In the light of the increasing prevalence of diabetes mellitus in the Caribbean with about 140,300 cases in Trinidad and Tobago as at 2015, it has become necessary to restrategize on new methods to tackle and curb this widespread disease and in good time too.
It was against this backdrop that the First Lady of the Republic of Trinidad and Tobago H.E. Reema Carmona; who has shown a deep passion for several health challenges faced in her country and has taken giant steps towards making life better for her people, in an exclusive interview with the Amazons Watch Magazine, reveals some of the ongoing activities aimed at tackling health issues, the steps individuals can take towards healthy living, as well as some of her visions for young girls and boys in Trinidad and Tobago. Excerpt:
Over a period of time, we have followed your commendable efforts and commitment towards improving the health and social wellbeing of the people of Trinidad and Tobago, and the Caribbean region at large. Even before your assumption of office as First Lady, some reports indicated that you were a patron of nearly 22 organizations. Please share with us some of your experiences while growing up in Trinidad and Tobago and what prompted the spirit of humanitarianism in you.
I was born in New Jersey (USA) in 1970 and then migrated to Canada for seven years. From the ages of 7-16, I lived in Trinidad and though a practising Hindu by religion, I attended St Brigid’s Roman Catholic Primary School and then on to a Presbyterian Secondary School, Iere High School, Siparia, Trinidad. This early exposure to different religions and cultures inculcated in me, the tolerance, appreciation, mutual respect and love, I have always had for all peoples. Growing up in the rural district of Fyzabad, Trinidad, was both challenging and rewarding. My family and I enjoyed the peace and serenity of country living, embracing genuine traditional values involving grandparents, neighbours, and elders in our community. My parents and my community nurtured in me, the need to be kind, courteous, respectful and compassionate, in a world fraught with man’s inhumanity to man. Mine is, therefore, active advocacy that moves and shakes indifference to social issues and insensitivity to the less fortunate, the marginalised and persons who are differently-abled.
Some basic amenities, such as equal access to quality health care, we’re not in constant supply or not in supply at all, because rural communities did not receive the same largesse as those in urban districts. These lived experiences and observations have inspired me as First Lady to assist in improving and transforming the quality of life for all citizens in T&T, regardless of race, socio-economic status, religion or political affiliation.
I consider myself fortunate to have grown up in the midst of the village community, Fyzabad, which was multi-racial, multi-ethnic and multi-religious. My community celebrated Eid-ul-Fitr, Divali, and Christmas with equal joy and intensity, where we would visit our neighbours and they would visit us, sharing their blessings, happiness, and joy. I recall my Hindu parents, inviting friends and family of all religions, to our home to light Deeyas and to celebrate Divali, the Hindu festival of lights. Those religious holidays were really wonderful days. Living in urban Trinidad now, I do miss those joyous times but I make the effort to carry on those religious traditions and practises. His Excellency and I celebrated Divali on the Presidential Grounds, for the first time, with traditional foods and entertainment for the public, who attended, lit Deeyas and participated in this joyous festival of lights.
My life has been an eclectic mix of diverse cultures. I lived in Ottawa for some eleven years, graduating from St Catherine’s High School and thereafter, graduating from the University of Ottawa with my BSc Degree in Economics. My brother, who has since become a medical doctor, attended University with me and I must admit, this gave me that much needed emotional and social support away from home. Shortly after returning from Canada, I met my husband who I had known before, living in the same district and who I had not seen for many years. Within two years, we got married and I am now the mother of two teenagers, Christian 16 and Anura 14.
My father’s death, a few years ago, from the ravages of brain cancer, was shattering. It, however, brought into perspective a family’s plight when dealing with the terminally ill. The search for adequate caregivers, the unavailability of a hospice in my village and the lack of palliative drugs to ease the pain, attributable to our archaic laws vis-à-vis, the registration of new drugs, I can never forget. Personal tragedy can certainly trigger a call to arms on behalf of the afflicted. I cannot bear to see people suffering or being taken advantage of and I have always felt that by small acts of kindness, there can be exceptional results. People just need to be loved and know that you care.
Your advocacies and noble activities have been centred on addressing a wide array of health and gender-based challenges such as non-communicable diseases, diabetes, autism, childhood obesity, child marriage and adolescent pregnancies, as well as women and youth empowerment. What is the scope of your involvement in this scheme of activities?
I have always encouraged young people and adults before and during my tenure as First Lady to engage in healthy eating, exercise, and living holistic lives. At present, I am the Patron and advocate of some twenty organisations (NGOs), which include The Vitas House Hospice (for the terminally ill); The Trinidad and Tobago Red Cross Society (Youth Arm); T&T Red Cross Kiddies Carnival (Carnival parade of young children in the traditional, heritage Mas of T&T); The Guide Dogs Association; The Girl Guides Association; The Orchid Society; T&T Diabetes Association; The T&T Heart Foundation; Princess Elizabeth Home for Children suffering from physical disabilities; T&T Blind Welfare Association and School for Blind Children and The Bonsi Society; Member of Caribbean First Ladies’ Forum (Every Caribbean Woman, Every Caribbean Child initiative); Advocate for the rights of persons who are differently-abled for example, Autism Spectrum Disorder (ASD); and a participant in 5Ks, 10Ks, Marathons/Walkathons for locally, regionally and internationally recognised commemorative days.
I feel I have been able to positively and proactively influence, by way of solution-oriented dialogue, the stakeholders in the governance and management of these causes, in a transformational and progressive way. I lobby and actively advocate against the reactive posturing of dealing with NCDs. I emphasise the importance of personal responsibility as it relates to one’s health and that healthy living begins from childhood. As a member of the Caribbean First Ladies Meeting Group (Every Caribbean Woman, Every Caribbean Child Initiative) supported by the United Nations, we, First Ladies of the Caribbean, actively seek to discuss and garner solutions for teenage pregnancies and HIV/AIDS prevention and management in the Caribbean Region. Caribbean society is confronted with a steady increase in adolescent pregnancies and HIV/AIDS, which hamper the productivity, efficiency, and quality of life of the youth population. My advocacy also extends to talking to young girls and women about safe sexual practices and delaying sexual initiation. Indeed, education is pivotal to girl/woman empowerment, because it affects awareness, self-esteem and opens all doors of opportunity for social mobility. We have been able to engage an internationally recognised pharmaceutical company, Gilead, to spread their wings of Corporate Social Responsibility (CSR), to include the Caribbean Region. This major corporate stakeholder has come on board, in particular, in Trinidad and Tobago, to assist this cause, in real terms.
I aggressively advocate locally, regionally and internationally for ‘disability justice’ and social equality, ensuring that persons who are differently-abled are treated with dignity, respect, equity and genuine inclusivity. Persons who are differently-abled must be afforded the opportunity to realise their dreams. At all times, in order to sensitize and generate consideration for persons with disabilities, I emphasise that persons with disabilities want opportunity, not charity, the opportunity of real jobs, that do not patronize their competencies, qualifications, and capacities. The message is simple- opportunities afforded must facilitate persons with Disabilities becoming the CEO of any company or member or Chairman of any Board or Head of State. Since my husband’s inauguration as President of the Republic of Trinidad and Tobago, every year, in the month of April, we commemorate Autism Spectrum Disorder (ASD), with a ‘Light it up Blue’ initiative to raise social and institutional consciousness, awareness and sensitivity towards the Autism Spectrum Disorder (ASD) demographic. For the entire month, a special tree on the Presidential Grounds is lit up blue, with banners prominently displayed, about Autism, so that the public is fully sensitized about ASD. This initiative has triggered a wakeup call to the national community, resulting in organisations and corporate T&T, lighting up blue, their buildings- something never experienced before in T&T.
I have impressed on our young people, at all our youth initiatives and events, the need to be responsible and intelligent users of Social Media and that although it is a beautiful form of self-expression, it can also be a minefield. Social Media must not be an environment for cyberbullying or denigrating each other. I advocate kindness, compassion and mutual respect from our young people in their use of social media, to empower rather than belittle; that we are free to disagree with each other’s opinions but that we must do so respectfully.
I believe in the youth population of T&T to create real, transformational change that will not only make a difference but make THE difference. I engage and connect to the youth population on issues of health, exercise, climate change, the environment, deforestation, Cyber bullying and social media, teenage pregnancy and HIV/AIDS, persons with disabilities and Non-Communicable Diseases (NCDs). On 21st March 2017, in celebration of International Day of Forests, His Excellency and I invited students from kindergarten to university, under our coined motto, “Plant a Plant in T&T” to plant some 25 varieties of fruit trees on the President’s Grounds. As Generation Next, our vision is to ensure that our young people are made aware of the significance of their roles in transforming and carrying our Nations forward.
Additionally, I am involved in my husband’s Student Initiatives- one in particular- where primary and secondary school students are given the opportunity to interact and speak with Heads of State during official Courtesy Visits and at the Presentation of Credentials of Ambassadors and High Commissioners at the Office of the President. Our young people are thus able to connect to governance, diplomacy and international relations, sensitizing them to their responsibilities as global villagers, since the discussions range from climate change, deforestation, sustainable economic development, pollution, international social and security issues, justice and the rule of law to personal responsibility. The dignitaries will often tell their life stories with a view to inspiring and motivating the young charges on the road to success and ambition. They are told life is an affair of infinite possibilities and that education, hard work, sacrifice, and vision are the keys that open all doors. From time to time, we both address young men and women in Trinidad and Tobago on pertinent, local, regional and international, social, economic and political issues, in an attempt to culture a youth population of critical thinkers, with the heart and the spirit for the progressive development of our country and the world. I have publicly stated that Child marriage is an anachronism that has no relevance in any progressive society. Young girls and women must coexist with their men folk in a holistic environment that encourages them to grow, flourish and prosper. I have been subject to attacks by persons who have taken umbrage at my stance on child marriages. I will not be deterred because we must ensure that no child is left behind.
In a joint message to mark the International Women’s Day-2017, H.E. Anthony Carmona, President of Trinidad and Tobago, said “society can only boast of civilized standards and progress, concomitant with Goals 4 and 5 of the 17 United Nations Sustainable Development Goals (SDGs)- when it treats its women and girls with the same dignity, equality, respect and honour as its men and boys. This means ending child marriages; protecting our women and girls against all forms of discrimination and abuse… and providing our women and girls with equal access to quality education and healthcare”. Kindly share with us some of your country’s successes and strides towards gender equality.
By its accession to the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the Republic of Trinidad and Tobago had expressed its commitment to the global struggle to eliminate discrimination faced by women and to the promotion of their enjoyment of civil, political, economic, social and cultural rights.
The Constitution of Trinidad and Tobago explicitly prohibits discrimination on the ground of sex and enshrines equality and guarantees the protection of the law. Equal opportunity legislation to prohibit discrimination on the grounds of sex, colour, race, ethnicity, origin, religion, marital status or disability in the fields of employment, education, the provision of goods and services and accommodation, has been enacted and is in force. The Equal Opportunity Commission and Tribunal have been appointed. Legislation preventing employers from discriminating against female employees on account of pregnancy has been passed. The Cohabitation Relationships Act, regulating the rights of cohabiting couples, entered into force in 1998. The Domestic Violence Act 1991 was repealed and replaced with legislation reflecting international standards, while the Legal Aid and Advice Act has been amended to allow more people, including women victims of domestic violence, to qualify for legal aid. The law relating to sexual offences has been amended to increase penalties for such offences and to penalize all forms of sexual violation, including rape and sexual assault within marriage. Implementing legislation to give domestic legal effect to the provisions of the United Nations Convention on the Rights of the Child, to protect and promote the rights of children, has been enacted and a Children’s Authority established. Women are now well represented in the Judiciary, Senior Managers in the Public service and in professions such as medicine, law, and accounting.
His Excellency the President has actualised gender equality, equity and fairness by appointing to Public Service Boards and Commissions, within his remit, competent, experienced and qualified women. Examples of this institutional dispensation in support of woman empowerment are the appointment of a woman as the Ombudsman of the Republic of T&T; two women for the first time as Chairman and Deputy Chairman of the Equal Opportunities Commission; a woman as the President of the Industrial Court; for the first time, two women as Chairman and Deputy Chairman of the Public Service Commission a body responsible for the appointment, promotion, disciplinary control and transfer of public officers in the Public Service; and for the first time, the Chairman of the Police Service Commission, a body responsible for appointing persons to hold or act in positions within the Police Service, executing disciplinary control on its charges. Many NGOs in T&T are led by women. On the 31 May 2017, His Excellency the President, as Patron installed the first gender-equal Trinidad and Tobago Olympic Committee (TTOC). Women have also been elevated to senior ranks in the military and protective services of T&T, a progressive and historically evolving move.
The need for gender equality and celebrating the benefits of a ‘gender-equal society’ must begin and be supported by institutional authorities including the Office of the President.
Trinidad and Tobago have recorded over 3,000 child brides in the last 20 years; while some findings indicate that 8% of girls in the country are married before the age of 18. In January 2017, the Attorney General of your country announced a bill to harmonize the country’s marriage laws and amend the legal minimum age of marriage to 18 years old. In expressing support for the legislative amendment to the Child Marriage Act, you shared a story of how your grandmother became a child bride at age 13 and was unable to realise her dream of becoming a teacher. Please tell us about this legislative amendment and how it will help your fight against child marriage?
I am pleased to report that our fight against child marriage in T&T has been legislatively successful and in June 2017 the Bill became law upon assent by His Excellency the President. The Miscellaneous Provisions (Marriage Act 2017 of T&T) will ensure that young girls are protected from this traditional malaise of being married off as chattels. Violation of this law would be met with the heavy sanction. This law now protects vulnerable girls from abuse and sexual violence, ensuring that they are able to thrive in a safe and equal space. This demographic will now have the opportunity to be part and parcel of the woman empowerment agenda and gender equality, which will invariably augment national economic development and quality of life.
I have to admit my deep-felt empathy for the vulnerable child-brides of the world. As a child growing up, I would often hear my grandmother’s plea of anguish, discontent, and dissatisfaction with child marriage and how she was married off at the age of 13 and prevented from pursuing her dream of being a teacher. She would often speak at length about the trials and tribulations encountered by this unfair, imposed circumstance. I could not relent from fighting this just cause because I could never forget my grandmother’s pain and hurt and the disadvantage she endured.
During one of your speeches at a regional event in Barbados, you noted that “Childhood Obesity is a pandemic in the Caribbean public health system. More than 30% of Caribbean adolescents are overweight or obese, with the apparent risk of developing NCDs, hypertension, diabetes, cancer and cardiovascular diseases in early adult life. When one considers the economic malaise of NCDs in the context of its cost to the Caribbean, 1.4% to 8% of GDP, it portends a crisis in the human development of the Caribbean region.” Please throw more light on the worrisome trend of child obesity and the possible measures to tackle it.
Over the years, I have noted obesity as a growing phenomenon from primary school to university and have recognised the connection between obesity and the consumption of junk food in our Caribbean societies. For many years, I have spoken tirelessly about unhealthy diets and the need for a health revolution among our citizenry; that it must take the form of healthy eating habits supported by a regime of exercise. In the face of damaging advertisements on television and the internet that glamorize unhealthy eating habits and choices, as stakeholders in the business of a good, healthy life, we need to take a stand. We need to initiate innovative ways and means of arresting this health crisis in the Caribbean. This is why I have promoted the child-advocate model as a means of trying to push and encourage the message of healthy lifestyles among all demographics.
For the last four years, I have advocated a radical change in the cuisine and drinks served to our children from school cafeterias. The authorities have since listened and the Honourable Minister of Health in T&T has banned the sale, from school cafeterias, of drinks and juices high in sugar content. Our advocacy must influence manufacturers to do the right thing on health issues by the proper labelling of foods. In the Caribbean Region, legislation is required to ensure that all foods sold are properly labelled in terms of fat content, cholesterol, and calorie content. This must form part of the advertisements of such foods so that informed choices can be made by a more discerning public. We must not glamorise bad eating habits and unhealthy lifestyles.
Additionally, I have vigorously supported various initiatives that sensitize the importance of healthy living because I recognise that there is a real link between childhood obesity and diabetes in the Caribbean Region. I therefore yearly support the Diabetes Residential Camp for Children hosted by the Diabetes Association of T&T. One of its notable components is the inclusion of nutritional management as a part of the discussion in this Diabetes Residential Camp. The first step to efficiently and safely manage diabetes is ensuring that the diets of children and adults with diabetes include minimal starch, sugar, and fats. As an active advocate for the eradication/ diminution of Non-Communicable Diseases (NCDs), an incisive aspect of my advocacy has been to inspire and trigger a culinary revolution in the kitchens of T&T, the Caribbean, and the world. As parents, both mothers and fathers have a duty to our children to ensure at all times that they are fed with foods that are healthy and nutritional. We have a responsibility to nurture a culture of healthy eating habits that invariably will impact on the quality of life of our citizens. Parents, therefore, have a critical role to play in determining the health of their child and to be aware that convenience on health issues can lead to greater costs in one’s future life.
Kindly tell us about the success of the Child-Advocate scheme in Trinidad and Tobago, vis-à-vis other action plans to address some of the health issues in your country and the Caribbean region.
I have noticed over the years that adults have been the mainstream messengers in the fight on health issues in my country and the rest of the Caribbean Region. I saw the need to bring on board, another type of messenger with whom children can connect naturally. As a result, I have promoted the child advocate model as a mechanism for spreading the positives of healthy lifestyles, healthy diet and the regime of sport and exercise. To put it simply, the child and not only an adult becomes the messenger among his or her peer group. Child advocates will promote healthy, sustainable lifestyles in their homes, communities and the Nation. There is a vast pool of such child advocates in the Red Cross, Girl Guides, Cubs, Brownies, Scouts and Cadet Associations that span the age group from 4-25, just waiting to be unleashed. These youth NGOs have traditionally been at the centre of National youth empowerment but have waned in impact through a lack of funding, inadequate resources, and human attrition. The child advocate represents a conduit for the promotion of leadership, humanity, compassion, self-esteem, respect, vision and ambition among his/her peer group. Only recently, I helped launch a Youth App, Youth TT Connect, a mobile app that connects with our Nation’s youths on matters of comprehensive sexual education and sexual reproductive health.
Healthy lifestyles must be supported by a healthy environment. The Office of the President has given support to a youth group initiative called the Sports Desk, a group of some 200 young men and women engaged in charity work. Part of our Youth Initiative is to sensitize our young people about the health crisis that exists in the often marginalised world of persons with disabilities including those suffering from Dementia and Alzheimer’s.
Some findings reveal that diabetes is the second leading cause of death in your country, with a record of about 140, 300 cases of diabetes in 2015. What are some of your efforts and that of your country, within a global and regional strategy context, to end this dangerous trend which is capable of draining the country’s economic resources?
Regrettably, in our hospitals, some 28% of bed space is occupied by Diabetics and an even greater number by those suffering from Non-Communicable Diseases (NCDs). This represents possibly one of the greatest challenges in the health sector. Traditionally, we have focused on the area of treatment and control and we, therefore, need to shift our reactive policy and forge an implementable, proactive philosophy of prevention. This can only be accomplished if the fight and the intervention against Diabetes Mellitus begin at the root of society, our young people, from birth into one’s adult years.
I am the Patron of the Diabetes Association of Trinidad and Tobago and our Association has been involved in a thrust to inform, educate and revolutionise people’s eating habits. At every opportunity, I am at pains to sensitize the audience I address, about the ramifications of bad eating habits and unhealthy lifestyles. I continue to impress upon mothers who are in the kitchens of the world to prepare healthy meals and ensure that the school lunch kit is filled with nutritional healthy foods and drinks, including fruits and vegetables. I have campaigned openly against juices and drinks with high sugar and caloric content and that we must stop glamorizing junk food without adequate warnings.
The Diabetes Association has been involved for some 16 years in organising and coordinating a Residential Camp for children with Diabetes Mellitus. Together with other facilitators, we address the concerns of parents and caregivers on preventative measures to deal with Diabetes. As previously stated, I have emphasised at the Residential Camp, the need to radically change our eating habits, pleading with parents to ensure that children have healthy lunch kits. This must be supported by having children engage in a sporting activity that they love, not what the parents love so that it effectively translates and solidifies good health in their adult years.
The Office of the President continues to support health initiatives. Only recently, a private sector Stroke and Diabetes Centre in Trinidad with a Caribbean outreach in Barbados, St Vincent, and other territories, was given Presidential support. Additionally, when assisting charity culinary events, I ensure that on all occasions, the Presidential booth serves only vegetable meals and fruit and vegetable drinks without sugar. I am really happy that at the recent Residential Camp, the Minister of Health publicly launched a National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2017-2021. He recognised that my husband and I have been very proactive in promoting healthy lifestyles and healthy eating nationally and he presented the publication to us. This National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2017-2021 publication delineates the strategic direction for the national response to Diabetes and NCDs. It utilizes key approaches to population health and development including primary health care, universal health coverage, standards of care and an integrated management system that is multi-sectorial involving the designated authority and the rest of the society. One of the unique and progressive aspects of this Publication is that it categorizes Alzheimer’s and Dementia as belonging to the sector of persons with disabilities.
How do you balance your domestic roles, as wife and mother of 2 children, with your societal obligations?
A mother plays a pivotal role in the holistic development of a child and I personally do not compromise or underestimate the importance of maternal responsibility and influence. I always remember that very profound statement of Jacqueline Kennedy Onassis, former First Lady of the USA, “If you bungle raising your children, I don’t think whatever else you do matters very much.”
As the First lady, what assists me in creating positive synergy between social responsibilities and family obligations are in part due to some of the human resources made available to me so that I can be strategic with my time through prioritisation and organisational skills. What helps me tremendously also, is that I exercise every day and it gives me the boost to meet and cope with the challenges of my responsibilities. I run approximately five miles every morning around the beautiful Queen’s Park Savannah, reputedly the largest green roundabout in the world. In any balancing act, I ensure I spend quality time with my family and sometimes I would invite the children to exercise with me. We do family gatherings on holidays and weekends and ensure that we visit our parents, siblings, and cousins regularly.
When I go to events in my capacity as Patron, my husband and children might sometimes accompany me, so that even at official functions, our family is together. This inclusivity is having the desired impact because our children are quietly and effectively-becoming advocates in their schools and among their friends in many areas especially healthy eating habits and the benefits of exercising. Regardless of what social obligations I have, I do make time for homework, school activities, sports games and parent-teacher meetings. I will never lose sight of my responsibility to my family and ours is a home of great love and care. My husband gives me unstinting support and many times he would stay at home and take care of our young children when I have to engage my social obligations. He has always been like that. When we were living in Europe and the children were toddlers, he was tremendous with changing nappies and I thought at the time he was the best nappy changer in the world. He has not changed his love and his level of commitment to us.
What’s the best way for the readers of Amazons Watch Magazine to connect with you?
I have noted, with great interest and admiration, the work and impact of Amazon Women’s Magazine on the lives of especially women and children worldwide. I am therefore honoured to be a part of this noteworthy publication and hope that my stories inspire a little girl or boy or an adult somewhere in this world. In this regard, I would love to connect with your readers and likewise learn of their stories, because at the end of the day, we live in a world of interdependence, made easier by way of technology. The following are the platforms on which I can be reached:
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