Open letter to Hon K Jagutpal Minister of Health & Wellness

Dear Hon Minister

First of all, may I wish you bon courage in coping with this major public health crisis that befell the country within a few weeks of your assuming ministerial responsibility.

What has prompted me to write this letter to you is the distressed appeal made by a doctor on social media which I heard two days ago, on Sunday, about the type of service being provided to him and others quarantined at Le Victoria hotel in the north, and to his mother at Souillac Hospital.

But first I will start with some general remarks. I must confess that I have not been listening to every single press conference that you and your colleagues have held, and I will therefore pick up only a couple of points from the ones I have seen, from what is being relayed on social media, and inputs from medical staff.

One clip that is repeatedly going around is your reply in Parliament to Hon Dr Arvin Boolell, Leader of Opposition. His question was legitimate, since he clearly had information about tourist arrivals. And your answer too was based on what was known at that time – that there was no confirmed case of Covid-19 as yet. Why? Because community testing had not yet been introduced, as it still is not being done. Secondly, the only screening that was available was the thermal testing of incoming tourists at arrival, which, according to Dr Pieter Pyot, currently Director of the London School of Hygiene and Public Health (and co-discover of Ebola virus, and pioneer in the fight against HIV-AIDS), is not entirely reliable. But there is also the fact that some clever tourists take paracetamol before they land, and obviously they will go undetected.

Nevertheless, thermal testing is a simple screening measure that is recommended. The decision to allow tourists from affected countries like China, France, Reunion, and for a cruise ship to visit was clearly a whole of government one as happens in a democracy, and I do understand that you had no option but to follow the principle of collective responsibility. But the people must know whether they were undergoing the thermal test.

About the comparative death figures for Mauritius and Reunion, the fact is that journalists are doing their job and have to earn their living, and the greener ones are under pressure to ask seemingly clever questions, being innocently ignorant of the complexities and nuances about the medical science involved. Paraphrasing what Jesus is claimed as to have said on the cross, ‘Forgive them my Father, for they know not what they do’, I would request you to forgive them for they know not what they ask. The difference, though, is they are persistent. If I may suggest, your reply under such circumstances should be that the proper analysis can only be carried out when all the stats are in when the pandemic (or epidemic) is over, so they’ll have to wait. There is no need to give any lengthier explanation, which will go over their heads anyway.

I must also draw your attention to the lack of PPE and essential drugs such as Ventolin nebulizer – apparently there is no stock at the Central Store – at Health Centres, which also receive patients with respiratory symptoms, and the staff there too need protection. 

But my main purpose is to make an appeal to you to urgently look into the conditions prevailing in the quarantine centres and take the immediate remedial measures needed. At the hotel the food served, according to the doctor’s version, was ice cold and served late. Is this an example of hostility to the bloody natives – the favourite description by the English during colonial times – and hospitality to the tourists?

And at Souillac, where the mother was transferred, there was no nursing or medical attention given for hours altogether, and no response to the calls made to the nursing staff. Further, when the food came, the plates (there were two in a room) were just shoved through a small opening as if the two persons there were pariahs. Even caged animals in a zoo receive with more care and compassion.

You will surely agree that such practices are totally unacceptable, and as Minister responsible also for Wellness I sincerely hope that you will ensure that henceforth all the persons in quarantine are treated with the humaneness and compassion that they deserve.

Besides, there is a need to revisit the medical supervision and case detection/confirmation protocol and treatment at the quarantine locations, so as not to confine patients there for unduly long periods, and consider self-isolation at home where this is indicated. 

I need to reiterate that health staff must absolutely be supplied with the standard protective gear recommended by WHO. May I also request you to also ensure their safety and send a clear message that any kind of violence against them, whether verbal or physical, will not be tolerated and will be severely sanctioned.

And finally, a suggestion: being in quarantine is very stressful emotionally, psychologically and physically. There are five clinical psychologists in your ministry. If this has not been done already, their services could surely be deployed to offer much-needed counsel and advice to those who are quarantined. This will become even more necessary should there be a need to extend the lockdown.

Thank you and wishing you and your team all the best during these difficult times.

Dr R Neerunjun Gopee
Director General Health Services (2006-2013)

* Published in print edition on 7 April 2020