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...Where money jingle in poor people's pockets, Babylon Handouts were aplenty and "growth rates" were outasight 
So we would expect nuff pot abwile, nuff book astudy, nuff healin' pon di land...and of course...nuff people awanting to stay home
The sad reality from the Oxfam study Debt & Poverty:
The 1980s The economic crisis was a major reason for the defeat of the PNP in the 1980 general election and its replacement by the Jamaica Labour Party (JLP), a party then oriented much more towards free-market economic policies than its predecessor.
Because the JLP's economic philosophy was more in tune with thinking in the multilateral lending institutions and in the US, it was expected that the government would be able to mobilise a large increase in external financial support, especially from concessional sources, and that this would help to revitalise the economy.
There was a modest recovery in economic growth in the early 1980s but adverse developments in the wider world economic climate again had serious consequences for Jamaica. The world recession in 1981/1982 reduced the demand for the country's exports of primary products, and in particular bauxite/alumina and this led to a worsening of the balance of payments position.
As a result a number of major economic measures were undertaken, supported by the IMF, in an effort to restore some viability to the country's economy and to reduce the balance of payments deficit. They included devaluation of the currency, an increase in taxation, cuts in government expenditures, the removal of import restrictions and the abandonment of price controls.
Whatever effect they may have had on economic indicators, these stringent and wide-reaching measures had a serious impact on living standards throughout the country. Despite the best efforts of the government to carry out the recommendations of the international lending institutions, the economy was on several occasions unable to meet the stringent performance criteria demanded by the IMF, with the result that agreements for external financial assistance were again temporarily suspended.
Although falling oil prices provided some respite in 1986, the economy was unable to overcome its severe structural macroeconomic imbalances: the inability to earn sufficient foreign exchange to pay for the country's import and debt servicing needs, and the inability of the Government to generate sufficient revenue to cover its necessary expenditures.
DEBT
Most of the debt was contracted between 1975 and 1985 in order to finance the Government's fiscal deficit and to provide short term support for the balance of payments. Most of the debt is owed to official creditors - multilateral lending agencies such as the IMF and World Bank and bilateral donors such as the US. The need to service the country's external debt by repaying principal and interest has created serious problems for both the finances of the Government and the economy in general.
Actual debt-servicing payments accounted for 47 per cent of foreign exchange earnings from exports in 1987; the burden has been reduced somewhat since then, with 26 cents out of every dollar of foreign exchange earned now being used to service Jamaica's debt, according to 1991 government figures. Some economists, however, dispute this figure.
Total government debt in nominal terms moved from US$688 million in 1975 to US$4032 million in 1989. In early 1992, despite much-publicised 'forgiveness' and rescheduling, the debt remained at more than US$4000 million.
For Jamaica, prices increased by an annual average of 17 per cent between 1975 and 1989. Between 1976 and 1980, the annual average inflation rate was over 20 per cent. During 1984 and 1985, however, in the wake of IMF adjustment measures, prices increased by over 25 per cent annually.
FOOD SECURITY
The price of food has increased at rates which are even faster than other items consumed locally; to the extent that 'food and drink' are estimated to account for over half of the expenditure of Jamaican households, these price increases have seriously affected the living standards of the poorer people. A recent study claims that food prices in Jamaica are only slightly lower than those in the United States, where the minimum wage is 11.5 times as high. In November 1989, for instance, a pound of chicken in Jamaican markets cost the equivalent of US$10.
The cost of feeding a family of five in Jamaica has risen astronomically since 1979, from J$24.27 to over J$220 as at June 1990. Data provided by the Nutrition Department of the Ministry of Health shows the stark deterioration in the situation facing Jamaican poor people who earn the minimum wage.
In June 1979, one minimum wage of J$26.00 earned by a household could meet the cost of feeding a family of five for a week. However, during the 1980s under the IMF/World Bank adjustment programme, a similar food basket purchase required between two and three times the minimum wage. Recently the minimum wage has been increased to J$120 per week, but with rising food prices this can barely purchase half of what is required to feed a family of five for a week. With increasing food prices, the nutritional status of poor people has worsened.
Although it is possible that some families may be able to offset the rising food prices by income-generating informal economic activities, there has been an increase in poverty-related illnesses particularly among young children. The number of children admitted to the main children's hospital in Kingston suffering from malnutrition and malnutritiongastroenteritis has more than trebled since 1978.
Over three out of every ten children attending public health clinics in 1989 were diagnosed as being malnourished. Successive governments have attempted to cushion the negative effects of IMF/World Bank measures on food consumption levels of poor people. In 1984, the JLP introduced a Food Stamp Programme to assist groups considered to be nutritionally 'at risk'. This programme provided bi-monthly amounts of J$20 in food stamps (currently J$50 per month) so that recipients could obtain basic foods such as cornmeal, rice and skimmed milk at various shops.
There were two categories of recipients; firstly, there were pregnant and lactating women, and young children, with neither group being subject to any means tests. Secondly, there were poor and elderly persons, who were provided with assistance only after an assessment of their financial needs.
The programme suffered from a number of weaknesses. The levels of government funding provided satisfied the needs of only one-quarter of those registered persons eligible to receive food stamps. Some people used the stamps for purposes other than the purchase of the specified food commodities. The programme could be, and was, used as an instrument of political patronage; some high-income households received the benefits.
HOUSING
Housing problems have plagued the country over the last two decades, with excess demand for housing leading to phenomenal increases in both house prices and rentals. Between 1987 and 1989, an average of 2,716 houses were completed yearly, with the public sector accounting for 90 per cent of these.
This building programme has satisfied only about 15 per cent of the total demand for houses. Housing costs have increased significantly, largely as a result of increasing import prices following the numerous devaluations of the Jamaican dollar. The housing sector is characterised by a high import content, particularly of construction materials. The price of locally produced materials also increased during the period. In 1989, for example, the price of lumber rose by 20% steel by over 25 per cent, cement by 28 per cent, and paint by 25 per cent. Housing costs have also risen as a result of increasing interest rates, which were raised as part of the adjustment programme. Loan interest rates have averaged over 25 per cent per annum over the last five years. Mortgage rates have also increased.
As a result, the price of a three-bedroomed house in a typically middle-class suburb in 1990 was nearly one million Jamaican dollars (about US$150,000). The prices for one-bedroomed apartments currently begin at about JS600,000 (about US$30,000.)
The average university graduate earning about J$50,000 following graduation can hardly expect to be able to purchase even the most basic of homes. The situation facing the average worker is much worse. House rents have increased to such an extent that most lowerincome families are forced to sub-let even the most dilapidated, poorly maintained house. As a result, there has been a rise in the number of 'squatters' who have built homes on illegally acquired land, in contravention of established building codes. Since the Government has considerable difficulty providing for housing.
SOCIAL SERVICES
Stabilisation and structural adjustment programmes have also encouraged increasing privatisation of social services, and this has also had the effect of significantly increasing prices, and thereby denying access to the poorest. There has been a marked deterioration in the quality of public services provided in the health, education and housing sectors in Jamaica over the last decade. Social services expenditure peaked during the mid-1970s under the PNP government.
As a percentage of GDP, social services expenditure fell from 14.5 in 1979 to 4.0 in 1985. Diminished social services have resulted mainly from government fiscal austerity measures associated with adjustment programmes. Recurrent expenditures on social services such as health and education have been drastically reduced. Investment in social infrastructure such as the building of new schools and hospitals has contracted, while necessary maintenance of social facilities is minimal.
HEALTH
Historically, Jamaica's public health care system, upon which most of the population rely, compared favourably with the best in developing countries. There are at present 24 hospitals and about 350 health centres, with each parish having at least one public hospital and nearly 20 health centres. The health sector presently employs over 10,000 workers.
However, over the last decade, the sector has shown a rapid decline. Total expenditure on health as a percentage of total Government expenditure fell from an average of over 9 per cent in the mid-1970s to just over 5 per cent in 1986-88. Although both recurrent and capital expenditure on health services declined, the decline in capital expenditure was more pronounced.
Capital expenditure reductions meant that vital equipment used in the hospitals and health centres could not be replaced. Reduced recurrent expenditures led to inadequate maintenance of facilities, unavailability of supplies including medicines, and less funding for salaries of medical personnel.
The most recent Economic and Social Survey of Jamaica (1989), published by the Planning Institute of Jamaica, clearly states that: ...Underfinancing of the health sector continued to affect adversely the provision and delivery of good quality health care.,In some critical areas output was reduced and the quality of medical care suffered because of inadequacy of the infrastructure, diagnostic and support services.
The attrition of manpower in critical areas of the service continued. The public health sector has been seriously affected by the loss of personnel at all levels. The public sector doctor/population ratio moved from one doctor for every 2,700 persons in 1971 to one for every 3,000 in 1980, with the latest figure being one for every 5,200. The ratio of nursing personnel to population declined from one nurse for every 540 Jamaicans in 1975 to one nurse for every 1,172 persons in 1985.
The economy of Jamaica 3 3 With reduced public expenditure on health which has led to deteriorating working conditions in the sector, there has been widespread resignation of health personnel. Coupled with layoffs which have also arisen due to contractions in government funding, the public health sector is now faced with a situation where nearly 30 per cent of all posts were not filled as at June, 1989.
Nearly one out of every five posts for physicians was vacant, about one out of every three for registered nurses could not be filled, while over half of the number of pharmacist posts were vacant. Attempts have recently been made to deal with some of the personnel shortages via increases in salaries and allowances for various categories of health personnel.
Nurses' salaries were doubled to J$40,000 per annum in 1990 (just under US$6,000 at the prevailing exchange rate), plus allowances. Hourly or sessional rates for all nurses have also been increased. As part of the adjustment programme, the government has since the mid-80s introduced policies geared towards improving the health sector's performance.
Firstly, as part of a 'rationalisation' programme, some hospital wards and many clinics were closed or downgraded. This has resulted in an actual decline in the number of public hospital beds available. Secondly, new fees were implemented in 1984 as part of a programme to cover more of the costs of public health care; this must have seriously disadvantaged poor people who rely heavily on these services.
Thirdly, support for privatising the health sector has been provided and as a result the number of private hospitals and clinics is increasing, and these charge market rates for the services provided. Fourthly, a programme for recruiting nurses in Commonwealth countries, including the UK has been introduced; additionally, incentives are being provided locally to attract more school-leavers into nursing.
Some of the policies introduced have increased the suffering of the poor who rely mainly on public health facilities. With reduced public health care, increased fees for these deteriorating services, and more widely available but more costly private health care, poor people find it much more difficult to get access to these services. However, given the poor quality of public health care, SLC figures show that 4 out of every 10 persons in the lowest income group are forced to use private medical care
where the cost per visit averages at J$56 (1989) compared to J$4 for public hospital care. The situation is similar with respect to the purchase of medicines as only three out of every ten in the poorest group purchased medicines from public sources. However, over eight of every ten in this group could not buy all the medications prescribed due the prohibitive costs.
EDUCATION
Education Education expenditures are of crucial importance for developing countries, which suffer from shortages of skilled manpower. An uneducated work force is riot capable of mastering the most advanced technology and its productivity is severely hampered; thus its output becomes uncompetitive when compared to other countries. In addition, it is estimated that the returns on educational spending, particularly in primary schools, are usually greater than the returns on physical capital expenditure.
Education has historically been the responsibility of the public sector. Less than five per cent of school places at the primary and secondary are provided by private schools. About 600,000 students aged between three and seventeen years old attend over two thousand schools serviced by about 20,000 teachers.
Up to the mid-1970s, the overall performance of the education sector in Jamaica compared favourably with countries at similar levels of development. Since then, however, there has been a marked decline in the quality of education.
As a percentage of GDP, government expenditure on education declined from over ten per cent in the 1970s to under five per cent in 1985. At the same time, public expenditure on education fell from nearly 18 per cent of total public expenditure in 1975 to 10.8 per cent in 1984.
On the capital expenditure side the situation has been even more serious; capital expenditure on education, which includes the construction of school buildings, installation of laboratory equipment and so on, declined from an annual average of nearly ten per cent of total government capital spending in 1974 to less than one per cent in 1986.
The implications of the cuts in public expenditure on the quality of education are serious. Both primary and secondary schools are very overcrowded as a result of inadequate classroom space. Many schools lack an adequate water supply
Spending on education has been drastically reduced as part of structural adjustment packages to cut government expenditure, and schools are now chronically short of teaching materials.
and sanitation facilities are extremely poor. Textbooks are not available to most students because of their prohibitive costs. With reduced government expenditure on education, working conditions in schools have deteriorated significantly. With teaching materials generally unavailable, and with real incomes of teachers declining, there has been a high rate of attrition in the profession. Many teachers are involved in the informal economy at various levels in an attempt to improve their declining living standards.
Many schools, including some of the 'top' secondary schools, have had to rely on various techniques to mobilise funds to help meet the shortfall in money provided by government. These have included requests for financial assistance from parents, and the holding of various commercial events such as fairs and parties to help top up teachers' salaries and provide for other areas of both recurrent and capital expenditure.
The poorer strata in the society are generally more seriously affected by this deteriorating educational provision. The SLC shows that in the age group three to five years, children in the bottom 20 per cent of Jamaican households are twice as likely as
36 Jamaica: Debt and Poverty those in the top 20 per cent not to be enrolled in school. The situation is closely similar throughout the entire school system. Since the majority of poorer children terminate their schooling in primary schools, the situation in primary schools warrants additional scrutiny. Enrolment in primary schools declined during the 1980s by about seven per cent over the period, while there has been an increase in the numbers of children of primary school age in the population.
At the same time the number of primary school teachers has also fallen to such an extent that the teacher/pupil ratio has actually worsened in spite of falling numbers of students. Th6re are also high levels of grade repetition and school dropouts at this level.
The SLC data is revealing:
• Over 60 per cent of the poorer strata children abandon mainly primary school between grades seven and nine;
•about one in every four primary schools students cited financial reasons for non-attendance at schools;
•over one in five primary school students have repeated a year more than once;
• the mean annual expenses per child in primary school were J$1119 (1989), with over 60 per cent of this being for 'lunch', and nearly 25 per cent for 'fees'.
What is even more alarming is the suggestion, from usually reliable sources, that over half of the children completing primary school are 'functionally illiterate.' For Jamaica as a whole, secondary education has shown remarkable deterioration.
Mainly as a result of the problems we have outlined above, secondary school performance is marked by low attendance levels and low achievement levels. Data available for total entries and passes for the GCE 'O' levels reveal clearly the seriously worsening situation in the secondary schools. Total number of both entries and passes have been declining.
Whereas in 1975, over 7,000 students took the English Language examination with a pass rate of nearly sixty per cent, by 1989, the comparable figures were 5,747 with only 34.5 per cent passes. In English Literature, both the numbers and pass rates have fallen significantly. Pass rates for Economics/ Accounts, Mathematics, Physics, Chemistry and Biology have also dropped.
With respect to the Caribbean Examination Council (CXC), examinations which are replacing GCE examinations in the Caribbean, the pattern has been no different. For example, the pass rates in both English Language and English Literature have both declined over the last two years, as have Economics/ Accounts and Mathematics pass rates.
2.6 Fighting back: two responses to material deprivation
With increasing levels of unemployment, deteriorating real incomes, and generally worsening living conditions in Jamaica, people have responded in a variety of ways. Two examples are given in this section. One widely used response has been migration.
Between 1975 and 1980, migration rates averaged about over forty per cent of the natural population decrease annually as many people, especially those with professional and technical qualifications, left Jamaica because of the perceived 'communist threat'. Between 1981 and 1985, however, the migration rates had declined to under 20 per cent of the decrease annually. However, Emigration is a positive response by individuals to worsening living conditions, but is draining the country of skilled personnel. Waiting outside the US Embassy in Kingston.
38 Jamaica: Debt and Poverty as adjustment policies leading to worsening living conditions began to have an effect, from around 1986 migration rates climbed to 49 per cent in 1986, 77 per cent in 1987, and 88 per cent in 1988. According to the Economic and Social Survey (1991), 24,600 Jamaicans emigrated in 1990, more than double the 1989 figure of 10,400.
As might be expected, at least one in every five migrants is a skilled worker whose departure leaves a significant vacuum in the country's labour market. There is also a significant amount of reported illegal migration to the US from Jamaica.
Another strategy which is used by a number of Jamaicans is participation in the informal economy. Informal economic activity is defined to include those which violate laws or official regulations, or contravene generally accepted standards and codes of business behaviour.
Illegal activities fall within the informal economy and these have shown some increases in the 1980s.
So we would expect nuff pot abwile, nuff book astudy, nuff healin' pon di land...and of course...nuff people awanting to stay home
The sad reality from the Oxfam study Debt & Poverty:
The 1980s The economic crisis was a major reason for the defeat of the PNP in the 1980 general election and its replacement by the Jamaica Labour Party (JLP), a party then oriented much more towards free-market economic policies than its predecessor.
Because the JLP's economic philosophy was more in tune with thinking in the multilateral lending institutions and in the US, it was expected that the government would be able to mobilise a large increase in external financial support, especially from concessional sources, and that this would help to revitalise the economy.
There was a modest recovery in economic growth in the early 1980s but adverse developments in the wider world economic climate again had serious consequences for Jamaica. The world recession in 1981/1982 reduced the demand for the country's exports of primary products, and in particular bauxite/alumina and this led to a worsening of the balance of payments position.
As a result a number of major economic measures were undertaken, supported by the IMF, in an effort to restore some viability to the country's economy and to reduce the balance of payments deficit. They included devaluation of the currency, an increase in taxation, cuts in government expenditures, the removal of import restrictions and the abandonment of price controls.
Whatever effect they may have had on economic indicators, these stringent and wide-reaching measures had a serious impact on living standards throughout the country. Despite the best efforts of the government to carry out the recommendations of the international lending institutions, the economy was on several occasions unable to meet the stringent performance criteria demanded by the IMF, with the result that agreements for external financial assistance were again temporarily suspended.
Although falling oil prices provided some respite in 1986, the economy was unable to overcome its severe structural macroeconomic imbalances: the inability to earn sufficient foreign exchange to pay for the country's import and debt servicing needs, and the inability of the Government to generate sufficient revenue to cover its necessary expenditures.
DEBT
Most of the debt was contracted between 1975 and 1985 in order to finance the Government's fiscal deficit and to provide short term support for the balance of payments. Most of the debt is owed to official creditors - multilateral lending agencies such as the IMF and World Bank and bilateral donors such as the US. The need to service the country's external debt by repaying principal and interest has created serious problems for both the finances of the Government and the economy in general.
Actual debt-servicing payments accounted for 47 per cent of foreign exchange earnings from exports in 1987; the burden has been reduced somewhat since then, with 26 cents out of every dollar of foreign exchange earned now being used to service Jamaica's debt, according to 1991 government figures. Some economists, however, dispute this figure.
Total government debt in nominal terms moved from US$688 million in 1975 to US$4032 million in 1989. In early 1992, despite much-publicised 'forgiveness' and rescheduling, the debt remained at more than US$4000 million.
For Jamaica, prices increased by an annual average of 17 per cent between 1975 and 1989. Between 1976 and 1980, the annual average inflation rate was over 20 per cent. During 1984 and 1985, however, in the wake of IMF adjustment measures, prices increased by over 25 per cent annually.
FOOD SECURITY
The price of food has increased at rates which are even faster than other items consumed locally; to the extent that 'food and drink' are estimated to account for over half of the expenditure of Jamaican households, these price increases have seriously affected the living standards of the poorer people. A recent study claims that food prices in Jamaica are only slightly lower than those in the United States, where the minimum wage is 11.5 times as high. In November 1989, for instance, a pound of chicken in Jamaican markets cost the equivalent of US$10.
The cost of feeding a family of five in Jamaica has risen astronomically since 1979, from J$24.27 to over J$220 as at June 1990. Data provided by the Nutrition Department of the Ministry of Health shows the stark deterioration in the situation facing Jamaican poor people who earn the minimum wage.
In June 1979, one minimum wage of J$26.00 earned by a household could meet the cost of feeding a family of five for a week. However, during the 1980s under the IMF/World Bank adjustment programme, a similar food basket purchase required between two and three times the minimum wage. Recently the minimum wage has been increased to J$120 per week, but with rising food prices this can barely purchase half of what is required to feed a family of five for a week. With increasing food prices, the nutritional status of poor people has worsened.
Although it is possible that some families may be able to offset the rising food prices by income-generating informal economic activities, there has been an increase in poverty-related illnesses particularly among young children. The number of children admitted to the main children's hospital in Kingston suffering from malnutrition and malnutritiongastroenteritis has more than trebled since 1978.
Over three out of every ten children attending public health clinics in 1989 were diagnosed as being malnourished. Successive governments have attempted to cushion the negative effects of IMF/World Bank measures on food consumption levels of poor people. In 1984, the JLP introduced a Food Stamp Programme to assist groups considered to be nutritionally 'at risk'. This programme provided bi-monthly amounts of J$20 in food stamps (currently J$50 per month) so that recipients could obtain basic foods such as cornmeal, rice and skimmed milk at various shops.
There were two categories of recipients; firstly, there were pregnant and lactating women, and young children, with neither group being subject to any means tests. Secondly, there were poor and elderly persons, who were provided with assistance only after an assessment of their financial needs.
The programme suffered from a number of weaknesses. The levels of government funding provided satisfied the needs of only one-quarter of those registered persons eligible to receive food stamps. Some people used the stamps for purposes other than the purchase of the specified food commodities. The programme could be, and was, used as an instrument of political patronage; some high-income households received the benefits.
HOUSING
Housing problems have plagued the country over the last two decades, with excess demand for housing leading to phenomenal increases in both house prices and rentals. Between 1987 and 1989, an average of 2,716 houses were completed yearly, with the public sector accounting for 90 per cent of these.
This building programme has satisfied only about 15 per cent of the total demand for houses. Housing costs have increased significantly, largely as a result of increasing import prices following the numerous devaluations of the Jamaican dollar. The housing sector is characterised by a high import content, particularly of construction materials. The price of locally produced materials also increased during the period. In 1989, for example, the price of lumber rose by 20% steel by over 25 per cent, cement by 28 per cent, and paint by 25 per cent. Housing costs have also risen as a result of increasing interest rates, which were raised as part of the adjustment programme. Loan interest rates have averaged over 25 per cent per annum over the last five years. Mortgage rates have also increased.
As a result, the price of a three-bedroomed house in a typically middle-class suburb in 1990 was nearly one million Jamaican dollars (about US$150,000). The prices for one-bedroomed apartments currently begin at about JS600,000 (about US$30,000.)
The average university graduate earning about J$50,000 following graduation can hardly expect to be able to purchase even the most basic of homes. The situation facing the average worker is much worse. House rents have increased to such an extent that most lowerincome families are forced to sub-let even the most dilapidated, poorly maintained house. As a result, there has been a rise in the number of 'squatters' who have built homes on illegally acquired land, in contravention of established building codes. Since the Government has considerable difficulty providing for housing.
SOCIAL SERVICES
Stabilisation and structural adjustment programmes have also encouraged increasing privatisation of social services, and this has also had the effect of significantly increasing prices, and thereby denying access to the poorest. There has been a marked deterioration in the quality of public services provided in the health, education and housing sectors in Jamaica over the last decade. Social services expenditure peaked during the mid-1970s under the PNP government.
As a percentage of GDP, social services expenditure fell from 14.5 in 1979 to 4.0 in 1985. Diminished social services have resulted mainly from government fiscal austerity measures associated with adjustment programmes. Recurrent expenditures on social services such as health and education have been drastically reduced. Investment in social infrastructure such as the building of new schools and hospitals has contracted, while necessary maintenance of social facilities is minimal.
HEALTH
Historically, Jamaica's public health care system, upon which most of the population rely, compared favourably with the best in developing countries. There are at present 24 hospitals and about 350 health centres, with each parish having at least one public hospital and nearly 20 health centres. The health sector presently employs over 10,000 workers.
However, over the last decade, the sector has shown a rapid decline. Total expenditure on health as a percentage of total Government expenditure fell from an average of over 9 per cent in the mid-1970s to just over 5 per cent in 1986-88. Although both recurrent and capital expenditure on health services declined, the decline in capital expenditure was more pronounced.
Capital expenditure reductions meant that vital equipment used in the hospitals and health centres could not be replaced. Reduced recurrent expenditures led to inadequate maintenance of facilities, unavailability of supplies including medicines, and less funding for salaries of medical personnel.
The most recent Economic and Social Survey of Jamaica (1989), published by the Planning Institute of Jamaica, clearly states that: ...Underfinancing of the health sector continued to affect adversely the provision and delivery of good quality health care.,In some critical areas output was reduced and the quality of medical care suffered because of inadequacy of the infrastructure, diagnostic and support services.
The attrition of manpower in critical areas of the service continued. The public health sector has been seriously affected by the loss of personnel at all levels. The public sector doctor/population ratio moved from one doctor for every 2,700 persons in 1971 to one for every 3,000 in 1980, with the latest figure being one for every 5,200. The ratio of nursing personnel to population declined from one nurse for every 540 Jamaicans in 1975 to one nurse for every 1,172 persons in 1985.
The economy of Jamaica 3 3 With reduced public expenditure on health which has led to deteriorating working conditions in the sector, there has been widespread resignation of health personnel. Coupled with layoffs which have also arisen due to contractions in government funding, the public health sector is now faced with a situation where nearly 30 per cent of all posts were not filled as at June, 1989.
Nearly one out of every five posts for physicians was vacant, about one out of every three for registered nurses could not be filled, while over half of the number of pharmacist posts were vacant. Attempts have recently been made to deal with some of the personnel shortages via increases in salaries and allowances for various categories of health personnel.
Nurses' salaries were doubled to J$40,000 per annum in 1990 (just under US$6,000 at the prevailing exchange rate), plus allowances. Hourly or sessional rates for all nurses have also been increased. As part of the adjustment programme, the government has since the mid-80s introduced policies geared towards improving the health sector's performance.
Firstly, as part of a 'rationalisation' programme, some hospital wards and many clinics were closed or downgraded. This has resulted in an actual decline in the number of public hospital beds available. Secondly, new fees were implemented in 1984 as part of a programme to cover more of the costs of public health care; this must have seriously disadvantaged poor people who rely heavily on these services.
Thirdly, support for privatising the health sector has been provided and as a result the number of private hospitals and clinics is increasing, and these charge market rates for the services provided. Fourthly, a programme for recruiting nurses in Commonwealth countries, including the UK has been introduced; additionally, incentives are being provided locally to attract more school-leavers into nursing.
Some of the policies introduced have increased the suffering of the poor who rely mainly on public health facilities. With reduced public health care, increased fees for these deteriorating services, and more widely available but more costly private health care, poor people find it much more difficult to get access to these services. However, given the poor quality of public health care, SLC figures show that 4 out of every 10 persons in the lowest income group are forced to use private medical care
where the cost per visit averages at J$56 (1989) compared to J$4 for public hospital care. The situation is similar with respect to the purchase of medicines as only three out of every ten in the poorest group purchased medicines from public sources. However, over eight of every ten in this group could not buy all the medications prescribed due the prohibitive costs.
EDUCATION
Education Education expenditures are of crucial importance for developing countries, which suffer from shortages of skilled manpower. An uneducated work force is riot capable of mastering the most advanced technology and its productivity is severely hampered; thus its output becomes uncompetitive when compared to other countries. In addition, it is estimated that the returns on educational spending, particularly in primary schools, are usually greater than the returns on physical capital expenditure.
Education has historically been the responsibility of the public sector. Less than five per cent of school places at the primary and secondary are provided by private schools. About 600,000 students aged between three and seventeen years old attend over two thousand schools serviced by about 20,000 teachers.
Up to the mid-1970s, the overall performance of the education sector in Jamaica compared favourably with countries at similar levels of development. Since then, however, there has been a marked decline in the quality of education.
As a percentage of GDP, government expenditure on education declined from over ten per cent in the 1970s to under five per cent in 1985. At the same time, public expenditure on education fell from nearly 18 per cent of total public expenditure in 1975 to 10.8 per cent in 1984.
On the capital expenditure side the situation has been even more serious; capital expenditure on education, which includes the construction of school buildings, installation of laboratory equipment and so on, declined from an annual average of nearly ten per cent of total government capital spending in 1974 to less than one per cent in 1986.
The implications of the cuts in public expenditure on the quality of education are serious. Both primary and secondary schools are very overcrowded as a result of inadequate classroom space. Many schools lack an adequate water supply
Spending on education has been drastically reduced as part of structural adjustment packages to cut government expenditure, and schools are now chronically short of teaching materials.
and sanitation facilities are extremely poor. Textbooks are not available to most students because of their prohibitive costs. With reduced government expenditure on education, working conditions in schools have deteriorated significantly. With teaching materials generally unavailable, and with real incomes of teachers declining, there has been a high rate of attrition in the profession. Many teachers are involved in the informal economy at various levels in an attempt to improve their declining living standards.
Many schools, including some of the 'top' secondary schools, have had to rely on various techniques to mobilise funds to help meet the shortfall in money provided by government. These have included requests for financial assistance from parents, and the holding of various commercial events such as fairs and parties to help top up teachers' salaries and provide for other areas of both recurrent and capital expenditure.
The poorer strata in the society are generally more seriously affected by this deteriorating educational provision. The SLC shows that in the age group three to five years, children in the bottom 20 per cent of Jamaican households are twice as likely as
36 Jamaica: Debt and Poverty those in the top 20 per cent not to be enrolled in school. The situation is closely similar throughout the entire school system. Since the majority of poorer children terminate their schooling in primary schools, the situation in primary schools warrants additional scrutiny. Enrolment in primary schools declined during the 1980s by about seven per cent over the period, while there has been an increase in the numbers of children of primary school age in the population.
At the same time the number of primary school teachers has also fallen to such an extent that the teacher/pupil ratio has actually worsened in spite of falling numbers of students. Th6re are also high levels of grade repetition and school dropouts at this level.
The SLC data is revealing:
• Over 60 per cent of the poorer strata children abandon mainly primary school between grades seven and nine;
•about one in every four primary schools students cited financial reasons for non-attendance at schools;
•over one in five primary school students have repeated a year more than once;
• the mean annual expenses per child in primary school were J$1119 (1989), with over 60 per cent of this being for 'lunch', and nearly 25 per cent for 'fees'.
What is even more alarming is the suggestion, from usually reliable sources, that over half of the children completing primary school are 'functionally illiterate.' For Jamaica as a whole, secondary education has shown remarkable deterioration.
Mainly as a result of the problems we have outlined above, secondary school performance is marked by low attendance levels and low achievement levels. Data available for total entries and passes for the GCE 'O' levels reveal clearly the seriously worsening situation in the secondary schools. Total number of both entries and passes have been declining.
Whereas in 1975, over 7,000 students took the English Language examination with a pass rate of nearly sixty per cent, by 1989, the comparable figures were 5,747 with only 34.5 per cent passes. In English Literature, both the numbers and pass rates have fallen significantly. Pass rates for Economics/ Accounts, Mathematics, Physics, Chemistry and Biology have also dropped.
With respect to the Caribbean Examination Council (CXC), examinations which are replacing GCE examinations in the Caribbean, the pattern has been no different. For example, the pass rates in both English Language and English Literature have both declined over the last two years, as have Economics/ Accounts and Mathematics pass rates.
2.6 Fighting back: two responses to material deprivation
With increasing levels of unemployment, deteriorating real incomes, and generally worsening living conditions in Jamaica, people have responded in a variety of ways. Two examples are given in this section. One widely used response has been migration.
Between 1975 and 1980, migration rates averaged about over forty per cent of the natural population decrease annually as many people, especially those with professional and technical qualifications, left Jamaica because of the perceived 'communist threat'. Between 1981 and 1985, however, the migration rates had declined to under 20 per cent of the decrease annually. However, Emigration is a positive response by individuals to worsening living conditions, but is draining the country of skilled personnel. Waiting outside the US Embassy in Kingston.
38 Jamaica: Debt and Poverty as adjustment policies leading to worsening living conditions began to have an effect, from around 1986 migration rates climbed to 49 per cent in 1986, 77 per cent in 1987, and 88 per cent in 1988. According to the Economic and Social Survey (1991), 24,600 Jamaicans emigrated in 1990, more than double the 1989 figure of 10,400.
As might be expected, at least one in every five migrants is a skilled worker whose departure leaves a significant vacuum in the country's labour market. There is also a significant amount of reported illegal migration to the US from Jamaica.
Another strategy which is used by a number of Jamaicans is participation in the informal economy. Informal economic activity is defined to include those which violate laws or official regulations, or contravene generally accepted standards and codes of business behaviour.
Illegal activities fall within the informal economy and these have shown some increases in the 1980s.
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