COVID-19 will severely test our health system

THE resilience of Jamaicans to the novel coronavirus disease 2019 (COVID-19) will be, among other things, a reflection of their health and the state of the public health system.

For many years Sir George Alleyne, director of the Pan-american Health Organization and later chancellor of The University of the West Indies, tried to educate governments in the Caribbean about the nexus between public health and economic development.

His famous dictum is: “The health of the region is the wealth of the region,” meaning that a healthy population is happier and more productive as the society would spend less on treating sickness and be more resilient to health pandemics.

The current COVID-19 crisis will severely test the state of the public health system in Jamaica. A system cannot be judged by how in operates in normal times but by how it responds to crisis. You only know if the fire alarm system is effective if it works when there is a fire.

No government could have predicted the COVID-19 pandemic but how effectively they have responded is a measure of the state of their public health systems, which have not yet been fully tested as the pandemic is still in the early stages.

The health of the majority of Jamaicans shows some level of vulnerability. For example, 63.2 per cent of Jamaican women are overweight and the incidence of non-infectious disease is alarmingly high. They include cancer, hypertension, diabetes, and immune system diseases.

Diabetes, a major contributor to premature death, is estimated to affect 15 per cent of the adult population in the Caribbean. The disease is a major cause of blindness, kidney failure, heart attack and stroke and is responsible for high rates of complications such as lower limb amputation. Cardiovascular disease is one of the noncommunicable diseases which accounts for 34.8 per cent of all deaths in Jamaicans.

The obesity rate in pre-school children is 14 per cent, much higher than the global average of five per cent. At the older age of six to 10 years, studies in Jamaica show rates of 17 per cent. Simultaneously, 3.5 per cent of children were moderately or severely underweight. This is a rough indicator of malnutrition.

Jamaica’s public health system has done well up to now and high commendation must be extended to the doctors, nurses, health professionals, the security forces and, of course, the Administration.

Yet, it is important to note some areas of concern. The physical infrastructure needs a lot of fixing. With the majority of Jamaica’s 318 Government health facilities and 24 hospitals now being over 50 years old, we face the challenge of refurbishing or rebuilding many of these facilities.

The public health system is losing nurses at an alarming rate. The Government has fortunately been able to recruit some 300 nurses from Cuba to strengthen the capacity at this time of crisis.

The number of physicians per 1,000 people in Jamaica was 1.32 as of 2017, down from 1.40 in 1997. We depend on a large number of Cuban doctors as well and we are grateful for their help.

The worse, we are told, is yet to come and how Jamaica copes will involve the responsible conduct of all Jamaicans. Let us rise to the occasion.