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April 1988

Ophthalmology in Jamaica

Author Affiliations

Kingston, Jamaica

Arch Ophthalmol. 1988;106(4):557-558. doi:10.1001/archopht.1988.01060130603047

Jamaica is a tropical island that presents stark physical contrasts, from the glittering seaside resorts of the north coast to the desolate sprawl of the shanties of Kingston. A similar disparity runs strikingly throughout all aspects of Jamaican life, perhaps most evidently in the access to medical and ophthalmic care. This article attempts to summarize the current state of ophthalmic practice and to illustrate initiatives for the future.

The island measures 234 km (146 miles; east-west) by 82 km (51 miles; north-south), with an area of 11547 km2 (4441 square miles). The highest peak of the Blue Mountains (2220 m [7400 ft]) affords views of Cuba. The average daily temperature at sea level is 26.7°C to 30.0°C 80°F to 86°F), and annual average rainfall is 195.6 cm (77 in). The population of 2.2 million derives from many cultures: the original Carib and Arawak Indians, West Africans (brought in as slaves to work the sugar plantations), and East Indians (arriving as indentured labor after emancipation). European, Chinese, and Lebanese minorities added to the community, producing a unique mix, illustrated by the national motto, "Out of many, one people." Disharmony and turmoil tend to be on the basis of political allegiance rather than racial origin or disparities of wealth.

OPHTHALMOLOGIC PRACTICE  There are approximately 18 ophthalmologists in Jamaica, 13 (72%) of whom practice in the capital of Kingston. Approximately one third are government contracted, another third are in private practice, and the remainder are "mixed." Herein lies one of the fundamental problems in Jamaica: the relative inaccessibility and expense of ophthalmic care to the poor and rural communities.Recently there has been a proliferation of insurancebased health maintenance organizations and private hospitals. Many Jamaicans may even seek consultation and treatment in the United States. On the other hand, the average per capita weekly wage is $130 Jamaican ($20 to $25 United States), and the vast majority must rely on government hospital service.

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