Could COVID-19 trigger a bigger ‘Brain Drain’ of Caribbean nurses?

BY. R.D. Miller

A delicate balance

After this unprecedented COVID-19 health crisis, what will be the job satisfaction rate of these facilities, healthcare systems, and nurses scorecards across the Caribbean?

Each year, hundreds of young people receive nurses’ degrees and critical medical assistant training throughout the Caribbean. Health services studies have shown that between 21 and 33 percent of medical systems have foreign-educated nurses, and that number has been increasing each year.

This new potential wave of “Brain Drain’ from COVID-19 is not for the lack of political gratitude, or photo-ops, or alliance with one party, but values medical experts contend critically in keeping them on the sand.

It is an intrinsic value that surrounding one’s opportunity to grow within an organization and the extrinsic value; pay and job security according to experts.

It seems a few of these islands could use an updated Occupation Health and Safety laws. The lack of such regulation I believe undermines protection; ethics in medicine and the integration between the relations with their patients.

The role of a nurse is equally important as a good doctor, a police officer, a teacher, or a safe community. Their presence often allows families to head back to work, or get time off from staying overnight on a hard chair waiting for an answer from a doctor.

A nation’s workforce remains a key factor in its ability to innovate and compete in a global economy. Retaining a nation’s long-term health and socio-economic stability represents its ability to develop leaders and produce action-oriented people with valuable skills. You can only accomplish that with incentives to keep your people on the ground.

These first responders are not there to test politics, they are eyes and ears of doctors, the ventilator power source, from preparing a clean bed to escorting a sick person, even ones with mental health issues while providing comfort to families during times of need.

The decision to stay

Well-sought-after working visas have become a one-way ticket out for many that can lead to permanent residency as demand will increase from countries like US, Canada, the UK; and other nations affected by COVID-19. These nurses will be like stockpiles gowns, masks and ventilators should there be another pandemic.

But keeping nurses prepared is bigger than an economic package from trillions of stimulus dollars passed by government globally. It cannot replace these professionals and thousands of lives lost on the front line.

What COVID-19 discovered is how unprepared even wealthy industrialized nations with high-ranked medical facilities were and imagine economically struggling islands. The stories reverberate from the lack of supplies, long hours, burnout, the emotional labor of watching people dying, and helpless when all their professional training taught them how to keep people alive.

Photo by Laura James

Today, a new analysis of caregiving widely observed in hospitals; the difficulties in balancing work and family responsibilities and emotions during this pandemic, now under the microscope.

Sure, government policies provided monetary relief, supplies, helped the financial markets, create economic activities from business closures, and unemployment, but experts noted that imported nurses have had a major impact on patients’ health, care systems economic and social development.

After COVID-19 took over the Caribbean shores; most leaders have held off the potential high tide through awareness, thus keeping their numbers low to-date, but that remains an open question.

Collaboration, as experts noted, promised by the Caribbean Single Market and Economy remains emblematic as the global hunt for talent continues. It looks more of a competition for equipment; fighting like modern-day pirates as supply and demand became a political sport.

The Caribbean Cooperation in healthcare will be critical in ensuring that not only members of the CARICOM States have better medical attention, but ensuring especially poor areas receive adequate treatment. In addition, addressing current  medical system that has outgrown its aging population

Traveling to some islands and especially rural areas, reaching a medical facility can take a long period unlike better-managed islands with and more access, but pay at the time of service will become more difficult for poor patients.

Haiti

Looking for an upgrade:

Protecting vital medical workers from now on will not be about competency, or how many press conferences held, but ensuring that nurses have a better standard to keep potential turnover low. There must be a relationship between job satisfaction and organizational commitment among these region health care systems.

Before COVID-19, concerns regarding upgraded technology, supplies and other equipment to save lives, even newborn vibrate through these wards. Some facilities the claim jeopardize both nurses’ and patients’ lives by putting them at a higher risk of an infectious disease.

Several health care professionals argued that COVID-19 gaps and facilities operating like an experimental drug with little accountability, while pundits’ praise leaders for their interest overlooking the systematic failures on many fronts to create changes.

Individuals who speak out especially about COVID-19 experience under strenuous and poor employment conditions, appeared to be silenced shortly after. This diminishes accountability, more susceptible to errors, reduce best practices, and more risks.

Photo by RF._.studio on

The reality:

The next flight out by these nurses is not a result of leadership style, gender equality, abandonment of their nationality or the lack of education; several have enormous student loans, safety concerns from high crimes, reports of underpaid with a little support system to ease emotional scars.

Many reports notes that the worst-affected countries see more than 80% of their “brains” emigrating abroad, such as for Haiti, Jamaica, and Africa to several small states with fewer than one million workers.

One nurse talked about vacations are being missed from the fear of losing employment, and that could reset the current salary after years of solid service. Her plans are an economic opportunity for a better work-life balance, (spouses, parents, children) hoping prepared system and organizational management as her role remains the same.

Although global movements may be restricted, a country like Cuban has supplied doctors and nurses with many other diseases and pandemic areas. Regardless of their political system or who received payment for their services, wherever they land, lives are being saved, as caregivers are becoming of great importance globally.

Over the next decades, the aging population will increase both hospitals and home-based care, according to healthcare professionals and scholars, and nurses will become more critical to meet the demands..

These nations will have to plug these gaps, and their medical system upward-mobility will diminish with migrated talents. Studies have shown some nurses make good salaries, but this profession should command excellent salaries, such as one in math, finance, science, or a career in petroleum, according to business reports..

Developing countries and some dominant Caribbean islands such as Jamaica, Trinidad and Guyana, Belize, and other Latin Caribbean nations, where prolonged economic symptoms have crippled major public medical facilities for decades, have much to lose.

The complexity of care

Although there are excellent doctors in the region in private facilities, there were reports that several practices closed because they too lack the proper resource, collaboration to conduct tests locally, and further educate their patients.

Many nurses will remain along these warm and beautiful shores avoiding brutal winters, but the region must also develop incentives for others to come back who have left to study medicine in countries like Germany, Cuba, the US, and other places.

There are reports of few modernization throughout the region, but cannot have trust in the system if some leaders seem to have a “pre-existing condition” that is a defensive and basic question asked about numbers of people tested for COVID-19 muted, but stimulus check being handed out are published, while dissenting views seen as antagonistic.

Caregivers’ experience imported, or local should not be polarized or exploited through politics. They are beyond a quick stop by a local shop, pave a road a week before an election; hand out a few dollars, then sell a false sense of community only to be missing until the next election cycle must stop.

As some of these Caribbean nurses evaluate and test their next passage, you may see one on a bus or subway heading to the next shift; as the economic strength of a nation depends on how healthy that society is.


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Protecting the future of Caribbean women from violence: Chinese Community Policing, maybe?

By R.D. Miller

Her Story/Their Story

At the beginning of January 2020, I registered with a few electronic news media from the Caribbean region, and within a few days according to my online feed reports about six murdered women, including others who have disappeared. Today I highlighted a few from an increasing list of victims and ceased counting. From Trinidad and Tobago, Jezelle Phillips, Gabriella Dunbarry, and Pollyan Chunlesingh.

From Jamaica, Neville Sinclair sought to escape a toxic relationship, Shantel in McMaster in a supermarket shot dead by her lover, Suzanne Easy, killed by the defense force Corporal Doran McKenzie who later took his life.

And from Guyana, Somattie Keosoram, Naiee Singh Naiee, 31, an ad­min­is­tra­tive of­fi­cer, and Sharon Burnett, 56 a shopkeeper.

Though several males have lost their lives to violence around a similar time. Many of these cases are unrelated to an intimate relationship, but studies have shown, on average; less than ten percent of men are killed by their female partners, while males kill over 80 percent of females.

Photo by cottonbro

Violence in general, especially domestic is a public health issue along many of these shores.

Studies have shown that on average about 40 percent of the Caribbean population identifies crime and security-related issues more severe facing their countries, further so than poverty or inequality. And while leaders debate, the psychological effects continue.

Does it matter if you are a teacher, student, wife, mother, aunt, or sister if the murder rates and violent crimes especially against women are high?

The chance of being kidnapped, robbed, raped, or murdered is also high. Unfortunately, before you finish reading this article, there will be other victims.

24-year-old, Shantel Whyte in a domestic relationship that went bad gunned down his love inside the store he managed. Many local reports noted that she was well-loved, energetic, and had a bright future. Accountability is also key to getting the community to become more engaged. Social media alone cannot replace good governance. Authorities habitually lack the resources, especially in rural areas, where technical skills to solve challenging crimes could use an upgrade.

Shaitel Whyte-24

Today, weapons have replaced discussion to minimize minor conflicts. And with the lack of resources for resolution, disagreements easily degenerate into brutal personal aggression and killings. Often, these perpetrators have overlooked criminogenic risks factors that include anti-social cognitions and behavior. (Domestic Violence-Podcast)

The silence is deafening

Often selective amnesia kicks in and it can no longer be a strategy. Minimization represents not a plan, tweets do not conjure fundamental support, nor frequent comparison to another country offers a solution.

Furthermore, a sudden visit to a victim’s home is good, but without resources or a quick policy that lacks getting to the root of the problem, women’s concerns at the table and the community included is not a long-term solution.

Though violence is ubiquitous, and there are many reports of mentally deranged or racist individuals with easy access to high-powered weapons killing or targeting innocent victims. However, the reported one or two-per-day killings on these shores are adding up regardless of location.

It seems that the same record plays over and over, we are going to look for solutions and where local concerns voices seem to be drowned out. Additionally, these atrocities must be solved thereby, capturing potential serial killers off local streets and communities.

How many women before these latest victims have gone missing, abused, or murdered, and those stories remain unsolved?

Far too often a consistent trend,” the police investigation is ongoing, while vulnerable victims families search for sufficient answers. When does the “next button stops along these shores, and many other places?

I wondered are the Caribbean women threaten with gradual extinction not by shark attacks, or aging but by the hands of their domestic partners. How many youthful lives have been cut short? Your next school teacher, police officer, doctor, social worker, or even prime minister. It looks like these perpetrators have taken out life insurance policies and to cash in many resorts to violence.

Photo by Anete Lusina

Even more problematic than the re-victimization attitude by some, as if they had it coming.

Often in our society, conversations on these cases begin with the interrogation of the victim.

“She could have run out of the situation .”

What caused her to be abused?….. Why didn’t she leave?

But no one ever asked him in jail, at school, church, or in the community; Why he targeted her?

Often many victims, and even who are tasked to help may deflect or minimize. We recognize the traditionalists, the “silent generation, “as experts noted, are individuals of an era raised to be seen and not heard.

A victim is killed by a spouse, ex-spouse, or some dating partner every 14 hours. And every 20 minutes an intimate partner abuse someone. Domestic violence accounted for about 19 percent of the total burden of healthcare for women age 15-44 according to experts and the center for domestic violence.

Every year, millions of women are emotionally, physically, sexually, or economically abused or killed by someone they recognize and love, a husband or a partner. These domestic and family violence cases are more than politicians arriving at a gruesome crime scene, captured a few pictures with a victim then posting on social media with little or no resources to follow.

Photo by RODNAE Productions

This issue is beyond a few tweets with a distorted sense of empathy. They should be galvanizing more and demand change and official accountability because “we are going to, “does not prevent fractures, third-degree burns, lacerations, disfiguring scars, and finally death in many cases.

On many Caribbean islands, and other places, Asia, Africa, Europe, and Latin America; domestic violence remains taboo in some cultures. It has an extensive history of masculine chauvinistic (macho) status.

Many still view street harassment as normal and few will admit that is a critical problem. Habitually this behavior escalates into unwanted touching, assault, kidnapping, and death.

Unfortunately, many victims remain in the shadows after being re-victimized, humiliated, blamed, and given little support, even for the offenders.

The upward socioeconomic mobility of women and other victims may have become a threat to some males because; she is now independent, confident, more educated, and that severely threatens traditional thinking where gender role defined and she was better suited or relegated to the kitchen.

This violence seems to be on a trajectory like in other places where ethnic, cultural, and religious cleansing from geopolitical conflicts. Human rights reports have shown, the vulnerability of women being targeted, and if they do not comply with orders many, are molested, brutalized, or killed.
 

The cycle, disconnect, and long-term impact

Swiftly accusing the victims is minimization, and the argument that those men kill from mistrust, terrible judgment, and she should stop talking back to how much they spent on her needs to be debunked.

She should run, but where is she going to hide in a system that has holes, that should protect their vulnerability. It is always what she must have done, and not what should have happened.

Many children who live in homes where there is domestic violence equally suffer abuse or neglect at a higher rate. This violence develops a pattern of psychological and overcoming this traumatic experience suffers long-term critical consequences in which some also become abusers.

Over three million children witness domestic violence in their homes every year. Some grew up falsely believing that if because concerned mum stayed it was ok. However, the lack of effective responses; resources, and often accountability by local law enforcement and judiciary; coupled with inadequate training for first-line responders to handle these violent cases, the cycle continues for helpless victims.

Often these victims’ stories are sometimes politicized, deflected, or little condemnation by elected officials to not disturb the tourist ships from docking, to keep hotels at capacity, or simply put, they likewise are indirect victims of the impact or fear to speak up.

Leaders must invest more resources in Community Policing, treatment programs, victim services, and youth organizations to identify these troubled individuals, job training, and rehabilitation to prompt a mental shift on how they mitigate conflicts.

These local systems must be able to identify the criminal symptoms with psycho-sexual assessments before you can deploy a vaccine.

The uptick in violence, especially against women, needs critical examination as to the cause supported by policies to offer more protection and support. Despite laws and women’s rights movements in the region dated back to the 1950s like in The Bahamas, led by Dr. Doris Johnson. However, several of these laws are outdated and may need to be amended to meet today’s concerns

More dialog is important, and not just when one is murdered. It cannot solve the familiarity of what happened at home stays at home with a call to a dear pastor, or few likes on social media while they seldom hold perpetrators accountable.

Very often, it is a 48-hour news cycle, guilt, social media bliss, and promises as if governance can be accomplished in a few characters. Some of your leaders should go back and read their social media promises and what will be arranged, with little or no support to follow-up for the victims.

Confronting violence against women is making sure that their community remains a great place to live, work and play with the ability to provide resources to underprivileged victims, food, and personal care items, and a safe place to tell their story without being revictimized.

Poverty, inequality, stigma, and polarization make critical resources difficult to offer family or personal counseling. Intervention would allow treatment, victim services: mediation or shelters. Throughout many Latin American and Caribbean communities, according to the experts, access to these services would change course.

Sadly, experts noted that some group interventions stay in the shadow, lacks proper staffing, closed shortly afterward, and the convicted offenders frequently require the cooperation of law enforcement to make sure they attend treatment programs.

Victims continue using the health care system more than others do, and for several years after.

Today, it seems some elected leaders suffer from selective amnesia regarding violence; robberies to ongoing missing students. They are often caught up in the complexity between policing, politics, and the community.

Vigilantly justice on top does not develop thriving communities. It only shows a deeper systematic issue in the communities and people must speak up to reduce violence. “See something wrong, say something.””


Maybe an alternative to reduce this senseless violence.

Since the outbreak of the Coronavirus, China stabilized over 60 million in one weakened to quarantine this infectious virus according to published reports. What if local law enforcement pursued a similar approach to address family and violent women?

China’s increasing presence globally studies and publications in recent years have shown making new inroads into the Caribbean islands and Africa. They have experienced a cultural explosion of Chinese companies and other recent investments.

These private investments reported offering a path to better economic growth and safety.

I reluctantly began hypothesizing given the Chinese influence on these shores. I entertain some deep thoughts and looked into this trend, and after calling a few experts and friends. They may offer a more robust public safety strategy to safeguard their investments.

If they should the Chinese takeover, high crime islands public safety operations, it may prevent more women from domestic violence killings and other criminal issues?

It will not become a structure of governing that is called a “police state” that only works in a Totalitarian system where the government exercise power through the police. This only leads to more citizen suspicion and anger toward law enforcement. And a delicate walk surrounding these nations’ politics and the constitution.

This idea is less than likely because reports have shown China has human rights issues like forcing Mandarin, as it has done the Uyghurs, an ethnic minority. But importing another approach to addressing these public health issues may work since they already invested and own key areas of these shores. This intrusion may upgrade technology and training.

This controversial practice according to scholars “who are their friends and all the enemies.”If these were to happen, violent criminals would face harsh restrictions of movements, and that alone is what many victims face in these toxic relationships.

These victims need your voice.

Violence against women continues to mask in the shadows in these communities. These victims deserve your support, and an action plan, after she gathers the courage to come forward.

There is a struggle, especially in the higher crime islands, to differentiate ideology from policies to combat this malevolent that is getting worse. Even if it decreases the number of cases of children who have gone missing or later found dead, it may be worth consideration.

Each year from Reggae Fests, Soca and Carnivals took over these nations, but beneath the costumes and rhythms; one loves vibes; someone is hurting from irrational decisions by perpetrators, and maybe these events should be placed on hold to highlight this epidemic.

The system needs to develop better assessments and interventions, mental health, and substance abuse. Often social media only focus on dense areas of crimes while rural areas have gone unnoticed. Speaking about domestic violence, build up confidence for the next generation of awareness. We can no longer accuse it of culture, where the objectification of women remains normal.

I anxiously hope more helpless victims will receive critically extra support from other women and organizations when they come forward without fear of the economic impact.

Violence against women must stay a critical priority not only in an election cycle. This issue will not stop throughout the world as many domestic partners will continue brutally abuse and kill regardless of the calendar day.

Photo by cottonbro