Truth and a good story

The Northland Age - - Opinion -

The North­land DHB has not been se­cre­tive about meningo­coc­cal W in our com­mu­nity. Why would we be? We have a his­tory of be­ing very open and trans­par­ent with our staff and the pub­lic.

How­ever, the only ef­fec­tive pub­lic health re­sponse to a dis­ease that can mimic a very wide range of con­di­tions, in­clud­ing arthri­tis, pneu­mo­nia, cel­luli­tis, throat in­fec­tions and gas­troin­testi­nal ill­nesses, that strikes rapidly and ran­domly, and has a high fa­tal­ity rate, is a vac­ci­na­tion cam­paign.

There is no con­cise pub­lic health mes­sage to warn North­landers, and the only an­swer is to en­sure our high-risk pop­u­la­tion is im­mune and pro­tected.

We can­not go out to the pub­lic and tell them to go and get their chil­dren vac­ci­nated when the cost is over $100 per child, and those that are at high­est risk can­not af­ford it. It has to be free.

Ad­vice from one of our most re­spected se­nior doc­tors to his col­leagues, who can af­ford the vac­cine and are pro-vac­ci­na­tion, is very dif­fer­ent from be­ing able to go out to the pub­lic with that mes­sage.

It would be un­fair and wrong for a pub­lic health or­gan­i­sa­tion to do that un­til we were al­lowed to pro­vide a free mass vac­ci­na­tion cam­paign.

We have been work­ing closely with the Min­istry of Health for over six months to be pre­pared for when we reached out­break sta­tus to al­low us to com­mence this cam­paign. Be­cause of in­ter­na­tional ev­i­dence and our own North­land his­tory and parochial­ism, we wanted to com­mence the vac­ci­na­tion cam­paign straight af­ter we had our first two adult cases of meningo­coc­cal W.

How­ever, we were very aware that, as with other coun­tries, the Min­istry of Health needed to track the dis­ease and wait un­til it reached out­break sta­tus to jus­tify both lo­cal and pos­si­bly na­tional vac­ci­na­tion cam­paigns.

This was also the case be­fore we com­menced our meningo­coc­cal C cam­paign in 2011. There was also the con­sid­er­a­tion of a global short­age of vac­cine.

Why has North­land had three lo­cal out­breaks of dif­fer­ent strains of meningo­coc­cal dis­ease, two more than any other re­gion in New Zealand? Poverty and in­equity.

The in­tense me­dia in­ter­est re­gard­ing North­land’s meningo­coc­cal out­break and the planned vac­ci­na­tion cam­paign high­lights the huge chal­lenges of poverty and that the re­sul­tant health in­equities can af­fect ev­ery­one and put all North­landers at risk.

It chal­lenges the sys­tem and whether it is meet­ing the needs of those who most need it. It must not put the whole bur­den of Ma¯ ori health and other in­equities on the health sys­tem.

There is no doubt that we can and must do bet­ter, and in North­land we are re­design­ing large parts of the health sys­tem to do that. We have made mis­takes, learnt from them, changed and im­proved sig­nif­i­cantly. How­ever, ad­dress­ing poverty and em­ploy­ment, hous­ing, ed­u­ca­tion, drug and al­co­hol abuse, road­ing and in­fra­struc­ture re­quire whole-of-sys­tem re­sponses and tar­geted govern­ment poli­cies. It’s not just down to the health sys­tem.

What I can’t abide is when our hard­work­ing health work­ers are crit­i­cised or there is an im­pli­ca­tion that the in­di­vid­ual care of our pa­tients, whether in the hospi­tal or in gen­eral prac­tice and the com­mu­nity, was less than ex­cel­lent. Our over 3000 staff and more than a thou­sand health work­ers in the com­mu­nity come to work ev­ery day to do their best to help peo­ple. That’s why they chose health as a ca­reer.

I’m not aware of any con­cerns about the care of the seven pa­tients who have con­tracted meningo­coc­cal W dis­ease in North­land.

I gen­uinely be­lieve that the vast ma­jor­ity of health­care pro­vided ev­ery day through­out North­land is ex­cel­lent.

So, chal­lenge pol­icy that doesn’t re­duce poverty and in­equal­ity. Crit­i­cise the sys­tem and the need to con­tin­u­ally im­prove, but please ac­knowl­edge the val­ues, in­tent and skill of the in­cred­i­bly ded­i­cated and hard-work­ing peo­ple who work in health.

DR NICK CHAM­BER­LAIN Chief ex­ec­u­tive North­land DHB

"Why has North­land had three lo­cal out­breaks of dif­fer­ent strains of meningo­coc­cal dis­ease, two more than any other re­gion in New Zealand? Poverty and in­equity."

PIC­TURE / FILE

North­land’s meningo­coc­cal out­break and the planned vac­ci­na­tion cam­paign high­lights the huge chal­lenges of poverty, writes North­land DHB chief ex­ec­u­tive Dr Nick Cham­ber­lain.

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