Montserrat Survey of Living Conditions (MSLC) Executive Summary

Montserrat Survey of Living ConditionsExecutive Summaryon a review of their Sustainable Development Plan 2008-2012 (SDP). This review provides an idealmechanism for some of the Poverty Action Programme recommendations to be rapidly incorporated intothe new version of the MSDP.2 Background and Context (Chapter 2)2.1 Geographic and Historical SettingMontserrat is one of the Leeward Islands in the Eastern Caribbean, lying 43km south-west of Antigua and64km north-west of Guadeloupe. It is approximately 102 sq km (16 km long and 11 km wide) andgrowing slowly due to volcanic deposits on the southeast coast of the island. The topography is entirelyvolcanic and very mountainous, with a rugged coastline with dramatic rock faced cliffs rising from the sea.Montserrat was populated by Arawak and Carib people when it was claimed by Christopher Columbus forSpain on his second voyage in 1493. The island fell under English control in 1632 when a group of Irishfleeing anti-Roman Catholic sentiment in Saint Kitts and Nevis settled there. The import of slaves startedat much the same time and an economy based on sugar, rum, arrowroot and Sea Island cotton wasestablished during the seventeenth and eighteenth centuries. Slavery was abolished in 1834 following thegeneral emancipation of slaves within the British Empire which occurred in that year.Falling sugar prices during the nineteenth century had an adverse effect on the island's economy and in1869 the British philanthropist Joseph Sturge formed the Montserrat Company to buy sugar estates thatwere no longer economically viable. The company planted limes and started production of the island'sfamous lime juice, set up a school, and sold parcels of land to the inhabitants of the island, with the resultthat much of Montserrat came to be owned by smallholders.From 1871 to 1958 Montserrat was administered as part of the Federal Colony of the Leeward Islands,becoming a province of the short-lived West Indies Federation from 1958 to 1962. It is currently one ofBritain’s remaining overseas territories with the Queen as head of state, a governor appointed by theQueen and a democratically elected Chief Minister.The last years of the 20th century, however, brought two events which devastated the island. In September1989, Hurricane Hugo struck the island with full force, damaging over 90 percent of the buildings andvirtually wiping out the then burgeoning tourist trade. Within a few years, however, the island had largelyrecovered - only to be struck again by the major eruptions of the Soufriere Hills volcano in 1995 and 1997.Two and half years of intense volcanic activity saw the southern, most populated and most fertile part ofthe island, evacuated and declared unsafe. Plymouth, the capital and the territory’s industrial, commercial,and government centre, was almost totally destroyed along with the island’s airport and hospital; manypeople lost their houses and had to be evacuated. Over half the population left and a steep economicdecline followed. Reconstruction efforts started in earnest in the early 2000s and the northern, habitablepart of the island now has government offices, schools, a hospital and an airport along with new housingestates and much improved roads. The island however remains largely dependent on assistance from theBritish Government.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES2

Montserrat Survey of Living ConditionsExecutive Summary2.2 PopulationThroughout most of its recorded history the population of Montserrat has varied between 10,000 and12,000 with a peak of 14,000 being achieved in 1946 (Table ES.1). However while the 1989 hurricane hadonly a minor impact on the population, the impact of the volcanic eruption has been catastrophic: in 1997,the population was around 3,400 – only 30% of the 1991 figure. By 2001, it had ‘recovered’ to around4,500 and to 5,000 by 2006 2 . The impact of the eruption on the geographic distribution of population isshown in Figure ES1.With a population as small as this, the start of completion of large construction projects can leadsignificant changes in population, as workers and their dependents arrive and leave; population growthrates can thus fluctuate significantly from year to year. Since 2000, live births and deaths have bothaveraged around 50 annually implying that there is a negligible natural increase in the population.Table ES1. Population Change, 1881-2006Figure ES1. Population Distribution, 1991 and2001Year Population AnnualGrowth rate60001881 10,0831891 11,762 1.6%1901 12,215 0.4%1911 12,196 0.0%1921 12,120 -0.1%1946 14,333 0.7%1960 12,167 -1.2%1970 11,458 -0.6%1980 11,606 0.1%500040003000200010001991 10,639 -0.8%1997 3,338 -17.6%2001 4,491 7.7%2006 5,031 2.3%0Plymouth1991 2001Rest of StAnthonySt George(St John'sMongo Hill,Barzeys)St Peter(isles Bay/Happy Hill)The population of all age groups has declined since the eruption but these changes have not affected allage groups equally. In 2001, the main changes were the much increased proportion of population in theworking age groups and a corresponding decrease in the population under the age of 15 whose proportiondeclined from just over a quarter to under 20%. By 2006, the proportion of the elderly had decreasedlargely due to the increased proportion of under 15s. The increased number of children implies both ageneral stabilisation of the population and that migrants are increasingly bringing their children. Howeverthe very low proportion of 15-24 year olds (11% compared with 17% in 1991), is clear evidence of a‘brain-drain’ as school leavers depart to find tertiary education and employment off the island.2 Initial results from the 2011 Census give a population of around 5,000, i.e. little change since 2006.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES3

Montserrat Survey of Living ConditionsExecutive SummaryAverage household size was 2.4 persons in 2008/09 which, while low by Caribbean standards, is slightlyhigher than after the eruption when it dropped to 2.1 persons. The proportion of households withspouses/ partners has increased to 38%, much higher than in 2001 when it was only 29% while theproportion of single person households had decreased from almost 50% in 2001 to 35%. Around 40% ofhouseholds are female-headed, similar to the 1991 proportion. All these indicators reinforce the view thatthe population structure of the island is gradually stabilising from its post-eruption structure when a largenumber of households fragmented.In 2008/09, 29% of household heads were foreign-born but a substantial proportion of these hadachieved belonger status. If this group is excluded, the proportion of non-national heads on the island isaround 15%.2.3 The EconomyThe economy of Montserrat today is the result of an array of unique factors and developments followingboth Hurricane Hugo and the volcanic eruptions in which social and economic structures and the island’sinfrastructure were decimated; large parts of the island were made (and remain to this day) uninhabitable.As a British Overseas Territory, Montserrat has been able to access loans and grants from the UnitedKingdom to rebuild and Montserratians were able to leave their homes for jobs and family in the UK,thereby decreasing pressure on the post-eruption economy. In consequence, the recovering economy isbased mainly on services (especially government) and construction, with little value added in the traditionalsectors of tourism and agriculture (Figure ES2).Through grants, loans and support from Montserratians living overseas, Montserratians have been able tomaintain a reasonable material lifestyle 3 , as measured by GDP per capita. In 2004, Montserratian GDP percapita in 2006 at around EC$22,000 was 50% higher than the ECCB average and 3 rd highest of the eightmember states.Nevertheless, the current weakness of the economy is evident. In 2006, in constant dollars, GDP was only53% of the level achieved in its pre-Hugo (1987) level (Figure ES3). Were it not for the fact that manyMontserratians left the island following the volcanic activity, per capita economic activity would be muchlower. The recent sluggish performance is largely the result of some large public sector projects beingcompleted with only the mining and quarrying sector showing growth as a result of exports of volcanicsand. In 2008, the economy grew by around 4% but inflation almost reached 5% resulting in a decline inreal GDP 4 . ECCB forecasts that the economy will continue to remain flat in the near term; risinginternational oil prices and the North American recession will further increase consumer prices. TheGovernment of Montserrat is forecasting GDP growth of 3% in both 2008 and 2009 based on the startupof construction projects at Little Bay and Government Headquarters, among others.3 In 2008/09: 53% of households had a motor vehicle; over 85% had fridges, TVs and telephones (landline or cell);40% had computers with most of these having internet access.4 GOM, Budget Speech, 2009.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES4

()EC$ x millionMontserrat Survey of Living ConditionsExecutive SummaryFigure ES2 : Montserrat, GDP by Sector,2006Figure ES3. Montserrat: GDP in constant EC$ millions,1987-2006Fig. 3 GDP in Constant Dollars(EC$ x million)180.0160.0140.0120.0100.080.060.040.020.00.01987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006The Government SectorFigure ES4: Government Expenditures and RevenuesEC$millions100806040200-20-40-602002 2003 2004 2005 2006-80Current Revenue Current Expendiiture Current Balance before GrantsSource: 2006 Annual Economic and Financial Review, ECCBGovernment activity is the main driverof the Montserrat economy. Giventhe natural disasters of the past 25years, the contraction of economicactivity and the need to rebuildinfrastructure,governmentexpenditures are greater than revenueinflows (Figure ES4). The resultingnegative balance is expected tocontinue over the short to mediumterms.Tax revenues (duties and levies, licensefees, consumption tax, etc.) accountfor about 45% of Governmentrevenue. On the expenditure side,personal emoluments 5 and pensionsfor government employees account forabout 55% of Governmentexpenditures.5 These will include teachers and health workers as well administrative officers.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES5

Montserrat Survey of Living ConditionsExecutive SummaryTotal social spending (education, health and social welfare) rose from EC$15.6 million in 2002 to EC$23.4million in 2007; around 1/3rd of this expenditure was on education and 2/3rds on health and socialwelfare. This expenditure has maintained a fairly constant share of total government recurrent expenditureof around 25%.2.4 EmploymentBetween 2001 and 2006, reconstruction activities led to employment increasing by almost 50% andunemployment dropping slightly to 12%. Women made up 44% of the active population. The pattern ofemployment also changed substantially between 1991 and 2001 with the government becoming by somemargin the most important sector accounting for 45% of total employment – a pattern that had changedlittle by 2008/09 when the self employed accounted for 19% of those working and 35% were privatesector employees. The principal trend in terms of occupational groupings, evident since 1991, is increasingproportions in both the most skilled (white collar) and least skilled (elementary) occupations; in contrast,the proportions of sales and skilled manual workers both decreased (Table ES2).Table ES2. Employment CharacteristicsType of Employment 1991 2001 2008/09Change 1991-2008/09Government/ Statutory Bodies 27% 45% 46% +19%Private employee 55% 39% 35% -20%Self employed 18% 16% 19% +1%Occupational GroupingManagerial, Professional, Technical 24% 30% 34% +10%Clerical and Sales 24% 27% 21% -3%Crafts and Skilled Manual 34% 25% 18% -16%Unskilled Elementary 18% 18% 26% +8%Total 100% 100% 100%Sources: 1991 and 2001 Censuses, Listing Survey 2006, SLC 2008/09Employment in construction and government (including health and education) dominate the economywith around 60% of all employment. There is negligible employment in agriculture or manufacturing.In 2001, non-nationals accounted for 22% of employment on the island. While they were found in alloccupations and industrial sectors, the proportions vary substantially: non-nationals are ‘over-represented’ 6in the unskilled, craft and professional groups, i.e. at both at both ends of the skills continuum. In termsof industrial sectors, they provide at least 30% of employment in domestic service, hotels, constructionand manufacturing; conversely, they are under-represented in government which is the most importantemployment sector of all.6 I.e. NNAT share of employment in an occupational group/ industrial sector is greater than their share of totalemployment.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES6

Montserrat Survey of Living ConditionsExecutive Summary2.5 Education, Health and HousingEducation in Montserrat is compulsory for children between the ages of 5 and 14, and free up to the ageof 17. Attendance is essentially 100% as is the transition from primary to secondary. Youth and adultliteracy is also very high.Health conditions in Montserrat are generally good:Life expectancy at birth was 81.0 years for women and 76.5 years for men with additional gainsexpected for both sexes. This compares favourably with other OECS islands.Only 1 infant death has been recorded since 1998 and none of children aged under 5 years.There were no reported cases of protein energy malnutrition.The most common recorded communicable diseases from 1998 to 2006 are respiratoryinfections (39%), influenza (33%) and gastroenteritis (14%). These diseases are prevalent invirtually every country. In contrast, there have been no cases of the communicable childhooddiseases (measles, etc.) since 1998.Only 2 cases of AIDS have been recorded on the island since 1998 although 21 persons testedpositive for HIV infection during the same period. Given that some of these left the island, theoverall rate of incidence amongst adults (15-49 years) would be substantially below theCaribbean average.The main medical concerns at present are diabetes and hypertension which respectively afflictapproximately 6% and 10% of the population; prevalence rates are not dissimilar to those in the USADiabetes along with heart disease are the main causes of death (respectively 21% and 44% of all deathsbetween 2003 and 2006) with cancers (13%) accounting for a large proportion of the remainder. Anotherhealth concern is an increasing prevalence of dementia with many elderly persons receiving psychologicalservices and with over 100 being cared for in government institutions.Housing tenure has changed considerably sincethe eruption (Figure ES4) with the proportionof households owning their property decreasingby almost half from 72% to 38% between 1991and 2001. Although there were increases inprivate renting and rent free housing, the majorincrease was in government rentedaccommodation which provided for one inevery 6 households in 2001. Currently, thesituation has improved substantially with theproportion of owned dwellings increasing to59% with a corresponding decline in the rentedsector – a reflection factors such as theconstruction of Lookout and the closure oftemporary hostels.Figure ES4: Housing Tenure, 1991, 2001, 2008% of hholds80%72%70%59%60%50%43%38%40%31%30%20%20%12%10%10%7% 7%0%0%0%Owned Rented Rent Free Other1991 2001 2008/09 Housing TenureMontserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES7

Montserrat Survey of Living ConditionsExecutive SummaryThe great majority of houses in Montserrat are single dwellings, have piped water, proper sanitation,electricity and use gas/ LPG for cooking. Overcrowding (defined as households with fewer living roomsthan persons), affected 21% of households, a similar proportion to that prevailing in 1991 7 . Nonetheless,around 30% of dwellings do not have concrete roofs – although this is substantially lower than theequivalent 2001 proportion, 45%.3 Poverty in Montserrat (Chapter 3)3.1 The Definition of PovertyPoverty is most often defined on the basis of an indigence (or severe poverty) line based on minimumfood requirements, and a general poverty line (minimum food requirements plus an element of non-foodexpenditure) derived according to the CDB methodology. In 2009, the annual indigence line is aroundEC$4,735 (c. EC$13/US$5 per day) for an adult male while the poverty line is around EC$14,400 (c.EC$39.5/US$15 per day).Current definitions of poverty are more wide-ranging than those based on income alone. They includeconsideration of, inter alia, living conditions, access to health and education, and less easily defined notionssuch as vulnerability, voicelessness, powerlessness, and lack of opportunity. The general concept of ‘wellbeing’has been used in this study to bracket these non-income aspects of poverty – this is an importanttheme of this CPA.In general, there is a high correlation between lack of income and lack of well-being. However this is notalways the case – some people and households living below the poverty line may not feel insecure orthreatened. Conversely, others, with incomes above the poverty, may experience lack of well-beingresulting from factors such as family disruption, teenage pregnancy, crime, drug abuse or be at risk offalling into poverty from one or more of these factors.3.2 The Extent of Poverty in Montserrat in 2008/09In late 2008/ early 2009, when the SLC was carried out, 25% of Montserratian households 8 and 36% ofthe population are poor. The level of indigence is however low at 2% of households and 3% of thepopulation 9 . Around 20% of both population and households are classified as vulnerable (i.e. withexpenditures up to 25% above the poverty line). Overall, 75% of households and 64% of the populationare not poor; if those most vulnerable to poverty are excluded, 56% of households and 44% of thepopulation are neither poor nor vulnerable to poverty. (Figure ES5).7 The 2001 census did not tabulate the number of habitable rooms.8 Persons residing in collective households, e.g. hostels, care homes, the hospital and the prison, are excluded.9 As with any sample survey, these estimates are subject to sampling error, which as a proportion of the estimate,increases with smaller percentages. The 90% confidence level for households in severe poverty is ± 1.4% while theconfidence level for those in poverty is ± 3.6%.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES8

Montserrat Survey of Living ConditionsExecutive SummaryThese data are generally consistent with thePPAs which indicated both low levels ofsevere poverty and high levels of poverty/hardship amongst the population – thewords ‘struggle’, ‘surviving’, ‘hardship’appear over 500 times in the discussionswhile issues related to the high price offood and utilities were mentioned byvirtually everyone. Conversely, there werevery few mentions relating to ‘hunger’which corroborates the low statistical levelof severe poverty. The only groups seen asbeing relatively unaffected by this situationwere senior civil servants, business peopleand politicians - around a third of thoseemployed.Figure ES5. Poverty in Montserrat, 2009100%90%80%44%70%56%60%50%20%40%19%30%20%32%23%10%0%2% 3%HouseholdsPopulationIndigent Poor not indigent Vulnerable Not PoorTable ES3 provides a comparison of poverty levels in Montserrat with those of other Caribbeancountries 10 . Montserrat’s poverty level is higher than most of the other countries, the exceptions beingBelize (which was carried out about the same time) and Guyana. The food share percentage of the povertyline is a good indicator of relative poverty levels, as this variable traditionally decreases with affluence.Montserrat, at 34%, is lower than all the cited countries except St Lucia.CountryTable ES3. International Comparisons of PovertyYear**% Popindigent% H’holdsindigent% poppoor*% H’holdspoorGinicoeff.Food as % ofPoverty LineMontserrat 2008/09 3 2 36 25 0.39 34%Antigua 2005/6 4 3 19 - 0.48 39%Barbados 2010 9 - 19 15 0.47 -Belize 2009 16 10 42 31 0.42 58%Dominica 2009 3 - 29 23 0.44 39%Guyana 2006 19 - 36 - - -St. Kitts 2008 1 - 24 - 0.40 -Nevis 2008 0 - 16 - 0.38 -St. Lucia 2005 2 1 29 21 0.42 31%St Vincent 2007/8 3 - 30 - 0.40 44%Trinidad & Tobago 2005 1 - 17 - 0.39 38%Based on this table, Montserrat’s low level of indigence is similar to that of most other countries.Conversely its level of poverty is higher than most, the exceptions being Belize (which was carried out10 These comparisons are not straightforward as the surveys were not undertaken at the same time and the calculationmethodologies, although similar, do vary. Furthermore, the current study was undertaken at a period when there hadbeen a serious hike in food prices.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES9

Montserrat Survey of Living ConditionsExecutive Summaryabout the same time) and Guyana. The food share percentage of the poverty line is a good indicator ofrelative poverty levels, as this variable traditionally decreases with affluence. Montserrat, at 34%, is lowerthan all the cited countries except St Lucia. Montserrat’s Gini coefficient situates it firmly amongst themajority of the countries shown in terms of income inequality.3.3 Characteristics of Poverty in Montserrat in 2009In terms of demographic characteristics, the findings are similar to those of many other CPAs and can besummarized as follows:Children (under 15 years) experience by far the highest poverty rate. This group accounts for over athird of the poor population.Those over 30 years, including the elderly, have a below average poverty rate. The elderly account forlittle more than 10% of the poor population.There is no difference in the incidence of poverty between males and females. Nor is there asignificant difference between male and female headed households.There is an unambiguous correlation between household size and poverty (Figure ES5). Largerhouseholds are much more likely to be poor and they account for a disproportionate proportion ofpoor households. Specifically, households with more than 2 persons account for over 60% of poorhouseholds compared with 34% of all households; the poverty rate amongst this group is around45%, almost double the national average. In contrast, the poverty rate for single person households isonly 11%. These contrasts are even more acute when population rather than households are used –over 80% of the poor population lives in households with more than 2 persons. The averagehousehold size of poor households is 3.5 persons compared with 2.1 persons for not poorhouseholds.Figure ES6. Poverty and Household size, Montserrat, 200950%45%40%35%30%25%20%15%10%5%0%47%35% 35%26%24%15%13%4%1 2 3-4 5+Household Size (persons)% of Poor Households % of Poor PopulationMontserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES10

Montserrat Survey of Living ConditionsExecutive SummaryHigher levels of poverty are also associated with:Households where no one is employed.Households headed by persons with only primary education.Montserratian-headed households.Overcrowded and renting households (virtually everyone has access to piped water, sanitation andelectricity.Lower levels of vehicle and computer ownership – but not telephones, fridges, TVs and washingmachines.The situation is however more complex than is implied by the above statistics which, in most cases, arenot statistically significant:In every category described there are more not poor people than poor people.Just because a group exhibits a lower than average poverty rate, does not mean that there are notimportant poverty related issues that need to be addressed.The data relate only to income poverty and do not take account of issues related to wellbeing.3.4 Difficulties faced by the PoorThe PPAs provide information on the difficulties encountered by different groups of the poor. The‘primacy’ of economic hardship came out strongly in the PPAs with more mentions relating to high prices,low wages and lack of employment opportunities - resulting from the sluggish economy and the spike inoil and food prices that occurred at the end of 2008/ early 2009 - than for all other issues combined. As aresult, many households are finding it hard to cope with weekly food costs, loan repayments, educationcosts and utility bills (electricity disconnections are increasing).For poor family households (55% of poor households have children), these difficulties can lead toadditional pressures on family relationships potentially giving rise to a range of adverse impacts onwellbeing:“I feel confused, frustrated and, powerless. When I get up in the morning and I don’t have sugar to put in mychildren tea, I have to ask the neighbour. I feel very stress. In Montserrat you hardly get someone to ‘stretch’for you. You have to fight the battle for yourself. I feel that my life is at risk, because I have a heart problem.I am sick and I cannot come up with money to go to the doctor. I feel at risk. Really tough, I have stress Ihave children to feed. I eat what the doctor told me eat, but it is very difficult. I have husband who is not“stretching” for me. He is not helping me.” (FGD Migrant Women, Salem)In turn, these pressures can give rise to a range of abusive, anti-social and risky behaviours: family breakup, domestic violence, child abuse, drug-taking, criminality and teenage pregnancy 11 , all of which increasethe risk of continuing and inter-generational poverty:11 Note that these can also arise independently of economic issues; see 3.7 below.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES11

Montserrat Survey of Living ConditionsExecutive Summary“Because parents have to work two or more jobs to make ends meet, there is no more interaction betweenparents and children. Children are not monitored properly by their parents and do not go home after schoolwhich may be a cause of delinquency”. (FGD Salem)The traditional form of support for the elderly is by family members. This type of support is in declineworldwide and, on Montserrat, has been accelerated by the volcanic eruption, which eliminated many ofsavings and assets as well as leading to family fragmentation. The elderly are thus increasingly dependenton pensions and social welfare - the majority of households with elderly persons have income from thesesources. Their prime concerns are thus different from those of other vulnerable groups: the low level ofwelfare/ pension payments, loneliness due to the absence of family members, access to health services,both of which can be compounded when mobility is impaired. These non-income issues can affect notpoor as well as poor elderly persons 12 .The economic downturn and the high prices have affected many migrants on the island in similar ways tonationals: increased unemployment, reduced working hours and increased pressure, sometimes intense, onhousehold budgets. For poor and less skilled migrants, the major issues of concern are those related toimmigration and work permits (the actual regulations and their application), differential access to healthcare and a sense of insecurity and vulnerability arising from their perception that their presence is resentedby many Montserratian. Conversely, there is a perception amongst some Montserratians that migrants aretaking their jobs 13 . There is thus a palpable sense of mutual distrust between migrants and Montserratians.Housing is mentioned over 60 times in the FGDs and KIIs, and particularly by the households relocatedfrom the devastated area, many of whom are living in rented property or shelters, and who are unable toaccess the funds needed to buy or build a new house of their own. Debt to foreign banks for mortgageson properties lost under the eruption remains a hindrance to some, as well as being an impediment to thereturn of non-resident Montserratians. The accommodation for poorer renting households is often lowstandard, overcrowded and inadequately maintained. At the same time, northern residents are critical thatvirtually all housing assistance has gone to relocatees and almost none to them, despite the fact that manylost their jobs with the eruption.On the other hand, non-financial issues related to infrastructure (e.g. water, electricity or roads) oreducation received substantially fewer mentions.There is fairly widespread criticism of the government’s performance, although some say that the GoM isdoing what it can but is constrained by outside factors, namely the macro-economy and the financialcontrol exerted by the UK government. These criticisms range from the failure to impose price controls orreduce taxes to a perception that the administration does not ‘care’ for the needy or listen enough to theirviews, and more seriously, a perception that the government is only looking after its own, e.g. throughfavouritism in the allocation of housing and jobs, protected pensions, as well as unrealised electionpromises. None of these occurs frequently in the PPAs but the overall impression of a lack of trust ispervasive as is a belief that the government holds the key to their future wellbeing.12 The quality and accessibility of health care is also the greatest concern of the physically and mentally-challenged.13 “We are double dying – people leaving and non-nationals are taking jobs” (Salem FGD).Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES12

Montserrat Survey of Living ConditionsExecutive Summary3.5 Coping StrategiesInadequate incomes whether due to low wages, unemployment, insufficient government assistance or lackof family support for those too old, too young or too disabled to work, necessitates the adoption ofcoping strategies. The main coping strategies identified during the study are shown in Table ES4. Ingeneral, these vary little between different groups; nor are they very different from those found in mostCaribbean poverty assessments.Table ES4: Coping StrategiesCopingStrategyBackyardgardeningSecondoccupationsReduced foodconsumptionReducingexpendituresespeciallyutilitiesFamilyassistance /remittancesGettingassistancefrom NGOsUsing savings/ selling assetsKIIs/ FGDsmentioningWho doesit?65% Those withland/ gardens44% The ablebodied.CommentsHas always existed but often hampered by poor soil and looseanimals and pests (iguanas) which destroy the crops.Includes renting rooms, both parents seeking jobs; cash-in-handjobs such as ironing, gardening, cleaning, etc.35% All Eating less; buying food on a ration basis or wholesale; usingstaples only; foraging. Leads to less nutritious diets and,infrequently, hunger.25% All those notin sheltersSee data above. Manifestations include using less light,purchasing energy saving light bulbs, cooking less, maximisingwash loads, minimizing water use, no longer using electric stoves,coal pot cooking*; walking rather than taking the bus; reducedsocial activities. By far the most prevalent is delaying payments.49% All Little evidence that remittances are having a significant onreducing poverty: under 6% of households received overseasremittances and in virtually all cases, these did not affect thepoverty status of the household. Net remittances are negative asNNATs remit more overseas than are received on the island.NaProstitution 3mentionsMostly theelderly andthe disabledNa All Rarely mentioned.Young womenPrincipally the Red Cross and churches but also Meals on Wheels(68 total mentions in all PPAs). Assistance is mainly in food. Bothorganisations rely on donations for the assistance they provide.One of the most extreme and infrequent.Emigration Na All More close family members had left the island than had arrived inthe last 5 years. This was also the primary coping strategyfollowing the eruptions.3.6 Priority NeedsThe PPAs also obtained information on residents’ views as to their priority needs. Figure 3.7 shows thedifferent patterns of policy suggestions obtained from the KIIs/ FGDs, which can be expected to takemore of an overview of the overall situation and the SSIs which are more likely to reflect the concerns ofindividual households. While the Figure shows broadly similar patterns with similar, and greatest, emphasison economic issues, the SSIs give greater relative importance to health, migration and governance issues.In contrast, the KIIs/ FGDs put more emphasis on agriculture, recreation facilities and infrastructure/major projects.The PPAs also provided a substantial number or more detailed suggestions, many of which have beenincorporated into the Poverty Action Programme (see section 6 below).Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES13

Montserrat Survey of Living ConditionsExecutive SummaryFigure ES7: Priority Needs as expressed in the PPAsPrices/ JobsAgricultureSSIs (responses=113)26%5%15%6% 4%12%4%12% 8%8%HealthTraining / EducationHousingSocial ServicesRecreation/ SportsFGDs/KIIs (responses =208)26%13%8%8%6%11%8%5% 4%12%Migration IssuesGovernanceInfrastructure/ MajorProjects0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%% of Responses3.7 The Causes of Poverty in MontserratThe primary causes of poverty on Montserrat are economic. This bears out recent research undertaken bythe World Bank 14 which shows that economic factors - lack of employment 15 , low wages and high prices -as the main causes of poverty - were the reasons that two thirds of households fell into poverty. Thesefactors were also the primary concern, and by a considerable margin, of every group interviewed duringthe PPAs be they unemployed, low waged, old or young, male or female, Montserratian or non-national.Figure ES6 shows that the underlying economic causes of poverty can be diverse. In Montserrat’s case,the most important are the spike in world market prices, its low natural resource base (especially since theeruptions) and the low demand on the island for goods and services. None of these are amenable to easysolutions.Economic issues are however not the only cause of poverty in Montserrat. Family breakdown, pressureson the carer parent to generate income as well as provide child care, domestic violence, unplannedpregnancies, drug and alcohol use, all play their part – and can lead to a cycle of continuing and intergenerationalpoverty from which it is very difficult for either parents or their children to escape.For other vulnerable groups, the issues are more fundamental. Their ability to work is limited for reasonsof age, infirmity, disability or parental duties. They thus have to depend on family and friends, with14 Narayan D., Pritchett L. and Kapoor S., 2009, Moving out of Poverty: Success from the Bottom Up, World Bank/ PalgraveMacmillan15 Only a minority of households (most of which are those with older persons) have no one working implying thatlow wages allied to increased prices are more of an issue than unemployment per se.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES14

Montserrat Survey of Living ConditionsExecutive Summarygovernment and other organisations stepping in to assist those who are alone or whose families are unableor unwilling to support them. Direct assistance from government is however negligible meaning that thosewithout family support have to resort to one or more of the coping strategies described previously.Figure ES6. Economic Causes of PovertyLack of investment Depressed local orWorld↓ ↓due to poor security / international markets formarketperceived corruption.goods.pricesNatural disasters/Resource depletion.No/ limited naturalresourcesLow demand for jobs and goods.No jobsExploitation.Profiteering. Lack oflabour laws/ tradeunionsHoarding.Inequitable termsof trade. HightaxationLack of skills No Work Low pay High pricesINSUFFICIENT INCOMENB. Items in larger font are considered to be those that apply most to Montserrat.Yet poverty is not just a question of income. Members of these vulnerable groups are also moresusceptible to some of the non-income aspects of wellbeing – loneliness, depression, vulnerability due toirregular support and absence of family members, and problems of housing and health care. By the sametoken the loss of wellbeing and social fragmentation and resulting psycho-social pressures resulting fromthe eruption are a long way from being healed.But these issues are not confined to vulnerable groups. Many Montserratians had to relocate following theeruption. Several of these still live in poor housing and are struggling with both the economic situation anda general feeling of vulnerability arising from their loss of houses, assets, income and family membersoverseas – over a third of households are single person. The psychological impact of the eruption stillcontinues and is likely to do so for years to come. In many PPAs, respondents referred to a loss ofcommunity spirit, mutual self help, togetherness – in short a loss of social capital - which exacerbatesproblems of economic hardship. In several cases, there is resentment towards migrants who are seen astaking jobs that should go to Montserratians. Conversely, for migrants, economic difficulties arecompounded by the view that their general wellbeing is adversely affected by having to pay more forhealth treatment, not being eligible for social welfare, bureaucratic issues related to work permits andimmigration requirements.Yet, by and large, the Montserratian population has a high standard of living in terms of consumer goods,a near universal availability of basic infrastructure, generally good housing conditions, and a very lowincidence of severe (food) poverty. In most cases therefore poverty on the island is largely due to theinability of current household incomes to keep up with the expenditures required to sustain current livingstandards rather than the absence of basic needs or severe unemployment – as is evident from the largeMontserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES15

Montserrat Survey of Living ConditionsExecutive Summarynumber of mentions of the words ‘struggling’ and ‘surviving’ in the PPAs. In this sense, the term hardshipis arguably more apposite in the Montserratian context than poverty.3.8 Changes since 2000Comparisons of the 2000 and 2008 PPAs reveal very similar results. This is not unsurprising given thatthey were both undertaken in periods of economic hardship. The factors causing these situations arehowever different. In 2000, the country was only beginning to recover from the eruptions while in 2008the economy was contracting due to the global recession and the completion of major constructionprojects. Both surveys are dominated by concerns about the high cost of living that has imposed a varyinglevel of hardship on a large proportion of the population. The coping strategies employed to enablepeople to ‘make ends meet’ are virtually identical as are the groups likely to be most vulnerable to severepoverty: the elderly, the mentally challenged and households with single headed families with children.There are however differences although these are a matter of degree rather than radical change. Inparticular, it is probable that the psychological impacts of the eruption have reduced, given that they arenow living in safe areas and considerable reconstruction has taken place. For instance, respondents arenow more concerned about improving current housing conditions than discussing the failings of the posteruptionshelter policy. If the sense of insecurity resulting from the eruption has, for many, decreased thisis partly offset by an increase in insecurity resulting from increased immigration, especially during a time ofeconomic stagnation. Issues related to unemployment and under-employment receive greater attention forthe same reason. Little attention was paid to migrant issues in 2000.Overall, responses received in the 2008 PPAs are more typical of those from other Eastern CaribbeanPPAs than those from 2000 16 . In the future, this is likely to be increasingly the case as memories ofMontserrat’s volcanic eruption fade to be increasingly replaced by the issues found in other CPAs –although they will be reawakened every time there is a spate of volcanic activity.4 The Institutional Analysis (IA) (Chapters 4 and 5)The objectives of the IA were to: (i) to identify the principal policies, programmes and activities relevant topoverty reduction; (ii) to assess the scope and effectiveness of these interventions; and hence (iii) toidentify potential recommendations as to how existing activities and can be improved and newinterventions introduced. The IA was undertaken through interviews and discussions with numerousgovernment, non-government and private sector organizations as well as the review of relevant documentsand statistics. The IA covered economic, infrastructure and social sectors. Suggestions arising from theIA, of which there were many, have been included in the CPA’s recommendations.16 Some of the differences may also be due to the different approaches in the two studies. The 2000 surveys wereundertaken just as the concept of PPA approach was gaining favour. At that time, poverty was still essentially seen inincome and quantitative terms; hence greater emphasis was given to exploring alternative definitions of poverty.Much of this is now the orthodoxy so more recent PPAs tend to stress the examination of the characteristics,concerns and needs of different sub-groups of the poor. This facilitates addressing the non-income aspects ofpoverty and deriving policy interventions for different vulnerable groups.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES16

Montserrat Survey of Living ConditionsExecutive Summary4.1 Economic SectorsThe most important findings of the IA for the economic sectors are:There are no obvious opportunities for a rapid expansion of Montserrat’s economy, nor do anynew sectors with substantial job creation opportunities suggest themselves. This is not to saythat measures such as the re-introduction of the ferry to Antigua or the continued expansion ofthe nascent sand-mining industry would not be beneficial.The same goes for the establishment of the Montserrat Development Corporation and thecontinued implementation of the new centre at Little Bay. These are currently the maingovernment ‘economic initiatives’.The Department of Agriculture has several potential projects but these would benefit from amore detailed evaluation, which if positive, would increase the potential for funding.There are a number of schemes and incentives for small business. These incentives are thoughtto be well-known by the target users and have had some success 17 . Constraints are: (i) thereliance on grant funding - which might not be sustainable; and (ii) inadequate small businessrecord keeping.There is little demand for credit for new businesses due both to a low level of interest amongstthe population and the lack of obvious investment opportunities. The National DevelopmentFund has a substantial portfolio of outstanding loans. There is negligible NGO activity in termsof micro-credit or income generating activities.There is a demand for more, and better, vocational training, e.g. linked to apprenticeshipprogrammes, even if this tends to improve the employment prospects of new job seekerselsewhere than on the island itself.4.2 Health ServicesThe Ministry of Heath provides a range of primary, secondary and tertiary care services through 4 clinicsand one hospital. Health services had to be re-established since the eruption. Child health clinics are heldweekly at all health centres; there was 100% registration of children under 5 in the clinics with almost100% vaccination rates. Family planning clinics are held weekly. Virtually all births occurred at thehospital and are attended by trained health professionals.The major concerns at present are the financing of health services and providing access to all. At present,treatment and consultations at the clinics are essentially free. Conversely, most residents pay for hospitalservices. These payments only cover a small proportion (under 10%) of the health budget and should thusbe seen as contributions rather than full cost fees. The main groups who do not pay are the elderly,children, the disabled and pregnant mothers; certain categories of civil servant are also exempt. Nonnationalsalso pay 1.5 to 2 times the fees of Montserratians.17 52 successful applicants in 2007 received grants between $1400 and $29,000 in agriculture, fishing, tourism,restaurants and printing; around 100 jobs were generated.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES17

Montserrat Survey of Living ConditionsExecutive SummaryHealth costs are rising due to better, but more expensive treatments, people are living longer thusrequiring more treatment and costs associated with chronic diseases are disproportionately high 18 . At thesame time, the impact of sudden health expenditure on family incomes can be severe for those who are onlow incomes. It is anticipated that the new Health Strategy will address these issues with options beingconsidered including a National Health Insurance System, increased user charges, possibly allied toexemptions for some groups being subject to greater means testing.There are also issues related to the quality of health care in terms of the availability of trained nurses anddoctors and access to less frequently needed health services. This is largely attributable to the small size ofthe population, which offers few opportunities for medical staff to gain a breadth of experience; thismakes the posts relatively unattractive. It also makes it harder to provide treatment for specialist problems,e.g. mental health.4.3 EducationPrimary and secondary education is compulsory up to age 16.government to all residents. Attendance is therefore almost 100%.Services are provided free by theGOM developed an Education in the Country Policy Plan for 1998-2002 in conjunction with DfID.Under this plan, the government is supporting initiatives in the areas of curriculum development, studentassessment and evaluation, professional development for teachers, post-secondary education expansion,and educational infrastructure and information technology. Considerable progress has been made in thelast few years. One new day care centre opened and another was expanded in 2002, which made it possiblefor more children to access early childhood education at minimal cost. Access to primary education alsoincreased in 2002 with the addition of a fourth grade in one primary school; in 2005, two additional gradeswere included. The Government constructed Montserrat Community College (MCC) in 2004 where boththe secondary school and high school are located.With the construction and expansion of facilities, the Ministry is now turning its attention to issues relatingto the quality of education and services to disadvantaged pupils. The Ministry states that a number ofchildren are underachieving; the truancy rate (over 50+ students every day) is also high. GOM alsoconsider that the behaviour of children is a key issue which adversely affects the educational attainment ofother pupils and have introduced a red and yellow card system to caution students. Despite improvements,significant proportions of primary school students have below average reading levels. Some lessons aretoo academic for some students. Some parents 19 find it difficult to come to school to discuss the issues.Children arriving from non-English speaking countries have trouble integrating as do sometimes thosewho started their education in UK. To address these concerns, the government has introduced severalprogrammes (see Box ES1).18 Drugs for diabetics and hypertensives (c. 13% of the population) account for over half the cost of drugs providedfree.19 E.g. low income and non-nationals who find access harder due to lack of transport. These tend to be thehouseholds with problem kids.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES18

Montserrat Survey of Living ConditionsExecutive SummaryBox ES1: Targeted Educational Programmes• The Every Child Matters (ECM) agenda, under which the government wants every child to be healthy,safe, contribute positively to society, achieve - and enjoy achieving - economic well being.• School lunches for all students at a nominal fee.• The Pupil Support Unit (PSU) was formed less than a year ago to address disciplinary concerns in thesecondary school. The PSU is intended to provide counselling programmes and act as a resource unitproviding basic child guidance and a place to pacify children in a managed environment. However thePSU has yet to be fully established and engaging parents with ‘problem’ children is not straightforward.• A Change Manager has been employed to provide guidance on the changes needed in schools and howto bring these about to improve the quality of education and pastoral care in the secondary school.• The Low Achievers Education Programme is designed to provide extra lessons/ tuition to improve thebasic skills of some first year secondary school students in order that they can fully participate insecondary school classes.Overall however, the education system in Montserrat is generally working well. Reconstruction of facilitieshas largely been completed, although space is still limited and there are insufficient spaces for sports andrecreation. Attention is now turning to issues relating to the quality of education and support for thosewith educational needs and social problems, which have been exacerbated by the tight economic situationand the fragmentation of families.4.4 Social ServicesGovernment social welfare services are provided by the Social Welfare Department (SWD) andCommunity Services Department (CSD) within the Ministry of Health and Welfare. Together thesedepartments offer a number of services to the poor and vulnerable including: regular and one off socialassistance in cash or kind; counseling; fostering and adoption services.The Social Welfare System (SWS) provides regular financial assistance to very needy elderly, mentallychallenged and physically disabled Montserratians. Criteria are tight and. essentially only those with noother means of support receive SWS. Since 2001 GOM has also provided a rental subsidy for vulnerablegovernment housing tenants; again most of the recipients are elderly or disabled. In 2009, there were 270beneficiaries of SWS and just under 100 for the rental assistance scheme. SWS benefits (EC$600 permonth) are significantly higher than the indigence line but are well below the poverty line. One off grantsfor emergency relief (food baskets, housing supplies, school uniforms) or medical care also provided (toaround 350 beneficiaries in 2008); criteria are very strict.Due to resource constraints, little assistance is available to poor family households who have been badlyaffected by falling incomes and rising prices. A recent review recommended that benefit levels should beraised and that eligibility should be more closely based on the needs of the applicant with less regard takenof other income sources of other household members. It was however recognised that the additionalfinance might prove difficult for this to be implemented. No recommendations were made to widen thecriteria to enable more non-elderly households to benefit.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES19

Montserrat Survey of Living ConditionsExecutive SummaryThe SWD have also identified improvements that need to be made within their organisation, includingclearer eligibility criteria, more focussed targeting and consolidating the administration of the regular andone-off programmes. Arguably, given budgetary constraints these should be the short term priorities.4.5 Social SecurityMandatory social security was introduced in Montserrat in 1986. At present around 2,100 employees and315 employers make contributions. Contributions are mandatory and collected from both employees andemployers. The scheme provides sickness and maternity benefits, invalidity assistance and old age/pension benefit. Self employed persons are expected to contribute 8% of their taxable income but noteveryone in this group contributes. In 2008, 570 persons received pensions, not all of whom will beresident on the island.The main current concerns are the level of the SS pension and the long term financial sustainability of thesystem. Proposals are included in the 2009 to address these issues including (i) gradually increasing theretirement age from 60 to 65 years; (ii) increasing the ceiling of the insured earnings to enable higherpensions to be paid; and (iii) index linking pension payments.4.6 The PoliceThe Montserrat Police Force is forward looking and has a number of programmes to address the socialaspects of criminal activity. These include training in domestic violence, child abuse, a community policinginitiative and close working relationships with other agencies (e.g. CSD, Education). Awareness campaignsare being run to combat domestic violence, child abuse and drug taking.4.7 HousingThe provision of public housing is the responsibility of the Ministry of Agriculture, Lands, Housing andthe Environment (MALHE). It has taken many years to address needs of Montserratians displaced by theeruption and remaining on the island. The situation is still not finally resolved with 70 families still living intemporary shelters and others in poor quality rented accommodation.Recent policy is for government to gradually get out of housing construction and leave it to the privatesector - but the private sector is slow to take up the challenge. Land is expensive and prices are increasingexacerbating the problem. It is also difficult for many to get a mortgage: assets were lost in the eruptionwhich led to non-payment of mortgages and consequently a poor credit rating.New initiatives are therefore being introduced. Grants have recently been re-introduced, for the first timehome owners who have sufficient funds of their own to construct a decent home within a 6-8 monthperiod but access to land and employment are required criteria. A more wide-ranging programme, HOME(Home Ownership Motivates Everyone) is included in the current budget and is designed to facilitateaccess to housing by people on low incomes and young professionals.4.8 Physical InfrastructureThe provision of basic physical infrastructure in the safe zone is now largely complete. Water supply, roadaccess and electricity networks are essentially universal. In consequence, the focus is now more onMontserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES20

Montserrat Survey of Living ConditionsExecutive Summarymaintenance and extending networks to the few areas with inadequate service. Grants from CDB’s BNTFprogramme are being used for this purpose and to provide small scale community facilities.4.9 NGOsA number of NGOs (e.g. the Red Cross, the Old People’s Welfare Association, the Red Cross and thechurches) provide services to very poor individuals and families. There are also several immigrantassociations, most of which concentrate on providing advice and guidance, and putting on social andcultural activities. Two general comments can be made about these activities:the overall impression from the PPAs is that the services that these organisations provide arewelcomed by their beneficiaries.these organisations are operating on a shoestring through donations and voluntary services. Thelack of funds is therefore a major constraint on the extent of services that they can provide andtheir ability to cater for the current level of demand.In summary, the NGOs/ CBOS, know what they are doing, are doing the ‘right’ thing, but are unable toprovide the extent of assistance that they would like to. In this sense they are in a similar position to SWDand CSD whose operations are also heavily constrained by financial restrictions.4.10 OverviewThe scale of the destruction caused by the volcanic eruptions required the complete re-construction ofsocial, physical and community infrastructure and systems in the safe zone. These programmes have beensuccessful in that basic infrastructure provision is now almost universal and social welfare, education andhealth services are all re-established.Attention is therefore shifting to issues related to the quality of, access to, and financing of these services.Most of these issues are already appreciated and policies and programmes to address them are beingimplemented, including several which are designed to directly benefit poor and vulnerable households.Several of these have been formulated or implemented in the last 12 months. Examples are social welfareservices and housing for the elderly and the disabled, education programmes for low achieving anddisruptive pupils, public awareness campaigns to address social issues such as drug-taking, antisocialbehaviour, domestic violence and child abuse. These initiatives are supplemented by a number of localNGOs, sometimes part-funded by overseas donors.The key issue is thus not so much one of an absence of relevant programmes but rather one of resourcing.In virtually every case, progress is hampered by insufficient funds and manpower. This situation has beenexacerbated by the current economic and fiscal contexts which have led to both an increasing demand forservices and are putting pressure on the funds available to address them.In this context, the way forward is to identify innovative approaches to these issues and to prioritisebetween the policies and programmes that have already been proposed in the MSDP and by theimplementing agencies concerned, often very recently. Given the likelihood that a significant increase infunds is unlikely in the short- or medium-terms, this puts a premium on identifying recommendations thateither do not have major financial implications or have the potential to attract donor funding.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES21

Montserrat Survey of Living ConditionsExecutive Summary5 Poverty Reduction and the MDGs (Chapter 6)Montserrat, unlike some Caribbean countries has not produced its own MDGs. The following analysistherefore relates to 24 targets developed specifically for Caribbean countries; these Caribbean MDGs(CMDGs) are based around the global MDGs:1. The eradication of extreme poverty and hunger2. The achievement of universal primary education3. The promotion of gender equality and the empowerment of women4. The reduction of child mortality5. Improvement in maternal health6. Combating HIV/AIDS, malaria and other diseases7. Ensuring environmental sustainability8. The development of a global partnership for developmentThe CPA undertook an assessment of the progress Montserrat has made to the achievement of theCMDGs. The main findings were: Montserrat has achieved, or is well on the way to achieving, CMDGs 2, 4, 5 and 7.Goal 1 (reducing severe poverty and hunger) has been achieved in to the extent that the incidenceof severe poverty is low – although the general poverty level remains high. Virtually all householdshave access to basic services.Goal 3 (empowering women) has been achieved in terms of education, partly achieved in terms ofemployment; issues of domestic violence are being tackled.Goal 7 has achieved its objectives in terms of the major diseases of poverty but now has toaddress those related to the NCDs, especially hypertension and diabetes – as do many Caribbean(and mom-Caribbean) countries.Goal 8 is not really applicable as its achievement largely depends on international rather thanGOM action.These findings are overwhelmingly positive. They nevertheless relate only to the CMDGs which do notaddress several of the issues raised in this report. Examples are: educational quality, migration and labourmarket issues, provision of welfare to the neediest, the care of the elderly, and social issues related tofamily break up and risky behaviour by teenagers and young adults. While not all of these are directlyrelated to income poverty, they are clearly important to reducing the non-income aspects of poverty andthe potential causes of future poverty. The CMDGs also do not address the issue of economic growth andemployment creation, which are of primary importance in reducing poverty – although as with Goal 8,GOM has little room for manoeuvre in this respect. The CMDGs should not therefore be seen asproviding a comprehensive framework for tackling poverty in Montserrat.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES22

Montserrat Survey of Living ConditionsExecutive Summary6 The Poverty Action Programme (PAP) (Chapter 7)6.1 The PAP in the Context of the MSDPThe MSDP constitutes the island’s main statement of development policy. Although poverty reductiondoes not figure as one of its main strategic objectives, it is explicitly mentioned in relation to the expectedoutcomes of the Human Development strategic objective: “a reduction in the percentage of the population livingbelow the poverty line”. Furthermore, poverty reduction is seen as one of the outcomes of the drive to extendand diversify agricultural production and is implicit in the support to vulnerable groups inherent in severalof the MSDP’s objectives and strategic actions; these address many of the issues raised in this study.Overall, the MSDP covers most of the topics and sectors that one would expect in a poverty reductionstrategy.Accordingly, there is little sense in the CPA preparing its own Poverty Reduction Strategy. The crucialquestion is therefore to devise a Poverty Action Programme (PAP) that can complement and reinforce theMSDP. This question was discussed at various junctures during the course of the study, as a result ofwhich the following general principles have been adopted:The PAP should concentrate on those issues which have formed the basis of the CPA’s research,and should not attempt to replicate the comprehensive coverage of the MSDP.The PAP should concentrate on specific interventions (projects and programmes) rather thanmore general and all-embracing strategic policies (many of which also exist in ministerial anddepartmental strategy documents).The PAP should also identify any policy areas which have not been addressed in the MSDP.Within this context, the CPA’s recommendations address the generic objectives of any poverty reductionstrategy: (i) establishing a business-friendly environment to encourage private sector investment and hencejob creation; (ii) improve the provision of social and physical infrastructure needed to satisfy the basicneeds of the population; (iii) improve conditions for those currently in poverty and for whom employmentis not a realistic option, e.g. single parents, older persons and the disabled; and (iv) address issues thatthreaten to increase poverty in the future, e.g. the social issues related to risky and antisocial behaviour.Furthermore, the PAP should identify actions which are deemed to merit the highest priority because: (i)they are most urgently needed; and/or (ii) they can be achieved at relatively low cost; and/or (iii) they areimplementable within a relatively short time frame. Identifying priorities will also facilitate discussionswith donor agencies as to future loans and grants.Priority SectorsThe CPA’s research concentrated on the following sectors and priority areas, and these are the ones forwhich specific recommendations have been made: (i) economic issues; (ii) agriculture and fishing; (iii)housing and land; (iv) health; (v) education; social welfare; (vi) social issues; (vii) immigration; and (viii)governance and institutions.These sectors were those most frequently cited as priority concerns in the PPAs and the interviews carriedout as part of the Institutional Analysis. All are considered to offer good potential for reducing povertyMontserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES23

Montserrat Survey of Living ConditionsExecutive Summaryand enhancing national social and economic development in the short and medium terms. The focus onthe above sectors should not be construed as invalidating or indicating lack of support for MSDP policiesand proposals not explicitly referred to in this document.The following Tables summarise the CPA team’s recommendations for each of these topics 20 . They havebeen derived from a combination of the PPAs, the Institutional Analysis, other relevant reports anddocuments, and the ToC’s professional experience. Taken together these recommendations constitute thePoverty Action Programme proposed by the CPA study team.6.2. Economics and FinanceTable ES5 contains the recommendations made for the general economic and finance sectors. In thePPAs, these issues were the primary concern of most respondents. However the suggestions made mostlyinvolved price controls, reducing import duties and taxation, and food subsidies. Such policies aregenerally considered to be economically unsound; they would also put pressure on government finances ata time when there are many other demands on government expenditure. These measures would also beuntargeted meaning that a large proportion of the benefits would go to not poor households. Thesesuggestions have not therefore been included. The recommendations presented also reflect the limitedopportunities for a substantial short-term expansion of private sector activities, although the developmentof a new town centre at Little Bay is likely to generate a flow of such opportunities in coming years.Overall the approach should be one of ensuring that potential entrepreneurs and new businesses can beassisted as and when opportunities arise rather than attempting to establish a more dirigiste strategy ofidentifying the sectors which should be targeted for expansion.Table ES5. Economics and Finance: Summary RecommendationsRecommendationReinstate regular and affordable ferry service toAntiguaRoad maintenance charge on aggregate exportersReview govt. pay scales to ensure that low wagedand non-established workers get increases.Establish a tribunal to hear cases where debts areoutstanding on properties in the exclusion zone.Publicise job placement service at LabourCommission to employers and job seekers.Publicise loan availability from MDC/ NDF.Examine alternatives to requiring collateral forloans, e.g. MCFIncrease numbers of tourist.RationaleEnable residents and traders to purchase and importgoods more cheaply from Antigua.Heavy vehicles cause disproportionate damage to roads.Increase incomes of lower paid, thereby reducinghardship and poverty.Reduce debt amongst relocatees and increase incomes;facilitate new house purchase.Solve this problem once and for all.Reduce unemployment.Improve accessible information on work permits andlabour market.Job creation and fostering entrepreneurship20 More detail is provided in the Main Report; not all the recommendations are included in these summary tablesMontserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES24

Montserrat Survey of Living ConditionsExecutive Summary6.2 Agriculture and FishingAgriculture is both seen as a growth sector in the MSDP and represents an important actual, and potential,coping strategy for households experiencing hardship due to rising food prices. Increasing the support toagriculture, especially, and fishing, was frequently suggested in the PPAs and in many of the stakeholderinterviews. Table ES6 contains recommendations as to how this support could be provided.Table ES6: Agriculture and Fishing: Summary RecommendationsRecommendationCommission short term consultancies fromagricultural and fisheries specialists to makerecommendations on: what crops can be grown,and where; associated support measures (e.g.seedlings, germ plasma, extension services),agro-processing, support to fishermen, etc.Extension of the pilot greenhouse project.Control of roaming animals through strongercontrols/ sanctions on owners.Develop a scheme to provide top soil from theexclusion zone to backyard gardeners.Extend remit of extension services to includebackyard gardening.Negotiate with land owners to provide access tounexploited areas suitable for cultivation.RationaleThere is a widespread desire to improve these sectors fromgovt. and public alike.Reduce dependence on imported produce.Increase availability of locally grown foodstuffs on the islandand thus promote healthier diets.Increase ability of households to be self-reliant and notdependent on imported foods.Will reduce risks of investment in small scale gardening due tocrop damage from falling ash.PPAs and other interviews indicate that this is a seriousproblem.Increase fertility of back yards in the north where there is littletop soil.Backyard gardening is an important coping strategy and wasfrequently mentioned during the PPAs.Fallow but cultivable land is a wasted resource. Identifyingcultivable land is of little value if cannot be exploited.6.3 Housing and LandAccess to housing is currently difficult if not impossible for many families, especially those on lowerincomes and with negligible savings and first time buyers. MALHE’s imminent HOME programmeshould help first time buyers while it appears that the availability of residential plots is increasing. Thegroup in greatest need thus appears to be those on low incomes, many of whom live in the older andlower quality government rented properties. Social housing is one solution but it tends to be expensiveand often leads to maintenance issues. Potential recommendations are presented in Table ES7.6.4 Education and TrainingAccess to schooling is free and attendance is high. Several new facilities have been opened recently years,a Change Manager has been appointed to improve the operation of the secondary school and severalprogrammes are in place to assist those with educational needs while the MSDP includes a wide range ofactions for this sector. Table ES8 shows those which, based on the findings of this report, are consideredto merit the highest priority; they reflect PPA comments on the school system which mostly usuallyinvolved specific issues rather than dissatisfaction with the overall system.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES25

Montserrat Survey of Living ConditionsExecutive SummaryTable ES7: Housing and Land: Summary RecommendationsRecommendationInvestigate the feasibility of providing partly or whollyserviced residential plots or with core housing provided.Transfer ownership of older T1-11 to occupants wherethey are able bodied with grants or soft loans for repairsand extensions. Otherwise rehouse occupants and sell/redevelop these plots.Develop a cash for work programme for the unemployedon maintenance of government housing.Enter into discussions with owners of vacant property tomake these available on medium term basis for renting tolow income groups.Enter into discussions with land owners to develop land inareas identified in the Physical Development Plan forresidential development.Establish a Land Tenure Dispute Arbitration agency toassist families to resolve land ownership disputesRationaleCheaper than building new houses.Will help to tackle issue of growing disrepair anddegradation of these properties in particular, and thehousing stock in general.Having poorly maintained properties seriously affectsquality of life. Yet occupiers may not have themoney/ skills to do so.Would maximise the use of the existing housingstock should be maximised. And would help addressdemand for low income rented property.Increasing land availability reduces tends to reducethe cost of land and hence housing.Land ownership disputes almost always lead todiscontent and result in underused land/ property.Table ES8: Education and Training: Summary RecommendationsRecommendationExpansion and full establishment of the Pupil SupportServices Unit (PSSU) to provide counseling, guidance andassistance to students with learning and behaviouralproblems.Introduce formal procedures to ensure the full participationof parents in the education of their children, especiallythose involved with the PSSU.Introduction of life skills, awareness (i.e. related to riskybehaviour), sex education, personal budgeting classes inthe secondary school and the Community CollegeMonitor the need for educational assistance to studentsfrom poor households (e.g. uniforms, textbooks).Improve the extent and quality of vocational trainingcourses including ‘on the job’ work experience.Develop apprenticeship programmes especially in theconstruction industry.Provide CSME certification for vocational trainingRationaleThe PSSU is recognised to be successful and manyrequest its assistance yet it is still largely reliant onvolunteers.It is unrealistic to expect that schools can ‘solve’ all achild’s non-scholastic problems – parentalinvolvement is crucial. Yet those children mostneeding assistance are often those with parents whodo not attend parent-teacher meetings.Life is not easy for children from poor and one parenthouseholds but the risks (and costs) of these factorsleading to unsustainable behaviour necessitatecountermeasures.The school and the PSSU are the best places toidentify children suffering due to hardship faced bytheir families.Not all students benefit from an ‘academic’ educationand many will not take up occupations using theseskills.Will facilitate employment throughout CARICOM.6.5 HealthOverall the health system is considered to be working satisfactorily. MOH sees the major problems to bethe control of non-communicable (lifestyle) diseases (diabetes and hypertension), health care finance andproviding equal access to non-nationals. By and large, the PPAs support this view. Table ES9 listspriority recommendations arising from the study’s research. None of these differ significantly from thosecontained in the MSDP nor do they from those recommended in other CPAs.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES26

Montserrat Survey of Living ConditionsExecutive SummaryTable ES9: Health: Summary RecommendationsRecommendationsProduce a booklet and publicity campaign based oneating according to the MCFB.Enhance system of home visits for those who find itdifficult to attending clinics.Ensure that the ‘doctor on call’ system is wellpublicised.Improve the supply of drugs for the chronically ill tothe govt. pharmacy.Health care finance:Assess feasibility of introducing NHIS.Review exemptions and current user charges tomake them more means-tested and increase costrecovery.Investigate the feasibility of establishing a rota ofvisiting specialists to provide services which are notcurrently available – especially for mentally ill.Eliminate disparity in medical costs for NNATsRationaleThe MCFB provides the cheapest way of achievinga healthy diet. If this is actively promoted, peoplecould reduce their food expenditure and achieve ahealthier diet.Many elderly and disabled persons find it hard toget to clinics yet do not have the means toorganise their own transport.These patients are often on low incomes andunavailability of drugs at the pharmacy means theymust pay more privately.Reduce insecurity and loss of income arising fromhealth care costs.Target exemptions to those most in need.Reduce pressure on health finances.Reduce the need for overseas medical treatmentand the impact that this can have on householdincomes.Improving the treatment of the mentally ill willbenefit patients and health personnel alike.Will eliminate an important source of NNATdiscontent.6.6 Social Assistance/ PensionsSocial assistance will always be important in the Montserrat context due to the number of elderly who areliving alone and receive no, or inadequate, pensions, the disabled who cannot work, and one parent andlow income households with children. The living standards of these groups are exacerbated by diminishedfamily support networks. Current social assistance benefits are generally accepted to be below thosenecessary to purchase the Minimum Cost Food Basket and other necessities. Furthermore, by and large,the current system is only available to the elderly and the disabled and does not cover very poor (let alonepoor) family households. Notwithstanding budgetary constraints, these are serious shortcomings.Accordingly, the reform of the Social Welfare System (SWS) is a strategic action of the MSDP. Some waysin which this could be achieved are shown in Table ES10.As a major increase in finance for social assistance is unlikely, the crucial decision is whether availablefinance should be used to increase benefits to those already receiving payments or to widen the eligibilitycriteria to include those not currently eligible, e.g. very poor families.Table ES10: Social Welfare: Summary RecommendationsRecommendationIncrease benefits to current recipientsWiden eligibility criteria to provide assistance tounemployed and working poor households.Increasing SS pensionsProvide a discretionary stipend to SWSRationaleCurrent benefits are below minimum living costs.Needy households without elderly persons arecurrently largely precluded from receiving socialassistance.Current SS pensions are well below basic livingcosts AND below SWS benefits.Will reduce their sense of dependence.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES27

Montserrat Survey of Living ConditionsExecutive Summaryboth improve government performance and to increase the level of trust between government and thepopulation; several are implicit in preceding tables.Table ES13: Governance: Summary RecommendationsIssue Recommendations RationaleIncrease transparency ofgovernment policy.Increase consultationswith affected groupsImprove governmentinformation servicesImprove public relations.Improve inter-agency coordinationEnsure that politiciansand civil servants are not‘protected’ from theimpact of economicdownturnsPromoting communityself-help and relianceImprove information basefor decision-makingthrough a detailedanalysis of the 2011Census.Avoid raising the population’s expectationsas to what government can provide,especially in terms of employmentgeneration and economic development.Provide leaflets to set down procedures forimmigration, health costs, doctor on callsystem, work permits and socialassistance; publicise via the media.Develop links with representative NGOs.organisations, e.g. OPWA, MontserratCouncil for the Elderly, migrantassociations.Retrain front office staff to be more client -friendly.Develop procedures for inter-agency coordinationon issues related to youthproblems, family matters and education.Key agencies are health, education, socialservices and the police.Restrict salary increases in times ofhardship and bias these towards the lowerpaid.Encourage the involvement of CBOs inaddressing social problems affecting theircommunities.Many recommendations to assist thevulnerable (e.g. the elderly, the poor, theunemployed, those at risk from neglectand abuse) affect relatively small, discretegroups of the population. Yet littleaccurate information on these groupsexists.6.10 Recommendations for the Caribbean Development BankGovernments cannot provide everythingthat residents would like and this factneeds to be understood.The issue is often not one of disagreementwith GOM policy but that affected groupsdo not fully understand what the policy/procedures are.Consultations should be informal ratherthan formal and targeted at affected groupson issues of direct interest.PPAs mention government not ‘listening’ -which causes resentment.Several PPAs mentioned the poor civility ofstaff they sometimes had to deal with.Multi-agency co-operation is essential foridentifying and dealing with issues relatedto educational under-achievement,disadvantaged poor children, anti-socialbehaviour and intra-family issues.Arguably needed to counter the notion thatthe government only looks after its own.BUT a fairly radical solution.A crucial issue but one with no readysolutions.The 2011 Census provides an accessibledatabase which can be used to examinethe incidence and characteristics ofvulnerable groups and hence facilitateevidence-based planning.Should be supplemented by short,targeted, surveys of key informants, e.g.teachers and health personnel.It is understood that the CDB is currently preparing a new Country Strategy for Montserrat. Accordingly,the study team examined the implications of the CPA’s findings for this strategy. First and foremost, thedependence of the island on grant-funding from the UK government is likely to continue for theforeseeable future. Secondly, a large number of physical and social infrastructure projects have beencompleted n the last 10 years. In consequence, emphasis is likely to shift to upgrading and maintenance onMontserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES30

Montserrat Survey of Living ConditionsExecutive Summarythe one hand and policies and programmes to improve the quality and coverage of government services.There also appears, given the small size of the island, little scope for private public partnerships, althoughthese may come if there is a policy to outsource government services.For these reasons, the likelihood of GOM taking out CDB loans appears remote in the short and mediumterms; this inevitably reduces the scope for CDB assistance to the island. In these circumstances, thereappear to be two main ways in which CDB can contribute to Montserrat’s future development:By continuing to provide funds to BNTF programmes on the island but with a greater emphasison social rather than infrastructure projects.By partnering with DFID on social programmes: DFID is the most important provider ofassistance to Montserrat, and is likely to remain so. Social issues are high on its agenda. Whilesome of these require capital investment, the priority is for training, capacity building, publicawareness raising and innovative ways of tackling social issues. CDB should consider workingwith DFID to develop, fund and implement these types of initiative.Not specific to Montserrat, the study team also recommends that CDB promotes Caribbean-wide researchinto:The analysis of census data to provide more fine-grained information on the structure ofhouseholds, particularly those containing children and elderly persons.Male attitudes and aspirations in relation to fatherhood and spousal relationships.Developing innovative approaches to social issues.6.11 Monitoring and EvaluationMonitoring poverty levels is critical if the effectiveness of government policies and programmes is to beassessed. Yet the best way of providing information on poverty levels - sample household surveys - arecostly and time consuming. Accordingly an annual reporting system should be developed using proxyindicators changes in poverty levels. Potential indicators are: water and electricity bill arrears anddisconnection rates, recipients of social welfare services (including the number of ‘rejected’ applicants), theincidence of children going to school hungry. The M and E system also needs to include an evaluation ofPAP activities and their effectiveness.7 Concluding RemarksReviewing the Study’s findings and recommendations, three facts stand out. The first is that the principalcause of continuing poverty on Montserrat is the economy – about which the government can dorelatively little. The second is that the coverage and service of physical and social infrastructure is not amajor issue, and does not appear likely to become one unless financial support from the BritishGovernment is withdrawn - which also appears unlikely. The third is that many of the concerns raisedapply to small, discrete groups of the population, e.g. the elderly on their own, women and children at riskfrom violence, teenage mothers, unemployed Montserratians, etc.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES31

Montserrat Survey of Living ConditionsExecutive SummaryThe need is therefore not so much for major programmes but for a raft of carefully formulated and closelytargeted interventions designed to address the needs of these disparate groups - which is essentially whatthe Poverty Action Programme is.It is recognised that the above recommendations were prepared in 2009 and while some revisions havebeen made as a result of comments made at the National Consultation in April 2012, many may no longerbe valid; if this is because they have already been implemented, this is all to the good. Nevertheless, theoverall impression from the National Consultation was that many of these recommendations are as validtoday as when the study was prepared. The upcoming review of the MSDP therefore provides an idealopportunity for the incorporation of some of these recommendations into government policy in the nearfuture.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES32