A container was blown away by the force of the winds (Hurricane Maria) and is blocking the entrance to the Hospital in Portsmouth (North of Dominica)
Credit: Patrick Cloos
In September 2017, Hurricane Maria ripped through the Caribbean, devastating the small island nation of Dominica in the Lesser Antilles, between Guadeloupe and Martinique. Université de Montréal professor Patrick Cloos saw the destruction first-hand when he travelled to Dominica with Doctors Without Borders after the disaster.
"I started writing my proposal for a research project as soon as I got back to Montreal," said Cloos, a professor in UdeM's School of Social Work and the Department of Social and Preventive Medicine in the School of Public Health. "I wanted to understand the impacts of climate change on small Caribbean island nations like Dominica."
In particular, Cloos looked at how the two climate disasters, Hurricane Maria and, two years earlier, Tropical Storm Erika, impacted the health of Dominicans. Working with Dominica's Ministry of Health, Cloos and his research team interviewed displaced people and held focus groups with primary healthcare professionals across the island's seven health districts.
"We wanted to hear their perspectives on underlying vulnerabilities and adaptation measures to climate change," Clos said. The study's findings, one of several scientific reports generated by the project, were published this past April in the journal Plos Climate.
Massive devastation and displacement
Like Tropical Storm Erika, Hurricane Maria was devastating. It completely or partially destroyed 90 per cent of homes on Dominica, displacing more than 50,000 people-over two-thirds of the island's population of approximately 70,000. It also damaged over 80 per cent of the country's infrastructure and wiped out the agricultural sector, including all banana and tuber plantations. Thousands of residents left the island in search of better opportunities in neighbouring countries such as Guadeloupe, Martinique and St. Lucia.
"There was a breakdown in social networks that affected not only quality of life, but also healthcare access," said Cloos. "As a result, the disasters impacted all dimensions of health, physical and mental."
Furthermore, the disruptions occurred against the backdrop of a public health system already under significant strain. "Dominican health professionals told us that even before the recent extreme climate events, there was a persistent shortage of human resources, equipment and medicines that even made it difficult for the primary healthcare system to control certain diseases," Cloos said.
Multiple factors drive vulnerability
The study found that a lack of resources, along with inadequate social and health policies, hindered families and communities in preparing for Tropical Storm Erika and Hurricane Maria, and in implementing measures that could have mitigated their negative effects.
"The study showed the need for more awareness initiatives in communities and schools - in particular, young people didn't have a clear understanding of climate change," noted Sarah Cooper, an UdeM doctoral candidate in public health (specializing in global health), who contributed to the study as a research assistant.
In addition, some risk-reduction initiatives already in place in Dominica lacked consistency and long-term impact due to insufficient funding and support to carry them out and maintain them over time.
"We have to bear in mind that institutions-local, regional, and international-also contribute to creating climate risks and vulnerabilities," Cloos explained. "Inconsistency in decision-making, including the absence of decisions on climate change and broader environmental issues, increases the vulnerability of populations to the harmful consequences of these disasters."
The bigger picture
Although Caribbean island nations account for only a small fraction of global greenhouse gas emissions, they are disproportionately affected by climate change. This has prompted calls for the world's wealthiest nations to provide substantial financial support to help small island nations strengthen their adaptive capacity.
"We can't make it the responsibility of these small island states, when the world's richest countries have historically been the largest emitters of greenhouse gases," Cloos said.
The researchers hope the project's recommendations will be acted upon by the relevant authorities. They have submitted a policy brief to Dominica's Ministry of Health and are working to build partnerships with other Caribbean island nations.
"We also have to continue raising awareness among policymakers of the links between climate change and health, and ensure that public health partners are included in conversations about climate change," said Cloos.
About this study
"What can be said about risks, vulnerabilities, and adaptation to climate change in Caribbean small island developing states (SIDS)? The case of Dominica. A qualitative study," by Sarah Cooper, Patrick Cloos et al., was published April 29, 2025 in Plos Climate.
