Via the Jamaica Observer, a column suggesting that Chikungunya has been the beast of 2014. Excerpt:
The public health system has crashed
A few days ago I sat down with a senior person in the Ministry of Health who related to me a tale of woe in relation to the state of Jamaica's public health system. He spoke to me with one condition at the top of his agenda of items. He wanted to remain nameless.
"As shocking as it may sound, public health inspectors reported that the parish of St Thomas was almost free of the Aedes aegypti mosquito. This was no just a fallacy, it was criminal."
"Criminal? What do you mean by that?" I asked.
"Our public health system in Jamaica has crashed. That is the best and most honest term I can use to describe it. Our public health inspectors cannot collect their travelling money so many of them simply stay in office and tabulate anything that is presented to them by the parish officers who are themselves underfunded. Much of that information is just concocted stuff.
"So far we have tabulated CHIKV-related deaths at 274 right across the island. Of course, the vast majority of these deaths were among individuals with other underlying health problems."
"So can I expect the ministry to publish these numbers?" I asked.
"Don't hold your breath. Let me explain why. In 2012 a subregional CHIKV meeting was held at the Pegasus. It was a PAHO/CDC-funded meeting designed to sensitise us to the sure coming of CHIKV in the region. It was attended by health representatives from 22 countries including those from Jamaica's Ministry of Health. Only one country carried out exactly what was recommended and that country was Cuba. To date, Cuba has had the lowest infection rate of CHIKV."
"What did Jamaica do?"
"Exactly nothing. Zero. Nothing," he said.
"The irony is, in the 1960s, Cuba copied the public system that Jamaica had operating then. Cuba maintained those standards while Jamaica's continued to slide and has now crashed. An entire generation of Jamaicans have grown up on seeing garbage strewn around, and we have not properly adapted to the new norms with the huge influx of plastics and Styrofoam."
"What can we do?" I asked.
"If a system in woefully underfunded it will continue to fail. Our public health centres, like clinics and hospitals, do not have sufficient medication. People are hardly visiting the clinics because there is no medication. So they visit the hospitals which only add to a very bad situation existing there. When they leave the hospital they are given prescriptions which they have to fill out of their own pockets. Many of our poorest people just go home and sit on the prescription. They have no choice."
According to the latest PAHO chikungunya update (December 19), Jamaica in week 49 had just 1,203 suspected chikungunya cases plus 78 confirmed and two imported cases. But if those numbers are indeed "concocted," then we have no idea of the true extent of chikungunya.