Chikungunya Spells Death

hqdefaultReverend Glen Archer, our champion spelling coach, seems to have died from chik-V complications. According to a Gleaner article published last Sunday, “He had been suffering from renal failure for the past five years, requiring dialysis two to three times per week.



 But his condition worsened in December when he got the Chikungunya virus”.

I don’t suppose the ministry of health would count Reverend Archer’s death as chik-V-related. He was probably not a ‘confirmed’ case. But there is so much anecdotal evidence of death as a result of the virus. Why has the ministry refused to acknowledge the high number of suspected cases?

And why has chik-V vanished from the news? It certainly has not left the bodies of its victims. Many of us are still suffering: fingers cramped up; feet hurting; constant pain all over with very little prospect of lasting relief. Chik-V is now chronic. It’s stale news.

Apart from the announcement of Reverend Archer’s death and Dr Shane Alexis’ warning of worsening complications (‘Chik-V combo’, February 12, 2015),  one of the most recent references to chik-V on the Gleaner web site turned up in Dr. Michael Abrahams’ amusing poem, “2014 Year in Review”, posted on January 5, 2015: “CHIKV pop dung almost everybody”. Dr. Abrahams’ estimate of the spread of the disease is much higher than that of the ministry of health.  And probably far more accurate!

OUT OF NOWHERE?

On the Observer’s website, the report on Reverend Archer’s death published last Monday also pointed fingers at chik-V. Before that, the latest reference to chik-V appeared in Mrs. Barbara Gloudon’s column, “From CHIKV to scepticism in the nation’s health care”, published on January 9, 2015. Neither Dr. Abrahams’ poem nor Mrs. Gloudon’s opinion piece is hard-core news.

Mrs. Gloudon proposed that chik-V “could be regarded as one of the most disturbing events we have experienced in a long time”. And, as a veteran journalist, she fully understands how news works. So she adds: “One is tempted to brand it a nine-day wonder . . . . ” That’s the temptation the media, in all forms, must always resist – the big story that quickly burns out.

Mrs. Gloudon doesn’t end her sentence there. She continues, “but it has turned out to be more than that”.  Chik-V is noteworthy “for the sneakiness of its attack and how painful the hurt it brought us, the likes of which we had never known before. The pains still continue for many.

images-1“Last September, when out of nowhere it descended on us the minister of health soon became eligible for the unenviable title of most battered politician of the year. Beaten into submission by the growing tide of public disaffection over CHIKV, the national health system trembled”.

But chik-V did not sneak up on us. It did not descend from nowhere. In 2011, the Pan-American Health Organisation (PAHO) and the Centers for Disease Control and Prevention (CDC) warned us that chik-V was coming. They jointly published a document, Preparedness and Response for Chikungunya Virus Introduction in the Americas.

NO BETTER PORK, NO BETTER BARREL

I don’t know when that document reached Jamaica. Unless it arrived after December 29, 2011, the Jamaica Labour Party would have been the government in office. Was the minister of health, Dr. Baugh, aware of the threat of chik-V? And, if so, what did he do about it?

In an article published in the Observer on September 26, 2014, with the headline, “Baugh: Chikungunya now a full blown epidemic”, the former minister of health speaks out: “According to Dr Baugh, all the doubts raised by the Government in response to the Opposition’s complaints about the uncontrolled spread of chikungunya in Jamaica have now been erased. He accused the Government of being arrogant and out of touch with reality on the ground”.

PAHO-technical-reportDr. Baugh is right. But it’s a case of no better pork, no better barrel. Both the JLP and the PNP failed us. Chik-V should not have come on us like a thief in the night.   The security guards should not have been sleeping on the job. I suppose the JLP government was too busy campaigning in 2011 to pay attention to chik-V.

But what’s the ‘excuse’ of the present Government? In May 2012, PAHO and the CDC put on a training workshop on chik-V at The Jamaica Pegasus hotel. Fourteen people from Jamaica attended that meeting. Did they spread the word? It doesn’t seem so. They should all be fired for negligence.

I recently gave an old lady a ride to the University hospital. She thought she had chik-V. A friend of hers had recommended kerosene oil for the rash. After using it one time, she stopped. She didn’t like how her skin was looking.

One of the tragedies of the chik-V epidemic is that the medical doctors had no idea how to help us. At first, they prescribed Panadol. And that was it. Then they added steroids to their bag of tricks. So we resorted to all kinds of self-medication: leaf of life, bizi, guinea hen weed, single bible, kerosene oil!  On and on we experimented.

If chik-V didn’t kill us, the combination of ‘cures’ certainly could. The doctor who tried her best to treat my unconfirmed chik-V told me recently that a new strain of the virus is on its way. And dengue is here as well. PAHO estimates that there may be more deaths from dengue than Chik-V across the Caribbean. Only God can help us.

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Defending Slackness At All Costs

Prime Minister and Minister of Health at press conference on public health crisis

Prime Minister and Minister of Health at press conference on public health crisis

So the prime minister, who is also the minister of defence, is perfectly satisfied with the performance of her minister of health. She has every confidence in Dr. Fenton Ferguson. It doesn’t seem to matter that the nation is in a perilous state: pop down, mash up, largely due to the incompetence of the minister of health and his technocrats in handling the chik-V crisis.

Yes, I know; this is my fourth column on the virus. And if you substitute chik-V for Ebola, you can also count last week’s column: why there’s no vaccine for chik-V. It’s the same story. Victims of chik-V are poor people in Asia, Africa and now Latin America and the Caribbean. They can’t guarantee huge profits for pharmaceutical companies.

The current estimate is that it takes 10 years and 1 billion dollars to develop a vaccine. Who is going to pay for that? Pharmaceutical companies are committed first and foremost to their shareholders. Don’t be fooled by the nice things they say about wanting to save lives. They are not evangelists. It’s all about the bottom line.

That’s why pharmaceutical companies are now insisting that they should be let off the hook if the new vaccines they are rushing to develop for Ebola turn out to be dangerous. They want to be indemnified. Damn! The word ‘indemnify’ is of Latin origin. ‘In’ means ‘not’ and ‘damnus’ means ‘loss, damage’. So the pharmaceutical companies want to be absolutely sure there’s no loss even if there is damage!

DAMN WITH FAINT PRAISE

30536443-out-of-control-words-over-a-red-3d-arrow-breaking-through-a-maze-wall-as-mismanagement-of-an-issue-pThe prime minister appears to have indemnified Dr. Fenton Ferguson against the spectacular losses the Jamaican economy has suffered over the last several weeks because of the mismanagement of the chik-V crisis. According to the Private Sector Organisation of Jamaica (PSOJ), approximately $6 billion and 13 million man hours have been lost because of the virus. I suppose those ‘man’ hours also include women.

Dr. Ferguson has been given a clean bill of health, it seems. The prime minister claims that he has “done nothing wrong”. Could she be pulling a fast one on us? I’ve always insisted that our prime minister is much more astute than her detractors would like us to believe. If I were Dr. Ferguson, I would be very worried about being commended for doing nothing wrong.  That’s next to nothing. It sounds a lot like being damned with faint praise.

Wikipedia defines that turn of phrase in this way: “Damning with faint praise is an English idiom for words that effectively condemn by seeming to offer praise which is too moderate or marginal to be considered praise at all. In other words, this phrase identifies the act of expressing a compliment so feeble that it amounts to no compliment at all, or even implies a kind of condemnation”.

I can just hear the kissing of teeth: Dat a no wa Sister P mean. She a defend Fenton Ferguson slackness fi true. She nah condemn im. OK. So I’m reading far too much into the prime minister’s words. But whether she intended it or not, her statement that the minister of health has done nothing wrong can quite reasonably be interpreted as condemnation.

In this chik-V epidemic, which might very well have knocked out at least 60 per cent of the Jamaican workforce, it’s simply not good enough that the minister of health has done nothing wrong. What has he actually done right? What kind of leadership has he provided to help us cope with this disaster? Has he not completely failed at his job? And shouldn’t he be forced to resign?

WHO ATTENDED CHIK-V WORKSHOP?

th_alarmed_faceI was alarmed to discover quite recently that in May 2012, a training workshop on chik-V was held right here in Kingston at the Jamaica Pegasus Hotel. Convened by the Pan-American Health Organization (PAHO) and the Centers for Disease Control and Prevention (CDC), the workshop brought together participants from 22 countries across the region.

The workshop focused on “Preparedness and Response for Chikungunya Virus Introduction in the Americas in the context of Dengue”. In 2013, PAHO published a report confirming that “the participants elaborated a draft preparedness, control, and response plan for CHIK outbreaks in the Caribbean sub-region, focused in 3 main components clinical management and epidemiology, laboratory diagnostic and vector control” [sic].

The report carefully documents the agreed plan of action:

  • “PAHO will communicate with Ministries of Health to convey the importance of preparing for the introduction of CHIK.
  • Participants of the training course will promote sensitization of Senior Health Staff at the country level (Minister, CMO, PS).
  • Each country Ministry of Health will review existing plans and develop country-specific programs based on the framework developed at meeting.
  • Each country Ministry of Health will evaluate the capacity of current dengue surveillance and response programs as a background for CHIKV introduction”.

Chikungunya-Poste-IV-413x256I would very much like to know who from our Ministry of Health attended that training course. And did they “promote sensitization” of the minister of health, the chief medical officer and the permanent secretary? Apparently not! With more than two years’ warning, what, if anything, did the minister of health do to prepare the country for chik-V? Not much. Doing nothing wrong is unquestionably not right. It’s slackness, plain and simple. And that’s indefensible.