Being responsible: Are we heading for tourism oblivion

My colleague, Prof. Pierre Mallia, argues persuasively that dialogue is needed as the country considers eliminating its archaic total ban on abortion

Now I need to be the bearer of bad tidings. We are, today risking the demise of our tourist industry here because of the over development, unethical behaviour, parochial sense of achievement and downright attitiude to the backscratching tendency! I can see no future for these islands if we go on with these habits; already I have been reading about people lookimng elsewhere for holidays, for booking their clients, for alternative destinations. Can you blame them?

It is so important that we open our eyes to the state of these islands – the chaotic driving, the lack of road courtesy and prudence, the total disrespect to public land by “gypsy style” campers, the deafness of the authorities to common sense and correct behaviour...need I continue? Maybe a few more examples – the lack of efferctive action to the rules and laws of the roadn by the public authorities; the erratic and hideous building resulting in a total deformation of the traditional landscape .... with this continued behaviour we are spiralling down into an abyss of an unattractive , desolate island where the only tourist will be the tacky, cheap and common person who may visit for three unattractive reasons – sex, drugs and debauchery.

It is pathetic to even think this, but I did warn you that I was the bringer of such bad tidings – and as always I am just the messenger , so do not blame me or shoot me when the tourism industry goes pear shaped. Can we reverse the situation?

That is a very good question – the answer can only come if we are committed, dedicated and determined that together we will fight the evils of over and unsustainable development, if we participate in the management of tourism, if we start with our localities and spruce these up and more than anything if we keep up the fight against incompetence and bad management of tourism by the authorities. Tourism investment comes from our taxes, we are key stakeholders – not the government, not the politician, but you and I – we are the key stakeholder. Open your eyes and mouths to the way in which we are treating this destination.

You need to remember that tourism belongs to everyone, remember those stickers some years ago with the words: MitTurizmu Jiekol Kulhadd (from tourism everyone eats) and that should stop you from being passive about taking action.

I believe we can reverse the present situation if we work together for the national interest instead of for the interests of a few uncouth persons.

Make an effort now , my offer to work with you, train you and develop a sustainable, well managed tourism activity still stands if you are serious about a better quality of life for all the islands.

Recommendations and summary

1. Let us continue to take responsibility through a national awareness steered by a group of NGOs focussed on the environment and communities. I am proposing here that the two NGOs I chair together with other NGOs come together to spearhead this campaign. We need to take the lead and not depend on government and politicians.

2. We should identify areas where we can regenerate local tourism for the quality visitor.

3. Recognize our duty as communities to enhance our environment and care for the precious trees that will add value to our moral, ethical and

physical quality of life. 4. Those NGOs and persons (including local councils) interested in working with me on this project should email me on

or call me on 99167805.

5. Let us get going - let us really build better and reverse the horrendous state of this island.

I sometimes wonder – am I writing for the converted? Are there any other persons who agree or disagree with me? I frequently meet people who read these articles – but these articles are not just there to be read on a lazy Sunday afternoon, they are there to sow the seeds of change from apathy to commitment – to make tourism an activity we can be proud of. Let me know what you think and how you feel about tourism.

Dr Julian Zarb is a researcher, local tourism planning consultant and an Academic at the University of Malta. He has also been appointed as an Expert for the High Streets Task Force in the UK. His main area of research is community-based tourism and local tourism planning using the integrated approach.

Ifully agree. However, I must take exception to his description of rape as a scenario where the woman is held against her will, her clothes are ripped, probably by a stranger off the street. This sequence of events plays into the false assumption that if her clothes were not torn, she perhaps even invited the attack. He also questions whether a sexual encounter counts as a rape if a person says “no” even after relations start consensually. On the contrary, consent is essential throughout any sexual encounter and forcing someone to continue after they have expressed their reluctance to do so rape. Most rapes are carried out by people known to the victim, including relatives, partners and friends, and sadly, anyone from any social background can experience rape. It is time to change the discourse about rape and teach everyone, starting from childhood how to behave respectfully around others.

Returning to the topic of abortion, in the opinion of Professor Mallia, the philosophical doctrine of double effect can and should be used to justify ending a pregnancy which is ectopic (where the embryo/fetus will die), or if the mother is receiving treatment for a disease such as cancer during pregnancy when a delay in treatment can affect prognosis. In my view, this list should also include any condition that can deteriorate during and after pregnancy, for example, some heart conditions, pregnancy in children in whom continuing the pregnancy could pose high risks, as well as severe mental health problems caused or exacerbated by pregnancy that may lead to serious self-harm or even suicide.

Quoting Mallia, “The problem with this principle is that although

is

it is a legitimate and a morally accepted philosophical principle, it was written by Thomas Aquinas and in fact usually referred to as the Doctrine of double effect. It is problematic because at the end of the day, for Catholic doctors, it is the Church which has to accept when and where it can be used as its four conditions need to be satisfied with utmost rigour”.

And herein lie the problems. First, the doctrine refers to Catholic doctors and the assumption across this fair land of ours seems to be that all doctors are Catholic and all must therefore follow this doctrine. Nothing could be further from the truth. There are some 2,500 doctors on this island, some of whom were brought up in other faiths, and some of whom have no faith at all. Must non-Catholic doctors use a Catholic doctrine to decide on clinical management?

Second, although Prof. Mallia clearly expounds the four conditions for the application of this doctrine, the clinical difficulty lies in determining exactly when the risk to the mother becomes grave enough to warrant ending the pregnancy. We certainly do not want another unnecessary maternal death such as that of Savita in Ireland or Izabella in Poland.

Doctors should not have to wait for the health of pregnant persons to deteriorate so badly that they are at the brink of death before medical action is taken. Here I would like to debunk the oftquoted statement by the antichoice brigade that since no mother has died in pregnancy in the past 10 years, we must be doing something right! Actually, maternal mortality statistics in Malta show that there was one maternal death in 2008 and another in 2010. So we have had two deaths in the past 14 years! Moreover, given that maternal mortality is reported per 100,000 births, and given that Malta has approximately 4,000 births per year, it would take some 25 years to expect even one maternal death. I hope we can all agree that using maternal death as a marker of good healthcare is a very, very low bar to set.

Third, there are absolutely no exceptions in the Maltese criminal law governing abortion. Any doctor, who chooses to apply the doctrine of double effect in their clinical practice, does so in breach of the law. This brings us neatly to the issue of medical induction of delivery (or abortion by any other name) before fetal viability. In this context, viability is defined as the ability of a fetus to survive outside the uterus, which in most western countries is generally accepted to be between 22 and 24 weeks. In the Prudente case, all amniotic fluid had drained away when her membranes ruptured at 16 weeks. Even if the pregnancy had continued, the lack of fluid would have seriously affected lung development and therefore the ability to breathe after birth. The fetus would have suffocated to death.

And finally, patients have rights too. They have the right to the protection of health and medical treatment that must be given without delay. In situations of non-viability when there is still a heartbeat, and when the pregnant person is at risk (as in the Prudente case), the rights of the pregnant person exceed those of the fetus. Quoting Mallia again, “One has to put into the equation the severity of the risks the mother has to endure and therefore patients’ rights dictate that she has to decide”. Here, I fully agree with Professor Mallia. The law must change to allow every pregnant person the right to choose what she deems best for herself.

Professor Isabel Stabile is writing on behalf of Doctors for Choice