The Pan American Health Organization/World Health Organization (PAHO/WHO) in collaboration with the Ministry of Health and Wellness (MoHW) along with funding support from the United States Government donated a variety of equipment to the Nursing Simulation Laboratory of the University of Belize. From the experience of the COVID-19 pandemic, a country’s health system must build the capacity of healthcare workers to respond to health emergencies efficiently and effectively.  Thus, various countries have been investing in human resources for health, especially the nursing workforce. This included enhancing nursing academic programs in the Caribbean where nurses can develop the skills to prepare them for the workforce and any future pandemics. “Nurses are the foundation and the backbone of the healthcare system, and they are most often the first person the patient encounters,” said Dr. Beth King, Medical Officer at the US Embassy. “I’m really proud to see so much focus on nursing education. If we can provide them with a good foundation and tools, they (nurses) will find a way to succeed and do the best they can for their patients, their families, and their communities.” In November 2022, Belize was one of the countries selected to participate in a pilot project where PAHO’s collaborating Center at the University of North Carolina as well as the University of the West Indies campus in Barbados assessed the nursing education system in the country, including the School of Nursing at the University of Belize. The team reviewed the academic curricula and inspected classrooms, simulation labs, library, computer rooms, practicum sites and other areas to strengthen nursing education in the country. They also spoke to nursing educators and clinical nursing instructors, nursing and midwifery associations and regulatory bodies, health facility administrators and health professionals, and the MoHW, among others. “PAHO is very pleased to have provided this technical cooperation to the School of Nursing, University of Belize to help to strengthen nursing education in the country in a sustainable way,” said Dr. Karen Lewis-Bell, PAHO/WHO Representative in Belize. “Working with our collaborating centres on nursing also helped to effect positive changes in the nursing curriculum and to strengthen the practical component of the training. We wish to thank the government of the United States of America for their funding support in this effort.” This donated equipment came as an additional component from that assessment that will allow nursing students to be placed in practical situations with equipment used in the health sector. The much-needed equipment included those that are essential for diagnosis and treatment such as electrocardiogram (EKG) machine, aneroid sphygmomanometer, fetal Stethoscope, nebulizer machine, vaginal speculums, instrument tray stainless steel with lid, overbed table, mobile-based exam lamp, as well as those for teaching, to include laptops, smart LED portable projectors, wall-mounted projectors and portable stereo speakers. “There is no doubt the value that we should have on our nurses,” said Mr. Vincent Palacio. “We are building this particular program. In a few months, we won’t have a faculty of health sciences, we will have a College of Health Sciences where the nurses’ program will be much bigger. Again, thank you for the generous donation and we will make the most of it in our program.” Additionally, with low retention and high turnover rates continuing to be a major cause of the shortages of nurses in the Caribbean region, Belize and the Ministry of Health and Wellness hope these pieces of equipment will enhance the University of Belize’s Nursing Program by building the capacity of the current nursing students and equip them with the necessary clinical skills and competencies to face the real-world challenges of the Belize health system. “It is a privilege to stand here witnessing this very important donation and I want to thank our partners,” said Hon. Kevin Bernard, Minister of the MoHW in Belize. “The Ministry is constantly looking at how we can retain our nurses, but at the same time ensure they keep up to pace with the necessary skillset that are needed to ensure that we can continue to deliver quality service to our Belizean people and how best it is when we can have our very own University of Belize provide that necessary training and skillset.” PAHO/WHO continues to collaborate with partners like the United States Government to support the preparedness and capacity of Belize’s health system.

At the end of the 37th Meeting of Caribbean Immunization managers held from 30-31 October, Belize emerged as the winner of the surveillance award presented by the Pan American Health Organization. Taking second and third place respectively were Guyana and Barbados, and the Henry Smith Award for most improved immunization coverage in 2022 was awarded to the Turks & Caicos Islands. Dr Karen Broome, PAHO Immunization Advisor, reported that the Caribbean subregion has reversed the decline in vaccination coverage that occurred in 2020 and 2021 with improvements in the third doses of DPT3 (94%), Polio3 (92%) and MMR1 (91%) recorded in 2022.  Nonetheless, there is still work to be done with MMR2 and HPV vaccines, which continue to struggle to meet their 95% and 80% targets respectively. Meanwhile, Professor Peter Figueroa, Chair of the Caribbean Technical Advisory Group on Immunization (CiTAG), commended the Expanded Program on Immunization (EPI) managers for their dedication and commitment and congratulated all countries.  He encouraged them to work together and support each other to sustain the gains and go forward stronger.  “We need to ensure that we ‘catch up’ fully, including those children who we have missed so that they do not remain susceptible. And we note the progress.  There has been definite progress - DPT 3, 94%, Polio 3, 92%, this is close to 95% and we want to go beyond 95%.  MMR 1 91%, but MMR 2 83%, so the MMR 2 has a drop out and we must close that gap and ensure that we reach our 95% targets,” Prof. Figueroa said.    He cautioned that in the Caribbean, because of the past successes of the EPI program and the elimination of several childhood diseases, most adults under 40 years of age are not aware of the childhood diseases for which we give vaccines.  “It is abstract. They don’t know what it is to see a child sick in a hospital or dying.  This also includes all the health care professionals under the age of 40.  They may never have seen a measles case, so we have to recognize that this makes it more challenging for us to get the message across how important vaccination is.  So, we need to start with health workers who have concerns or who are being influenced by misinformation, identifying these concerns, and preparing a systematic program to educate health care workers first,” Professor Figueroa stressed. Belize’s EPI Manager, Dr Liliane Middleton was excited to take the first place. She described it as a testament to the hard work of public and private health professionals and noted that Belize was focused on strengthening surveillance indicators, recording more samples, getting more people trained and retrained and going into the community to promote and provide vaccines. “I am so excited.  I am delighted.  Emotional… because I did not expect for us to win that prize.  I was speechless.  It is a great feeling because we got the support from the staff and so winning this prize is a joyful feeling.  I know the staff out there is happy, so it is an honour that we won this prize,” Dr Middleton expressed. During the meeting the participants received updates on the vaccination program in the Americas and in the Caribbean, and the status of the Measles/Rubella and Polio Elimination initiatives, as well as a briefing from the PAHO Revolving Fund.  They also heard country reports from Barbados, Belize, Grenada, St Lucia, Trinidad and Tobago and the Bahamas. The meeting concluded with an ‘Effective Communication for Vaccine Uptake for Caribbean EPI Managers’ workshop which included communicating vaccination related risks, integrating gender and intersectionality into risk communication, and community engagement and navigating discourse among marginalised communities.  The Henry C Smith Immunisation Award was established in 2004 in honour of Mr Smith, the first PAHO-EPI Technical Officer for the Caribbean subregion. Mr Smith’s formal service in the sub-region spanned from 1977 to 1995.  He attended this year’s meeting and is still active in providing guidance to Caribbean Immunisation Programmes today through his participation in the CITAG. The Immunisation trophy was established in 2001 by EPI-CAREC (Caribbean Epidemiology Centre), on behalf of the Family and Community Health, Immunisation Unit at PAHO.   ***END*** CONTACT: Lisa Bayley - bayleylis@paho.org, PAHO/WHO Office of the Subregional Program Coordination (Caribbean) About the Pan American Health Organisation:  The Pan American Health Organization (PAHO) works with the countries of the Americas to improve the health and quality of life of its population. Founded in 1902, it is the world’s oldest international public health agency. It serves as the Regional Office of WHO for the Americas and is the specialized health agency of the Inter-American system. The PAHO Subregional Program is responsible for providing subregional technical cooperation and to strengthen PAHO’s engagement with the Caribbean Subregional integration mechanisms, the Caribbean Community (CARICOM) and its various bodies and organs; and to build synergistic partnerships with the West Indies (UWI), among others. PAHO’s subregional technical cooperation specifically focuses on public health issues which would benefit from economies of scale and for which agreement on proposed collective responses and actions would produce a far greater impact rather than individual country responses. The Subregional Program also plays a role in coordinating among the different PAHO country offices.

Three major initiatives to strengthen Belize’s social protection system advanced in October 2023 with support from the ILO under the Joint Sustainable Development Goal (SDG) Fund Programme: Building a resilient Belize through universal, adaptive, and sustainable social protection.

Ranging from capacity building in statistical systems and contributions at the national Social Protection Summit to the development of a cost assessment of unemployment insurance, the activities are part of an overall roadmap for achieving more inclusive social protection. They pave the way to greater access for social protection for all people in Belize, especially the poor and most vulnerable, so they can benefit from economic opportunities, decent jobs, and livelihood opportunities that will improve their standard of living.

A training session to enhance capabilities of focal points on social protection statistics so they can effectively pave the way to a national social protection strategy, was held from on 16 October 2023 in Belize City. The capacity building event was co-facilitated by the ILO and the Government to cover effective data collection, calculating Sustainable Development Goal (SDG) indicators and other social protection indicators and mapping of the data ecosystem. Sessions were led by Darlene Haylock, Sustainable Development Officer at the Ministry of Sustainable Development, Joana Borges, ILO Specialist for Social Protection and Occupational Safety and Health, and Pamela Bradley, ILO National Project Coordinator, with support from ILO Consultant Pilar Cariño.

Immediately after the training, Belize’s Social Protection Summit (17 to 20 October 2023) provided a platform to further develop the national social protection strategy. The ILO was represented during the four-day event by Joana Borges who provided technical insights and guidance to promote the advantages of investments in social security, including poverty reduction and minimized disruptions to livelihoods during crisis situations, and other areas of support. Key participants included decision makers and social partners, the National Trade Union Congress of Belize (NTUCB) and the Belize Chamber of Commerce and Industry (BCCI). Notably the Ministry of Human Development, Families & Indigenous People’s Affairs (MHD) and the Ministry of Economic Development (MED), and Social Security Board (SSB) served as key facilitators to encourage dialogue among all stakeholders.

“The ILO was honoured to play an important role at the Social Protection Summit. The gathering represented a significant milestone within the framework of the Joint SDG Fund Programme to make progress on the national strategy to achieve a comprehensive social protection floor in Belize, ensuring inclusivity across the spectrum,” said Joana Borges.

In another area of related support, the ILO will soon publish a cost assessment for an unemployment insurance (UI) scheme in Belize. The report provides two specific design options aligned with the two most important ILO Conventions for UI: the Social Security (Minimum Standards Convention, 1952 (No. 102) and Employment Promotion and Protection against Unemployment Convention, 1988 (No. 168). Authors also include a scenario in which a shock such as a natural catastrophe or economic downturn affects the country to emphasize why social protection mechanisms such as UI are essential for socio-economic stabilization.

"In addition to the other participating United Nations agencies, the ILO's support has been an important thread in the tapestry of work we have been doing through the Joint SDG Fund Programme in Belize. The ILO's commitment to decent work and social justice has stood as an important pillar to the larger outcomes of the project and we appreciate the guidance they have lent to the cause," said Ms. Gabrielle Hulse, Economist in the Belize Ministry of Economic Development.

As the Joint SDG Programme prepares to conclude the Resilient Belize project in the next few months, the ILO is committed to continuing to work with the Government of Belize and social partners to ensure the country’s social protection strategy provides a solid foundation for implementation that expands and improves access to social protection nationally. Dialogue around the unemployment insurance and other recommendations coming out of the actuarial valuation being carried by the SSB, in partnership with ILO, will also be very strategic in the near future.

More information about Building a resilient Belize through universal, adaptive and sustainable social protection is available on the ILO's website .

The shuffling of chairs and papers is heard across the campus. The outdoor tent fills with hopeful faces waiting to be assisted in applying for the Government of Belize’s amnesty. Luz*, 50, and her daughter Ada*, 18, are setting up tables, printers, and other necessary items that will be used throughout the day for an amnesty support program led by UNHCR and local partner, HUMANA People to People in southern Belize. About twenty percent of Belize’s asylum-seekers reside in the region. At the end of 2021, the Government of Belize announced an amnesty program that included asylum-seekers, allowing them a secondary pathway to permanent residency. “When I first heard about the amnesty, I couldn’t believe it. I ran to HUMANA’s resource center to see if it was true and immediately asked how I could help others learn about this unique opportunity,” shares Luz enthusiastically. She and Ada came to Belize three years ago in search of their own new opportunity as well as a new home after suffering the tragic loss of a family member by gang violence in Honduras. The day after Luz’s oldest son was murdered while he was on his way to work, men in ski masks started coming to her home at night. They would park their motorcycles in her yard and terrorize her by walking around the house, checking to find any unlocked entry points. “I placed furniture in front of all the doors because I was so scared,” recalls Luz. “In Honduras, many 14-year-olds are already gang members. Everyone in the community knows that to become gang members, they had to kill someone.” One night, as she peeked through her window, she heard a gang member on the phone talking about her and her daughter. At that moment, she realized they needed to flee. Luz, her daughter Ada, and 4-year-old son Danny* left in a hurry, only carrying a piece of small luggage and her purse - the last sign of a normal life. “I couldn’t even visit my parents one last time to say goodbye because it was too dangerous” she recalls with tears in her eyes. She hasn’t seen them since. “I slept on cardboard with my children for a few nights when we first arrived in Belize, until HUMANA and UNHCR assisted me with basic supplies, including a mattress.” After finding some stability in Belize, Luz and Ada joined Manos Unidas, a volunteer group led by HUMANA that helps asylum seekers and locals living in the community of Bella Vista.   “Just as they helped me when I first arrived, through me, they can continue to help others,” says Luz. She and Ada attended an educative session on amnesty, led by UNHCR with informational support from the Government of Belize, which explained the process of applying and who were eligible. From that moment on, Luz and Ada reached out to others in their community to ensure they accessed this opportunity.  “I’ve helped many people understand their right to asylum and taken them to the Refugees Department to register,” explains Luz. “Now, I’m sharing information on how to apply for amnesty with them.” UNHCR and local partners, including Help for Progress, Human Rights Commission of Belize, and HUMANA People to People began visiting communities across Belize to provide this assistance. Ada and Luz began volunteering. Ada fills out the application forms in English, which she can now do after learning the language through HUMANA’s English as a Second Language (ESL) course. “It feels very nice to be able to help others, especially because I remember coming to Belize and not understanding English” recalls Ada. “Now, I’ve volunteered in eight different communities by filling out applications for hundreds of asylum seekers. People even come to our home to ask for help with the application forms.” Ada was also able to fill out her family’s application forms and submitted them at the start of the amnesty process. Luz and Ada feel grateful for this opportunity, especially after the tragedy they endured in Honduras two years ago. UNHCR has been able to assist 2,639 asylum seekers and other vulnerable individuals to apply for the Government of Belize’s amnesty program, including Luz and Ada. Over 12,000 asylum seekers and migrants have applied for this amnesty, which will allow them the right to employment, education, and healthcare, while also allowing them to give back to Belize through paying taxes and social security. Children will be able to enroll in secondary and tertiary education and all will be able to share their talents with the nation. “Even if I am granted permanent residence,” says Luz, “I will always be here to serve others,”   *These names have been changed to protect their identities.