I worked in Barbados years ago for a short time and it was the same story. Apparently the speeds have increased, but the ILECs still probably have a stranglehold on prices and speeds. The prices for outgoing calls were so high people would use "callback" services to essentially make a reverse call from the US to the island and then connect to the intended destination at a lower rate. The fastest connectivity used to be ISDN, seems like ADSL now.

What would probably bother me most are certain cultural differences. If they're majority conservative or religious they might go to extremes like hating or outlawing homosexuality, and most alternative culture would probably be frowned upon. Could be different now, but I remember hearing songs on the radio about killing all gay people...