Turks and Caicos Islands

2003, 1,813 in 2004 and 1,632 in 2005 (ECLAC, 2010). In 2007, aside from the public hospital facilities which
were part of the health care network included four private clinics, seven primary health medical centres
and seven family planning clinics (ECLAC, 2008). The hospitals per 1,000 inhabitants in the territory was 2.3
in 2000 and dropped incrementally each year to 1.3 beds per 1,000 inhabitants in 2006 (ECLAC, 2010).
Other relevant facilities in the health care sector include two public laboratories located in the two main
hospitals, one in a private hospital in Providenciales and the National Epidemiology and Research Unit
(PAHO, 2007).
In the case of an emergency such as during a natural disaster there are standby generators. However, there
are fewer generators than essential facilities which require them and this can put hospitals in a vulnerable
position in the event of an emergency (ECLAC, 2008). This is an area where the adaptive capacity of the
health sector in cases of emergency can be strengthened. Over a third of imports to the island are geared
towards fuel which is first imported to Providenciales and Grand Turk and then further distributed to other
islands and cays in the territory. In the event of extreme weather conditions, this presents a problem of
meeting the demand for these islands and cays that would depend on their fuel supply from the main
islands (ECLAC, 2008). Again, logistics such as this example are important in health protection.
One major issue that impacts on the health care sector is that incurred from immigrants from neighbouring
countries, such as Haiti and the Dominican Republic. While many persons legally contribute to the labour
force, they often consist of illegal immigrants, which place a great burden on social services of the island
(Kairi Consultants Limited, 2000a). Diseases are often associated with the illegal immigrant population. As
the HEU, Centre for Health Economics (2009) notes, “Haitians flow into small towns and villages, some
living in bushes and squalor, to escape the life of deprivation in their home country. These immigrants place
heavy demands on the health and other social services of the country”. The TCI Poverty Assessment noted
that the poor living conditions associated with these immigrants is a threat to the quality of the tourism
product as it posed a risk to increased incidence of communicable diseases in communities where they
exist, most notably in Providenciales (Kairi Consultants Limited, 2000a). Persons with illegal immigrant
status also do not seek health care assistance to avoid being deported by authorities (PAHO, 2007) which
can contribute to the spread of communicable diseases and make them harder to contain.
Over 63.3% of the population sought health care from the public sector according the Poverty Assessment
and national census of 2001 and the majority of persons were either satisfied or very satisfied with the
health services offered (Kairi Consultants Limited, 2000a). While the health care statistics of the Turks and
Caicos Islands mirror a more developed country with few reported cases of communicable diseases, there
are a number of basic issues that challenge the ability of the health care system to cope with diseases that
have climate change signals. As such, infectious disease surveillance and disease outbreak management
have been identified as priority needs after Hurricane Irene Hit in August 2011 (PAHO, 2011). The initial
assessment also suggested psychological support for those most affected. Infectious disease surveillance
was also employed post Hurricane Ike and Tropical Storm Hanna as well as an increase in health care
professionals (thirteen professionals most notably in the areas of vector control management, water
sanitation, public health inspection, mental health and public health nursing) from Ministries of other
Caribbean territories (PAHO, 2008). The territory also engages in integrated vector control at the
community level (Medlock et al., 2010) which is important in the controlling the spread of the vector borne
diseases throughout the year.
Vaccinations are also an important adaptive measure that has been employed by the health sector in the
territory to address the threat of certain diseases. For example for diphtheria, the vaccination coverage was
95% in 2005 (PAHO, 2007) and continued vaccination coverage can work to protect the population from
diphtheria threats especially from immigrant populations with poorer environmental conditions and
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