Doctors, nurses on call
envelope in the development of the sector, despite their work being overshadowed by the negativity surrounding them.
The world changed in December 2013. A two-year-old toddler died from Ebola in a remote village in Guinea, and a traveller brought the chikungunya virus to the small Eastern Caribbean country of St Martin. Chikungunya was virtually unknown in the West and the virus quickly spread through the virgin population that had no immunity.
Jamaica had been officially preparing for the outbreak for two years and the minister had warned of its inevitable arrival in his sectoral debate presentation in April 2014. However, the expected arrival of chikungunya was a national disaster akin to an unforeseen Category 5 hurricane.
The Ministry of Health appeared shifty in its reporting of the number of cases of chikunguyna as it stuck with reporting confirmed cases and the grossly under-notified suspected cases. By the time the ministry stopped playing the numbers game, its credibility had suffered a major blow. Persons felt that officials were hiding the truth and this led to conspiracy theories flourishing.
The embattled minister could not convince the population of the need for personal responsibility in vector control as he was constantly kept on the defensive as to the extent of the outbreak. Politics, of course, came into play as the virus ravished the country leaving hundreds of thousands hobbling and contributing to a number of deaths.
This 'chikun-gate' crisis seriously damaged the minister's reputation, with scores calling for his resignation.
As thousands sought medical attention at the already overburdened health centres and hospitals, the system faced a near total collapse.
Inadequate infrastructure, lack of resources and crippling staff shortages led to prolonged waiting times. Among the greatest tragedies of the epidemic were persons who lost their lives waiting for medical attention.
Sensational stories of persons dying in the emergency rooms were reported, but persons who died on the wards or had worse outcomes because of the delays in getting definitive treatment were overlooked.
As frustration with the long waiting time grew, some hooligans resorted to threats and at times physical attacks on health- care workers. In fact, some emergency departments were turned into war zones. Chikungunya had been a stress test that showed the glaring inadequacies in the health system. And when we thought it couldn't get any worse, Ebola showed up in Dallas, Texas.
This Ebola outbreak started with a Guinean toddler in a remote frontier village.
Within months that isolated case morphed into the largest and deadliest outbreak of the disease the world had ever seen. More than 16,000 persons became infected in eight countries with nearly 6,000 dead since the start of the epidemic. The outbreak was largely ignored by the world until it spread to Nigeria. Although quickly confined to 20 cases with eight deaths, there were jitters across the world where doomsday scenarios were envisioned should the virus hit a major metropolis.
The world panicked when a Liberian national was diagnosed with the deadly virus in a Dallas hospital. Even worse were the bumbling efforts of the United States to control the outbreak as there were two cases of local transmission of the virus.
With Ebola suddenly close to our shores, and already reeling from the chikungunya epidemic, Jamaicans became panicky. Distrustful of the Ministry of Health and questioning the levels of preparedness for a possible Ebola outbreak, there was a palpable fear across the nation.
Demoralised health-care workers threatening to abandon their posts should the virus hit did little to comfort the masses. Rumours of Ebola cases sprang up across the country, each associated with a fiasco that underscored our level of unpreparedness.
In the end, we got reassurance with more organised, multisectoral national responses to chikungunya and Ebola. Crucial to this was the invaluable assistance of our old ally, Cuba. With promises of logistics, training and manpower support, the Cubans strengthened our preparations significantly. The worst of the Ebola epidemic has likely passed and with a stronger prevention programme in place, Jamaicans can rest easier.
As difficult as the year was for the health sector, there is hope for 2015. The election of new Nurses' Association of Jamaica and Jamaica Medical Doctors Association presidents, as well as a new chief medical officer and permanent secretary, who have all expressed their willingness to work together for the improvement of the sector holds promise.
Add this group to a minister of health whose legacy now hinges not on his prior accomplishments, but his ability to reform an ailing sector, and we just might have healthier days ahead. The greater involvement of the private sector and civic groups in the national chikungunya and Ebola responses sets a welcome precedent for future collaborations with the ministry.
Hopefully, this gathers momentum and we all continue to chip in for the betterment of the system, as a healthier nation is a more productive and happier nation.
n Dr Alfred Dawes is the president of the Jamaica Medical Doctors' Association. Email feedback to firstname.lastname@example.org.