launched in an effort to increase the skills of its primary school teachers, nearly one-quarter of whom were unqualified. Turks and Caicos also worked to refurbish its primary schools, reduce textbook costs, and increase equipment and supplies given to schools. For example, in September 1993, each primary school was given enough books to allow teachers to establish in-class libraries. In 2001, the student-teacher ratio at the primary level was roughly 15:1. Public secondary schools include: HJ Robinson High School (Grand Turk) Clement Howell High School (Providenciales) Long Bay High School (Providenciales) Raymond Gardiner High School (North Caicos) Marjorie Basden High School (South Caicos) International School of the Turks and Caicos Islands, a private school which serves preschool through grade six, is in Leeward, Providenciales. In 2014 it had 106 students. It was known as The Ashcroft School until 2014. The Turks and Caicos Islands Community College offers free higher education to students who have successfully completed their secondary education. The community college also oversees an adult literacy program. Once a student completes their education at Turks and Caicos Islands Community College, they are allowed to further their education at a university in the United States, Canada, or the United Kingdom for free. They have to commit to working in the Turks and Caicos Islands for four years to receive this additional education. Charisma University is a non-profit private university recognised by the Turks and Caicos Islands Ministry of Education, Youth, Sports and Library Services that offers accredited undergraduate, graduate, and post-graduate degree programmes, along with certificate programs in various disciplines taught by over a 100 faculty members. The public University of the West Indies Open Campus has one site in the territory. Healthcare The Turks and Caicos established a National Health Insurance Plan in 2010. Residents contribute to a National Health Insurance Plan through salary deduction and nominal user fees. The majority of care is provided by private-public-partnership hospitals managed by Interhealth Canada, one hospital in Providenciales and one hospital on Grand Turk Island. In addition, there are a number of government clinics and private clinics. The hospitals opened in 2010 and have been accredited by Accreditation Canada since 2012. Economy The economy of Turks and Caicos is dominated by tourism, offshore finance and fishing. The US dollar is the main currency used on the islands. Historically the salt industry, along with small sponge and hemp exports, sustained the Turks