By TD Fuego
“…no person shall be treated in a discriminatory manner by any person in the performance of any public function…”
— Section 16.2 of the Constitution
Imagine you are a modest couple, blessed with two lovely kids. The boy is 5 and the girl a year younger. Your widowed mother also lives with you and, fortunately, she gets on well with your spouse. Though not a mansion with every mod-con, you have your own home thanks to your inheritance. With your mother’s pension of Rs.3k, your family’s total disposable monthly income is Rs.15k, with which you manage to live reasonably well.
Above all, both you and your mother are in good health and you are a happy family, something many of your richer friends would envy. Save for a wished-for win on the Loto (who doesn’t?), life could not be better as far as you are concerned.
Unfortunately, the proverbial ill-wind is never too far away from any of us. One day, you get a telephone call from your son’s school—apparently he had a fall and is in some pain. With you employer’s permission, you rush to retrieve the boy and take him to the local hospital. The A&E doctor finds nothing wrong and sends you home with some painkillers. Days later, the boy is still not feeling well. So, you take him back to the hospital, where they decide to carry out some tests.
A week later, the hospital tells you something no parent wants to hear. The tests show that your son has. Whilst you are still trying to absorb this awful shock, they further inform you that treatment is not available in Mauritius. If you want, you can take your son overseas to India, because the government has an agreement with certain hospitals there and, obviously, it is cheaper than Europe.
So, you start your demarches. First, you discover that the cost of treatment will be in the region of Rs.1m. Second, provided that you meet the Top Secret criteria of the MoSS, the State will give you the princely sum of Rs.200k. On another occasion, you might have wondered why the criteria that are used to decide whether you are entitled to something must be kept secret from you. But, the bigger worry for you right now is the balance of Rs.800k that remains to be found.
Nil desperandum, you are told. The Police will kindly give you or any person of your choosing a Permit so that you can make public collections during three months. Only the person whose name appears on that permit may collect from the public; it is an offence to use a photocopy and give to anyone else, no matter how willing they are to help.
Imagine again. You son is very ill. All you may have is the promise of Rs.200k and you must find a whacking Rs.800k from public collections within three months. You ask around and discover that the maximum you can hope to collect is Rs.5k per day on busy market days and week-ends. A quick calculation tells you that it will take you a minimum of 160 days to collect the requisite sum and you have half that time in which to achieve the “impossible.”
But, you cannot afford to lose hope; you must stay strong and fight for your son. As a couple, you decide, therefore, it is best your wife gives up her work in the textile factory and undertakes the collection. Meanwhile, you are aware that your son can (i) at best, stay stable (ii) at worse, deteriorate, and (iii) the worse case scenario, die! Imagine living with that whilst you see your boy turn from a happy football-mad kid into a morose little boy with no energy or will to play any kind of games with his friends.
So, you persevere and, eventually, miraculously, with a loan from your bank and the help of strangers, family, friends and NGOs, you manage to get the money together and your wife and son proceed to Chennai for treatment. They stay there some time whilst the specialists treat your son’s disease. Thankfully, with modern communication, you are able talk to them regularly and keep each other’s morale up.
But, whilst they are still there, you read in the newspapers that the State finances in full the cost for certain treatments that are referred overseas by the MoH. These are brain, eye and heart surgery. Given the potential number of rare diseases, this is a very small list. But the mere fact that it exists at all gives plenty of food for thought as to why it does not include your son’s disease.
Imagine, yes imagine again how you would feel. Anger, betrayal, discrimination are some of the words that would come to mind. Who in their infinite wisdom has decided that you should be made to pay for the cost of treatment and not the others? What are the criteria by which they came to this appalling, discriminatory decision?
Section 16.2 of the Constitution: Protection from Discrimination stipulates that “…no person shall be treated in a discriminatory manner by any person in the performance of any public function conferred by any law or otherwise in the performance of any public office or any public authority.”
But, how are you to know all this? How do you get any redress? Indeed, is there any?
Duty of care
The National Health Service (NHS) is mandated with providing medical care on demand to every citizen of Mauritius. Obviously, being a small country, we cannot expect to have all the expertise and infrastructural facilities required. It would not make much economic sense to invest millions in building up the expertise and facilities for the treatment of diseases that are quite rare.
So, for an indefinite future, the NHS is going to have to recommend overseas treatment for certain types of diseases. Having done so, the State has a moral — if not legal — obligation to pay in full the cost of any such treatment. It is not as if your son is indulging in a bit of Medical Tourism!
If his treatment was available here in Mauritius, it would be provided free of charge. So, why are you expected to pay for it when the MoH refers you overseas? Is it your fault that treatment is not available here? Is it your fault that your son is suffering from a disease that does not figure on the select list that are fully funded by the State?
The money? Let no one fool you; the money is there! If you look up the advertisement before the launch of Loto, you will find that “58% des revenus bruts de la Loterie Nationale seront versés à un fond spécial……dans la domaine de la Santé.” If the treatment of your son’s Leukaemia does not qualify, then someone needs to explain to you the reason for this.
A Wing and a Prayer
Meanwhile you must hope and pray like crazy that the treatment has worked and your son does not suffer a relapse. Because, if he does and you need to take him back to Chennai, you will have to find all the money by yourself the next time: it would seem that the State only gives a grant of Rs.200k for the first treatment. Does not make sense to you? I am sorry; me neither.
* Published in print edition on 14 January 2011