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A Regional Health Agency ( Agence régionale de santé ) is an administrative public body of the French State responsible for implementing health policy in its region. Created on 1 April 2010, the regional health agencies are governed by Title III of Book IV of the first part of the Public Health Code (code de la santé publique).

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65-461: These institutions, created under the law 2009-879 of July 21, 2009 entitled "Hospital, Patients, Health and Territory", are intended to ensure a unified management of health in the regions, better meet the needs of the population and increase the effectiveness of the system. In concrete terms, one of their roles is to modernize and rationalize the supply of care and to ensure the proper management of hospital and medical expenses. The agencies act within

130-576: A constituent territory of the European Union and the Eurozone , the euro is its official currency and any European Union citizen is free to settle and work there indefinitely, but is not part of the Schengen Area . It included Saint Barthélemy and Saint Martin until 2007, when they were detached from Guadeloupe following a 2003 referendum . Christopher Columbus visited Guadeloupe in 1493 and gave

195-533: A deep mark on the memory of the local inhabitants. In 1995, three hurricanes (Iris, Luis and Marilyn ) hit the archipelago in less than three weeks. Other notable hurricanes include Okeechobee in 1928, Betsy in 1965, Cleo in 1964, Inez in 1966, and Irma and Maria in 2017. With fertile volcanic soils, heavy rainfall and a warm climate, vegetation on Basse-Terre is lush. Most of the island's forests are on Basse-Terre, containing such species as mahogany , ironwood and chestnut trees . Mangrove swamps line

260-523: A half months following the eruption. K–Ar dating indicates that the three northern massifs on Basse-Terre Island are 2.79 million years old. Sections of volcanoes collapsed and eroded within the last 650,000 years, after which the Sans Toucher volcano grew in the collapsed area. Volcanoes in the north of Basse-Terre Island mainly produced andesite and basaltic andesite . There are several beaches of dark or "black" sand. La Désirade , east of

325-592: A magnitude of 6.3 on the Richter scale and caused the death of one person, as well as extensive material damage. The population of Guadeloupe was estimated to be 378,561 on 1 January 2024. The population is mainly Afro-Caribbean . European, Indian (Tamil, Telugu, and other South Indians) , Lebanese , Syrians , and Chinese are all minorities. There is also a substantial population of Haitians in Guadeloupe who work mainly in construction and as street vendors. Basse-Terre

390-512: A territory in 1848. Since 1982, following the French government 's policy of decentralisation , overseas departments have elected regional councils with powers similar to those of the regions of metropolitan France. As a result of a constitutional revision that occurred in 2003, these regions are now to be called "overseas regions"; indeed, the new wording of the Constitution gives no precedence to

455-403: A union leader ( Jacques Bino ) was shot and killed. The strike lasted 44 days and had also inspired similar actions on nearby Martinique . President Nicolas Sarkozy later visited the island, promising reform. Tourism suffered greatly during this time and affected the 2010 tourist season as well. Guadeloupe is an archipelago of more than 12 islands, as well as islets and rocks situated where

520-499: Is chaired by the regional prefect and has 24 members: The supervisory board approves the budget and the financial accounts. It issues an opinion on the regional strategic plan and the multi-year contract of objectives and means. Each agency has a regional health and autonomy conference that contributes to the development of health policy in the region and two public health policy coordination commissions, one for prevention, school health, occupational health and maternal and child health,

585-520: Is crossed by numerous geological faults such as those of la Barre or la Cadoue, while in depth, in front of Moule and La Désirade begins the Désirade Fault, and between the north of Maria-Galante and the south of Grande-Terre begins the Maria Galante Fault. And it is because of these geological characteristics, the islands of the department of Guadeloupe are classified in zone III according to

650-603: Is located in Pointe-à-Pitre and is responsible for researching environmental hygiene, vaccinations, and the spread of tuberculosis and other mycobacteria . The relative wealth of Guadeloupe contrasts with the extreme poverty of several islands in the Caribbean region, which makes the community an attractive place for the populations of some of these territories. In addition, other factors, such as political instability and natural disasters, explain this immigration. As early as

715-537: Is similar to that of Basse-Terre, with volcanic hills and irregular shoreline with deep bays. There are numerous other smaller islands. Basse-Terre is a volcanic island . The Lesser Antilles are at the outer edge of the Caribbean Plate , and Guadeloupe is part of the outer arc of the Lesser Antilles Volcanic Arc . Many of the islands were formed as a result of the subduction of oceanic crust of

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780-412: Is south of Antigua and Barbuda and Montserrat and north of Dominica . The capital city is Basse-Terre , on the southern west coast of Basse-Terre Island; the most populous city is Les Abymes and the main centre of business is neighbouring Pointe-à-Pitre , both on Grande-Terre Island. It had a population of 395,726 in 2024. Like the other overseas departments, it is an integral part of France. As

845-421: Is the political capital; however, the largest city and economic hub is Pointe-à-Pitre . The population of Guadeloupe has been decreasing by 0.8% per year since 2013. In 2017 the average population density in Guadeloupe was 240 inhabitants per square kilometre (620/sq mi), which is very high in comparison to metropolitan France's average of 119 inhabitants per square kilometre (310/sq mi). One third of

910-405: Is the third-largest island, followed by La Désirade , a north-east slanted limestone plateau, the highest point of which is 275 metres (902 ft). To the south lie the Îles de Petite-Terre , which are two islands (Terre de Haut and Terre de Bas) totalling 2 km . Les Saintes is an archipelago of eight islands of which two, Terre-de-Bas and Terre-de-Haut are inhabited. The landscape

975-540: The Atlantic Plate under the Caribbean Plate in the Lesser Antilles subduction zone . This process is ongoing and is responsible for volcanic and earthquake activity in the region. Guadeloupe was formed from multiple volcanoes, of which only La Grande Soufrière is not extinct. Its last eruption was in 1976, and led to the evacuation of the southern part of Basse-Terre. 73,600 people were displaced throughout three and

1040-567: The Battle of Matouba on 28 May 1802. Realising they had no chance of success, Delgrès and his followers committed mass suicide by deliberately exploding their gunpowder stores. In 1810, the British captured the island again , handing it over to Sweden under the 1813 Treaty of Stockholm . In the 1814 Treaty of Paris , Sweden ceded Guadeloupe to France, giving rise to the Guadeloupe Fund . In 1815,

1105-494: The Compagnies républicaines de sécurité , resulting in four deaths. In May 1967 racial tensions exploded into rioting following a racist attack on a black Guadeloupean, Raphael Balzinc, resulting in eight deaths. An independence movement grew in the 1970s, prompting France to declare Guadeloupe a French region in 1974. The Union populaire pour la libération de la Guadeloupe (UPLG) campaigned for complete independence, and by

1170-524: The Guadeloupe woodpecker . The waters of the islands support a rich variety of marine life. However, by studying 43,000 bone remains from six islands in the archipelago , it was found that 50 to 70% of snakes and lizards on the Guadeloupe Islands became extinct after European colonists arrived; they had brought with them mammals such as cats, mongooses, rats, and raccoons, which might have preyed upon

1235-608: The Liyannaj Kont Pwofitasyon went on strike for more pay. Strikers were angry with low wages, the high cost of living, high levels of poverty relative to mainland France and levels of unemployment that are amongst the worst in the European Union. The situation quickly escalated, exacerbated by what was seen as an ineffectual response by the French government, turning violent and prompting the deployment of extra police after

1300-613: The Treaty of Vienna acknowledged French control of Guadeloupe. Slavery was abolished in the French Empire in 1848. After 1854, indentured labourers from the French colony of Pondicherry in India were brought in. Emancipated slaves had the vote from 1849, but French nationality and the vote were not granted to Indian citizens until 1923, when a long campaign, led by Henry Sidambarom , finally achieved success. In 1936, Félix Éboué became

1365-612: The euro as their currency. The overseas departments and regions are not the same as the overseas collectivities , which have a semi-autonomous status. Guadeloupe and Réunion each have separate departmental and regional councils, while in Mayotte, Guiana and Martinique, the two layers of government are consolidated so one body wields both sets of powers. The overseas departments acquired these additional powers in 1982, when France's decentralisation policy dictated that they be given elected regional councils and other regional powers; however,

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1430-583: The 1970s, the first illegal immigrants of Haitian origin arrived in Guadeloupe to meet a need for labour in the agricultural sector; alongside this Haitian immigration , which is more visible because it is more numerous, Guadeloupe has also seen the arrival and settlement of populations from the island of Dominica and the Dominican Republic. In 2005, the prefecture, which represents the State in Guadeloupe, reported figures of between 50,000 and 60,000 foreigners in

1495-469: The 1980s the situation had turned violent with the actions of groups such as Groupe de libération armée  [ es ; fr ] (GLA) and Alliance révolutionnaire caraïbe (ARC). Greater autonomy was granted to Guadeloupe in 2000. Through a referendum in 2003 , Saint-Martin and Saint Barthélemy voted to separate from the administrative jurisdiction of Guadeloupe, this being fully enacted by 2007. In January 2009, labour unions and others known as

1560-820: The Russian Admiral Fyodor Ushakov evicted the French from these islands, and though France regained them via the Treaty of Tilsit in 1807, the three departments were not revived. Under the 1947 Constitution of the Fourth Republic , the French colonies of Guadeloupe and Martinique in the Caribbean ; French Guiana in South America ; and Réunion in the Indian Ocean were defined as overseas departments, joining Algeria in North Africa , which had previously been divided into three departments and

1625-478: The Salée River. Much of the forest on Grande-Terre has been cleared, with only a few small patches remaining. Between 300 and 1,000 metres (980 and 3,280 ft) of altitude, the rainforest that covers a large part of the island of Basse-Terre develops. Vegetation there includes the white gum tree, the acomat-boucan or chestnut tree, the marbri or bois-bandé or the oleander; shrubs and herbaceous plants such as

1690-421: The active volcano La Grande Soufrière , the highest mountain peak in the Lesser Antilles with an elevation of 1,467 metres (4,813 ft). In contrast Grande-Terre is mostly flat, with rocky coasts to the north, irregular hills at the centre, mangrove at the southwest, and white sand beaches sheltered by coral reefs along the southern shore. This is where the main tourist resorts are found. Marie-Galante

1755-439: The agencies be reviewed, and regularly underlines the difficult dialogues between the directorates of the institutions and the agencies. The intervention of Guy Collet gives a reflection of a generally very mixed assessment of the agencies: "The operation of ARS is marked by an excess of bureaucracy" [...] "Hospitals have the feeling of a constant intrusion into their management and management" [...] "they must leave professionals

1820-534: The area became a French colony, the Spanish name was retained – though altered to French orthography and phonology . The islands are locally known as Gwada . The islands were first populated by indigenous peoples of the Americas , possibly as far back as 3000 BC. The Arawak people are the first identifiable group, but they were later displaced c.  1400 by Kalina -Carib peoples. Christopher Columbus

1885-530: The chaotic political situation, Britain invaded Guadeloupe in 1794. The French responded by sending an expeditionary force led by Victor Hugues , who retook the islands and abolished slavery. More than 1,000 French colonists were killed in the aftermath. In 1802, the French Consulate government reinstated the pre-revolutionary government and slavery, prompting a slave rebellion led by Louis Delgrès . The French authorities responded quickly, culminating in

1950-512: The choice of ways and means to achieve these goals." Guadeloupe Guadeloupe ( / ˌ ɡ w ɑː d ə ˈ l uː p / ; French: [ɡwad(ə)lup] ; Guadeloupean Creole French : Gwadloup , IPA: [ɡwadlup] ) is an overseas department and region of France in the Caribbean . It consists of six inhabited islands— Basse-Terre , Grande-Terre , Marie-Galante , La Désirade , and two Îles des Saintes —as well as many uninhabited islands and outcroppings. It

2015-478: The defense and security zone is known as the regional zone agency. It is responsible for assisting the zone prefect in the implementation of national security and especially health defense missions, and thus to prepare and apply, if necessary, the ORSEC plan . Since 2016 there have been 17 regional health agencies. The establishment of regional health agencies has disrupted practices within hospitals. Initially supporting

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2080-473: The department. Overseas departments and regions of France The overseas departments and regions of France ( French : départements et régions d'outre-mer , pronounced [depaʁtəmɑ̃ e ʁeʒjɔ̃ d‿utʁəmɛʁ] ; DROM ) are departments of the French Republic which are outside the continental Europe situated portion of France , known as " metropolitan France ". The distant parts have exactly

2145-519: The direction of the French colonial leaders Charles Liénard de L'Olive and Jean du Plessis d'Ossonville ; they formally took possession of the island for France and brought in French farmers to colonise the land. This led to the death of many indigenous people by disease and violence. By 1640, however, the Compagnie des Îles de l'Amérique had gone bankrupt, and they thus sold Guadeloupe to Charles Houël du Petit Pré who began plantation agriculture, with

2210-423: The dry season called "Lent" from January to June, and the wet season called "winter", from July to December. Located in a very exposed region, Guadeloupe and its dependencies have to face many cyclones . The deadliest hurricane to hit Guadeloupe was the Pointe-à-Pitre hurricane of 1776, which killed at least 6,000 people. In 1989, Hurricane Hugo caused severe damage to the islands of the archipelago and left

2275-466: The first African slaves arriving in 1650. Slave resistance was immediately widespread, with an open uprising in 1656 lasting several weeks and a simultaneous spate of mass desertions that lasted at least two years until the French compelled indigenous peoples to stop assisting them. Ownership of the island passed to the French West India Company before it was annexed to France in 1674 under

2340-574: The first black governor of Guadeloupe. During World War II , Guadeloupe initially came under the control of the Vichy government , later joining Free France in 1943. In 1946, the colony of Guadeloupe became an overseas department of France. Tensions arose in the post-war era over the social structure of Guadeloupe and its relationship with mainland France. The 'Massacre of St Valentine' occurred in 1952, when striking factory workers in Le Moule were shot at by

2405-417: The former regional hospitalization agencies (agences régionales de l'hospitalisation), created in 1996 which had the status of public interest groups (groupements d'intérêt public), the regional directorates of health and social affairs, the departmental directorates of health and social affairs and the directorates of health and social development in Guadeloupe , French Guiana and Martinique. They also replace

2470-577: The framework of a Regional Health Project which can be the subject of local health contracts concluded by the agency, in particular with the local authorities and their groupings, concerning the promotion of health, prevention, care policies and medico-social support. They are financed by a State subsidy, contributions from the health insurers and the Caisse nationale de solidarité pour l'autonomie , as well as, possibly, their own resources and voluntary payments from local authorities or institutions. They replace

2535-462: The island its name. The official language is French; Antillean Creole is also spoken. The archipelago was called Karukera (or "The Island of Beautiful Waters") by the native Arawak people. Christopher Columbus named the island Santa María de Guadalupe in 1493 after Our Lady of Guadalupe , a shrine to the Virgin Mary venerated in the Spanish town of Guadalupe , Extremadura. When

2600-405: The islands. The overseas collectivity of Mayotte held a referendum on 29 March 2009. Of the votes, 95% were in favor of becoming an overseas department. Mayotte became an overseas department on 31 March 2011. Each overseas department is the sole department in its own overseas region ( French : région d'outre-mer ) with powers identical to the regions of metropolitan France. Because of

2665-828: The land is devoted to agriculture and all mountains are uninhabitable; this lack of space and shelter makes the population density even higher. The most populous urban unit (agglomeration) is Pointe-à-Pitre - Les Abymes , which covers 11 communes and 65% of the population of the department. The three largest urban units are: In 2011, life expectancy at birth was recorded at 77.0 years for males and 83.5 for females. Medical centres in Guadeloupe include: University Hospital Centre (CHU) in Pointe-à-Pitre, Regional Hospital Centre (CHR) in Basse-Terre, and four hospitals located in Capesterre-Belle-Eau, Pointe-Noire, Bouillante and Saint-Claude. The Institut Pasteur de la Guadeloupe ,

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2730-677: The large islands; mangroves and mantids have almost disappeared in Marie-Galante , Les Saintes and La Désirade; the salinity of the fresh water table has increased due to "the intensity of use of the layer"; and pollution of agricultural origin (pesticides and nitrogenous compounds). In addition, the ChlEauTerre study, unveiled in March 2018, concludes that 37 different anthropogenic molecules (more than half of which come from residues of now-banned pesticides, such as chlordecone) were found in "79% of

2795-508: The leeward coast of Basse-Terre. The coastal forest is more difficult to develop because of the nature of the soil (sandy, rocky), salinity , sunshine and wind and is the environment where the sea grape, the mancenilla (a very toxic tree whose trunk is marked with a red line), the icaquier or the Coconut tree grow. On the cliffs and in the Arid zones are found cacti such as the cactus-cigar (Cereus),

2860-600: The main islands, has a basement from the Mesozoic , overlaid with thick limestones from the Pliocene to Quaternary periods. Grande-Terre and Marie-Galante have basements probably composed of volcanic units of Eocene to Oligocene , but there are no visible outcrops. On Grande-Terre, the overlying carbonate platform is 120 metres thick. The islands are part of the Leeward Islands , so called because they are downwind of

2925-444: The mountain palm, the balisier or ferns; many epiphytes: bromeliads , philodendrons, orchids and lianas . Above 1,000 m (3,300 ft), the humid savannah develops, composed of mosses, lichens , sphagnum or more vigorous plants such as mountain mangrove , high altitude violet or mountain thyme. The dry forest occupies a large part of the islands of Grande-Terre, Marie-Galante, Les Saintes, La Désirade and also develops on

2990-416: The native reptiles. In recent decades, Guadeloupe's natural environments have been affected by hunting and fishing, forest retreat, urbanization and suburbanization. They also suffer from the development of intensive crops (banana and sugar cane , in particular), which reached their peak in the years 1955–75. This has led to the following situation: seagrass beds and reefs have degraded by up to 50% around

3055-506: The northeastern Caribbean Sea meets the western Atlantic Ocean. It is located in the Leeward Islands in the northern part of the Lesser Antilles , a partly volcanic island arc . To the north lie Antigua and Barbuda and the British Overseas Territory of Montserrat , with Dominica lying to the south. The two main islands are Basse-Terre (west) and Grande-Terre (east), which form a butterfly shape as viewed from above,

3120-553: The one-to-one correspondence, informal usage does not distinguish the two, and the French media use the term département d'outre-mer ( DOM ) almost exclusively. As integral parts of the French republic and the European Union , overseas departments are represented in the National Assembly , Senate , and Economic and Social Council . The areas also vote to elect members of the European Parliament (MEP), and also use

3185-403: The other for care and medico-social support. In each region, the agency implements public health policies in services responsible for health at work, school and university health and maternal and child health: external environment: noise pollution, outdoor air quality, healthcare waste, impact on the health of human activities. The regional health agency located in the administrative center of

3250-542: The prevailing trade winds , which blow out of the northeast. This was significant in the days of sailing ships . Grande-Terre is so named because it is on the eastern, or windward side, exposed to the Atlantic winds. Basse-Terre is so named because it is on the leeward south-west side and sheltered from the winds. Guadeloupe has a tropical climate tempered by maritime influences and the Trade Winds . There are two seasons,

3315-419: The prickly pear, the chestnut cactus, the "Tête à l'anglais" cactus and the aloes. The Mangrove forest that borders some of Guadalupe's coasts is structured in three levels, from the closest to the sea to the farthest. On the first level are the red mangroves ; on the second, about 10 metres (33 ft) from the sea, the black mangroves form the shrubby mangrove; on the third level the white mangroves form

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3380-419: The regional unions of the health insurance funds (unions régionales des caisses d'assurance maladie). They are supervised by the ministers responsible for health, social security, the elderly and the disabled, administered by a Director General with a supervisory board. The Director General grants authorizations of health facilities and services and medico-social institutions and services. The supervisory board

3445-509: The role of the ARS as local relays of health and social strategies of the State, and supporting the institutions in their governance choices, the Hospital Federation of France has complained about the bureaucratic drift which imposes on institutions choices sometimes guided solely by economic imperatives and profitability. Since 2010, the federation has requested that the role and prerogatives of

3510-511: The same status as mainland France's regions and departments. The French Constitution provides that, in general, French laws and regulations (France's civil code, penal code, administrative law, social laws, tax laws, etc.) apply to French overseas regions the same as in metropolitan France , but can be adapted as needed to suit the region's particular needs. Hence, the local administrations of French overseas regions cannot themselves pass new laws. On occasion referendums are undertaken to re-assess

3575-421: The seismic zoning of France and are subject to a specific risk prevention plan. The 1843 earthquake in the Lesser Antilles is, to this day, the most violent earthquake known. It caused the death of more than a thousand people, as well as major damage in Pointe-à-Pitre. On 21 November 2004, the islands of the department, in particular Les Saintes archipelago, were shaken by a violent earthquake that reached

3640-528: The sentiment in local status. Since March 2011, the five overseas departments and regions of France are: France 's earliest, short-lived attempt at setting up overseas departments was after Napoleon 's conquest of the Republic of Venice in 1797, when the hitherto Venetian Ionian Islands fell to the French Directory and were organised as the departments of Mer-Égée , Ithaque and Corcyre . In 1798,

3705-485: The tall mangrove. Behind the mangrove, where the tide and salt do not penetrate, a swamp forest sometimes develops, unique in Guadeloupe. The representative species of this environment is the Mangrove-medaille. Few terrestrial mammals, aside from bats and raccoons , are native to the islands. The introduced Javan mongoose is also present on Guadeloupe. Bird species include the endemic purple-throated carib and

3770-548: The term "overseas region" was only introduced with the French constitutional amendment of 28 March 2003. Due to distance from the EU and local proximity some areas participate in economic fora and organizations of mutual interest geographically close-by. Such as Martinique and Guadeloupe taking part in both the Organisation of Eastern Caribbean States (OECS) and Association of Caribbean States (ACS); or French Polynesia taking part in

3835-444: The terms "overseas department" or "overseas region", though the latter is still virtually unused by the French media. The overseas collectivity of Saint Pierre and Miquelon was an overseas department from 1976 to 1985. All five of France's overseas departments have between 200,000 and 1,000,000 people each, whereas Saint Pierre and Miquelon has only about 6,000, and the smaller collectivity unit therefore seemed more appropriate for

3900-576: The tutelage of their Martinique colony. Institutionalised slavery, enforced by the Code Noir from 1685, led to a booming sugar plantation economy. During the Seven Years' War , the British captured and occupied the islands until the 1763 Treaty of Paris . During that time, Pointe-à-Pitre became a major harbour, and markets in Britain's North American colonies were opened to Guadeloupean sugar, which

3965-529: The two 'wings' of which are separated by the Grand Cul-de-Sac Marin  [ ceb ; fr ; nl ; sv ] , Rivière Salée  [ fr ] and Petit Cul-de-Sac Marin  [ ceb ; fr ] . More than half of Guadeloupe's land surface consists of the 847.8 km Basse-Terre. The island is mountainous, containing such peaks as Mount Sans Toucher (4,442 feet; 1,354 metres) and Grande Découverte (4,143 feet; 1,263 metres), culminating in

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4030-678: The watersheds analyzed in Grande-Terre and 84% in Basse-Terre." A report by the Guadeloupe Water Office notes that in 2019 there is a "generalized degradation of water bodies." Despite everything, there is a will to preserve these environments whose vegetation and landscape are preserved in some parts of the islands and constitute a sensitive asset for tourism. These areas are partially protected and classified as ZNIEFF, sometimes with nature reserve status, and several caves are home to protected chiropterans. The Guadalupe National Park

4095-543: Was created on 20 February 1989. In 1992, under the auspices of UNESCO , the Biosphere Reserve of the Guadeloupe Archipelago ( Réserve de biosphère de l'archipel de la Guadeloupe ) was created. As a result, on 8 December 1993, the marine site of Grand Cul-de-sac was listed as a wetland of international importance. The island thus became the overseas department with the most protected areas . The archipelago

4160-493: Was the first European to see Guadeloupe, landing in November 1493 and giving it its current name. Several attempts at colonisation by the Spanish in the 16th century failed due to attacks from the native peoples. In 1626, the French, under the trader and adventurer Pierre Belain d'Esnambuc , began to take an interest in Guadeloupe, expelling Spanish settlers. The Compagnie des Îles de l'Amérique settled in Guadeloupe in 1635, under

4225-555: Was traded for foodstuffs and timber. The economy expanded quickly, creating vast wealth for the French colonists. So prosperous was Guadeloupe at the time that, under the 1763 Treaty of Paris, France forfeited its Canadian colonies in exchange for the return of Guadeloupe. Coffee planting began in the late 1720s, also worked by slaves and, by 1775, cocoa had become a major export product as well. The French Revolution brought chaos to Guadeloupe. Under new revolutionary law, freedmen were entitled to equal rights. Taking advantage of

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