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Key Note Address at the 68th Annual Heath Research Conference

Introduction

First, permit me to welcome you to Saint Lucia, unquestionably, THE most beautiful island in the Caribbean and I daresay, in the world.

Second, permit me to say to the leadership of CARPHA, that the Government and people of Saint Lucia deeply appreciate the invaluable support that CARPHA gave to us during the COVID-19 pandemic. Put simply, Saint Lucia and the Caribbean could not have survived the pandemic without CARPHA’s platinum support. I consider the establishment of CARPHA and the Caribbean Climate Change Centre (5Cs) as two of the most visionary decisions taken by CARICOM Heads over the past 25 years.

Third, I must also thank CARPHA for choosing Saint Lucia as the venue for this important conference on the critical theme. This conference offers an opportunity for all local stakeholders who are committed to and interested in helping to abate crime and violence in Saint Lucia and across our region, to be part of this discussion. 

Reflections on Conference Themes

I welcome the research focus of this conference because it will help to fill some of the gaps in our understanding of both the drivers of crime and violence, as well as their public health impacts, at an individual and community level. 

As I reflected on the themes of the various panel discussions and presentations of this conference, I came away with these four thoughts.

The first is that dealing with crime and violence in the Caribbean is far more complex and challenging than many decision-makers and the people of the Caribbean might appreciate.

Secondly, I was able to better appreciate how targeted and sustained research on key current and emerging issues can help to abate crime and violence in our region.

Thirdly, I felt reassured that we have the intellectual capacity in the region to address what is arguably, the biggest threat to the sustainable development of the Caribbean.

My fourth thought is captured in this question that I posed to myself and now to you:

How can we organise the abundant intellectual talent in our region to support evidence-based decision-making on crime and violence? I will be offering some thoughts on this question, later in these remarks. 

I was struck by the theme of the panel discussion which will follow my address, and which is posed as a question, “Tackling Violence in the Caribbean: Can We Win?”

I can tell you that every Prime Minister and every Minister in our region is of one mind about this. We are determined to win, because the consequences of failure are too frightening, and too severe to even contemplate.

Whenever a homicide occurs in Saint Lucia, the question that dominates my mind is: 

WHAT MUST WE DO TO WIN TO STOP?

How can we deploy whole-of-society approaches in our countries and region?

How can we marshal our individual and collective resources in our countries and region to ensure that we win? 

How can we learn from each other’s successes, good practices, and mistakes? 

I see this conference and others to follow as critical elements in our win strategy. I want to make a special appeal to politicians and aspiring politicians; it is time to stop trying to score political points with crime statistics. The blame game needs to stop. We are near pandemic levels. 

Importantly, this event allows us to continue refining some of the ideas and recommendations made at a special regional symposium on a similar theme in Trinidad and Tobago. The consensus reached at this event, which was attended by CARICOM Heads of Government, was that there is considerable scope for public health management approaches to be used to prevent and control crime. My hope is that following this conference, a regional Task Force will be established to supply CARICOM countries with a medium to long-term action plan, while we continue the implementation of short-term measures. We have recently appointed a Minister for Crime Prevention to assist in this fight.

Twin Existential Threats

Aside from Climate change, crime and violence present the most serious threats to sustainable development in our region. This scourge has all the characteristics of an epidemic. Based on the statistics from across our region, it could rightly be described as a public health crisis. Many factors are contributing to its spread. Poverty, lack of access to resources, inequitable distribution of the benefits of development, declining family values, and youth unemployment are among the causes that are frequently cited. Enabling the spread of this virus is the rapid emergence of a gang culture, that seems to have no age limit. Governments at “six and seven” to contain its spread within communities and especially within the school system.

 

The Importance of a Research Agenda

There is much that we know, but there is so much more that we don’t know and don’t understand about crime and violence in our region. After decades of research, we still do not fully understand why individuals respond differently to the same environmental factors.

For example, we know that children who are maltreated are at high risk for antisocial behaviour and criminality, later in life. But we can’t explain why most maltreated children, often from the same family, do not become delinquents or criminals. Research done in other parts of the world says this may be due to the way certain genes interact with various environmental factors. Despite not having a clear understanding of the situation, my Government is working to remove as many of the environmental factors as possible. 

We know too that poverty and unemployment are major drivers of antisocial behaviour. But we also know that most people who are poor and/or unemployed do not resort to crime. The standard policies used by Governments to create decent jobs involve stimulating the economy and setting a livable minimum wage. However, in the absence of the right mindset, no wage will be adequate and therefore, Governments’ efforts to de-link poverty and unemployment on the one hand and crime and violence on the other, will not succeed. 

For some people, any job is better than no job, while for others, a job that does not pay enough is not worth doing. Some people will take as many jobs as they can, to help them achieve their goals, while others look to one job to achieve their goals. 

One obvious explanation is that people are wired differently. However, I raise these questions, because they point to the need for deeper research to help Governments to design and implement policies and strategies, that will elicit the desired responses from most of the target population.

These concerns notwithstanding, my Government continues to do all that it can to provide decent jobs to help pull our citizens out of poverty. We are making steady progress. The number of persons with jobs increased from 75,016, in 2020 to 97,394 jobs in 2023, representing 86 percent of the working population. Saint Lucia has seen consecutive declines in its unemployment rate every year, since July 2021. The rate dropped from 21.9 percent in 2021 to a near, record-low, of 14 percent in 2023 but we are still not satisfied.

My Government is very encouraged by the overwhelming response of Saint Lucian youth to its youth economy programme. A Youth Economy Agency was established by an Act of Parliament in 2022, to carve out a unique space in the economic system for youth entrepreneurship and business growth, and to provide young people with opportunities to turn their hobbies into entrepreneurship and their skills into businesses. The Agency provides finance, business development, marketing support, and training and mentorship. Since it was launched a year ago, with EC$20 million in financing from the Caribbean Development Bank (CDB), this agency has funded 445 projects in areas such as the arts, agriculture, production and marketing, sports and wellness, services, and technology.

Our hope is that beyond creating a national ecosystem of 3500 young entrepreneurs, this initiative will create a “feel-good culture” among all young people and help them build confidence in themselves. Related initiatives which are being financed by the US Government through the Caribbean Basin Security Initiative in Saint Lucia, include the Youth Resilience, Inclusion, and Empowerment (Y-RIE) Programme which seeks to develop the learning output of Saint Lucian youth, prepare them for professional job opportunities, connect them with professional development initiatives, and strengthen community and family structures that impact youth development. 

Additionally, the programme entitled “Opportunities to Advance and Support Youth for Success (OASYS)” also funded by USAID seeks to improve the diversion of youth away from custodial sentences, support evidence-based diagnoses and treatment in rehabilitation and diversion; and facilitate the reintegration of youth into the Saint Lucian community after rehabilitation. 

We have initiated ACT, Alliance for Community Transformation through the Saint Lucia Social Development Fund to assist young men with deviant tendencies.

It is also our hope that young people who wish to venture into lawful businesses will avail themselves of the opportunities created by the Youth Economy Agency. However, we harbour no illusions that those who are now engaged in the business of crime will move to lawful businesses. We need to have a clearer understanding of why a growing number of young people in our region choose to ignore the clear evidence that the only outcomes from a life of crime are temporary or permanent loss of freedom or loss of life. We need to understand what is driving our people into gangs and what is keeping them in gangs. We need to understand these dynamics so that we can devise the right policy and strategic responses. 

Towards an Early Warning System

What seems to be clear from the research is that often, the roots of antisocial behaviour go back to one’s childhood. Given this consensus, the logical question that arises is: how do we set up an early warning system, that allows Governments and their social partners to act as soon as red flags of antisocial behaviour are raised?

This is a huge challenge that is beyond the capacity of any one social institution, acting alone. Still, it is a challenge that we must address, head-on. Among other things, it will involve redefining the roles and functions of our police, our schools, and our primary and secondary healthcare facilities. It may even involve re-designing our police stations, to better deliver community policing. It will require an integrated data management system, linking our schools, health and wellness centres and police stations in all communities, with the goal of spotting, sharing, and treating early warning signs, such as poor mental health, physical abuse, poor family relationships, and criminal behaviour, and to track the progress of these individuals over time. 

The growing presence of gangs in our schools also means that we must rethink the role of our schools, as well as the content of school curricula. To reduce or prevent violent behavior among school-aged children, our schools will have to become more than mere providers of academic-based education. Emphasis must also be placed on equipping students with the requisite emotional intelligence, including self-awareness, self-control, and social problem-solving, to thrive in a school or community that is at risk of gang violence. 

Besides schools, our primary and secondary healthcare facilities have critical roles to play, as increasingly, perpetrators and victims of violence are treated there. In some countries, hospital-based violence intervention programs that involve screening and intensive case management have been shown to be successful and cost-effective in reducing the reoccurrence of violent injury.

Addressing the Public Health Impacts of Crime and Violence

One area that we must give more attention, to is the management of public health impacts of violent crime. Admittedly, our social institutions are not set up to fully handle this imperative in all its dimensions. It is now standard practice for family members and witnesses of violent crime to ask news reporters to hide their faces and to alter their voices, when carrying stories on incidents of violent crime. This is a clear sign of fear, that can linger long after the incident is forgotten and it can manifest itself in long-term, mental and physical disorders, including non-communicable diseases, such as cardiovascular diseases, diabetes, and kidney disease and revenge. Recently, early morning joggers who discovered the victim of a homicide in a parked car, spoke of their fear of continuing their exercise routines, pointing to the indirect impacts of violent crime on personal health.

Of great concern to me and my Government is the diverse impact of violent crime on children, which goes beyond experiencing or witnessing violence, and includes the loss of one of both parents, impairment of emotional health, poor performance at school, and a higher tendency to drop out of school, the need for revenge, reduced employment opportunities, and a stronger likelihood of engaging in anti-social behaviour. With the increasing presence of the internet, children are also victims of cyberbullying.

The effect of violent crime on the emotional and physical health of our security forces, and medical personnel, is also of great concern to my Government.

The Coincidence between Public Security and Public Health Approaches 

While my government continues to provide unprecedented resources to our police, it has become clear that only a multi-disciplinary, proactive, and evidence-based approach can bring about a sustainable abatement of crime and anti-social behaviour in our country.

Acting on the WHO’s advice, my Government is aiming to address the underlying risk factors that increase the likelihood that an individual will become a victim or a perpetrator of violence.

Public health and public security share similar policy objectives, as they both aim to provide the maximum benefit for the most people. Programmes for primary prevention of violence, that are based on the primary health care approach, can help to expose a broad segment of a population to prevention measures and to reduce and prevent violence at a community level. This approach will enable the relevant agencies to assess what I call “the epidemiology of crime.” By that I mean, understanding the underlying economic, social, and environmental drivers of crime and risk factors and applying targeted interventions to help divert individuals, families, and communities at high-risk, away from violent crime.

Restoring Family Structure and Values

A focus on the family and the community is warranted because these are the twin incubators of good and bad behaviours and values. So goes the family, and so goes the community.

Over the past two decades, we have seen a steady decline in the traditional structure and function of the average family in our region. The system that enabled parents to earn a living while their children were cared for by immediate and extended family members is no more; thus, disrupting the transfer of positive family values. A preventive approach would entail the deployment of multi-disciplinary teams of family practitioners to give sustained moral and emotional support to at-risk families.

I also see benefits from applying the primary health care architecture in our countries to public security, with community police stations adopting the preventive culture and approach of community health centres, contributing to research on standard public security data, and feeding intelligence to a central point where it can be analyzed, and recommendations sent up the chain of command, for targeted interventions in anti-social behaviour hotspots. Of course, this will have to be done in a secure and confidential manner.

Towards a Regional Institutional Architecture

In my address to the regional symposium of CARICOM Heads of Government on crime, I recommended that CARPHA’s high quality, laboratory services and technology and research be replicated in tackling violent crime. I believe our region will benefit immensely from having an effective network of crime labs at the national and regional levels. I also recommended that a technical working group be established to provide objective and independent knowledge and expertise, and to ensure that research and implementation of forensic technology is relevant and responsive to the needs of the forensic science community. The work of the University of the West Indies will also be integrated.

Moving Forward  

Adopting a public health approach to public security will require huge investments in capacity building, both in terms of equipment and training of frontline personnel. Ideally, we will need a comprehensive assessment of the training needs for the adoption of a whole-of-government and whole-of-society approach to crime prevention and control. We will need a corps of well-trained and resilient counselors, and psychologists in our schools and communities who can handle the emotional stress of working with at-risk children and provide family therapy for young people at risk of gang involvement and exploitation.

I believe all Caribbean Governments would benefit from a targeted and sustained action research agenda, that provides real-time data on trends and dynamics of violent crime in various hot spots. It seems to me that to be effective, this data will need to be generated at the level of the individual, who may be predisposed to criminality. Much of the evidence on strategies to prevent and reduce crime and violence focuses on children and adolescents. However, additional research and interventions are needed to address crime and violence throughout the life of an individual.

I believe one way we could do this is through the establishment of a collaboratory or group for cooperation on the abatement of crime and violence in the Caribbean, which would include all agencies with mandates in this area, as well as professionals and which would feed into annual meetings of CARICOM Heads of government. I believe this issue is critical enough to warrant at least a full day of discussion that would lead to decisive action. 

Conclusion

Without a doubt, the incidence of crime and violence in the Caribbean presents a public health crisis that is surpassed only for the time being,  by the COVID-19 Pandemic. The same degree of resolve, ingenuity, and commitment that we used to overcome the pandemic must be applied to dealing with the crisis created by the crime and violence in our region. And, it is a crisis.

WE MUST WIN THE WAR AGAINST CRIMINALITY IN OUR COUNTRIES. FAILURE IS NOT AN OPTION.

I commend all who worked tirelessly to stage this conference. I encourage all our first-time and repeat visitors to carve out some time during your stay with us to experience as much as Saint Lucia has to offer and to attend the Jazz festival.

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