Monday, October 13, 2014

The risk of inadequate health management

MONROVIA, Liberia — A man walks past a billboard warning people of the deadly Ebola virus in Monrovia on Friday. The number of people killed in the Ebola outbreak has risen above 4,000, the World Health Organisation has said. The latest figures show there have been 8,376 cases and 4,024 deaths in the worst-affected West African nations of Guinea, Liberia and Sierra Leone. (PHOTO: AP)

THE world has, in recent weeks, been very concerned with the Ebola virus and more importantly, containing it. Here in Jamaica, we have been dealing with the effects of the chikungunya virus, more commonly referred to as ChikV, while also keeping our eye on what is happening with Ebola, as this can be very devastating for Jamaica and the global economy.

I have seen many comments on social media, and I have posted a few as well, debating what measures should be put in place, and where responsibility lies. Some of these discussions have been constructive, some have been irrational, and some have been political. Many can only qualify as the rantings of ignorant people who don't have the ability to understand what the temperature is beyond the tip of their noses.

What is very clear to me is that proper health management in these circumstances is not something that we should seek opinions and consensus on, as the consequence of failure and delay is too horrendous. Sure, we want to consult with various stakeholders, but that consultation must take place with stakeholders who can make a difference to the fight, and not just consult for consulting's sake.

You also want to constantly review all processes, and be critical of what is not going right, but that should be constructively done in order to improve the situation, not seek one-upmanship.

This means that the management of the health care system generally requires astute and objective leadership which must be free of both ego and sensitivity, and must be able to communicate.

We must also understand that leadership is not just government and other officials, but must be leadership within our businesses, households, and wider communities. In other words, as the prime minister said, health management is more about personal responsibility than anything that can be done at a policy level, as health is really a personal issue. Whether it be ChikV, Ebola, or lifestyle diseases, it is all about how we manage our surroundings that affects us and those around us.

With that said though, leadership is responsible for communication and education, and we can all agree that this CHIKV outbreak was not managed properly. This should be accepted as such by the authorities. But once that is done, then let's put it down to a practice run for the real threat of Ebola, and other infectious diseases that are not here as yet.

So the press conference on Thursday with the prime minister and Sandrea Falconer is a good start to a much better approach after ChikV.

The Medical Association of Jamaica, as reported, also seems more confident in the current approach to the preparation for Ebola, and all of us need to be involved in the fight to keep it away. Which, by the way, means ensuring that we observe safety procedures when we travel, and when we return to Jamaica we are honest about where we went and any possible exposure. Again, the role of personal responsibility.

I say all of this because there is a huge risk

to improper health management, which includes inadequate communication and education. A recent report says that (i) approximately US$32.7 billion will be needed to fight Ebola in West Africa; (ii) failure to contain the epidemic could compromise the future of not only West Africa, but the entire continent.

In other words, this could be much worse than the 2008 financial crisis if it is not dealt with quickly. Any hint of an outbreak in Europe, Asia, North, or South America (largest global markets) could plummet financial markets and cause significant reduction in earning power and consumption. Also, unlike the slowdown in global markets caused by bad mortgages in 2008, this could lead to much more devastating and long-term consequences, as we would see global brands and physical markets disappearing.

This is why all the major developed countries are treating this as a major potential crisis and are pledging billions of US dollars in the fight, because if this is not controlled it could be the end of the world as we know it. In other words, a health crisis resulting from a disease like this is worse than any financial market crash or world war. In fact, it could lead to a global financial meltdown and war.

This is why personal responsibility is very critical, and why Jamaica needs to do everything to protect its borders and residents. This is not about giving some people a "bly", as we are used to doing.

The reality is that we are a tourist destination and we are just trying to cope with an IMF agreement which seems to be bearing some fruit, but we still remain very fragile. We also have a poor health infrastructure, a significant percentage of unemployment and people living below the poverty line, relative to other parts of the region and the world.

Therefore, the best line of defence for us is to ensure that our borders are well protected, and that proper and effective monitoring of anyone suspected is in place. Anyone who believes they have symptoms or have been exposed and do not report it to the authorities should face criminal penalties.

And anyone in authority who is negligent in their duties to act or report should also face penalties. This is how seriously we should approach this situation, as the possible economic and social fallout from this is like a final event.

It is going to require all of us in Government, Opposition, private sector, public sector, and civil society to work together. We need to support each other with action and criticisms. Anyone who is going to take a leadership role has to be big enough to rise above criticism, accept it where relevant and just get the job done.

I say all this, fully aware that there are no cases here, but also understanding that the time to act is not when something happens, but before. As they say, 'prevention is better than cure', and that is definitely so in this case.

I am heartened by last Thursday's press conference by the prime minister, and the comments by the MAJ. The education and communication must be very consistent and transparent as we move forward. Too much information is better than too little.


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