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Ministry of Health: Pandora’s Box
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony. FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
Pandora’s Box from Greek mythology is, in reality as projected in the literature, a jar known as “pithos” in the Greek language. The story of Pandora and her jar is recounted in Hesiod’s “Works and Days,” a poem from around the 7th or 8th century BCE. The concept of Pandora’s Box, as it is commonly known today, originates in this story. Zeus presented Pandora to Epimetheus, Prometheus’ brother, as a bride. Pandora brought the jar with her, and despite Zeus’ warning, her curiosity got the better of her. She opened the jar, and as a result, all the evils, sorrows, and miseries that had been sealed inside were released into the world. Pandora immediately closed the jar, but it was too late to prevent the spread of these negative forces.
In an analogy of sorts, a most disturbing and distressing one at that, the Sri Lankan Ministry of Health is a most apt and rather dreadful comparison to the Pandora’s box or jar. All kinds of problems surface from time to time from this open jar of evil and the despicable tribulations that emanate from this jar of deception, corruption and appalling governance, are virtually a regular feature, week in and week out. This author is not going to waste his time by enumerating in colourful and graphic detail the very many problems that have been thrust upon the unsuspecting poor people of our country by this so-called ministry. They have Qranged from innumerable problems with medicines, staff shortages, exodus of some of the best medical brains, to even poor maintenance of the infrastructure. One would not be surprised if the buildings that belong to the Ministry of Health gradually crumble too, by and by. Yet for all that, in this sinking ship of a doomed Ministry, which has touched the pits of the world, there is a hoard of Neros playing their fiddles while Rome burns fiercely.
The latest misfortune is the arrival in our country of a disease that was not seen here for a very long time. We are referring to meningococcal disease which is a killer of children and adults. It was ostensibly brought by unvaccinated devotees of the Moor population following their Haj pilgrimages. Although it was mandatory for people going to Mecca to attend to their spiritual needs, to be vaccinated against meningococcal disease, very many of them went and came back without being vaccinated. You might ask why they were not vaccinated. The real reason was that MENINGOCOCCAL VACCINE WAS NOT AVAILABLE ANYWHERE IN SRI LANKA, either through the Ministry of Health or even the Private Sector. The Ministry of Health had totally failed in its obligations and responsibilities to all Sri Lankans by not having sufficient stocks of the vaccine. They knew for sure that a large mass of people would be going on that Haj pilgrimage. It was very poor planning, woeful governance and a callous disregard to the health of our Sri Lankan people, together with a blasé attitude to their duties and responsibilities. I am sure that the pilgrims were more than willing to get vaccinated but the vaccine was not available; a kind of “Kalu Nika” in Sinhala, totally unavailable. I am sure that the bug responsible for meningococcal disease must be happily floating around in many areas of the country by now. O Tempora, O mores.
There is another looming problem regarding another vaccine. It is the vaccine against Yellow Fever. This is a disease that is rampant in certain areas of Africa and it is spread by the Aedes aegypti mosquito. That mosquito is in Sri Lanka already and it just needs a couple of imported cases of yellow fever to allow it to let fly with the disease. There are large numbers of our people who travel to and come back from many different African countries every week. Yellow fever is a serious disease that has the potential to cause liver and kidney failure and there is a 20 to 50 percent mortality associated with the more serious forms of the disease. The vaccine produces life-long immunity with just one dose. THAT VACCINE IS NOT AVAILABLE IN SRI LANKA NOW. It was available up to perhaps about a year ago but is not to be found anywhere in Sri Lanka now. It has been the case for many months now; perhaps close to a year. I have used up all the fitting uncomplimentary adjectives for this kind of debacle in the earlier paragraphs and it would just be sufficient to say ‘absolutely disgraceful’. The powers-that-be who sit in air-conditioned offices, drawing very large salaries in the concerned ministries, should take total responsibility if there is an epidemic of yellow fever in the not-too-distant future. It would need only a few imported cases for it to start spreading like wildfire.
This author retired from our Sri Lankan National Health Service 16 years ago. There were some minor issues and problems in the Ministry of Health even at that time. We went through wars, civil disobedience campaigns, insurrections, natural disasters and a whole host of other significant catastrophes. Yet for all that, the Ministry of Health never sunk so low as to even remotely approach the miserable state that it is in now. The problem is that even in the hierarchy of the Ministry, people are not allowed to work properly by the powers-that-be and to add to that there are a whole lot of square pegs in round holes. From the top downwards, the nincompoops reigning supreme seem to listen to jokers rather than to accomplished professionals. As a Ministry, it probably has some of the very best brains in the country working for them right around the country but then it needs a real statesman to harness their capabilities and take meaningful steps to put the house in order.