International Social Work and Social Welfare: Caribbean
Abstract and Keywords
The Caribbean is a multiethnic, multilingual archipelago of island and mainland territories, with similar experiences of European colonialism and modern-day globalization. Inequality poses a greater challenge than poverty in most countries. Although most diseases associated with underdevelopment have been eradicated or controlled, life-style diseases are on the increase and the region is second only to sub-Saharan Africa in the prevalence of HIV and AIDS. Social service provisioning is modeled on the traditional welfare state approach, although few countries achieve universal levels of service. Social work is well established particularly in the English-speaking countries.
Geographically the Caribbean region comprises an archipelago of islands stretching from the Bahamas at the northernmost point through Cuba, Hispaniola (Haiti and the Dominican Republic), Puerto Rico and east through the Virgin Islands and Anguilla then south through Antigua & Barbuda to Trinidad and Tobago, and including two territories, Belize and Guyana on the mainland of Central and South America respectively. Although not a Caribbean country, Suriname in South America participates in several intergovernmental meetings and forums. The total population of the Caribbean is ∼35 million. Cuba, the Dominican Republic, and Haiti have the largest populations (11.3, 8.8, and 8.4 million people respectively), followed by Jamaica and Trinidad and Tobago (2.6 and 1.2 million people respectively). Several countries have populations of less than one million: Guyana (740,000), the Bahamas (301,000), Dominica (78,000), and St. Kitts & Nevis (40,000) (United Nations Development Program Web site: http://hdr.undp.org/hdr2006/statistics/). Despite a common history of colonialism and the transatlantic trade in Africans, the population of the Caribbean is racially, ethnically, and culturally diverse. A few countries still have indigenous populations (Belize, Dominica, Guyana, and St. Vincent and the Grenadines). Guyana and Trinidad have large East Indian populations, and groups of people of European, Chinese, and Middle Eastern descent are found across the region.
Economic and Political Features
Economic activity in the region is based on agriculture. Sugar, banana, and coffee are the main crops grown. Both sugar and banana production have declined significantly. In recent times, a major source of livelihoods for many is tourism. There are substantial manufacturing industries in Barbados, Jamaica, and Trinidad and Tobago, and the latter has a large petroleum and petrochemical industry. Past economic gains derived from these sectors are being eroded. The rapid expansion of the number of hotels has raised issues of environmental sustainability and in some instances the erosion of residents' rights of access to some of the best parts of their country. The picture is further complicated by the heavy domestic or foreign debt burden borne by several countries, and increasing levels of foreign ownership. In addition, the region is very susceptible to the impact of natural hazards such as hurricanes, floods, and most recently, volcanic activity in a few islands. These factors combine to create high levels of vulnerability to external economic shocks and reduce the resources available to support the development of the human and social services.
Several countries perform well in the United Nations Development Program human development index rankings. Several countries were in the top one-third of the index in 2006, including Barbados (ranked 31st of 177 countries), Cuba (50th), Bahamas (52nd), and Trinidad and Tobago (57th). With the exception of Haiti, most are also poised to achieve most of the Millennium Development Goals, especially those related to the eradication of absolute poverty and the achievement of access to universal primary education.
Most countries in the Caribbean boast of their multiparty democratic status (see Sunshine, 1996, for an overview of region). In the English-speaking Caribbean there have been occasions of political unrest, some violent, in Grenada, Guyana, Jamaica, and Trinidad and Tobago. In addition, free and fair general elections are only recently becoming the norm in Guyana. Cuba maintains its particular brand of single party governance, and countries such as Haiti and Suriname continue to struggle for lasting sovereignty.
Poverty is one of the major challenges facing the Caribbean. While poverty levels have been trending downward, several countries—for example, Belize, Dominica, and St. Vincent and the Grenadines, have more than 30% of their people living below the official poverty line (United Nations Development Program [UNDP], 2004). In Haiti, more than half the people live on less than one dollar per day. In addition, the region is plagued by high levels of inequality, for example, in the Dominican Republic, St. Lucia, and Grenada.
The prevalence of HIV and AIDS in the Caribbean is second to that of sub-Saharan Africa. Similar to that region, the primary mode of transmission is heterosexual sex. The infection rate among women is increasing steadily. The region had an estimated average prevalence rate of 1.4% in 2003, but this figure disguises the wide variation in prevalence that exists. The prevalence of HIV infection exceeds 3% in Haiti and 2% in the Bahamas and Trinidad and Tobago. The rate in Jamaica is regarded as having stabilized at 1.2%, and it is less than 0.2% in Cuba (because of an aggressive testing and confinement program and the universal availability of antiretrovirals). There are an estimated 16,000 children who have been left orphaned by the disease (UNDP, 2004). Given the level of underreporting and the number of undiagnosed cases, UNAIDS recommends that official prevalence rates should be increased by as much as 40% (UNDP, 2004).
Most of the communicable diseases traditionally found in developing countries have been eradicated or brought under control in the Caribbean. However, the pace of “development” has resulted in an increase in a number of lifestyle diseases such as diabetes and hypertension, as well as diseases such as cancer, the treatment of which is costly for the state, which is the main provider of health-care services for the majority of people in the various territories.
Educational provisions in most countries are comparable to those of many middle-income industrial countries, with an extensive system of mainly community-sponsored preschool facilities and near universal primary and extensive secondary education. There are an increasing number of public and private higher education institutions in the region. The challenges for this sector relate to ensuring equity in the quality of instruction provided and attracting and retaining the cadre of qualified professional staff required by a modern educational system.
Social Policy and Welfare Services
The countries in the Caribbean have very similar social welfare programs. Both the English Poor Law and labor legislation have shaped many of the social insurance and social assistance systems in the English-speaking Caribbean (see Maxwell, 2002, for a detailed discussion). Services in the French and Dutch territories mimic those in the European metropole because of their colonial history or continued colonial status.
In the English-speaking Caribbean, means tested social assistance is available, primarily to older adults, persons with disabilities, and children. The proportion of those receiving this type of assistance does not exceed 4% (Barbados), and in most other countries such as Belize, Grenada, and St. Lucia, this proportion is a mere 1.5% (Baker, 1997). A range of in-kind transfers are part of the policy mix in most Caribbean countries. Nutrition support, especially in the form of food for work and school feeding programs, is a popular option in the region. In-kind assistance often complements social assistance cash payments, and is restricted to those unable to work by virtue of age or disability. Very few countries provide assistance to the so-called able-bodied poor, except in cases of emergency, such as fire or flood. Limited compensation for injury on the job has been available for more than 50 years, following labor uprisings throughout the region, which led, among other things, to the recognition of trade unions.
Barbados is the only country in the English-speaking Caribbean that provides unemployment insurance and has what could be regarded as the most developed social security system in the subregion. Barbados's social spending (health, education, social security, and welfare payments) represents 12%–16% of GDP, and the replacement rate for social insurance benefits varies between 40% and 60% of beneficiary incomes. This is unlike Jamaica, where social insurance benefits are paid at a flat rate below the official minimum wage. Jamaica's social expenditure as a percentage of GDP is less than 10% per annum (Baker, 1997). Indeed, social spending for most of the countries in the Caribbean falls within this range. In recent times, World-Bank-inspired social protection programs have focused on increasing the efficiency of services by targeting persons negatively affected by structural adjustment.
A significant departure from this framework is Cuba's social welfare system. Up to 1990, social welfare spending (including for health and education) in Cuba was about 21% of GDP. The state was the exclusive provider of a system of universal social services. The break up of the Soviet Union and a tightening of the U.S. embargo led to a dramatic decline in Cuban economy in the 1990s, and occasioned a radical reorganization of many state institutions (the “Special Period”). Nonetheless, the government not only maintained but also increased its level of social spending, so that by the end of the 1990s public social welfare expenditure had increased to 32% of GDP. However, the economic policy changes that were implemented resulted in the reemergence of a number of social problems and a reduction in the purchasing power of the average Cuban citizen, and continuing controversy over the lack of political freedoms. These developments were addressed by opening up a role for indigenous and international nongovernment organizations and a substantial expansion of the cadre of professional social workers. Efforts to reach the most vulnerable have led to the emergence of a debate about targeting the delivery of services, the adoption of community-based approaches to service delivery, and an emphasis on community development (Uriarte, 2002; Valdes & Valdes, 2004).
Role of Social Work
Professional social work education has been provided in the English-speaking Caribbean for almost 50 years, beginning at the University of the West Indies (UWI) campus at Mona in Jamaica. Social work training is now provided at all three UWI campuses: Mona, Jamaica, Cave Hill, Barbados, and St. Augustine, Trinidad. The undergraduate programs are generalist in nature, while the M.S.W. degree programs allow students to concentrate on a particular field of practice. Paraprofessional training programs are also offered directly by or under franchise from the UWI. The UWI campus at St. Augustine in Trinidad has recently established a small doctoral program. Social work training is also available at the University of Guyana, the University of Belize, the University of Suriname, the College of the Bahamas, and at a number of other universities and colleges. A 2006 meeting of representatives of social work programs in the region had representatives from a total of 12 such programs.
The majority of social workers in most countries in the region are employed in the public sector. The greatest number work with agencies serving children and families, or with the justice and rehabilitation system. The majority of social workers engage in casework, and there is an increasing demand for workers with specialist clinical skills to handle cases such as those related to child abuse, and domestic and community violence. In the field of community development, there is an increasing emphasis on supporting employment creation (whether through skills and personal development training programs or through microcredit schemes). Community workers in countries such as Jamaica are also called on to facilitate processes to reform the system of governance to create the possibility of greater consultation and participation. Very few social workers are involved in advocacy or policy practice.
The number of professional social workers in any single Anglophone Caribbean country varies from less than 20 in the smaller islands to close to 1,000 in the largest island, Jamaica. There have been efforts to establish professional organizations in many of the territories, the most enduring efforts being in Barbados, Guyana, Jamaica, and Trinidad and Tobago. These organizations regularly sponsor training programs for their members, and occasionally speak out on public policy issues. The issue of the regulation of the profession is currently on the agenda of most of these organizations.
Cuba again has its own distinctive history. Professional social work education was available at the University of Havana from as early as 1943. However, the revolutionary government curtailed university level education and assigned many social work functions to its popular organizations such as the Federation of Cuban Women. A limited number of social workers were trained at technical institutes for specific duties in areas such as public health. The challenges of the “Special Period,” inaugurated by the changes in the 1990s, led the government to dramatically expand its cadre of paraprofessional and professional social workers. Four Social Work Training Colleges where young people aged 16–22 years receive intensive 6–10-month training were established in the mid-1990s. Over 8,000 of these young people have been deployed to identify and mobilize material assistance for individuals with special needs. The University of Havana has once again introduced university level professional social work education. The result of these initiatives is a dramatic expansion in the number of social workers in Cuba in the last 10 years.
Language has restricted the establishment of relationships between the various groupings in the region, but some interchanges have occurred especially through encounters at regional and international conferences. There is a regional Association of Caribbean Social Work Educators (ACSWE). The ACSWE hosts a biennial conference that attracts a large regional and international audience, and publishes an annual journal, the Caribbean Journal of Social Work. The ACSWE is a suborganization of the International Association of Schools of Social Work.
Baker, J. (1997). Poverty reduction and human development in the Caribbean – A cross-country study. World Bank Discussion Paper No. 366. Washington, DC: The World Bank.Find this resource:
Maxwell, J. (2002). The Evolution of social welfare services and social work in the English-speaking Caribbean (with major reference to Jamaica). Caribbean Journal of Social Work, 1, 11–31.Find this resource:
Sunshine, C. (1996). The Caribbean: Survival, struggle and sovereignty. Washington, DC: Ecumenical Program on Central America and the Caribbean.Find this resource:
United Nations Development Program [UNDP]. (2004). Regional report on the achievement of the Millennium Development Goals in the Caribbean Community. New York: Author. Electronic version.Find this resource:
Uriarte, M. (2002). Cuba – Social policy at the crossroads: Maintaining priorities, transforming practice. An Oxfam America report. Retrieved from http://www.oxfamamerica.org/newsandpublications/publications/research_reports/art3670.html
Valdes, J. C., & Valdes Paz, J. (2004). Institutional development and social policy in Cuba: “The special period.” Journal of International Affairs, 58(1), 175–188.Find this resource: