Editing Martinique (section)

== Health ==
[[File:HI949 (16235502897).jpg|alt=A patient is transferred between an aircraft and an ambulance at Le François airport.|thumb|A patient is transferred between aircraft and ambulance at [[Martinique Aimé Césaire International Airport]].]]

=== Regional health agency ===
A [[Regional Health Agency|regional health agency]] for Martinique (Agence régionale de santé Martinique) was set up in 2010. It is responsible for applying French health policy in the territory, managing public health and [[Health care in France#Health care system|health care]] regulations.<ref>{{cite web|date=29 April 2021|title=L'ARS Martinique, une agence engagée pour la santé des martiniquais|url=http://www.martinique.ars.sante.fr/lars-martinique-une-agence-engagee-pour-la-sante-des-martiniquais|url-status=live|archive-url=https://web.archive.org/web/20201126095119/https://www.martinique.ars.sante.fr/lars-martinique-une-agence-engagee-pour-la-sante-des-martiniquais|archive-date=26 November 2020|access-date=6 September 2021|website=www.martinique.ars.sante.fr|language=fr}}</ref>

=== Healthcare professionals ===
As of 1 January 2018, Martinique had a workforce of 1,091 doctors. For each 100,000 people of its population, there was a density of 141 [[General practitioner#France|general practitioners]], 150 specialists, 53 dentists, 1,156 state certified nurses and 90 pharmacists.<ref>{{cite web|date=14 April 2020|title=Professionnels de santé au 1<sup>er</sup> janvier 2018 {{!}} Insee|url=https://www.insee.fr/fr/statistiques/2012677|url-status=bot: unknown|archive-url=https://web.archive.org/web/20210906201849/https://www.insee.fr/fr/statistiques/2012677#tableau-TCRD_068_tab1_departements|archive-date=6 September 2021|access-date=6 September 2021|website=www.insee.fr|publisher=[[Institut national de la statistique et des études économiques]]}}</ref> Self-employed doctors are represented by URML Martinique, created under the [[Hospital, patients, health, territories]] bill. URML Martinique works in partnership with ARS Martinique, [[National Fund for Health Insurance|l'Assurance Maladie]], the Ministry of Health and Local Authorities to manage regional health policy.<ref>{{cite web|title=Qui sommes-nous ?|url=https://urml-m.org/votre-urml/qui-sommes-nous/|url-status=live|archive-url=https://web.archive.org/web/20210227205702/https://urml-m.org/votre-urml/qui-sommes-nous/|archive-date=27 February 2021|access-date=6 September 2021|website=Urml Martinique|date=7 July 2020 |publisher=Unions Régionales des Médecins Libéraux Martinique|language=fr-FR}}</ref>

=== Health facilities ===
The University Hospital of Martinique (Le Centre Hospitalier Universitaire de Martinique) is a [[teaching hospital]] based in Fort-de-France, in an agreement with the [[University of the French Antilles]]. It is the largest French- and English-speaking university hospital in the Caribbean, having more than 1600 beds. These include 680 medical, 273 surgical and 100 obstetrics beds, with another 30 in its [[intensive care unit]]. The hospital operates a 24-hour emergency service.<ref>{{cite web|title=University Hospital Of Martinique (UHM,CHU de Martinique)|url=http://www.universityhospitalmartinique.fr/|url-status=live|archive-url=https://web.archive.org/web/20210311215441/http://www.universityhospitalmartinique.fr/|archive-date=11 March 2021|access-date=5 September 2021|website=www.universityhospitalmartinique.fr}}</ref>

=== Chlordecone controversy ===

==== Actions of the French government ====
After the discovery of the toxicity of [[chlordecone]], a dangerous insecticide, and the health risks it posed, the French state put in place certain measures to protect the Martinican and [[Guadeloupe]]an populations, allocating nearly 100 million euros towards the implementation of these measures.<ref name="Ferdinand-2020">{{Cite report|last=Ferdinand|first=Malcom|date=5 January 2020|title=Le chlordécone au prisme des sciences humaines et sociales. Rapport scientifique du workshop organisé les 6 et 7 novembre 2019 à l'Université Paris Dauphine|url=https://hal.archives-ouvertes.fr/hal-03097964|access-date=24 October 2021|archive-date=23 October 2021|archive-url=https://web.archive.org/web/20211023000912/https://hal.archives-ouvertes.fr/hal-03097964|url-status=live}}</ref> The soils are regularly tested and subjected to strict regulations related to the standards of potability.<ref name="Ferdinand-2020" /><ref name="Gaumand-2005">{{Cite book|last1=C|first1=GAUMAND|url=https://side.developpement-durable.gouv.fr/Default/doc/SYRACUSE/203741/evaluation-des-actions-menees-en-rapport-avec-la-presence-de-chlordecone-et-autres-pesticides-organo|title=EVALUATION DES ACTIONS MENEES EN RAPPORT AVEC LA PRESENCE DE CHLORDECONE ET AUTRES PESTICIDES ORGANOCHLORES EN GUADELOUPE ET EN MARTINIQUE|last2=A|first2=GRAVAUD|last3=VERDELON (X.)|last4=M|first4=VERNEREY|date=2005|access-date=24 October 2021|archive-date=23 October 2021|archive-url=https://web.archive.org/web/20211023235633/https://side.developpement-durable.gouv.fr/Default/doc/SYRACUSE/203741/evaluation-des-actions-menees-en-rapport-avec-la-presence-de-chlordecone-et-autres-pesticides-organo|url-status=live}}</ref> Martinique is also subject to regular mapping processes to delineate highly contaminated areas. River fishing is also prohibited in order to limit health risks, as rivers represent high-risk contamination areas.<ref name="Ferdinand-2020" />

Since 2008, the French state has developed three action plans establishing strategies to protect local populations, raise awareness regarding the effects of chlordecone, as well as to support the agriculture and fisheries sectors.<ref name="Martinique-2021">{{cite web|title=Saison 1 / La Chlordécone en vidéos (explications, conseils, mesures) / Chlordécone / Environnement, santé publique / Politiques publiques / Accueil - Les services de l'État en Martinique|url=https://www.martinique.gouv.fr/Politiques-publiques/Environnement-sante-publique/Chlordecone/La-Chlordecone-en-videos-explications-conseils-mesures/Saison-1|access-date=20 October 2021|website=www.martinique.gouv.fr|archive-date=20 October 2021|archive-url=https://web.archive.org/web/20211020225935/https://www.martinique.gouv.fr/Politiques-publiques/Environnement-sante-publique/Chlordecone/La-Chlordecone-en-videos-explications-conseils-mesures/Saison-1|url-status=live}}</ref>

A French parliamentary commission revealed in 2019 that more than 90% of Martinicans have been exposed to chlordecone, which was authorized for use between 1972 and 1993 in the banana plantations of the Antilles. The committee judged the three "Chlordecone Plans" launched by the State since 2008 to be inadequate; recommendations were provided via its [[rapporteur]], [[Justine Benin]] [[Member of Parliament (France)|MP]], to address prevention and research into cleanup methods for a fourth plan, scheduled for 2020.<ref name="20minutes-2021">{{cite web|title=La commission d'enquête sur le chlordécone rend ses conclusions|url=https://www.20minutes.fr/sante/2658759-20191124-pollution-chlordecone-commission-enquete-parlementaire-rend-conclusions|access-date=21 October 2021|website=www.20minutes.fr|date=24 November 2019|language=fr|archive-date=13 April 2020|archive-url=https://web.archive.org/web/20200413034033/https://www.20minutes.fr/sante/2658759-20191124-pollution-chlordecone-commission-enquete-parlementaire-rend-conclusions|url-status=live}}</ref>

The parliamentary commission of inquiry called the French state into question for having authorized the sale of chlordecone as an insecticide, as its toxicity was known, but "responsibilities are shared with economic actors. Firstly, industrialists, but also groups of planters and certain elected officials."<ref name="LeFigaro-2019">{{cite web|date=26 November 2019|title=Antilles : l'État, "premier responsable" de la pollution au chlordécone|url=https://www.lefigaro.fr/actualite-france/antilles-l-etat-premier-responsable-de-la-pollution-au-chlordecone-20191126|access-date=21 October 2021|website=LEFIGARO|language=fr|archive-date=26 November 2019|archive-url=https://web.archive.org/web/20191126042924/https://www.lefigaro.fr/actualite-france/antilles-l-etat-premier-responsable-de-la-pollution-au-chlordecone-20191126|url-status=live}}</ref>

==== Health consequences ====
Chlordecone is known to have harmful effects on human health, with scientific research identifying it as an endocrine disruptor or hormonally-active chemical agent, as well as a probable carcinogen, particularly in relation to increasing chances of prostate cancer occurrence and recurrence.<ref name="Martinique-2021" /><ref name="Ferdinand-2020" /> As an endocrine disruptor, chlordecone can also lead to delayed cognitive development in infants, an increased likelihood of pregnancy complications, and may disrupt the reproductive process.<ref name="Ferdinand-2020" />

The chlordecone molecule has physical and chemical characteristics that allow it to remain for several centuries in soil, river-water and groundwater, thus spreading beyond the location of the banana plantations where this insecticide was initially administered.<ref name="Ferdinand-2020" /><ref name="Martouzet-2021">{{Cite journal|last=Martouzet|first=Denis|date=2022|title=Jessica Oublié et al., Tropiques toxiques. Le scandale du chlordécone|url=https://journals.openedition.org/geocarrefour/17224|journal=Géocarrefour|volume=96|issue=2|doi=10.4000/geocarrefour.17224|s2cid=251047096|language=fr|issn=1627-4873|access-date=24 October 2021|archive-date=21 October 2021|archive-url=https://web.archive.org/web/20211021204644/https://journals.openedition.org/geocarrefour/17224|url-status=live|url-access=subscription}}</ref> Although chlordecone has not been used since the 1990s, the health risks remain. Chlordecone contamination occurs through contaminated food and drink.<ref name="Martinique-2021" />

==== Local community response ====
In the streets of Fort-de-France, approximately 5,000 to 15,000 residents of Martinique demonstrated in protest on 27 March 2021, denouncing the possible statute of limitations on a complaint filed by civil parties for the use of chlordecone in causing life endangerment (''mise en danger de la vie d'autrui).''<ref name="Franceinfo-2021">{{cite web|date=17 March 2021|title=Scandale du chlordécone : "L'empoisonnement" à ce pesticide en Guadeloupe et en Martinique "n'est pas prescrit", clament les parties civiles|url=https://www.francetvinfo.fr/monde/environnement/pesticides/scandale-du-chlordecone-lempoisonnement-a-ce-pesticide-en-guadeloupe-et-en-martinique-n-est-pas-prescrit-clament-les-parties-civiles_4336009.html|access-date=18 October 2021|website=Franceinfo|language=fr-FR|archive-date=18 October 2021|archive-url=https://web.archive.org/web/20211018001519/https://www.francetvinfo.fr/monde/environnement/pesticides/scandale-du-chlordecone-lempoisonnement-a-ce-pesticide-en-guadeloupe-et-en-martinique-n-est-pas-prescrit-clament-les-parties-civiles_4336009.html|url-status=live}}</ref> The complaint was issued on 23 February 2006.<ref name="Franceinfo-2021" /><ref name="Geo-2021">{{cite web|last=AFP|first=GEO avec|date=16 March 2021|title=Chlordécone en Guadeloupe et en Martinique : vers une ordonnance de non-lieu ?|url=https://www.geo.fr/environnement/chlordecone-la-grande-majorite-des-faits-etait-deja-prescrite-des-le-depot-des-plaintes-204082|access-date=18 October 2021|website=Geo.fr|language=fr|archive-date=18 October 2021|archive-url=https://web.archive.org/web/20211018001519/https://www.geo.fr/environnement/chlordecone-la-grande-majorite-des-faits-etait-deja-prescrite-des-le-depot-des-plaintes-204082|url-status=live}}</ref>

The French government's actions in response to the historical authorization of chlordecone are often criticized by residents of Martinique and local associations involved in the "Chlordecone Scandal." The lack of information transmitted to the population concerning the danger of chlordecone between 1993 and 2004 is one of the main concerns expressed.<ref name="Franceinfo-2021" />

The civil complaint in 2006 was issued by several associations from the islands of Martinique and Guadeloupe, and was in response to the long-term impacts of government-authorized chlordecone use in polluting the islands' natural environments and affecting the health of inhabitants.<ref name="LeMonde-2021">{{Cite news|date=27 February 2021|title=Scandale du chlordécone : plusieurs milliers de manifestants en Martinique contre " l'impunité "|language=fr|work=Le Monde.fr|url=https://www.lemonde.fr/planete/article/2021/02/27/scandale-du-chlordecone-plusieurs-milliers-de-manifestants-en-martinique-contre-l-impunite_6071431_3244.html|access-date=18 October 2021|archive-date=18 October 2021|archive-url=https://web.archive.org/web/20211018001518/https://www.lemonde.fr/planete/article/2021/02/27/scandale-du-chlordecone-plusieurs-milliers-de-manifestants-en-martinique-contre-l-impunite_6071431_3244.html|url-status=live}}</ref>

=== COVID-19 pandemic ===
{{main|COVID-19 pandemic in Martinique}}

Martinique's first cases of coronavirus (COVID-19) were confirmed in March 2020.<ref>{{cite web|title=Coronavirus : deux cas confirmés en Martinique|url=https://la1ere.francetvinfo.fr/martinique/coronavirus-deux-cas-confirmes-martinique-807587.html|url-status=live|archive-url=https://web.archive.org/web/20200306135023/https://la1ere.francetvinfo.fr/martinique/coronavirus-deux-cas-confirmes-martinique-807587.html|archive-date=6 March 2020|access-date=5 September 2021|website=Martinique la 1ère|date=5 March 2020 |language=fr-FR}}</ref> The pandemic has since put provision of health services under significant stress; as of 2 September 2021, Martinique had recorded an [[excess mortality]] at all ages, and of all causes since the week beginning 26 July 2021.<ref>{{cite web|last=|date=2 September 2021|title=COVID-19 : point épidémiologique en Martinique du 2 septembre 2021|url=https://www.santepubliquefrance.fr/regions/antilles/documents/bulletin-regional/2021/covid-19-point-epidemiologique-en-martinique-du-2-septembre-2021|url-status=bot: unknown|archive-url=https://web.archive.org/web/20210905145016/https://www.santepubliquefrance.fr/regions/antilles/documents/bulletin-regional/2021/covid-19-point-epidemiologique-en-martinique-du-2-septembre-2021|archive-date=5 September 2021|access-date=5 September 2021|website=Santé Publique France|language=fr}}</ref>