Turks and Caicos Islands

Table 4.4.3: Reported cases of gastroenteritis in the Turks and Caicos Islands between 2000 and 2009
Year 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Sum of Gastroenteritis < 5 yrs
209 183 72 197 197 360 302 280 365 303
Sum of Gastroenteritis ≥ 5 yrs - 1 22 210 207 350 426 513 571 825
Total no. cases 209 184 94 407 404 710 728 793 931 1128
(Source: CAREC, 2008a; CAREC, 2008; CAREC, 2008b; CAREC, 2010)
Conversely, heavy rains and subsequent flooding can give rise to an increase in incidence of diseases
especially where pit latrines are in use as was the case after the flooding brought on by Tropical Storm
Hanna (ECLAC, 2008). Acute haemorrhagic conjunctivitis also known as ‘red-eye’ is also spread due to poor
sanitation conditions and has occurred consistently over the years (CAREC, 2008a). Outbreaks can affect
the tourism industry, as was the experience in 2005 when there was a gastroenteritis outbreak (due to
Norwalk Virus) in a hotel which affected 47 guests and staff over four week period (CAREC, 2005).
Currently, the percentage of the population using an improved drinking water source was 98% in 2008 and
98% of urban population had access to improved sanitation facilities (ECLAC, 2010). The majority of the
population (93%) live in urban areas (ECLAC, 2010). In the last census conducted in 2000, 34.1% of the
population used pit latrines (Kairi Consutlants Limited, 2000a) and there is currently no public sewerage
disposal on the island (Byron, 2011). Indeed the Turks and Caicos Islands solid waste and fecal waste
systems are known to increase the spread of disease and encourage pests (PAHO, 2007, 2011). Water
sources on the islands vary depending on water demand of the population and economic activities existing
on a given island. There is the potential for potable water resources to become increasingly inaccessible by
the poor as availability decreases and the price of production increases in the territory (Climate Change
Committee, 2011b). There may be a rise of the diseases previously mentioned if water resources become
scarcer coupled with higher unemployment rates and deterioration in social conditions.
Legionnaires’ disease - Legionnaires’ disease is associated with water and is linked to climate change due to
the greater incidence of the disease in hot humid rainier conditions (Fisman et al., 2005). Legionnaires’
disease is essentially a severe form of pneumonia which arises when the host is exposed to “aerosolised
water containing the bacteria or aspirates water containing the bacteria” (Fields et al., 2002). It thrives in
stored hot water (32 - 45°C) environments such as in spas, hot tubs and humidifiers which create a suitable
reservoir for harbouring the bacteria. In addition it also thrives in natural waters, pipes, distribution
systems, air conditioners, showers and cooling towers (Fisman, et al., 2005; Rose et al., 2001). It is
therefore a disease of relevance in the tourism industry, having been the cause of illness on a number of
cruise ships (Fisman, et al., 2005) and tourist hotels in various parts of the world. However, in the
Caribbean region, research on the prevalence of the disease is limited to work at a hotel in Antigua
conducted by Hospedales et al., (1997) and the quality of potable water in hospitals in Trinidad and Tobago
by Nagalingam et al., (2005). Nonetheless its relevance to health and climate change in the Turks and
Caicos Islands is evident, given the high dependence on the tourism sector and the expanding cruise ship
industry. Given the climate and the need for water storage in the Caribbean region it is clear that there is
always a risk for Legionnaires’ outbreaks.
Food security
The Turks and Caicos Islands do not have a significant agricultural sector owing to poor soil quality, the size
of the islands and low annual rainfall so it therefore has to import substantial amounts of food. Most of the
food consumed in the Turks and Caicos Islands is imported outside of fisheries resources which are
traditional part of the diet (Kairi Consultants Limited, 2000a). As such, food imports account for a significant
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