Chikungunya has been the beast of 2014

Saturday, December 27, 2014

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One day last week I was at my favourite village shop in the little town square of Sterling Castle, and it was as good a time as any to swap CHIKV stories as a rare Christmas breeze made its presence felt.


Tim didn't tell me his exact age, but said: "I am in your age bracket," then went on to relate to me his experience with the big secret behind CHIKV infections — the many deaths which have occurred but are said to be unrelated to the mosquito-borne illness.


"I was out with friends sometime in September, and all of a sudden the place began to spin around me. Before I fell, a friend reached out and held me, and then he and others rushed to one of their cars and sped off to the doctor. By the time I reached to the doctor's office the fainting spell had died down, but the doctor told me I had a high fever, it was probably CHIKV then began to write me a prescription."


What Tim told me next scared the living daylights out of me. "The doctor was an Indian looking man. He leaned back in his chair as the pen slipped from his hand. Then his upper body just fell across the chair. I suddenly became well and rushed out and got his assistant."


Tim said that after he left the doctor's office he went home, related what took place and afterwards had one terrible week of joint pains, bodily weakness, loss of appetite, weight loss, and pure misery. I pointed out to him that months after I had my bout with the infection in October, it has left a legacy specifically in arthritic pains in my left elbow and in the joints of the fingers of my left hand. "Never had those pains before, but now I have them and it doesn't seem as if the pain is about to go away. Anyway, tell me more about the doctor."


"I called his office and they said he was in the hospital having all the signs of CHIKV. A week later, his assistant called back and said he had just died. It was listed as cardiac-related problems."


This ties in with what I have been hearing on the streets.


As the JLP caretaker for St Thomas Eastern, Delano Seiveright is in a position to gather a ton-load of information on many matters and, what he relates in a Gleaner article about under the radar CHIKV deaths comports with my own observations.


Seiveright relates issues having to do with just one constituency in one parish. I have spoken to more than a few political representatives, and they are pretty much settled on the same position in their constituencies.




The public health system has crashed


A few days ago I sat down with a senior person in the Ministry of Health who related to me a tale of woe in relation to the state of Jamaica's public health system. He spoke to me with one condition at the top of his agenda of items. He wanted to remain nameless.


"As shocking as it may sound, public health inspectors reported that the parish of St Thomas was almost free of the Aedes aegypti mosquito. This was no just a fallacy, it was criminal."


"Criminal? What do you mean by that?" I asked.


"Our public health system in Jamaica has crashed. That is the best and most honest term I can use to describe it. Our public health inspectors cannot collect their travelling money so many of them simply stay in office and tabulate anything that is presented to them by the parish officers who are themselves underfunded. Much of that information is just concocted stuff.


"So far we have tabulated CHIKV-related deaths at 274 right across the island. Of course, the vast majority of these deaths were among individuals with other underlying health problems."


"So can I expect the ministry to publish these numbers?" I asked.


"Don't hold your breath. Let me explain why. In 2012 a subregional CHIKV meeting was held at the Pegasus. It was a PAHO/CDC-funded meeting designed to sensitise us to the sure coming of CHIKV in the region. It was attended by health representatives from 22 countries including those from Jamaica's Ministry of Health. Only one country carried out exactly what was recommended and that country was Cuba. To date, Cuba has had the lowest infection rate of CHIKV."


"What did Jamaica do?"


"Exactly nothing. Zero. Nothing," he said.


"The irony is, in the 1960s, Cuba copied the public system that Jamaica had operating then. Cuba maintained those standards while Jamaica's continued to slide and has now crashed. An entire generation of Jamaicans have grown up on seeing garbage strewn around, and we have not properly adapted to the new norms with the huge influx of plastics and Styrofoam."


"What can we do?" I asked.


"If a system in woefully underfunded it will continue to fail. Our public health centres, like clinics and hospitals, do not have sufficient medication. People are hardly visiting the clinics because there is no medication. So they visit the hospitals which only add to a very bad situation existing there. When they leave the hospital they are given prescriptions which they have to fill out of their own pockets. Many of our poorest people just go home and sit on the prescription. They have no choice."


I could relate to that, as I have been asked by many people to assist them in filling prescriptions. One man I know who needs an operation to "scrape his eyes" has been prepared for nearly a year to have his operation done at the KPH. Each month they keep on putting it off for the next month, and when I saw him last week he was almost totally blind in one eye.




Rats have taken over and leptospirosis is a threat


Many Jamaicans are convinced that it is not mosquitoes that are causing the CHIKV infection. I put this question to the health expert.


"You know, many Jamaicans may be on to something there. First is, some people have been having CHIKV and dengue. Dengue comes with muscle pain, CHIKV with joint pain. But there has also been an uncomfortable number of deaths which I believe are related to leptospirosis which also comes with intense and excruciating pain.


"Listen, there is a rat outbreak in Jamaica and, in the absence of any control, it is close to being unmanageable. Recently the National Health Fund was raided to give MPs money for Christmas work. We have our priorities terribly misplaced.


"When you add the lack of mobility of public health inspectors, the tendency of Jamaicans to buy box food and the lack of civic pride, our gullies are stuffed with plastic and impending disease.


"You know what the response was from Jamaica's health ministry after that 2012 PAHO meeting at the Pegasus? They said no money was available for the needed clean-up."


I was simply stunned.


"Rats are running all over the rural areas and they have become a fixture in the urban inner-city communities. If you think we have a problem now, wait until a year or two down the road. We could have kept to manageable levels the CHIKV outbreak, but we did nothing and many people are going to have to get used to arthritic pains in their lives for many years."




observemark@gmail.com


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