When bad old habits die hard

Public health

It was recently brought to public notice that, henceforth, the Ministry of Health would allow husbands to stay by their wife’s side during childbirth in hospitals.

One wonders what took the Ministry so long to come up with a sound decision. In modern times, it is the most natural thing for a woman to want her husband to be by her side while she goes through the pains of childbirth, and for a man to want to hold his wife’s hand while she is giving birth to their child. This simple fact seems never to have crossed the minds of our health ministers, officials and doctors for decades whereas it has been common practice in developed countries. Most of them studied abroad decades ago and are fully aware of what is accepted in hospitals. They cannot claim ignorance on the issue, can they? After all, it’s a matter of feelings and being human, and adopting humane rules for the happiness of common folks.

“The inability to change a system or to witness the low pace of reform and change breeds an attitude of resignation and fatalism in people which makes them accept unacceptable things. There has been improvement as regards equipment and treatment. Yet, there are still a lot of sudden deaths which go unexplained. Not to mention the general level of patient care in hospitals, with more than twenty beds in a single hall with people ailing and moaning…”


Years ago, the matter was raised in this column following distressing tales of women who were left alone for hours to cope with childbearing without any relative being allowed by their side. You might as well shout in a desert, your words echo back in the vast emptiness at every attempt to give voice to unnecessary pains the public had to put up with. Parents are forbidden to stay with their children undergoing medical treatment in hospital wards. Similarly, the medical authorities seem to be floating on another planet, totally unaware of the trauma caused by the sudden separation of children from their parents when the latter’s presence is most needed.

To say the least, there is a wide gap between the expectations of the public, its awareness of how things should be done and how things wallow in a quagmire of apathy due to the lack of awareness and incompetence of the authorities. As if, notwithstanding contact with foreign modern structures where advanced methods and rulings apply, politicians stubbornly maintain low standards locally. Out of bad old habits or indifference?

While we are at it, may we remind the Minister that many people in Mauritius are wary of taking relatives to hospitals, wary of dubious treatment prescribed by practitioners and do not appreciate that the medcine lopital is handed down to them at the counter of farmasi lopital without even a look or a polite word. Above all, so many people breathe their last in hospitals and doctors generally fail to explain the exact causes and the name of medicine given to patients.

Maybe just like politicians, some practitioners think they do not owe anyone any explanation. How many times do we not hear of the famous pikir done to patients who are kept in the dark about the name and content of the fatal injection and relatives devastated by the sudden death of their dear ones? Same scenario in medical centres in villages. Recently, in Triolet Medical Centre, one doctor replied sharply to questions put to her on the illness that she had to treat. She resented being interrogated on what concerns a patient’s health, and ordered a relative out of a consultation room. She’d rather deal with the patient only and ignored the remark on the right of being accompanied and asking questions. The relative worked for years in a hospital in the UK. Welcome back, diaspora!

The awful attitude of the doctor is just one example among others. It recalls the peremptory tone of the young lady magistrate looking down at the populace in the crowded hall of a tribunal. A distorted concept of authority still creeps into the mindset of those who are entrusted with the duty of serving the public. Service is wrongly assimilated with subordination which is assumed not to befit the position of authority obtained by personal merits and academic qualifications.

The root cause of such warped thinking can be traced further back than the post-colonial legacy of rulers and subjects. It is an internalized vision of an age-old feudal pattern of relationship and communication which breeds an aversion in the minds of those detaining authority and some power to look at others in the eyes and talk to them in a normal civilized way.

Doing so would put them and others on an equal footing. And this is anathema to them; it is an unbearable idea to treat others as equals. They delude themselves into believing that the standoffish and arrogant attitude gives them a sense of superiority over others who come up to them for service and treatment.

The same feudal mindset leads politicians and ordinary clerks and officers to consider others as units, not as individuals. They prefer to engage in monologues or reserve polite conversations among themselves, and dictate orders to and expect obedience from the rest of the populace.

Attempts to improve and humanize the health sector took off on a serious determination of the late Hon K. Deerpalsingh, and there is still a long way to go. Reports of profit-minded specialist doctors who ask patients at hospitals to come for private consultation, pay Rs 600-Rs 800, for medical prescription for better medicine from France do not land on the desk of the Minister. One cardiologist appears to be doing it on a regular basis. His patients are mostly old-age pensioners. This is called exploitation of vulnerable people. As regards the gynaecology service, the day when nurses treat pregnant women awaiting child delivery with humanity and compassion is yet to be celebrated. Now that hubbies will be allowed in, attitudes might change hopefully.

The inability to change a system or to witness the low pace of reform and change breeds an attitude of resignation and fatalism in people which makes them accept unacceptable things. There has been improvement as regards equipment and treatment. Yet, there are still a lot of sudden deaths which go unexplained. Not to mention the general level of patient care in hospitals, with more than twenty beds in a single hall with people ailing and moaning, and a repulsive smell of medicine floating around. Indian hospitals have essential oil perfume which refresh halls and create a positive psychological impact on patients and visiting relatives alike. What about introducing the same element over here?

The high standard of patient care given in a private clinic in Curepipe starting with a warm reception by nurses, a doctor, followed by a specialist and a night stay looks like VIP treatment compared to lower standard in public hospitals. Yet it is normal patient reception in public hospitals in developed countries. But when health is big business, you are likely to pay over Rs 15,000 for one night in a Mauritian private clinic.

Upon taking office, the Minister of Health announced a few positive changes in hospitals. To our delight, he assured us that doctors and nurses will learn to say hello and smile to patients. This is not part of university curriculum; it is part of your earlier family upbringing and your perception as a member of society, your sense of responsibility and duty, and the way you interact with others. Good luck, Minister Husnoo! Big challenge, indeed! It might last for a few months just as the discipline imposed on marsan ambulans who are occupying the pavements and market street of the capital again in utter disregard of the law.

Health care is a key sector which is of great concern to most citizens. We know that there is an opiniated lot in Mauritius who believe that we are living in the best of worlds and our institutions are beyond reproach. The rest of us know this is not true and wish we all could rely on our local health system to deliver.

Just as we wish the police force do their duty as protectors of law and citizens, and not act like brutes and murderers. The trial of the policemen involved in the death of Iqbal Toofany in police custody should raise the question of their recruitment and training. What law requires policemen to keep in police custody a driver who fails to show his road tax sticker and plate number? The ‘mentor’ Minister in charge of internal security might as well review the training of policemen as regards their duty irrespective of the colour, creed, ethnicity, religion and social status of citizens they deal with. It is a blatant case of human rights abuse.

En Force Maurice creating a synergy and uniting people from different walks of life to bring improvement and change in different areas has huge challenges ahead. But one should be resilient and never give up. The very act of thinking and developing a free critical mind is a glimmer of hope. Otherwise, the absence of thinking inevitably leads to decadence.

 


* Published in print edition on 18 May 2018

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