2012.
The Ministry of Social Transformation through the Saint Lucia Social Development Fund in
conjunction with the Division of Human Services should combine with other stakeholders to
come up with strategic social security programmes that will meaningfully benefit older persons
who are most vulnerable.
Health
Care of Older persons with disabilities
The SLBWA and the National Council Of and for persons with Disabilities (NCPD) are the two
organizations in the forefront that provide care and support to older persons with disabilities. The
former provides, through its eye-care services and rehabilitation unit, individual support and care
to improve the everyday living skills and quality of life for persons with visual impairments. In
addition, the SLBWA provides services a range of services, which are sometimes not available
from government-run institutions, at more affordable rates than the private sector. , Two of its
main services include eye-exams and procurement of spectacles. Once or twice a year eyesurgery is available when a visiting ophthalmologist is in Saint Lucia (not only the elderly
benefit from this service). This organization has also spearheaded the recent formation of a
“Glaucoma Association” in which over 80% of the members are persons over 65years and are
recipients of assistance in the basic areas of eye-care, peer-support and access to information and
daily living skills with the disease.
31 32 The NCPD has its challenges and constraints and whenever possible provides support either
through small cash donations or use of wheel-chairs, walkers etc. A physiotherapy unit is also
available for those who may need it. Continuous self development training programmes forms
part of the Council’s on- going programming.
Both of these organisations are instrumental in assisting their clients in accessing the Medical
Benefits Card which allows the holder access to medical services and pharmaceuticals at no costs
at the public institutions. (Exemption Card).
Equitable access to health services
No recognizable or institutionalized discrimination exists in the accessing of health services in
Saint Lucia. Issues of concern do exist mainly with respect to the ease of access and affordability
of services by the poor and.
The GOSL in the early 2000’s waived the consultation fees (EC$20.00) that was charged for
access to health services at wellness centers. This change now facilitates free access to health
care by a larger proportion of the population.
Monitoring of long-stay institutions
There are seven (7) well known residential homes for older persons spread all over the island
giving access to the entire population. Four of these are owned by the Catholic Church, two
private and one by the Government of Saint Lucia. The most recently constructed is the Comfort
Bay Senior Citizens Home, which presents a very modern, expansive and well equipped
premises in the south of the island, the town of Vieux Fort.
Most or all of these cater for the holistic development of the resident by providing suitable
ongoing programmes. Each of these homes receive a subvention from government, which in
discussion it was expressed by management of the homes, that it was inadequate to meet current
needs.
32 33 At present the Division of Human Services monitors the performance of these homes to ensure
standards of care are in keeping with what is prescribed internationally. No formal evaluation or
monitoring system has been established.
The Mental Wellness Centre is the other institution that provides long term care for the elderly
who are mentally unwell and is owned and managed by the GOSL. The Ministry of Health
monitors the services offered at this fairly new institution and all reports indicate that there exists
a number of resource challenges that negatively affect the ability of the management team and
caregivers of the institution to meet the stated objectives and expected services standards of the
institution.
Creation of palliative care services
At present these services are administered within the current structure of the homes and where
other assistance is need this is sought at the level of the hospitals or private doctor’s clinics.
There are a few professionals who offer alternative (life style) health care/natural services like
acupuncture, acupressure and reflexology, mostly in the north of the island however it is very
difficult to determine to what extent older persons make use of these. An influx of health and
beauty spas and clinics has occurred on the local landscape offering many types of interventions
geared at soothing, relaxing and bettering individuals coping mechanisms for their heath
challenges, particularly stress and pain.
In addition there is one private clinic owned and managed by a world- renowned pain specialist
who offers his services particularly for those suffering from chronic pain syndrome.
There has been an increase in the number of psychologists and therapists now available for
providing care to older persons. It must be said however that in recent times the St Lucian public
are becoming more aware of the need to create more high level palliative care.
Access to health care for older persons with HIV
HIV counseling and testing has been well integrated into the primary care system in Saint Lucia,
as has antiretroviral therapy through mobile community clinics. As with any service that may
33 34 require higher levels of care as the disease progresses, strengthening referral services will be a
key activity moving forward in Saint Lucia. Saint Lucia laboratories conduct CD4 counts, but are
not equipped to test viral loads. These tests are sent to Barbados.
Antiretroviral drugs are distributed for free in the public sector to registered patients but less than
half of known infected individuals were enrolled in care in 2009; it is not known if the nonenrolled are not accessing services at all or accessing services in the private sector or overseas.
One of the weaknesses of the National AIDS Program, as identified by the Secretariat, is the
inability to reach vulnerable populations including older persons and therefore limited data are
available on the status of these groups.
Existing stigmas are still prevalent and keep many persons away from accessing care before it is
too late.
The Division of Human Services developed a Policy and operations Manual for the Assessment
and Payment of Public Assistance (2008) and in which guidelines for making payments of public
assistance to PLWHA are clearly outlined and are easily accessed.
Environment
Promotion of continuing education
The Ministry of Education through its NELU has provided continuing education to the Adult
Population for a number of years. Its mandate indicates that the age range of its target group is
16 years and over however there is nothing that precludes older persons from accessing the
education/training opportunities presented there. Discussions indicate that at least 10% of the
students are over 50 years of age. There is no doubt that there exist other areas of collaboration
that could be explored with other stakeholders who provide services to older persons to introduce
new educational/training initiatives for older persons.
34 35 Elimination of discrimination and violence in old age
Whereas the number of cases of discrimination of older persons appears to be diminishing and
these persons are becoming much more integrated and accepted in the general society with
greater appreciation for their contributions, abuse of older persons continues to be of major
concern. It would appear that in addition to some institutional abuse; verbal psychological,
physical, financial, sexual abuse and neglect are occurring persistently at the individual level,
despite the many training and awareness interventions ongoing to mitigate these. A most recent
rape of a 90 year old woman has brought this fact into sharp focus as there was great public
outcry at this heinous infraction. Recent efforts by the National Council Of and for Older persons
to successfully train over 150 care givers (for older persons) is a move in the right direction to
build further awareness.
Recognition of the contribution of older persons in the care economy
As previously mentioned the ageing population continues to grow and as more persons live
longer it would mean that they would be a need for improved and additional services. In St Lucia
there are no statistics available that indicate the contribution of older persons in the care
economy however indications is that there is growing interests in providing services for that
sector. In recent times residential care has been increasing and even beginning to grow
competitively as there appears some disparity in the quality of service provided.
Housing for older persons
The GOSL embarked on a programme of assistance to housing for older persons all around the
island in the period 2000-2005. By the time the programme came to an abrupt end over 300
homes were built or refurbished for older persons.
The present government has placed on its agenda low cost housing and housing for the poor and
vulnerable which will directly and indirectly benefit some older persons.
35 36 CONCLUSIONS AND PRIORITIES FOR THE FUTURE
Overview
Ageing is not a disease but a normal part of the life process. Ageing is inevitable and irreversible
but does not automatically lead to ill health and disabilities. Many of the health conditions and
by extension the poor quality of life associated with ageing can be prevented or delayed in
societies particularly small- island states like Saint Lucia if governments choose to make the
introduction and implementation of policies and programmes including national action plans on
ageing a major part of their socio-economic development agenda.
Although there has been a concerted effort made to improve these initiatives in recent times by
not only the Government but also civil society in St Lucia the job is far from over. The future
must be approached strategically focusing on the existing gaps and the instituting of mitigating
policies, programmes and projects in keeping with the MIPAA and the Brasilia Declaration
which point to a focus and awareness enunciating clearly and stating that there must be a
commitment by all to “spare no efforts to promote and protect human rights and fundamental
freedoms of all older persons, work towards eradication of all forms of discrimination and
violence and create safety nets for older persons to exercise their rights.”
LEGISLATIVE /POLICY
Conclusions/Existing Gaps
At present the policy situation indicates that no national policy on ageing exists. The central
players are driven mostly by their own agendas with little or no clear indication that any system
of collaboration exist that allows for achieving expected synergies and optimum use of the scarce
resources.
The two major pieces of legislation that guide the socio-economic security of older persons are
the Public Assistance Act No. 17 of 1967 and the National Insurance Corporation Act No. 18 of
2000. These deal mostly with older persons becoming beneficiaries of Government Public
36 37 Assistance and Pension Plan respectively and are inadequate in any other area of contributing to
a better quality of life or protection of the fundamental human rights of older persons.
No initiatives for the creation of decent work for older persons are available and must be
explored with urgency.
Recommendations/Way Forward
1. There is need to quickly finalise an existing draft National Policy for Older Persons with
process that must include a nation- wide consultation geared to procure the most recent
ideas and suggestions of all the stakeholders involved in ageing in St Lucia.
2. A review of all existing legislation that deals with older persons must be undertaken with
a view to making them more current and relevant and in keeping with international
conventions, principles and programmes are aligned to meet the goals and
recommendations espoused in and of MIPAA and Brasilia Declaration. Policies relating
to the areas of quality of care, total elimination of all forms of elderly abuse and access to
the physical environment must be given top priority in these initiatives.
3. Operational guidelines and standards must be developed and implemented/monitored for
all adult day care centers and residential homes. The appropriate resources to allow for
the mechanisms expected to enforce and monitor these guidelines and standards must be
made available
4. National consultations must be organized to bring all stakeholders in the employment,
labour and human resources development sector along with Government officials to
examine means of creating and maintaining decent work for older persons.
5. In recent times many older persons have been the victims of financial abuse. In that
regard, representation should be made to the local financial institution to examine
mechanisms that would address this worrying phenomenon and protect the rights and
assets of these older persons
6. The GOSL through its Training Division must see it necessary to continuously keep the
areas of specialization in Geriatrics and Gerontology on its priority list to obtain
assistance for those who choose to pursue long term studies (and qualifications).
37 38 PROGRAMMATIC
Conclusions/Existing Gaps
There is an increasing need for the elderly to seek and maintain good quality health care even as
it appears to be coming increasing difficult because of the rising cost of same and the inadequacy
of the Government’s current assistance programmes in this regard. In many instances the elderly
are forced to make choices between health care and the purchasing of food (meals).
In many areas of Saint Lucia the elderly find it extremely difficult to participate in any
meaningful way in any social, economic or cultural activities primarily because of the absence of
any such programmmes and the availability of a suitable venue/location. Since there is no doubt
the size of our elderly population seems to be increasing and as a result will continue to make
demands on our Society in general to cater for their needs and wants it is necessary to sensitize
the public to this phenonmeon so as not only the older persons but persons in general. Ageing
must become top of the island’s socio-economic programming agenda and a household topic of
discussion/conversation.
Recommendations
1. Serious consideration must be given to re-align the Division of Human Services with the
Ministry of Social Transformation which would present better support and coordination
of programmes and increase efficiencies and effectiveness in this regard.
2. The GOSL should look to the implementation of a sustainable programme of Universal
Health Care that will increase the social safety net of all St Lucians and provide greater
access to top quality health care to older persons free of costs or at subsidized rates.
3. The GOSL should look seriously at the construction and equipping of adult day care
centers strategically placed in communities all around the island to improve its outreach
programme and target an increased number of older person
4.
An appropriate and adequate national Human Resource Development Programme should
be designed in collaboration with the Sir Arthur Community College to address the
38 39 medium and long term needs of the sector particularly in the areas of geriatrics and
gerontology.
5.
A national public awareness campaign on Ageing and all associated relevant issues
should be launched by the GOSL along with assistance from other stakeholders. The NIC
and the Financial Institutions should be approached primarily for assistance and support.
ADMINISTRATIVE
During this intervention it became clear to the consultant that there are many areas where
possible collaboration between different stakeholders exist however these opportunities
were not embraced. There is need therefore to highlight these and take steps to
recommend ways to improve the current situation. There is a serious need for the
collection and analysis of data concerning the elderly at all levels. There appears to be
some effort to improve as it relates to the health of these individuals and what obtains in
the Ministry through the social assistance programmes however there is need to widen
the process to include other institutions/organizations involved with the elderly
consistently.
Recommendations/Way Forward
1. Well structured meetings, discussions among the management teams of residential homes
(monthly, quarterly) should be organized to allow for better exchange of ideas and
development of synergies. Through this effort/exchange the possibility exists that will
further strengthen the resolve of the parties involved to affect legislative, policy and
programmatic decisions. The establishment of a national umbrella body should be
pursued in the short to medium term.
2. All residential homes for the elderly must have as part of their development strategy
constant and relevant staff training and development programmes.
3. All residential homes for the elderly and adult day care centers should institute and
maintain quality assurance standards.
39 40 4.
Technical and financial assistance should be accessed by the Government of Saint Lucia
to both private and public sector organizations involved in services for the elderly at all
levels to develop the administrative capacities to maintain data bases, and customer
friendly websites all geared to inform not only the organizational decision making, but
also the national development agenda.
INSTITUTIONAL DEVELOPMENT
Conclusions/Existing Gaps.
The valuable contributions made by the various stakeholders in the service sector as it relates to
ageing must be encouraged. However at present there is much duplicity of effort and misuse of
resources. There is need for better collaboration and cross fertilization of ideas from the parties
involved. In discussions it was clear that management of the residential homes should be holding
more relevant discussions geared to the sharing of certain resources in the quest to obtain some
economies of scale. The Division of Human Services must take charge of the entire sector and so
should increase its visibility and leadership in this regard. The division must be seen as the
champion of ensuring the Human Rights of older Persons are respected at all times in all strata of
the Society.
There is a need for the entire public to become more aware of what has been taking place
(successes and concerns) as regards to ageing particularly the pace at which the population is
ageing and the socio-economic challenges faced both individually and collectively as a people.
The NIC has in some way attempted to make the point and seek to eliminate a significant
number of the myths and stereotypes associated with ageing but there is still need for a wider
dissemination of information to create greater awareness in general.
More adult day care centers in strategic geographical locations are of a necessity as the demand
intensifies for organized, structured services and programmes or the growing number of older
persons.
Residential care in Saint Lucia is on the increase and some of these come under tremendous
pressure to maintain high standards of service delivery with the limited resources available.
40 41 Apart from a few member groups/organizations which exist specifically to look after the interest
of older persons (mostly pensioners) there is little or no movement in this regard.
Currently a gap exists where it comes to community based organizations specifically focused on
older persons and their needs. With a thriving CBO network implementation of prescribed
national and some organizational policies and programmes could become much easier, less
expensive and more effective.
The human resources capacity of the Division of Human Services is wholly inadequate and as a
result after taking care of the urgent public assistance programme there is little more that can be
achieved as a result of this deficiency.
The recent construction and operation of a ‘state of the art’ elderly residential home in the south
of the island should be used as a spring board to action and development of institutions of quality
on the island.
Recommendations/Way Forward
1. The Government should review the annual subventions allocated to these residential
homes so at to increase them if possible, even as they look forward to standardizing their
operations. The same hold for the Helpage National Council of and for Older Persons
which at present operates on a shoe-string budget.
2. The phenomenon of the Club 60’s of previous years must be examined in great detail as
there continues to be a need for an efficient and effective network of CBO”s to assist in
meeting the socio-economic needs of the ever increasing ageing population on the island.
3. The GOSL must look immediately to strengthening the institutional capacity of the
Division of Human Services to better meet the needs of older persons in the island. The
personal growth and professional development of the staff of this unit along with those of
the government owned Comfort Bay Senior Citizens Home must be given top priority.
4. Any National Policy of Older Persons designed must clearly define the leadership roles
and the extent of their power base, of the various stakeholders of this sector, including the
Ministry of Health and its Division of Human Services.
41 42 5. The Division of Human Services must be brought in line with contemporary units with
similar mandates. An organizational review of the division should be taken immediately
to improve efficiencies and effectiveness in tune with the revised legislation, national
policy and strategic programming.
6. The GOSL should look seriously at the construction and equipping of adult day care
centers strategically placed in communities all around the island to improve its outreach
programme and target an increased number of older persons.
7. Continuous strengthening of the primary health care system with its emphasis on
community based activities and family care must be used to target older persons (and
younger ones also). Better lifestyle choices must be at the forefront of any public
awareness or development programmes particularly for an ageing population.
8. A concerted effort must be made to build low income houses for older persons, ideally
through a private /public partnership as there is a growing need.
9. Overall there must be a concerted effort made by all the stakeholders involved in the
ageing sector to better document and catalogue all information, programmes , research,
findings, policies etc. so as to better inform decision making processes in the future.
There is need for more empirical evidence to identify and implement priorities.
Conclusion
St Lucia as a small island state must continue to place itself strategically to make use of the
capacity building initiatives that will come its way in the area of the development programmes
for ageing. Public awareness and sensitization on the crucial importance of providing for the
ageing population must be an ongoing process as that change in the mindset of the general
populace is the beginning of real development and change. A gentle smile or touch is good but
improvement to the quality of life of older persons needs more that and every Saint Lucian
citizen younger or older must be prepared to play his or her part no matter how small it seems.
“We all in dis ting together”
42 43 REFERENCES/BIBLIOGRAPHY

Report on Older persons Rights Symposium 2003.

Malta Country Report on National Follow up to UNECE Regional Implementation
(Jacintha Lee)
Strategy of the MIPPA- 2011
(Joseph TROISI)

Report on Helpage International Twelfth Regional Meeting- 2008

Violence and abuse of older persons Workshop Report -2005
(Helpage St LuciaNational Council)

St Lucia National Policy for Older Persons (Draft) 200
(Helpage St Lucia National Council)

Common Health care in Older persons- report 2011 (Helpage St Lucia National Council)

Minimum Standards Adult Day Care Services(Draft)- Helpage St Lucia National Council

St Lucia Health System and Private Sector Assessment 2011- USAID

Government of St Lucia population and Housing Census 2010-Statistical department St.
Lucia.

St Kitts and Nevis National Policy on Ageing 2009-2010-Misistry of Social Development

Strategic Plan Helpage St Lucia Council of and for older persons (Draft)

St Lucia Health Systems and Private Sector Assessment (Draft)- 2011 USAID
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Status Report on comfort Zone Senior citizens home -2012 (Draft) Charmaine Hippolyte
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