Trinidad and Tobago

Trinidad and Tobago are located in the Caribbean Ocean, just off the coast of Venezuela. The entire state is comprised of 23 islands; Trinidad, the largest, is 4,828 square kilometers, while Tobago, the second largest is just 300 square kilometers. Like many countries in the Caribbean, it is a multiethnic, multicultural society comprised of the descendents of groups brought there over the centuries.

The combined population of the islands is 1,065,000. The birth rate is 12.9 per 1,000, the death rate is 10.57 per 1,000, and the migration rate is minus 11.07 migrants per 1,000, leading to a population decline of minus 0.87 percent annually—the lowest population growth of any country in the world.

Economics seem to be the driving force behind the falling population. Trinidad and Tobago are liberal democracies, highly industrialized societies with strong exports in agricultural goods, petroleum, and petrochemicals; there is strong foreign investment and a growing tourist sector. Still, the per capita income for Trinidadians and Tobagonians is $8,580 a year, and 22 percent of the population live under the poverty level—4 percent on less than $1 a day. Unemployment stands at 8 percent.

Key health demographics are solid. Life expectancy at birth is 65.71 years for males and 67.86 years for females. Infant mortality is 25 deaths per 1,000 live births; another 20 per 1,000 die between the ages of 1 and 5. Maternal mortality is 160 per 100,000 live births. Nine-ty-two percent of women receive prenatal care and 96 percent give birth with the help of a trained attendant.

Major infectious diseases are under control. Ninety-five percent of all children receive immunizations for polio, hepatitis B, diphtheria, pertussis, tetanus, and other risks. Ninety-one percent of the population have access to safe drinking water and 100 percent use sanitary facilities. The country was declared malaria-free in 1965. Leptospirosis rates have been dropping for years. Meningococcal infections are sporadic, as are cases of dengue fever. Food-borne illnesses such as salmonella and shigella increased between 2002 and 2004, as did influenza and hepatitis B.

The human immunodeficiency virus (HIV)/AIDS rate stands at 3.2 percent, with about 29,000 islanders living with the virus and an estimated 1,900 deaths from the virus through 2003. Tuberculosis rates have also risen. The Ministry of Health has recently expanded its AIDS education campaign.

Deaths related to violent crime have increased in recent years, fueled in part by a growing drug trade and increased gang activity. Deaths due to domestic violence have also risen. Traffic-related fatalities climbed from 5.8 deaths per 1,000 accidents in 1998 to 11.2 deaths per 1,000 accidents in 2003.

In 2004, Parliament passed the Occupational Safety and Health Act, creating the framework for worker protection on the job. Among its provisions, it codified the right of employees to refuse work “where safety or health is in danger.” Subsequent amendments will increase the authority of state officials to monitor safety and levy fines and other remedies.

The government spends about $120 per capita on healthcare each year. The Ministry of Health runs the state hospital system and the insect-vector control and surveillance programs, and monitors food safety and water quality. There are eight large hospitals and 107 clinics scattered throughout the islands, augmented by a private-care sector. In 1997, the World Health Organization counted 1,004 physicians and 3,653 nurses working within the country.

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