Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 7, Number 3, 2002

Living to 100
by Tony Deyal

It’s no secret.
You take fresh foods, clean water, pure air and lots of exercise. You add low stress, a loving family and strong belief in God. For Dominica’s centenarians, it all adds up to a longer and healthier life.

 Elizabeth Israel
Dominica’s centenarians include the world’s oldest living person, Elizabeth "Ma Pampo" Israel, pictured here two years ago when she was "only" 125.  (Photo © Powys Dewhurst)
If Christopher Columbus ever returned to the Americas, the only country he would likely recognize is the little Caribbean island of Dominica. Given its inhabitants’ reputation for longevity, he might even remember some of the islanders from his first visit. Out of a population of 70,000, 21 Dominicans are more than 100 years old.

Dominica’s centenarians include the world’s oldest living human, Elizabeth "Ma Pampo" Israel, profiled two years ago (when she was "only" 125) in Time magazine. "The daughter of a slave, she started working on a plantation at the age of 25 and retired 79 years later," Time reported. "She ascribes her longevity to her diet—including lots of dumplings and bush tea."

Time doesn’t mention it, but Ma Pampo married in 1922 and had one son, who died at the age of 30. That was well over half a century ago. She has one grandson, who is alive and well somewhere in the United Kingdom.

Ma Pampo herself is well cared for today, and her home in Glanvillia, outside the town of Portsmouth, is clean and comfortable, if small. During a recent visit, she confirmed how hard she had to work as a child, picking coconuts and limes for a starting salary of two cents per day.

Earlier this year, because of an ingrown toenail that became infected, Ma Pampo had her right leg amputated below the knee. It healed easily and without further complications, but the ordeal left her generally bedridden. At almost the same time, her next-door neighbor and good friend of many, many years, Rose Peters, died at the age of 118. Yet Ma Pampo refuses to give up. She remains curious, lively and communicative, with a strong sense of humor. Her zest for living is evident, as is the simplicity of her life and her lack of interest in worldly goods.

Fluent in the native Kwiyol (a French patois) and Kokoy (an English-based pidgin), in addition to standard English, Ma Pampo ascribes her long life to hard work and good food. She shuns anything canned or processed. While in the hospital earlier this year—one of only three visits in her entire life to the Dominican capital of Roseau—she threw away a peanut butter sandwich, saying she would not eat anything that was not "natural." She talks glowingly of the beneficial effects of dumplings (seasoned boiled flour chunks flavored with broth); river crayfish and crabs; tuna, mahi-mahi and mackerel from the sea; and local tubers: cassava, dasheen, eddoes, yams and tannia.

Ma Pampo still loves to listen to the Kokoy programs on the radio and the Franco-African rhythms and melodies that dominate the airwaves. When I asked her what I could do to live to be her age, she laughed heartily and thought for a moment. Then she said that I should eat good food. She added, however, that food is now so polluted with fertilizer that it is difficult to trust. Then she commended me to God.

An island apart

The terrain, flora and fauna of Dominica are unforgettable. Except for the few villages that hug the coast and mountainsides, the island has remained unspoiled and little changed during the 500 years since Columbus first visited the Caribbean. Twenty-nine miles long and 16 miles wide, it is still a land of cloud-capped volcanic mountains and lush tropical rainforests; steep valleys with tangled lianas and tumbling, crystal-clear streams; rainbow-hued flowers ranging from magenta ginger lilies to brilliant orange heliconiae, bright pink antirrhinums to rich purple orchids; iridescent butterflies that look like flying bits of gemstone-studded brocade; and birds of all sizes, colors and plumage that coo, squawk, shrill and sing, including the national icon, the Sisserou parrot, immortalized on the Dominican flag. The country has 12 large waterfalls, six varieties of tropical rainforest and more than 365 rivers, one for each day of the year. There are hot sulfur springs and coldwater streams almost side by side. It is said that you can catch a fish in one river and cook it in the other.

 Wigg John Francis
Wigg John Francis, 103, attributes his long life to ‘good drink, good food’ and God.  (Photo © Tony Deyal)
Tourism minister Charles Savarin attributes Dominicans’ longevity to the island’s pristine environment. "Many people still drink water straight from the rivers," he says. "The water is naturally filtered and entirely without chemicals. There are no industrial plants emptying into the streams and the sea. Most of the country is heavily forested so that we may have more oxygen here than anywhere else."

He points out that when today’s centenarians were growing up, the island was without chemicals, fertilizers or motor vehicles. People had to walk or row their small boats long distances. Everyone had to work hard for a living, sowing and reaping their own crops as well as working on sugar plantations.

Until two years ago, Wigg John Francis, who is officially 103, tended his garden and raked his own grass. He lives in the agricultural community of Dublanc, on Dominica’s west coast. He questions the official date of birth derived from his baptismal records, saying he is really 107.

Francis remembers being adopted as a boy by his aunt in the capital. He never attended school; instead, he worked as a farmer, fisherman and sometimes gravedigger. Until two years ago, he actively supervised younger gravediggers, showing them who was buried where and which plots were still available. I asked him to what he owed his long life, and he replied sharply in patois, "Ask God. It is He who gives me sustenance." He then added, "Bien bue, bien mange." Good drink. Good food. Natural and without chemicals, a mixture of tubers and fish. Francis was not averse to alcohol, and he smoked cigarettes, although he quit some years ago. He was accustomed to exertion, sometimes rowing the 30-mile round trip to Roseau or the 10 miles to church and back with his family. He believes in bush tea and bush medicine—holistic, herbal healing. His biggest problem is "old age": His eyesight is fading and his head hurts. Yet he walks unaided, albeit slowly, and washes his own face.

Francis says he has lived a good life "as God says." He is lovingly and well cared for by his granddaughter, Theresa Jubenot, and her husband Honoré. He is clean and clear-witted. When I asked him what I could do to live to his age, he looked me up and down and then laughed in my face.

In contrast, Professor Gerald Grell, dean of the Portsmouth Campus of Ross University, an offshore medical school based in Dominica, took me quite seriously. He explained that having so many centenarians (30 per 100,000, 66 percent higher than the United States’ rate of 18 per 100,000) is highly unusual and that he is supervising a research project to determine what the causes might be. While he is not certain about the specific reasons for there being more female (17) than male (four) centenarians in Dominica, he notes that the evidence so far points to the environment as the major factor in all cases. None of the centenarians are directly related, so there is no common genetic factor. They live in different communities, so their longevity is not localized. He believes that what the centenarians have in common is that they all worked very hard during their lives, ate the basic organic foods and fresh fish that abound in Dominica, and breathed the oxygen-rich atmosphere that encapsulates the country like a bubble of good health.

Grell also points to three other important factors. The first is that Dominicans live as extended families in small, relatively isolated, semi-self-sufficient communities. They share a strong respect for the elderly; people are proud of their parents and grandparents and take care of them when they are ill or need help. The second factor is a deeply rooted belief in God found commonly in Dominica’s almost universally Roman Catholic population. Religion, not merely attendance at church on Sundays, is a way of life. The third is that Dominicans live relatively simple, stressfree lives.

Health to the people

"This is a country where we relax and where we are not afraid to laugh at ourselves," says Minister of Health Herbert Sabaroche, who hails from the small fishing village of Bioche on the west coast and is related to Wigg John Francis. "It is interesting that the 21 persons who are over 100 years old are not restricted to any one geographical area of Dominica but are spread throughout the country.

 Wigg John Francis
Ma Daroux, 101, credits ‘healthy food,’ a loving family and also God.  (Photo © Tony Deyal)
"This means the whole of Dominica has an environment conducive to long life. Fresh foods, clean water, pure air, a high level of relaxation, good family support, belief in God, low stress, and lots of exercise —that is what life in Dominica is all about."

He adds one more element to the mix of contributing factors. Sabaroche stresses health care in Dominica. "Our primary health care system is one of the oldest in the region and one of the best or most comprehensive," he says. "It is decentralized, and instead of waiting for people to come to us, we take health to them. We reach out to the people."

One example that stands out, and which is in its own way as significant as Ma Pampo’s achievement, is the story of Augista Mathilde Daroux, known as "Ma Daroux." Diagnosed with hypertension in the early 1970s, she has survived and in fact thrived, and now at 101 walks unaided, sleeps soundly and has perfect bladder control. Grell describes this as unprecedented and noteworthy as a health phenomenon.

"Normally people with hypertension are not expected to live so long. However, Ma Daroux has been faithfully taking her prescribed medication, and the combination of hard work, good food, clean air and a supportive environment has contributed to her being so fit mentally and physically at the age of 101."

Ma Daroux lives on a hilltop overlooking the coastal village of Petit Savane. Next to her house is a spring used by villagers for washing. Her small and neatly kept home is fenced by bay trees, whose exotic fragrance mixes with that of the flowers she has planted in her garden. Born on New Year’s Day, 1901, she went to school at the age of 12. Her parents paid her teacher with vegetables and fish. She left school early and went to work. She had eight children. She attributes her long life to healthy food: lots of cane juice, honey, arrowroot, fish, river crabs, prawns and crayfish. She is cared for by her children, who speak of her with love and pride.

Perhaps because she is not of the television generation, Ma Daroux goes to sleep early and wakes early, as do other centenarians. She also drinks herbal tea and is convinced of the virtue of bush medicine for routine ailments. She also is very religious.

As is Louisa Joseph, 103, whom I visited at Vielle Case, high in the mountains, where at some points the road is level with the housetops. Joseph was half-asleep, clutching her chaplet (rosary beads) when I arrived at her home. Clean, tidy and smiling, she attributed her long life to hard work and good food. She spoke of having a good marriage and sharing with her neighbors. She said quietly, "I lived like God says. Whatever I had, everybody got." When I asked her what I should do to reach her age, she too laughed.

Elizah "Ma Bradley" Phillip, 114, of the village of Wesley on the east coast, has lost most of her hearing so was unable to address the same question. However, her 87-year-old daughter and caretaker did the laughing for her.

Antonia Fevrier, 104, of the village of Grandbay at the southernmost point of the island, was having breakfast when I arrived. She likes malted drinks and sweet biscuits. She ignored my question, perhaps deeming it either unanswerable or irrelevant.

But Ma Daroux was different. When I asked her what to do to live as long as she has, she said, "Eat lots of callaloo"—a spinach-based soup common in the Caribbean. Deep green in color, it has an unprepossessing appearance that contrasts strongly with its scrumptious taste. It is made from the leaves of the dasheen plant, seasoned with garlic and onions, and contains black pepper leaves together with crab, fish or salted meat.

Other people have laughingly suggested that I use crapaud water, a soup made from frog meat that is an island delicacy and, together with fried frogs’ legs, part of the island’s French culinary heritage. I have passed the message on to my wife, who has a vested interest in my longevity. Now I plan to drink my callaloo and crapaud water, and on my 100th birthday to go to Dominica and wait for Columbus to return—or, for those who believe in reincarnation, perhaps to return myself as Columbus.

Tony Deyal, a former consultant to the Pan American Health Organization and now a newspaper columnist, was last seen in Dominica toasting PAHO’s centennial with a glass of cane juice.

Have bounty, will share

 Wigg John Francis Tourism is the fastest-growing industry in the world, and the most important in most of the Caribbean, particularly now that the banana industry has gone into decline. Dominica, which has been pursuing ecotourism, is working to develop a health tourism project in collaboration with the Pan American Health Organization (PAHO), which has spearheaded a Tourism and Health Project in the Caribbean region.

Both health minister Herbert Sabaroche and tourism minister Charles Savarin of Dominica are optimistic about the success of such an approach. Says Sabaroche: "Health tourism is a challenge for the future. We see it as a unique opportunity to capitalize on our natural resources and to ensure that we retain and maintain those resources, the most important of which are our people and our unique way of life. We have no objections to sharing these with other people and to allowing those whose health can benefit from being here in Dominica to use the services and to contribute to their improvement."

Savarin has pointed out one practical difficulty that tourism faces in Dominica. "Many people mistake us for the Dominican Republic," he says. "This creates a marketing problem. I would like people to remember that Dominica is the world’s healthiest island and that we are well served with good connections by airlines….With PAHO’s help, and with our already established health care system, we are well placed to merge health and tourism for the benefit of our country and our visitors."

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