Addressing Crime and Dengue Fever in the Bahamas

by Larry Smith

The big story this week was from the House of Assembly, where the government tabled a raft of hugely anticipated legislation designed to ratchet up the fight against crime.

The measures included changes to the Bail Act, the Firearms Act and the Dangerous Drugs Act, as well as new laws to protect witnesses and curb the sale of stolen property. Two new courts will apply stiffer penalties for drug and gun crimes, and border controls will be strengthened for firearms.

In the run-up to the introduction of these proposals, National Security Minister Tommy Turnquest criticised judges for being "too liberal" in giving bail to suspected offenders. Lawyer Dion Hanna called the minister's remarks "intemperate," but I disagree. I would say his remarks speak to an important question of justice and public policy. Whether they were right or wrong is another matter.

The chief justice obviously felt they were wrong, but he did not really explain why - at least not in a way that ordinary folks could understand. He merely advised the public to spend time in the courts to determine what the reality was, while leaving us mostly in the dark as to what circumstances lie behind the current controversy.

And that's a big part of the problem. We are fed only bits and pieces of information from time to time, so it's difficult for most of us to keep track and intelligently assess the issues. The authorities are never very helpful when it comes to providing information. They think that's one of the perquisites of power.

For example, the Tribune recently reported that in the space of five days last July, 22 suspects were released on bail. Six were charged with murder, and at least three had criminal records.

Minister Turnquest has also disclosed that from 2006 to mid-2008, 177 suspects were charged with murder and most already had criminal records, including some who had been previously charged with murder. More than a third were out on bail when they allegedly committed the latest murder, he said.

Turnquest is on record as saying that crime statistics should be published regularly and in full, but this does not appear to happen - it is difficult to get good data on these critical public issues in a timely manner.

The minister has also admitted that "those who commit crimes, including horrific killings, are not being brought to justice as speedily as they should, due to challenges in the criminal justice system.

"Too many persons on bail are committing criminal offences," he said. "Our constitution provides that a person be brought before the courts and tried within a reasonable time, or be released either unconditionally or upon reasonable conditions. We need to try these cases in a reasonable time."

We do indeed. But the impression of a thoughtless judicial elite pandering to criminals from their ivory tower is simply not accurate, according to lawyers familiar with the system.

"Judges are harder here than in other jurisdictions," former Bar Association chief Wayne Munroe told me. "Our remand periods are longer. You get bail here after 18-24 months if your case is not proceeding. The only other reason to get bail here is if the judge feels there is not a strong case against you. In the US or the UK, the general rule is for felony trials to be completed in six months."

According to Munroe, the acquittal rate in the Bahamas is as high as 80 per cent. "A lot of that is due to incompetence - either they are arresting people just to charge someone, or they think the person did it but can't prove it.

"We don't want to have a rule that just because you are charged you shouldn't get bail. That is unconstitutional. If a person is so dangerous why not just try him quickly and put him behind bars so he can't get bail?"

In his recent national address on crime, Prime Minister Hubert Ingraham acknowledged that the length of time it takes to bring offenders to trial and the relative ease with which bail is available to known repeat offenders was fueling "a creeping culture of lawlessness" in the Bahamas. He said bail should not be granted in murder, armed robbery and rape cases unless defendants could not be tried within three years.

There is a feeling in some quarters that the government's proposals relating to bail may be overturned by constitutional challenges. Responding to Minister Turnquest's remarks about liberal judges, Chief Justice Sir Michael Barnett said "the constitution guarantees certain fundamental rights to everybody who appears before us -- the presumption of innocence and the right to a fair trial within a reasonable period of time. We must respect that right."

But in order to properly weigh this issue we need facts and information. How many suspects are bailed annually, for what offences and after what length of remand? How many of these people commit crimes while on bail? What happens to them after that? What are the reasons for them being bailed? I could go on, and on.

Most would agree that the best solution by far is to have a speedy trial. And the government does now seem to be working to improve the system by upgrading facilities, adding more courts and appointing more judges, although prosecutors still seem to have problems making and managing their cases.

But we should remember that in our common law system, bail is a fundamental right unless there is a compelling reason to deny it. in other words, an accused person should be given bail unless there are substantial grounds for believing that he or she would leave the jurisdiction, commit another offence, or interfere with witnesses.
   
British courts consider the type of offence, the character and record of the suspect, and the strength of the evidence when deciding on bail. According to the Crown Prosecutors Office (which provides guidance to British judges), there is a restriction on the right to bail for repeat serious offenders, those who commit a crime while already on bail, and for adult drug users.
   
American law also allows for the pre-trial detention of suspects based on their perceived danger to the community. Bail can legitimately be denied to those charged with violent crimes, a capital offence, serious drug offences, multiple felonies, or if the they poses a serious risk of flight or witness tampering.

Tough Call is no lawyer, but common sense says it should be easy for Bahamian judges to apply the same considerations - provided that accused persons can be tried within a reasonable time.

Bail decisions can have far-reaching consequences for the victims of crime and for the public in general. But we have to balance that with the fact that suspects are innocent until proven guilty in a court.

Denying bail generally and for long periods is an existential threat to our civil liberties - which have been hard-won by centuries of struggle against arbitrary rule.

Dengue Epidemic
"A widespread outbreak of dengue fever (has) occurred. The disease had first been reported as far north as Jacksonville and it gradually spread south along the coast of Florida until it reached Miami where some 10,000 cases were reported.

"The disease made its appearance in New Providence in October and spread rapidly. Unless the most stringent measures are taken to control the breeding of (the Aedes aegypti) mosquito, outbreaks of the disease may be expected from time to time."

That account appeared in a 1927 report by Sir Wilfred Beveridge, a top British health specialist. Beveridge was commissioned by the colonial government to investigate public health conditions on New Providence after a typhoid epidemic killed several tourists. At the time, sanitation and hygiene conditions on the island were appalling.

Epidemic is a frightening word that can mean different things to different people - especially if your family or friends are among those affected. But in medical terms it is "the occurrence in a community or region of an illness or other health-related event clearly in excess of normal expectancy". In other words, a widespread outbreak of disease.

There is little doubt that we have been dealing with an unusual epidemic of dengue fever this summer - the hysteria in some quarters was palpable. From online discussions and radio talk shows, you would have thought there was a conspiracy afoot to kill Bahamians that the government was covering up.

But Nassau has experienced regular dengue fever outbreaks in every decade since 1978.  In fact, experts say dengue is one of the world’s most aggressive re-emerg­ing infections.

According to a 2008 article in the Journal of the American Medical Association, the increase in dengue fever is a common development across the region. And as dengue has surged throughout Latin America and the Caribbean, its fatal form, dengue hemor­rhagic fever (DHF), has appeared in many countries.

Globally, dengue and DHF case counts have been rising steadily for more than 50 years. DHF cases as a percentage of total dengue cases are now about 2.4 per cent. Epidemic cycles occur every three to five years, and over time, the peaks have become progressively higher. Even more worrisome is the increasing trend of DHF cases.

According to JAMA, "An explanation for why a group of viruses so well adapted to humans, having caused debilitating but nonfatal influenza-like illnesses for centuries, should suddenly expand geo­graphically into new areas, and also turn more deadly, has proved elusive."

Dengue is caused by any of four related viruses. The mosquito vector, Aedes aegypti, also transmits yellow fever. Apparently dispersed from its ancestral African home by shipping and the slave trade, Aedes aegypti became established 400 or more years ago in tropical and subtropical settings worldwide, adapting to human domestic environments. The mosquito lives within a 300-foot radius of where it was born and breeds in clear water collected in buckets, tyres and other open containers.

Although asymptomatic and mild cases are common, clas­sic dengue fever is clinically similar to influenza. DHF and its severe or fatal form, dengue shock syndrome (DSS), are complications. An important discovery in the 1960s was that DHF and DSS occurred mostly in asso­ciation with second dengue infections, and uncommonly in association with first, third, or fourth infec­tions.

Prevention relies on mosquito control programmes, which are costly and difficult to maintain, often requiring paramilitary efforts. The Pan American Health Organization's Integrated Management Strategy for Dengue Prevention includes communication to change public behaviour, integrated vector management, epidemiology, laboratory diagnosis, clinical management and the environment.

According to PAHO's Caribbean Programme Coordinator, Dr. Bernadette Theodore-Gandi, "We all recognise that the management of dengue demands involvement of all sectors of the population, health professionals, and a significant community involvement, to control the environmental factors leading to the breeding of the mosquitoes."

Health Minister Dr Hubert Minnis estimates some 5,000 dengue cases have occurred in the Bahamas this summer. There has been one death confirmed by autopsy but several others are under investigation. The fact is that when someone who has dengue dies, that death is not necessarily attributed to the virus. It could be caused by other factors.

"I am satisfied with the official response to the outbreak," Dr Minnis told me last week. "PAHO was involved, and peripheral clinics were immediately opened with extended hours, especially weekends, to relieve any additional strain on the hospital. We are not covering up or hiding the number of deaths. In fact, I have asked the public to inform the Ministry of any suspicious cases so that we can have them investigated for accuracy."

Unfortunately, a lot of the responsibility for mosquito control rests on the average Bahamian. Nevertheless, it is clear that successive governments will have to pay much more attention to this expanding public health threat. The economic and social consequences of more frequent epidemics could be severe.

The good news is that several vaccines are in various stages of advanced development, with clinical trials currently underway on five candidate vaccines. Trials in the most advanced stages are showing encouraging preliminary data, and the leading candidate could be licensed as early as 2015.

Comments

[Dr. Julius Theophilus]

Crime. This can destroy a country. The very fabric of our economy assumes that we are a safe country where people can visit, enjoy themselves and contribute to the economy of the Wonderful Bahama Islands. I grew up in Nassau during a time when most Bahamians did not lock their cars or their homes and stealing was a major blemish to one's character. Rape, murder, armed robbery and the like were for all intensive purposes unheard of and if they did occur, the whole country came to a stand still and called on the name of God and His son Jesus Christ to restore order at once. The Nassau I grew up in had less than 12 murders a year and people trembled at the mere sound of the Cat-O-Nine Tail. Respect for your fellow Bahamians and their property was paramount in the Bahamas I grew up in. Tamarine Switch ruled many backsides and we thank God to this day as most of us turned out pretty good and are law abiding. Families in the Bahamas I grew up in looked out for one another and instilled character, strength and virture not only in their children but their neighbors' children also. The Bahamas I grew up in had courts that dealt expediantly with crime of all sorts and justice was swift and effective. The Bahamas I grew up in took pride in the fact that our CRIME level was low and we boasted about the Bahamas being one of the safest countries in the WORLD. Not so today and may Almighty God and His Son Jesus Christ help us all. From my lips to God's Ear.

[Eddie]

The problem is actually lawyers. They have broken the system and now even them want it fixed.The job of the lawyer is to be an advisor.The only way to repair it is to bring in common folks who will ignore the advisor when he advises them to make him "the chief".

[larry smith]

Re: Dengue fever. On October 18 Deputy Chief Medical Officer Dr Delon Brennan provided a summary of this summer's epidemic.

He confirmed 7,000 clinical cases, which represented about 20 per cent of those who actually had the disease (but had mild or no symptoms).

Health officials saw the first cases of dengue in early July and the outbreak peaked in late July, when 1477 cases were reported over a two-week period. In August there were 2510 reported cases. Since then the numbers have dwindled, with no confirmed cases this month at all.

Brennan said the Bahamas experienced a dengue fever outbreak every five to eight years.