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Who is to live and who is to die: the plight of Jerry and Sukabula [Appeared as “The coup-killing game” The Fiji Times, 27 June 2001]

28/03/2012

The public have been deeply saddened and outraged by the death of  Jerry Cokomata, before he could be flown overseas for medical treatment.

So would we all, just as if the child had been ours.

Why are we blaming the Ministry of Health?

But why is the public castigating the Ministry of Health for not readily making available the required money- some forty thousand dollars?

Perhaps partly, as The Fiji Times editorial has pointed out, the MOH may be criticised for double standards: they have been quick to send influential patients overseas, but not the poor.

But let us not make the Ministry of Health the scapegoat in such matters of life and death.

Why is Health not receiving more money from Government?

The public must ask themselves: why is the Ministry of Health not receiving enough money from the Government budget?

Why is Government not curbing wasteful expenditure?  Why is Government not raising more revenue from the economy?

And who are responsible for the coups which have brought theFijieconomy to its knees, drying up Government revenue, and the Health budget?

And the public must honestly ask itself, does it want to pay higher taxes so that our needy people can enjoy medical treatment of the quality enjoyed by citizens of rich countries?

Take the last issue first.

Those we see  needing help only the tip of the iceberg

Make no mistake- Jerry, Sukabula and Priya are only the tip of the iceberg.

Go to any hospital in Suva, Nadi, Lautoka, Labasa, and you will find hundreds of people- children, adults, elderly, who are suffering from life threatening illnessess or injuries- to do with the heart, the brain, the liver, the kidney, the prostrate, stomach, intestines, the reproductive systems… the list is endless.

They also could be saved if  they were sent overseas for the best medical treatment available.

There are thousands more throughout the country, who do not even know that they have potentially fatal illnesses, because our screening procedures are so weak.

We are talking about tens of thousands of cases needing overseas treatment.

And each of the these medical treatments could costs tens of thousands of dollars.

Priya’s case alone has cost the Ministry budget some $150 thousands and the bills are still coming in and being paid by the Ministry of health.

If the Ministry of Health paid for all the overseas treatments needed, we are easily talking about spending $100 millions per year.

That is twice the total annual health budget of Government, which has to pay for doctors, nurses, hospitals, health centres, medicines etc throughout the whole country, serving 800 thousand people.

Where would the money come from: the hidden deaths?

Even if the public demanded another $10 million allocation for overseas treatment, which part of the Health budget (or the total Government budget) would they like to see cut?

Governments have great difficulty firing employees or reducing their salaries- the powerful unions (and voting power in elections) will prevent that.

What is easy for governments to cut,  and they do cut, are the non-staff items of expenditure- the equipment, the drugs, the transport allocations, and desirable initiatives such as rural health centres and preventative programmes.  These items do not vote in elections.

And for each million dollars less spent on these items, there are dozens of unnecessary deaths quietly taking place, throughoutFiji.

Some child or mother dies in childbirth in a rural village because there is no trained personnel available to supervise some complication.  Some adult dies because of insufficient medicine or equipment in a rural health centre, or because an ambulance is not available.

For these hundreds of deaths, there are no TV cameras around to film the tears of the loved ones, and project the agony on the TV screens or newspapers of the nation – not dramatic and sensational enough.

But supposeFijifound another $10 millions for overseas treatment for its needy citizens, it still will not be enough.

Where will we draw the line? Who will draw the line?

The media have pulled at our heart-strings because patients like Priya and Jerry have been young children who arouse our deep protective urges and emotions, cutting across racial and class backgrounds.

Would theFijipublic be as concerned if the patient had been a retired fifty five year old?

And who would be given the terrible responsibility to decide that  a fifty five year old person (somebody’s father or mother) should not be given another twenty years of life?

The Minister of Health? The Ministry officials?  The person’s private doctor?  Some committee of citizens?

And on what basis would they decide?  How many years of working life left to the patient? Or what the patient has already contributed to the economy over the previous thirty years?

What if the person has been a subsistence farmer who has contributed little to the national economy in the way of taxes?

But hold it, enough of these questions.

Can Government find some extra money?

Why can’t Government find another $10 millions for the Ministry of Health budget?

What about the $220 millions wasted on the NBF disaster?

The millions wasted on special projects through which politicians bought votes and civil servants looked the other way?

What about the $16 millions we are quite happy to spend for another elections?

What about the tens of millions of dollars that inefficient public enterprises are not paying as taxes or dividends to Government (because some unions blindly oppose public enterprise reform)?

What about the millions of revenue lost because  Government, over the last 15 years, has reduced taxes for the rich in this country?

What about those of us who will oppose an increase in taxes (VAT and income tax) to fund medical insurance for all the needy in the country, which could cover overseas treatment?

And finally, what about those who plotted and executed the coups and army mutiny of 2000, that wrecked the economy and the government budget, including that for the health ministry?

What of the many intelligent people (even with university degrees) who continue to support and justify the coups, refusing to publicly acknowledge that constitutions should only be changed through legal means and not violent thuggery that has claimed dozens of lives?

More coups? More army mutinies?

 

And what of the media fears of the possibility of yet more army mutinies, supposedly because some do not want naval officers to be commanding.  Any more army mutinies, and the economy will be totally wrecked, making even less available for the Health budget, while the army daily spends even more money at the Vatuwaqa rifle range, preparing for that horrible eventuality.

 

Readers may wish to read again my Fiji Timesarticles of 24 December 2000 (“Our costly coups”) and 31 December 2000 (“Discount rate dragons and mahogany”) which point out the hundreds of millions of dollars the economy loses, and the hundreds of millions of dollars of revenue that Government does not get, because of all the coups.

 

If we had not had the 1987 and 2000 coups, the Ministry of Health could easily have tens of millions of dollars more than currently.

 

And the lives of sick children like Jerry and Sukabula may not have been at the mercy of public charity.

 

No.

 

Let us not make the Ministry of Health into a scapegoat over the death of Jerry.

 

Take a closer look at ourselves.

 

[Appeared in The Fiji Times, “The coup killing game: was Jerry’s death caused by gun rule?”The Fiji Times, 27 June 2001]

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