Someone asked me how I was celebrating our 50th Independence. Celebration? What celebration? Let me quote from a letter published in a newspaper last Saturday which says: “I will celebrate 50 years of Independence when every household in Trinidad and Tobago has electricity and pipe-borne water. I will celebrate when parents are no longer afraid to let their children out of their sight, when citizens are free to walk the nation’s streets, when the elected government and the opposition decide to really put our people and our country first in all they do, when Trinidad and Tobago reflect ‘every creed and race has an equal place.’ Until then, I guess, there will be no celebration of independence for me.” Idealistic? Yet much of it is true. So, given the state of the health services, how could any doctor celebrate? What is there to celebrate? Is the country healthier than it was in 1962? I am a paediatrician. I take care of children. Are the children better off today? Then, the malnutrition was marasmus. Now the malnutrition is obesity. Are the public health services any better now?
Sure, there have been some successes. Our immunisation programme is good. There haven’t been any cases of diphtheria, whooping cough, tetanus, polio, measles, mumps, rubella since the 70s. Meningitis cases are down. The Oral Rehydration Programme successfully eliminated hospital admissions and deaths from gastro. That’s about 200 fewer children dying per year. That’s satisfying. What else is there to brag about in the public sector? CDAP? CDAP has only a couple of drugs that can be used for children. That’s discrimination. Nobody knows what is happening to the Children’s Fund, that high-powered scheme thought up by a politician and that has little to do with the burden of child disease in T&T. There’s no paracetamol on the children’s wards. The labs, when they function, want adult quantities of blood for routine tests. There are no radiographers trained in taking children’s x-rays, and chest x-rays still return as full-body ones, unnecessarily exposing children to excessive radiation. Forget about services for child abuse, dyslexia, ADHD, hearing, vision etc. They are almost non-existent. The Children’s Authority Act, after languishing for over ten years in Parliament, still has not been proclaimed and the Children’s Authority itself labours to pay the few staff it has been able to hire. Any other advance in children’s issues has come from the private sector.
By private sector I do not mean the nursing homes which have sprung up like weeds in the last decade. Not at all. You still cannot hospitalise a seriously ill child in a nursing home. They do not have the facilities for this, both in equipment and in personnel.
There are more private paediatricians available now and more and more people are aware that, at least in the first five years of life, good medical care means going to a paediatrician, never mind that paediatricians are trained to take care of children until age 18. No, private as in NGOs, those goody-goody groups without which we would be in even more dire straits than we now are. Community Chest’s efforts since 1984 initially broke the back of congenital heart disease. In 1988, when the directors of Community Chest, in view of the tremendous work we were doing for the community, asked the then Minister of Health for assistance, his reply was, “That’s nice but what are you all doing for my party?” Today the local Caribbean Heart Care Programme continues its good work. The Just Because Foundation, started by the parents of a child who died of cancer, is doing the same thing for children with cancer.
Ivis Gibson’s organisation, Families in Action, with the superb assistance of the National Gas Company and Hasely Crawford of Phoenix Park Gas Processors and some other companies, assists needy families. The Informative Breast Feeding Service, TIBS, does the same with mothers who wish to breastfeed. It’s only in the last year, thanks to the former Minister, Therese Baptiste-Cornelis, that TIBS became the recipient of a fairly reasonable annuity from the Ministry of Health. Despite having our own medical school for the last 25 years, we continue to depend on foreigners to staff our hospitals and health centres—Cubans, Filipinos, Indians and Nigerians. Now it’s Venezuelans in the private sector. My patients tell me they have difficulty explaining themselves to the foreigners and it’s getting to the point where you might soon have to speak a foreign language to assess medical care. What do we have to look forward to in the future? Improvement? Not at all, because it seems that the MoH is about to attempt to address the issue of obesity by establishing partnerships with the very same people who put us in here. Under the guise of “corporate social responsibility,” the same international corporations who advised parents to give their children junk food in their ads will now suddenly develop a social conscience and advise the MoH on policies on how to stop eating their food. Independence fadder!