Sunday, March 22, 2020

Health Must Be a Centralized Service


Health Must Be a Centralized Service

How America is failing to come to term with coronavirus spread is the focal point in this little brief but how Ceylon is taking giant steps on its own accord with little help from W.H.O. is the result of the Ministry of Health's capacity to rise up to the challenge.

I have worked both in public and private sector and the private sector can never take a lead in public health (private sector thrives on failure of the Ministry of Health) sphere at all.

I see President Trump who comes from private sector tries to overcome the bureaucratic system and take a lead by stopping the flights from China, Italy and Europe and stopping the spread in flight by airlines including Singapore airline was a bold step; while the European commission (IMF included) with its bureaucratic leading from Brussels become a laughing stock of the world (Italy becoming the melting pot of coronavirus with its own mishandling) and make its sphere of activity in Europe the epicenter of coronavirus.

This is not how things should have been managed.

I am not sure of our doctors’ union who was bum sucking a government of late could take any credit but they should take a lead to protect its own force including nurses and health care workers by providing protective gear including masks and gowns.
A raw monk leading a nurses union is the other side of the coin, who are hell bent on striking with a drop of a hat.

Having said that help ministry established by the British was well organized with Malaria Campaign our first success of eradicating Malaria in 1968 (still a threat from imported cases from India) and later controlling cholera, infectious hepatitis, amoebic dysentery and shigella and salmonella (typhoid) epidemics are our success stories of the Ministry of Health.

Small pox vaccine and polio were a success story when I was a kid.

Having said that AIDS and venereal diseases are not a success story at all!

Our immunization strategy is not bad at all but there is room for improvement.

I have seen even diphtheria and tetanus in this country and was a vocal advocate of immunization scheme and introduced Mumps, Measles and Rubella (M.M.R) in the private sector and then the late Ranasinghe Premadasa was annoyed that all foreign guys/girls were coming to Kandy to get their children vaccinated by me.

To his credit he introduced M.M.R in public sector before his demise.

I was failure as regard to chicken pox and I got chicken pox in my second working year and herpes zoster when 55 years old.

However, I was able to successfully introduce Acyclovir for chickenpox meningitis in UK. 
Failing to stop bleeding in thrombocytopenic haemorrhage I tried using hyperimmune serum successfully in few cases.
I give credit to British system (NHS) and their free training of medical graduates and I am against guys (in Ceylon) in the private sector opening medical schools for their kith and kin with money.

Coming back to coronavirus America not having enough ventilators for their patients is shocking.

America was a pioneer in ventilators.

How come they become defunct?

U.K. did not have ventilators in 1980s and imported Bell Ventilators from America.

I was one who was lucky then to use a Baby Belling ventilator in U.K. (mastered its use starting first with CPAP) and big ventilators in New Zealand.

Now this field is taken up by the fully qualified anaesthetists.

In passing I must tell that I applied for a job where a semi-government hospital who acquired a ventilator (late professor Carlo Fonseka was in the interview board and a guy much junior to me representing Health Ministry) wanted to select a candidate and offered the job to a female candidate with no experience.

I took my turn to blast the interview board for wasting my valuable time (I was working in private sector, then).

The bottom line is that Health Ministry should be centralized.

I do not believe in Provincial Councils and decentralized health sector with no coordination.

This applies to Police Force, too and they are doing a wonderful job at a trying time as a centralized force.

For me Army should always be in barracks except when war is declared!

Using them to beautify the city demean their uniform their discipline and status and politicizes them indirectly in the process.

Finance should be centralized and we haven’t had a civil servant in this post over 50 years after late Ronnie De Mel.

Chandika, Mahinda, even D.B. Wijetunge and Ranil and Ravi were failures of big time.

Less I talk about NM Pereara is better.

We are in a debt TRAP now!

Education both secondary and university should be centralized but our education system is in ruins without direction with so many ministers and state ministers.

Current Coronovirus Control and our Malaria Success give us time to reflect on our Centralized Health Ministry which is doing a salutary job.

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