Mauritius: The glass half full but…

By Dr R Neerunjun Gopee

The following events occupied prominent space in the news headlines from around the world during the past week :

• The struggle to control the cholera epidemic in Haiti;
• Stampede on a swaying bridge in Cambodia leading to nearly 500 deaths;
• Bomb blast at a shrine in Pakistan causing over a dozen deaths;
• Second blast kills 29 miners trapped in a mine in New Zealand;
• Five civilians killed by militants in Afghanistan;
• 21 people killed in drug violence in Brazil during a police raid;
• Student protesters (against a hike of university fees) engage with police in London, lighting a bonfire; several arrested and police suffer casualties; protests also in Sheffield and Glasgow; insinuations/allegations/accusations of this being a ‘class’ war, protesters dubbed being from the middle class wanting the lower classes to tax-fund their education;
• The Irish reel under a proposed four-year austerity plan without parallel in Ireland’s recent history: the government to cut the minimum wage by almost 12 per cent, slash welfare expenditure, reduce public sector pay and lower the rate at which earners start to pay income tax, with a bailout package from European Union and the International Monetary Fund.

Any normal, reasonable person residing in this country would – should, in fact – no doubt consider himself fortunate to be living in an environment where civilian peace and social stability are assured and taken for granted most of the time. We do not deny that over the years there have been a couple of sporadic eruptions that were premised on misperceptions of the degree of individual and collective responsibility that one must be prepared to assume for personal and social advancement.

It is also a fact that these outbursts were promptly enough contained, mainly by the intervention of responsible public figures who realised that the country’s future couldn’t be allowed to be jeopardised, and voices of reason soon overwhelmed the destructive tendencies of the hotheads. As in all societies that are subjected to a multitude of local and global pressures, we should expect that such violent expressions may still surface from time to time, and be both logistically and mentally prepared to face them so as to restore social equilibrium without delay if ever we should be faced with them again.

What saddened me as a doctor when I was watching the BBC news on 21 November about the cholera epidemic in Haiti were the comments of the reporter from Haiti. The failure to gain rapid control over a disease which had already caused hundreds of deaths very rapidly was ‘explained’ by the scale of the epidemic, government ineptitude and the absorptive capacity of government. Apparently, only 4 million US dollars of the 52 million dollars of aid received in the wake of the devastating earthquake had been used so far. Stocks of the vitally needed saline solution – THE remedy against the diarrhea cause by cholera – were lying piled up in the stores, unable to reach the people who needed them urgently so as to save their lives. There were harrowing pictures of patients, especially women and children, lying on the hospital beds or even in the hospital premises awaiting to be treated by the few dedicated doctors with little means at their disposal.

The commentator said that the quality and availability of water and the absence of sanitation were a major problem — but, he added, Haiti already did not have a public health infrastructure to start with. What further disturbed me was the picture of mobs busy rioting against the presence of UN personnel there, accusing them of being responsible for bringing the cholera into their country!

From a public health perspective, this is where I consider that we are indeed very lucky here that our leaders addressed the issue of water and sanitation in the country early on in our development. Many of us grew up in the time of the public fountain and unhygienic toilets which were situated out in the yard; in many places in the rural areas people used to go to the river to collect water for both cooking and cleaning purposes. However, from 1960 onwards and more rapidly after independence things started to improve across the island. Today, yes there are water shortages, but the authorities are aware and are doing the utmost – though sometimes we feel it’s not enough – to address the issue.

In addition to that, we have introduced a programme of vaccination that today has almost 100 % coverage, something unique in the Sub-Saharan region. Besides, with free education and many other environmental and social schemes that have been implemented from the very beginning of our development, all these which are today known as the ‘social determinants’ of health, ensured that we reached far ahead socio-economically. The result is that today our standard of living approximates that of many developed countries, and for this we have to be grateful to the founding fathers for their vision, initiative and drive.

The latest budget maintains many of these acquired rights and broadly seems to have met the expectations of the people at large. At least, say those who know better about such matters, the fundamentals have not been shaken. Whereas others in advanced countries are facing the prospect of massive job losses and cuts, besides the curtailing of other benefits, here we do not face such austerity. To that extent we can say, therefore, that the glass is half full.

But we have to be vigilant. The much-calumnied George Bush was not entirely wrong when he made reference to forces of evil. Unfortunately they do exist and are around us, both in broad daylight and also lurking around in the dark. They are of the type munh me Rama Rama bagal me chhuri – sweet words on your face but ready to stab you in the back, and constantly plotting to do so. So we must be prepared so as not to be taken by surprise; nevertheless, if all of us were to focus on the positive – the glass half full – we may collectively diminish the reach and impact of those dark forces. And this is a constant struggle.

* Published in print edition on 26 November 2010