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Always looking for a quick fix

Tuesday, January 16, 2018

There seems to be general acceptance that governance in T&T is in a mess. Can it be ever improved? Based on my experience as a medical doctor over the last 40 years, and with the greatest of regret, I have to say no. I hope I am wrong.

Specialists in Paediatrics prefer to see “special” paediatric cases. They do not really want to see babies with a diaper rash, although they will. They prefer to see babies with eczema. Diaper rash is acute, easily treated with exposure and cream. Eczema is a chronic disorder, difficult to manage, takes time to get the child better and even then you cannot expect a “cure” for many years, if ever.

Paediatricians do not really want to see a child with a cold. In 95 per cent of cases, the child will get better without any medication. But they will see such a child brought to the office. They prefer to see children with bronchial asthma. Asthma is another chronic disorder, difficult to manage, and it takes a lot of time and energy out of the parents. Usually the child will need to take medication off and on for years.

A convulsion from fever also does not need a paediatrician’s involvement, although again, they will attend to the child in such a situation. Most children with fever convulsions have one, perhaps two and they are horrible to watch but like most Trinidadian proclamations, they are innocuous, and go away quickly. Paediatricians much prefer to see children with epilepsy or recurrent convulsions, who may fit two or three times a week or every day or even every hour. That’s a man agement dilemma and it takes a lot of skill to assist such children and their associated neurological problems.

Another common problem is the child who has suddenly failed a school exam. One exam. Perhaps two. That is usually fairly easy to fix. The teacher is usually the problem. It’s more difficult to deal with the child who may have a learning disorder, has to be diagnosed and then managed perhaps with medication, perhaps with environmental manipulation. All this takes time, multiple visits, understanding, empathy, experience and so on.

It’s unfortunate but this needs to be said. Far too many Trinidadian parents appear to be congenitally incapable of dealing with a chronic medical problem. Most want a quick fix. Translate that into life in T&T.

One spends an hour talking to the parents of the child with eczema, a treatment is agreed upon, it is made clear that the rash will take two or three weeks before improving significantly and one week later the parents call, there has been no improvement and the child’s cousin with a diaper rash got better in three days. They are upset.

Similar things happen with asthma, epilepsy, ADHD, learning disorders, chronic allergic rhinitis, chronic constipation, any chronic disorder.

We good at short distances, sprints, one hour race to Tobago in July, little letters to the Guardian, rum shop talk, short term import and sell for a quick profit, 20:20 cricket, help foreigners find oil, give them permission to sell it and take a cut. We poor at the longer distances, anything over 400 metres we burn, organising a ferry service, writing novels, constitutional reform, diversification, Test match cricket (the occasional genius aside), taking pitch out of the ground and selling it ourselves.

The few exceptions confirm the rule.

Our governance problems are not acute. They are chronic and rather more complicated than illness. How does anyone expect the political scene to improve when that will take years of long hard work? Hard work that up to now, we have showed no inclination to do in any field? Far easier to get a green card and head off north to where people have struggled for years to establish societies based on a certain amount of law and order. Island people we are and island people we will remain.


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