Unarguably Maldives’ health system has made tremendous improvements and has had commendable achievements over the past 2-3 decades. Despite this, the health sector and healthcare providers have been struggling to gain patient’s confidence and maintain a good rapport and a positive image. There are many valid reasons for the ‘bad’ image that are quite directly related to the quality of care provided. Similarly, it should also be acknowledged that there are several health professionals trying their best to provide an optimum, quality care amid all the shortcomings and difficulties we have.
A Bangladeshi citizen was brought in critical condition to the ADK Hospital recently. He didn’t have money to pay for his medical expenses and the hospital cannot send him back as he was too sick. It took over a week with the joint efforts of the Hospital, Department of Immigration and Emigration, and the High Commission of Bangladesh to identify his legal employer only to find that he lives abroad now!
Universal health insurance would undoubtedly be the single best thing the current government has done, which directly affected the lives of ‘every’ Maldivian. This had been the dream of many Maldivians but something beyond the comprehensibility of some that didn’t believe this would be possible.
Way back in 2004 or 2005, we started witnessing the first obvious increase in the assaults on health professionals. I remember talking about this on a Television Maldives live forum where I urged the government to take it seriously and stop it before it gets out of control, and we find ourselves with insufficient professionals to continue with health services. What we were seeing back then was more of verbal abuses with very few physical assaults. Failure to take measures to prevent it have indeed led to the pathetic situation of today, where there is more of physical and sexual assaults than verbal! Not to say that verbal assault is justifiable, but the gravity of the matter has taken us to a point where there is very real and imminent threat on the continuity of healthcare service in the Maldives.
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Corporate model of healthcare is an industrial economics model as I mentioned in my earlier article (http://jamsheed.org/article/330). Managing health facilities is not the same as managing a business entity as there are very specific and unique characteristics inherent to healthcare. If these differences are not understood, we will be putting the limited financial resources in wrong places at wrong times due to a failure to understand the ‘real’ needs and priorities of a health facility! There are several issues that need to be discussed in the debate of an appropriate healthcare model. While such a discussion should be much broader than what I have discussed here, this article mentions few important issues.
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A corridor chat I had with a colleague recently compelled me to brush up the (rusty and limited) knowledge I have from the health economics module of my Public Health Masters programme. The discussion was on free trade or market approach in healthcare. While there are some economists who support markets in health system many (mostly health economists) do not. It is widely agreed that healthcare has some (interesting) characteristics due to which the more basic or industrial economic models cannot be used or should be used cautiously.
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Areca nut is probably one of the most widely used psychoactive substances in the Indian subcontinent and chewing it alone or in combination with other substances is a common practice in the Maldives too. Habits of chewing areca nut include taking fresh, dried, cured or roasted areca nut; either alone or mixed with catechu (a vegetable extract containing tannin), slaked lime, flavouring agents, spices, sugar; mostly wrapped in betel leaf. Many people often add tobacco to the mixture. Most of those who indulge in this habit are unaware of its risk including cancer.
We went for a small shopping and thought of getting some fresh air on our way back home. Riding towards home on marine drive, we had to take a detour between the waste collection site and the stadium block. I stopped at the roadblock guarded by two police officers in uniform, to see what was going on.
The primary goal of a ‘health’ care system should be keeping people healthy, not to get people well when they become sick. The latter is a sick care system, where the primary focus is on treating sick patients and the reasons for their sickness are largely left out.
Dengue Fever (DF) is the fastest emerging arboviral infection, spread by Aedes mosquitoes and a major public health problem in most of the tropical and sub-tropical countries. A disease outbreak compatible with dengue had been reported in China as early as 992 AD. The first recorded epidemic of dengue was in 1635 in the French West Indies. The first confirmed epidemic of Dengue Haemorrhagic Fever (DHF) was recorded in the Philippines in 1953–1954.
