The messenger isn’t spreading messages well: health crises in Jamaica 

I’ve lost track of how many times Dr. Marion Bullock-Ducasse has been on the radio (or TV, though I watch the news only rarely), or been cited in the written press, but it’s a lot. Why has that happened? 

Jamaica has been plagued (sorry), recently, by waves of health issues, and as chief medical officer (CMO), she has become the face of blame, shame, and explanation about the recurrent health problems. I shy away from saying crises because that may be alarmist. But, public health matters matter much to most people. So, when people hear of, or experience, things that put their health at risk, naturally, they become afraid. 

So, when a new mosquito-borne virus seemed close to our shores, people sought information and assurances. We know such diseases, because dengue fever is prevalent. But what was this new-fangled thing, called chikungunya? The ministry of health turned its head and looked the other way, offering little concrete information, then denying its widespread existence and effect, then scurried to deal with what became  a full-fledged epidemic. People suffered the pain of the virus, struggled to get the simple pharmaceutical medication that would alleviate the worst bone-aching symptoms, reverted to various forms of herbal medicines which many swore were effective, hoped and prayed that aedes egyptae mosquitoes were not biting them. They scoured for and scoured out plant pots, dog feeding bowls, old tyres. They went on ‘clean-up’ campaigns to get trash out of gullies. The message came that people were to blame, because their nastiness provided the right conditions for breeding these insects. Some people died because Chik-v worsened existing health conditions.  Bad people! 

What marks would you give those guiding national health policies and services based on that? High or low? Low, we agree. 

But, the minister in charge asked us to not judge him on Chik-v. He wanted to get it, so he’d feel like most people. I’ve still not understood that wish. A stunt? But, let’s give him his wish and hold off judgement based on our wonderful discovery of the joys of drinking bitter green papaya leaf juice andliving with the smell of mosquito repellent.

Ebola didn’t hit our shores, but it came close, according to reports of people with similar symptoms sighted on land or nearby. The mere hint of it sent hospital staff into panic in Mandeville regional hospital, with them locking up a suspected victim. The country began bans on return travel from some affected countries. 

The health ministry began issuing cards to arriving visitors from overseas about communicable diseases and that people should look out for symptoms (especially, fever) over the following 6 weeks. 

We had a massive fire at Riverton dump, that covered the Kingston metropolitan area with a pall of noxious fumes for days. It was so bad that the responsible minister would only visit the dump wearing a gas mask. (Note that image, and check where your mask is…😫) Out came the CMO to tell us how badly affected we would be by the poisons released into the air we had to breathe. I remember driving through Washington Boulevard and thinking about all the benzine coursing though the lungs of the children waiting for transport to school as we looked at the grey haze. Our long-term suffering isn’t clear, but maybe future generations will be able to study what impact that polluting episode had.

Now, we’ve learned that two outbreaks of infectious bacterial diseases in neonatal units in two major hospitals caused the death of 18 infants since June this year, having infected 42. The minister told us that he only heard about the cases a week ago, and acted as soon as he knew. He didn’t act that fast in the sense that he delayed for 4 days calling a press conference, after disclosing what he knew. Whatever he needed to do, that delay in addressing the public and media speaks volumes about understanding what health issues mean, especially about a story that was broken by the media. Four days during a health emergency is like an eternity. 

Many will suspend belief on the minster’s claim. Why? 

It beggars belief that medical professionals, seeing a spike in infections and deaths would not pass that information to their superiors. If they thought they had things under control, good management practices would suggest that a report would show that the outbreak occurred, was contained, and give kudos to those who did such good jobs. That would have been music to the minister’s ears, as he tries to convince the country that health provision is improving. 

If the infections were not contained, a different report would be made pointing to problems and failings and how to avoid their recurring. That would also be music to the minister, as it would show good focus on problem-solving. Maybe, people would be disciplined if it was clear that humans failed. 

But, not reporting up the line? No, that makes little sense. More likely, reports were made but the gravity of the problem was understated. Let’s leave speculation there. 

Back to Dr. Bullock-Ducasse. As spokesperson during the various problems, she’s sounded calm and assured. Clearly, she wants to convey absence of chaos and panic. She often gives good advice on how to proceed. But, each time she appears, and also when the minister speaks, one thing seems glaringly missing. That is a clear sense of what those suffering may be going through on the ‘worry index’, that measures people’s anxiety over their health. That reached new numbing insensitivity when the message came across that such infections and deaths of premature infants is ‘normal’. Whatever statistics may show, losing a newborn in NEVER normal. 

The health ministry has many problems, caused by many things material and cultural. More money going to the sector won’t change that culture, which has deep in it a tendency to hide the truth. That’s what can explain that the minister did not know for so long. That’s fear at work. Why is it there?

Author: Dennis G Jones (aka 'The Grasshopper')

Retired International Monetary Fund economist. My blog is for organizing my ideas and thoughts about a range of topics. I was born in Jamaica, but spent 30 years being educated, living, and working in the UK. I lived in the USA for two decades, and worked and travelled abroad, extensively, throughout my careers and for pleasure. My views have a wide international perspective. Father of 3 girls. Also, married to an economist. :)

One thought on “The messenger isn’t spreading messages well: health crises in Jamaica ”

  1. Oh yes, those famous words: “Don’t judge me on chik v”! I had a horrible health episode recently (pains and fever) which I think may have been a relapse. Brilliant post, Dennis – you touched on that apparent immunity to people’s suffering, on the part of our officials. Especially Dr DuCasse with her weirdly calm and flat tone of voice… This, I think, is what hurts the most… So yes, I DO judge the Minister on chik v, and everything after…

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