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Expanding healthcare service major concern for Maldives Govt

For new President Mohamed Nasheed, expanding healthcare equitably across Maldives is one among many challenges. Though, compared to many countries in Asia, Maldives fares better on health indices but patients still fly to Singapore or India for advanced treatment, reports Sutirtho Patranobis.

world Updated: Sep 24, 2009 22:08 IST
Sutirtho Patranobis

In six months, Doctor Owais Aziz seemed to have adapted well to life on an island; from crowded, chaotic Karachi of 20 million people to Thulhaadhoo, a 380 metre-long, 230 metre-wide-island in Maldives with, well, 2800 people on it and white, grainy sand around it.

The island has a neatly-built school with 22 Indian teachers, a football field and three general stores that sell Axe deodorants and Kashmir-brand rice from Pakistan besides a mosque and a hospital. Many homes are made of broken corals. And then there is wall graffiti, bordering on the unhinged: ``Never Die Eminem’’, ``Boy Zone’’ and ``Hot Boy’’.

Aziz has an 18-month contract with the Maldives government and is one among two doctors on the island. ``My colleague,’’ he said, ``is from Jammu and Kashmir.’’

Life is lazy with a dozen patients-a-day on average, the money is good and on his off days, Aziz gets to jump into a motorboat and ride over the calm, transparent blue-green waters of the Indian Ocean to an uninhabited island to fish or to ponder, at leisure, about his marriage next month.

But the sea is not always calm. On days or nights when the waters are choppy and the rain is lashing, Aziz prays that there is no medical emergency on the island. ``Rough sea is a big issue. We cannot transport patients to the atoll hospital or to Male, which has the biggest hospital. It is a helpless situation,’’ he said.

It’s not Thulhaadhoo alone that faces this crisis every now and then. There is one doctor for every 1000-1400 patients in Maldives but the problem arises when patients are stuck in one of the 200 inhabited islands – Maldives has 1192 islands -- because of rough weather. Idyllic islands could then become isolated death traps.

For new President Mohamed Nasheed, expanding healthcare equitably across Maldives is one among many challenges. Compared to many countries in Asia, Maldives fares better on health indices but referral hospitals in the country are few. For advanced treatment, patients still fly to Singapore or India.

Nasheed of course has only just begun. It was October 9, 2008, when multiparty and multi-candidate elections were held in the Maldives for the first time in its 44-year-old independent history. The run-off was between Nasheed, former journalist and political prisoner, and incumbent President Maumoon Abdul Gayoom.

The transition from a dictatorial regime to a democratic one was peaceful. Nasheed won the political battle but many more were looming.

Maldives economy, for one, is creaking under a 34 per cent GDP deficit. A tourism dependent economy, the economic slow down has hit the country hard. Nasheed expects that a green tax of $ 3 on every tourist per day will inject some cash into the local economy. The green tax bill will be introduced in the coming session of Parliament. Prices were always high in Maldives because of its import-based economy. For example, the rent for a two-bed room apartment in capital Male is around $ 1000 per month. In many instances, couples not known to each other have to share a two-bed room apartment to cut costs.

Nasheed would have to take a few unpopular decisions as well. Like downsizing the number of civil servants in Maldives. The population of Maldives is around 3.6 lakh and it has 39000 civil servants. Nasheed recently told a group of journalists visiting from Colombo that he plans to cut that number by 15,000. But, first, he said a ``safety net’’ has to be created and they have to be trained for rehabilitation. ``Can’t throw them on the street,’’ he said.

Then there is the dark, portentous cloud of global warming hanging over the islands. Thulhaadhoo island, for one, is facing severe coastal erosion. It is among the 50 islands where the sea is greedily eating into the land; several more could be drowned as sea water slowly rises. At least 16 need immediate intervention. Nasheed called Maldives a ``frontline state’’ in the battle against global warming and is pinning hope on India that it would stop the ``you did it (global warming)’’ and ``I did not do it’’ rhetoric with the west and look for a solution in the December climate summit in Copenhagen.

And even if the ``doomsday scenario’’ was of relocating the entire population of Maldives when the sea water rises to the neck, the idea, environment minister Mohamed Aslam said, was to stay and fight global warming.

Might as well. Not many on the beautiful and fragile islands of Maldives have the option of returning home after 18 months like Owais Aziz from Karachi has.

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