The Honourable Dr. Terrance Drew
Prime Minister of St. Kitts and Nevis
Keynote Remarks Panel Discussion: Aiming for Change: Firearms and Public Health Intersections
68th Annual Health Research Conference
St. Lucia 25 April 2024
Salutation
The Honourable Phillip J. Pierre, Prime Minister of St. Lucia, Dr Joy St. John, Executive Director of CARPHA, Dr. Sharon Belmar-George, Chief Medical Officer (CMO) of St. Lucia, Distinguished Panel Members: Dr. Natasha Sobers, Dr. Nicolas Florquin, Mr. Callixtus Joseph, Ladies and Gentlemen,
I am deeply honoured to address you today on a matter of utmost urgency and importance: firearm violence in our region. As we gather here, I am reminded of my immense responsibility and commitment to address this issue, not only as the Prime Minister of St. Kitts and Nevis with responsibility for National Security and Healthcare; but also, as the Chair of CONSLE.
It is tragic to look at the effects of gun violence across the region. The proliferation of firearms poses a grave threat to our societies, fuelling crime, exacerbating conflict, and undermining the rule of law. With approximately 80% of homicides committed by firearms in many CARICOM Member States, it has led to devastating effects, creating a pervasive culture of fear, trauma, and insecurity in our communities, and also at an individual level.
Remarks
As a medical practitioner, I am very aware of the public health impact of gun violence. Survivors of gun violence often suffer from severe physical injuries, such as gunshot wounds, which can lead to disabilities, chronic pain, mental health disorders such as post-traumatic stress disorder and long-term medical complications. This extends beyond the individual who was shot, but to the families who have to provide care and support. It is also critical to understand that treating gunshot wounds and related injuries places a significant burden on national healthcare systems, consuming resources and personnel that could be allocated to other healthcare needs. The Caribbean Firearms Study documented that the average medical expenditure required to treat a single firearm injury was equivalent to between 2 and 11 times the annual per capita public health spending in three case countries (Bahamas, Barbados, and Jamaica).
What has also become quite alarming, is the trend of increasing paediatric firearm injuries/ gunshot injuries among young children and adolescents.. How can we have a society where children feel unsafe to play and roam freely with their friends in our neighbourhoods and schools? I just focused on injuries but let us not forget the high number of deaths/ or mortality rates across the region due to firearms.
Do you know what age group this impacts the most? If you guessed young males (between the ages of 15-30 years), you are correct. Let us think about the consequences of having what should be the most productive age group in our regional population dying prematurely from gun violence. While young males are the main perpetrators and victims of gun violence in the Caribbean, young girls and women are also deeply affected. They are often among the victims of gun violence, suffering injuries or fatalities in shootings or related incidents. Also in high-risk communities, gun violence can lead to the displacement of families, forcing young girls and women to flee their homes in search of safety. This displacement disrupts their lives, education, and social networks, exacerbating their vulnerability and increasing their risk of exploitation or abuse.
As a regional leader, I believe it is our collective responsibility to take decisive action to address this crisis and ensure the safety and security of all our people. At the national level, I have already put in place a zero-tolerance approach to violence with a comprehensive plan to address crime through multisectoral initiatives. At the regional level, the Heads of Government of CARICOM began discussions on the public health approach to violence at the CARICOM symposium on Violence as a Public Health Issue: The Crime Challenge held in Trinidad and Tobago on April 17–18, 2023. As a result of this meeting, the Heads of Government declaration not only focused on strengthening traditional approaches to law enforcement and crime legislation but also recognised the diverse origins of violent crime require a regional response that incorporates a public health approach.
Violence undermines the gains that our business and tourism sectors are trying to make after the COVID-19 Pandemic. Our Heads of Government have this as part of the focus in the 2023 Port of Spain Outcome document from the Symposium on Crime and Violence
Against this backdrop, I applaud CARPHA for utilizing its Annual Health Research Conference for us to understand and promote research on the public health approach to crime and violence. Over time, organizations such as the World Health Organization (WHO) and the Centre for Disease Control and Prevention (CDC) have published studies on understanding violence as a contagious and epidemic health problem. The public health approach to solving problems consists of three main elements: Prevention, Treatment/Care and Rehabilitation. Throughout this Conference, several researchers and featured presenters will explore public health initiatives and research being conducted to contribute to the public health approach to violence.
It is a timely opportunity for us to recognize the importance of regional institutions collaborating to conduct research and partnering with Member States to inform the development of evidence-based anti-violence programmes/ projects. As a medical practitioner, and having worked in public health in the region, I recognize that emphasis must be placed on Caribbean data driving the development of tailor-made strategies to prevent and decrease gun violence.
Further to this, a multi-sector approach must be coordinated to focus on using this regional data to implement policy recommendations in preventing and reducing firearm violence.
Therefore, this Panel Discussion is ideal for bringing the perspectives of security, public health, and the research sectors together to speak on this epidemic of firearm violence. It highlights regional work already conducted in the Caribbean Firearm Study to guide policies, future research, and interventions in the region within the security and public health sectors to address firearm-related violence. It also discusses research on a current project, “Pathway to Policy: Integrating Security and Public Health Responses to Firearms Trafficking and Violence in the Caribbean”; being implemented by the Small Arms Survey together with CARICOM IMPACS, the Caribbean Public Health Agency (CARPHA), and the George Alleyne Chronic Disease Center at the University of the West Indies (GA-CDRC). This initiative will work towards improving the quality and availability of relevant data and analysis on matters of firearms proliferation and misuse in the Caribbean.
Let me reiterate:
The impact of gun violence on our communities is profound. No one is spared not the most vulnerable, not our children. As a region, we must take urgent action to address the root causes of gun violence and support services guided by research and best practices, designed to create safer and healthier communities.
I am looking forward to these important discussions today in this panel forum; and throughout the Conference about research on firearm violence, and recommendations on reducing this violence in CARICOM. As a region, we must work together to advance a future of peace, security, and prosperity for all our People.