The Jamaican government is on the verge of an interesting cliff. It risks losing an important piece of social capital. Many would say that decades of false hope regarding economic and social progress had left a large portion of the population ready to discount what politicians said as rhetoric. That was especially true near elections. But, at its core, the nation tends to hold on to the fact that certain institutions and areas are free from the untruth business. One of these is health. It’s an area that affects everyone, and whose reliability is needed to keep people at ease, and whose failings could put the whole nation at risk. People understand that our health provisions lack the sophistication of North America or Europe. But, we can usually rely on a certain level of service acceptable to most. The other aspect is that the guardians and framers of health policy tend to see nation and not party. That sense of assuredness may be changing, and fast. Why?
The emergence of this virus spread largely by two types of mosquito, first in the region, then on this island, has posed important questions about health services and health policy. Gaps in both are opening or appearing.
At first, the health minister sought to quell fears, while the virus was not present in Jamaica, but had appeared in the region. His avowed intent was to avoid panic. In fact, his ministry went an extra step in that direction, by not wanting to talk publicly about the virus. I said at the time that this seemed more likely to backfire, because people tend to suspect cover up when politicians are silent about evident problems that may be near. To ignore this seems to have been naive.
Once case emerged, in July, first imported, then others emerged quickly–home-grown; the minister sought to assure people that the spread was slight. That might have been true at first, but anecdotal evidence was emerging that something was changing fast. It was, perhaps, unfortunate that the main source of this counter view came from an opposition politician, care taking for his party in the same constituency as the health minister. That political dimension obscured the reality that the official data were lagging badly developments on the ground.
Good reasons exist for holding firm to official data, but officials should have other confirmatory evidence, that perhaps come to hand faster. If such do not exist, that is a gap that needs filling, even if it’s just a crude thing like a list of doctors or clinics to consult. But it should be something that flows naturally from regional health authorities. If it existed, but was bring ignored, that’s another problem.
What this numbers gap did, though, was put in question the minister’s grasp on health reality and, therefore, the right response to the health crisis that was emerging. His low figures suggested no need for immediate action, while other information suggested a situation running out of control, rapidly. He lost time to inform, advise, and take preventative actions. He was slow to act, because he believed he had no need to act.
Pressure burst pipe, they say in Jamaica.
The minister suddenly accepted that he was out of touch and sought to redress that by abandoning his official figures. He then made a national address on the virus. The content of his address left many questions open. Talk of working “assiduously” and seeking personal responsibility to improve the state of the environment by removing breeding grounds, sounded like the cries of a child who should have been working on a school project, but got distracted, only to find that the due date had arrived and the project had to be brought in. Last minute scramble. Looking for excuses–where is that dog? It’s not my fault. It was a shambles.
Days later, we get information about measures to take, the state of medication supplies, the complicated picture of several viruses in circulation simultaneously, with similar sentences.
Then, just as it was clear that the health ministry really wasn’t on top of things, we hear that a more virulent disease (which happens to have similar symptoms but jus spread differently, by bodily fluids and contact) had jumped from Africa, and relative distance, to being on our doorstep. Ebola had landed in the south of the USA. Our nakedness was now complete. We need a different and more careful approach to this disease, because it spreads by contact, and while we have no case here, yet, the risks of infection are different and far more worrisome.
A ridiculous amount of time and public goodwill has been wasted. If awareness was there officially two years ago, that wasn’t transferred to the public. From the time the chikungunya virus landed in the Caribbean in December 2013, we should have had people’s eyes opened to the risks, prevention, cures, and more. Over six months of public education could have occurred. Instead?
The danger is that people do not believe health officials. That may well cost them. Alternative theories about source, cures, and more have taken hold, with Jamaicans having centuries of traditional practices and medicines on which to draw. Whereas people tend to trust a doctor for knowledge of diagnosis and treatment, we have a doctor in whom few have confidence or faith.
The residence and office of the U.S. president was exposed to a glaring security breach last week. Today, the head of the secret service tendered her resignation. Failure to uphold her mandate. Lack of departmental leadership. Sloppy practices. Position untenable in the face of pressure from elected officials and the media. More things went dangerously wrong, there. But, no lives were lost, with much embarrassment.
Jamaican politics does not have a tradition of officials or ministers offering their resignation when they have failed to carry out their functions well or have lost public trust, despite any degree of criticism by elected officials or the media. I wonder if some deaths will be what it takes for even a hint of change, there.