I don’t know about you, but I think a much bigger deal needs to be made of the fact that this is WHO-designated World Health Worker Week (April 2-8).
I saw one estimate that
with a world population of close to 8 billion, there are an estimated 59 million
health workers – 70% of whom are women. This includes the full range of professionals
and other staff who work in a health or social care setting – both private and
public.
The statistics for
T&T are not entirely unimpressive but subject to numerous levels of
interpretation and important nuances. For example, in 2019 there were between
3.5 and 4.0 nurses and midwives per 1,000 population.
I have seen different
figures in different places, and the Registered Nurses Association has pointed
to some negative qualitative values such as the low number of ICU and
specialist nurses and the well-known flight of knowledge and skill.
But this is not all
about the numbers, as important as they are. The focus must remain on the
environment in which these people work, including low official priority, poor
infrastructure, overcrowding, and occasional lack of supplies. Important as it
is, it’s not just the money.
Over the past three
years, we have had special cause to recognise the important role of healthcare
workers and to pay tribute to their strength and resilience through a most
difficult period in human history.
Yet, on Thursday April
9, 2020, when in T&T we were asked to spend a minute or so to stand and applaud
these people for their work as we faced a pandemic, there were those who chose “scamdemic”
theory, the “overkill” narrative, unforgotten sourness, and partisan hubris to
shun the call.
We stood at the neighbour’s
fence and joined with little Isabella and Milan clapping and cheering for the people
on a frontline that has since witnessed the loss of over 4,300 lives, including
some of theirs.
My sister, Vanda, has
been a nursing heroine all her working life and I am aware that she has not been
alone. Our first round of applause went to this group of healthcare workers.
Our system places a
majority of workers in the sector under state employment. This means that
governments have a high level of control over conditions for the proper
execution of duties - both the enabling “hardware” (infrastructure and tools) and
“software” (appropriate management systems and regimes for compensation and rewards).
Years ago, a former
minister of health confessed to me, privately, that his portfolio had been subjected
to a high degree of “benevolent neglect.” It was around the time I was noting
the move to encourage “customer service” as linguistic substitute for the
notion of “patient care” in the public health system.
I am not sure if this “customer”
thing still prevails (though I visited the superb Arima General Hospital as
recently as Saturday), but to me at the time it did not help the cause of the state
health system to mimic the predisposition of private facilities.
Most of us can rattle
off the private healthcare stories – that time a family member on the eve of
major surgery was made to await the proceeds of a substantial ATM withdrawal
before being attended to et cetera, et cetera.
There might be a good
argument for moving toward “customership” in the state sector but so many years
later, I am yet to witness any substantial benefit arising from prior efforts –
not the least being the plight of healthcare workers.
It did not require a
sense of “customership” on Saturday when I visited a relative at AGH to witness
high-quality care and professionalism in the work of the nurses and attendants
on duty.
But it did occur to me
that clean, comfortable, and well-maintained premises play a role in worker
satisfaction and, resultingly, a positive attitude toward the jobs at hand.
Even more should be adequate remuneration and benefits in keeping with one of
the most important jobs in any society.
Under such
circumstances, private medicine would have no real advantage over socialised
medicine – whatever the dogmatic ideologues and millionaire practitioners contend.
Hopefully, when the UN
High-Level Meeting on Universal Health Coverage (UHC) convenes in September, countries
of the Caribbean will have something to offer to the ongoing discussions on proper
health care for all. In the process, we should report on what has been done to
benefit workers in the sector and to encourage better quality service and care.
