Dr David E Bratt

The day af­ter Bud­get Day. I should be a Venezue­lan for­tune teller to be able to write some­thing be­fore the il­lus­tri­ous event. In T&T for­tune tellers make more mon­ey if they look or sound Span­ishy. In Venezuela it's the op­po­site. All "cu­ran­deros," the tra­di­tion­al Venezue­lan term for "al­ter- na­tive med­ical prac­ti­tion­er," should have a hint of some "Trini­tario" in them, ie African, for that is what the or­di­nary Venezue­lan be­lieves a Tri­ni should be.In Cara­cas, the lat­est rake, a word that pre­cise­ly lo­cates the user in­to the era of Sil­ver Stars and the ear­ly PNM, is that a cer­tain fe­male rev­erend, of the heights of Gua­napo church fame, was seen in Venezuela as­sist­ing Mr Chavez in his bat­tle against the agents of cap­i­tal­ism. If Tri­ni look is good, Tri­ni born must be bet­ter, no?Since this is the same woman who, it is al­leged, was sent to Zim­bab­we by the then PM as a spe­cial en­voy to share with Mr Mu­gabe "a vi­sion that she had re­ceived from God, in which he re­vealed his de­sire to see change in Africa," and he is still in pow­er, the omens are pos­i­tive.

One con­tin­ues to won­der where the good­ly woman, the for­eign gen­tle­man who was giv­en the or­der to "ex­e­cute de­sign and en­gi­neer­ing" of the church and the band, Di­vine Echoes, that was sup­posed to play in said church, now are. One hopes that the me­dia will be as tol­er­ant of the present bud-get as they are with past mis­takes.Let me take in front and say that there will be lit­tle change as far as health is con­cerned. Al­though health is now men­tioned quite fre­quent­ly when bud­get ques­tions are asked of the man in the street, it is not a pri­or­i­ty for the mys­te­ri­ous tech­ni­cians in the Min­istry of Fi­nance and the politi­cians, who re­al­ly de­cide where the mon­ey goes.Lis­ten­ing to bud­get af­ter bud­get speech, one won­ders how much in­put the tech­ni­cal peo­ple in the Min­istry of Health have in­to its prepa­ra­tion?

If the func­tion of a Min­istry of Health is one of ad­vo­ca­cy with­in the Gov­ern­ment and of es­tab­lish­ing a sys­tem with­in which the or­di­nary cit­i­zen can take re­spon­si- bil­i­ty of his health, then our min­istry has re­peat­ed­ly failed on both counts. This would en­tail clear­ly de­cid­ing what our health pri­or­i­ties are, al­lo­cat­ing re­sources to man­ag­ing these pri­or­i­ties and ed­u­cat­ing the pub­lic about these pri­or­i­ties. Can any­one in T&T say they know what our health pri­or­i­ties are and what they have to do to com­bat them? Lifestyle dis­eases-obe­si­ty, di­a­betes, heart at­tacks, strokes, high blood pres­sure and so on-are the new buzz words.It's been shown that there is a re­la­tion­ship be­tween what you eat and how ac­tive you are and these dis­eases and they cost gov­ern­ments bil­lions of dol­lars in treat­ment, so much so that at last, as they did for cig­a­rette smok­ing, gov­ern­ments are be­gin­ning to do some­thing about the caus­es.

Where are our ed­u­ca­tion­al pro­grammes for lifestyle change? And I do not mean those bor­ing, use­less, civ­il-type pro­grammes, put on at some un­god­ly hour ear­ly on Sun­day morn­ings, that no one ever watch­es, but dy­nam­ic, ex­cit­ing, mul­ti-me­dia cam­paigns cre­at­ed by one of our tal­ent­ed lo­cal ad­ver­tis­ing agen­cies.Where are the tax breaks for com­pa­nies that sup­port ex­er­cise pro­grammes for their work­ers? Where are the tax­es on fast food? Why are we en­cour­ag­ing fast food com­pa­nies to re­turn? Short-term gains in tran­si­to­ry em­ploy­ment mean long-term health prob­lems.I hope I am wrong but I ven­ture to re­peat what I have said be­fore, that this bud­get will make it clear that health and the Min­istry of Health is a ten-days won­der for this or for any pre­vi­ous gov­ern­ment.

It will re­main so as long as the pub­lic hos­pi­tals and health cen­tres are looked up­on as char­i­ta­ble in­sti­tu­tions where poor peo­ple go for a "free­ness" or to die and as long as rich peo­ple, in­clud­ing politi­cians, be­lieve they have enough time to get to Mi­a­mi or Cu­ba or Lon­don for their health­care.We have not even be­gan to ad­dress the is­sue of chil­dren's health. De­spite a cer­tain move in that di­rec­tion and old talk in abun­dance, chil­dren are not a pri­or­i­ty. Set­ting up a chil­dren's emer­gency fund looks good and gains pop­u­lar­i­ty but mere­ly helps the sick­est at a very high price in­deed.How are the sick­est be­ing cho­sen? Is it cost ef­fec­tive? What is be­ing done for dis­abled chil­dren? What is be­ing done for abused chil­dren? Bu­reau­crat­ic con­straints con­tin­ue to ham­per the de­vel­op­ment of the Chil­dren's Au­thor­i­ty.

There is hope with the es­tab­lish­ment of the new Min­istry of Gen­der, Youth and Child De­vel­op­ment un­der Ver­na St Rose-Greaves.There is talk of the es­tab­lish­ment of two di­ag­nos­tic cen­tres to deal with chil­dren with spe­cial needs, so­cio-eco­nom­ic de­pri­va­tion, AD­HD, dyslex­ia, autism etc. There is talk of a high-risk reg­is­ter for track­ing vul­ner­a­ble new­borns and com­put­erised co­or­di­na­tion of their med­ical prob­lems through­out life.All of these things are pos­si­ble. We can do them. We our­selves. We do not need to bring in for­eign con­sul­tants. Give our bright young peo­ple the tools and let us see how far we can reach.