EDITORIAL - Lesson from a case of malaria
Last week's reported case of malaria in St Ann should be a signal to the Government of the need for a new, and broader, discussion on health-care priorities, as well as what this newspaper believes should be its mission of doing the small things and getting them right.
The grand schemes, of course, have their place. But they are often unaffordable and sap attention from what already exists and is workable, even if in need of upgrading.
Health Minister Fenton Ferguson's plan for the construction of a specialist paediatric hospital in western Jamaica is a case in point. This facility, if it is built, will compete with existing institutions for the limited resources available to the health sector. The likely outcome in such a situation is that no one gets enough and there is an all-round decline in the quality of service.
The better option: We allocate the resources that would go to a new hospital to upgrading the existing, and decent, Bustamante Hospital for Children in Kingston into a top-class institution, capable of serving the needs of all Jamaicans.
It can't be beyond us to establish a good referral system from other institutions to this specialist hospital, while putting in place a system of preventative medicine that limits the need for the kind of care provided by a specialist institution. In the case of children, the childhood diseases and their causes and prevention are well known.
They, by and large, have to do with a combination of public education and public health management. There is value, for example, in maintaining the message of mothers attending pre-and post-natal clinics, of children being vaccinated, and of personal and public hygiene.
This brings us back to malaria, of which there are an estimated 200 million-plus cases globally and more than half a million deaths annually. Most of these cases are in Africa. The World Health Organisation is working hard towards the elimination of the disease over the next few years.
After an outbreak of 406 reported cases between 2006 and 2009, Jamaica is among the category of countries seeking to prevent the reintroduction of the disease, whose vector is the female of certain of the species of the anopheles mosquito.
We are unlikely to be able to eliminate these mosquitoes from Jamaica, and it is always possible, as has again happened, that we will import a case. But a public health system that ensures vaccination and includes robust vector-eradication programme has worked. It previously eliminated malaria in Jamaica. A similar programme for the Aedes aegypti mosquito would also reduce the frequent outbreaks of dengue.
We sense, however, a major faltering, if not a total breakdown, of public health and public hygiene services in Jamaica. We don't collect garbage well, and stagnant drains and potholes have provided breeding places for mosquitoes.
Nor do we feel an aggressive engagement of communities on public, or even primary, health-care issues. Lip service is occasionally paid to these matters.
Our ministers, however, like to talk of grand schemes. Like a new, shiny hospital for children in Jamaica. How it is to funded, equipped or manned is another question.
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