14 March 2003

Plymouth, Montserrat: In 1995, most of Montserrat's population, its infrastructure, and its services were located in the capital city of Plymouth, under the volcano's shadow. The population in 1993 was 10,481. The service-oriented, tourism-based economy had construction as the predominant income generator. Most said life was comfortable.

When the volcanic crisis began in July 1995, a series of evacuations were ordered, and 7,000 people left the island. The rest were relocated and rehoused in the once rural north. Families were separated and many community support networks faltered, creating an imbalance with a larger older population and a fragmented social structure.

By 1998, the entire capital of Plymouth and several of the surrounding communities were completely destroyed by volcanic matter such as pyroclastic flows and ash. The Montserrat Government, working with the UK's Department for International Development (DfID), the United Nations Development Programme (UNDP), as well as other international organizations, began planning and rebuilding a new infrastructure in Montserrat's northern "safe" zone.

There are currently five UN Volunteers on Montserrat, each involved in their areas of expertise. As Montserrat's Occupational Therapist, I provide rehabilitation and therapy services at the hospital, three nursing homes, the special needs classroom, four village clinics, private homes, and the island's Community Centre. Also, working with other volunteers, my husband and I are reintroducing Special Olympics back in Montserrat. This program was shut down during the early stages of the volcanic crisis.

As staff member of the Community Services Department, I am assisting with different capacity-building endeavors. I contribute to the "healthy living" radio programme, the parent educator's group, organize elderly social interactions, seek funding sources for durable medical equipment, and coordinate exercise programmes for at-risk youths. On weekends, my husband and I volunteer teaching gymnastics for children, a class our four boys enjoy very much too.

I work at the recently opened, Warden Supported Apartments and Community Centre on Montserrat. This project is a successful effort by the Montserrat Government, DfID, and the United Nations. These accessible apartments are for Montserrat's volcano refugees and evacuated elderly to return to living independently once again in the northern safe zone.

During the initial evacuations, many of Montserrat's elderly were housed in temporary shelters, which later evolved into three separate nursing homes. While traditionally these people would have been cared for at home by family, neighbours or friends, many were either left on their own or admitted to the shelters.

Helping these elderly people out of the shelters and nursing homes and into Warden Supported Apartments was a high priority for the Montserrat Government. As an OT, this project involved an extensive amount of consultation from beginning to end. I worked with the contractors and architects on accessibility during construction. I was a member of the team responsible for the assessment and selection of over 300 potential residents, and worked with training those selected to live independently again. This was a challenge for many of the elderly as they had been living in nursing homes or shelters for several years. To be eligible for admission into the Warden Supported Apartments, one had to be over 60, or exist with a physical disability. The individuals living in shelters were given high priority.

The "Look Out Warden Supported Apartments and Community Centre" opened in October 2002, on schedule, under budget and very smoothly. The 50 apartments were built with the "aging in place" concept. Door widths are 36", showers are barrier free, and all have grab bars. There are pull-down type shower seats built into the walls of each shower. There is ample knee clearance under the sinks, lower height cupboards, user-friendly faucets, and wheelchair ramps where needed. Bright, uplifting colourful paints were used to help create a superb combination of function and Caribbean charm.

The Community Centre offers occupational therapy services, an activity area, coin-operated laundry, a dining facility, an atrium garden, a fully equipped kitchen for Meals on Wheels (MOW) and accessible toilets and showers.

The warden's office is located within the Community Centre, and is equipped with phone communications to each apartment. The Warden's living accommodations are also located on site.

The Centre offers weekly activities for all of Montserrat's seniors. Working adults now bring their home-bound elderly parents as well. Individuals and businesses donate craft materials for the grass-roots craft group. Volunteers teach basket-making and traditional Montserrat crafts. A guest speaker is also featured each week to stimulate and educate the residents.

UN Volunteer Tammy Foote assists special needs students at Brades Primary School in Montserrat. Photo by Richard Nyberg. In addition, the Centre is used by various civic groups and non-governmental organizations (NGOs) which brings the general community closer to the seniors. There is a primary school across the road, facilitating several inter-generational gatherings, sharing of jumbie stories and holiday celebrations. A van belongs to the residents and is used to transport them to doctor's appointments, shopping and social outings. The local fishermen bring their catch to the seniors and sell from their truck. A real sense of village-community is emerging. The Look Out Warden Supported Apartments and Community Centre is one of the finest facilities of its kind in the Caribbean. The collective effort by the Montserrat Government, DfID, the United Nations, as well as the tenacity and strong spirit of the local people, has successfully returned Montserrations to independent living once again.

There were however, challenges along the way with the contractors regarding the interpretation of "accessibility". It was difficult to communicate with them that accessibility is essential and not merely an option. The transition to independent living brought challenges for some of the residents as well, particularly with using the foreign to them, four-burner electric stoves. Instruction, practice and modification to the burner's dials, helped simplify the workings of the stove.

As the OT for the Centre, working with the two wardens and the Community Services Department staff, we provide the residents with ongoing support, instruction and therapeutic interactions and activities. We are currently determining an evaluation procedure that will best serve the residents' needs as their functioning status changes.

The Warden Supported Apartments and Community Centre is but one of several projects and areas of service that I as the UNV/OT am involved in on Montserrat. This collective effort by the Montserrat Government, DfID, and the United Nations has successfully returned these local people to independent living once again.

As the remaining Montserrations continue to share their island with the active Soufriere' volcano, the people's ability to adapt is strengthened. The apartments and Community Centre is another positive sign of Montserrat's sustainable future. There is now a growing, renewed sense of their country's permanency in the elderly residents. As one resident so eloquently stated, "This apartment is not a temporary shelter. It is my home."