Day: May 17, 2011

Q&A: Cathy Waters, CEO Indira Gandhi Memorial Hospital

Cathy Waters is the new Chief Executive of Indira Gandhi Memorial Hospital (IGMH), the main hospital in the Maldives. She is one of three foreign medical experts brought out by the UK-based Friends of Maldives NGO and the Maldives High Commission to improve the country’s standard of medical treatment, alongside Medical Director Dr Rob Primhak and Nursing Director Liz Ambler.

JJ Robinson: How did your role at IGMH come about?

Cathy Waters: I’ve been on holiday to the Maldives many times, but it’s been a very different experience living and working here, compared to the sanitised version [of the country] you get at the resorts.

I knew nothing about Friends of Maldives – instead a friend of mine sent me an advert in the Health Services Journal, and said “This is the job for you.” I thought it was interesting, was interviewed in December and found myself out here very quickly, in February.

My background is 28 years working in the UK’s National Health Service (NHS), starting as a clinical nurse and working my way up. For the last 15 years I’ve been working in management, and the last eight as Chief Executive of a primary care trust, which commissions health care services.

I’ve had lot of exposure training and working in hospitals, as well as the broader healthcare system. I left the NHS three years ago and worked in a small management consultancy in the UK, which involved going into companies that were facing problems, and working with them to solve those and bring about change.

My last big contract involved working with big local authority in London than needed a transformational change. In reality it meant making significant savings – we had to make 80 people redundant.

JJR: What was your understanding and knowledge of what the position involved before you arrived?

CW: I understood that IGMH is one of five entities that comes under the umbrella of the Male’ Heath services Corporation (MHSC), IGMH being the largest entity, at about 90 percent.

I knew they needed to make significant changes to patient care, and the overall environment for patients. I knew IGMH needed change, which was part of attraction for me as it was somewhere I could utilise all the skills I had to bring about that change.

I also knew it was a hospital that people care passionately about. There’s a real sense that it belongs to the community and that we should be providing high quality services.

One of the things I noticed early on was that staff morale was very low, and people were unsure about what was happening with the organisation and had all sorts of concerns about the future. One of the things I did when I started was observe what going on and try to be very visible as a chief executive, spending time with the doctors and in the labour ward.

A new executive nurse director Liz Ambler is already here, and a Medical Director Dr Rob Primhak will be joining in July, so together we want to be able to demonstrate importance of management staff and clinical teams working closely together. We need to break down some of those barriers and reduce the divide between management and clinical services.

JJR: You arrived three months ago on the tail end of the collapse of the Apollo deal, a 15 year agreement signed in January 2010 with India’s Apollo Hospital Group to manage IGMH. What actually happened?

CW: I did read about Apollo. My understanding was that they wanted to bring about significant change but they wanted significant resources to do that, and that wasn’t an option. One of the things I’m very clear about is that we need to bring about significant change, but within the existing budget. That might involve reviewing everything we do as an organisation.

Unless we can find resources elsewhere we have to work within the budget we’ve got. That’s quite a challenge, because previously there may not have been the same budgetary controls [there are now]. We have to be careful how we utilise our very precious resources.

JJR: What parallels have there been so far with your earlier experience?

CW: Working in an organisation where there are significant financial challenges, and working in an organisation where patient needs are very clearly evident. The population is very vocal about what they want and need – some of that is about manging expectations.

One of the things I know we need address is that people can’t access doctors as quickly as they want. We need to increase outpatient appointments. At the same time there is no system of triage, or prioritisation of the emergency room, which we are now developing.

JJR: It’s true that many people claim the quickest way to get an appointment is to have the mobile number of a friendly doctor.

CW: We have a Maldivian ER consultant in training who is coming back to develop a triage system and ensure those patients who need to be urgently seen are seen straight away, or that those with minor ailments are seen by someone else, or not as quickly.

From what I understand there isn’t a word in Dhivehi that translates into ‘urgent’. We have quite a lot of work to do to make sure patients get to the right place at the right time.

One thing common to people working in the NHS and IGMH is that staff are passionate about what they do. We have to channel that in a positive way. We need to engage staff in decisions rather than it being a top-down management style.

This means helping them to be part of the decision making process, which can be difficult to get your head around. The key groups are patients and staff – happy patients mean staff are pleased they are doing a good job, equally, happy staff are more likely to perform well.

Sometimes it’s very simple stuff – such as saying ‘Thank you, well done.’ I don’t think that’s happened here very often. It doesn’t take a lot to say thank you.

The work that went into planning for mass causalities for the Friday of the recent protests was great. It was a really great example of working as a team and getting everything ready for an influx of casualties.

I recognised the hard work that had gone in so I made sure I came in on the Friday and was part of what was going on, so staff felt supported, and afterwards I wrote a thank you memo. Simple stuff like that makes people feel valued for what they are doing.

IGMH was gifted to the Maldives by the Indian government

JJR: What have been some of the key cultural challenges?

CW: There is a very, very different work ethic to the UK. Some of the things I’ve found very different and very frustrating are about how people manage their time, and motivating people to work. That’s a huge issue.

Getting people to plan ahead and put processes together is challenging. One exciting project is expanding the intensive care unit – I said we need a proper process and justification of the expansion, a proper plan about how we are going to do this. For me there’s a discipline to this, but it’s not always the way things have been done.

Also different and very distinct to IGMH is the lack of use of email – staff still attempt to use memos. I’m trying to encourage the use of email, and encourage people to think ahead and write agendas for meetings.

JJR: On other side of the cultural question, what has been the reaction among staff to a foreigner coming in as a top-level manager?

CW: Inevitably there’s been a degree of suspicion at someone new coming in, at someone from the UK coming in and imposing their views. For me what has been important is how we work with people and lead. I firmly believe that how you lead is important – working with staff, rather than telling them what to do. You do need boundaries and parameters, but people need a sense of direction, and permission to do things themselves.

The other issue is that my contract is for a year with the possibility of extending to two years. Whatever I do, I will feel I’ve failed if I haven’t managed to find someone in IGMH to transfer leadership skills to, and leave a positive legacy. The worst thing would be for me to do would be to go back to the UK and for things to tumble down. That would be an absolute failure on my part.

JJR: How did these obstacles come across? Were there initial difficulties?

CW: People have been very accommodating and very welcoming. I’ve convinced people that they don’t need to stand up when I walk into the room, which was very traditional, and I don’t expect people to call me “ma’am”. People generally been very welcoming. There’s been a few challenges with language barriers, although this has proved less of a problem than I thought it would be. I have very good support in meetings- I might do an overhead presentation, and it is translated into Dhivehi. Unfortunately I’m failing miserably at learn Dhivehi words. Generally people have been helpful and make sure I’m involved in what’s going on.

JJR: What are some of the unique characteristics of the Maldivian hospital-going public?

CW: They are very demanding, and very quick to blame the doctors if things go wrong. Inevitably in a hospital things go wrong, by the very nature of the work we do. And because IGMH is the country’s main hospital, we inevitably get the more complicated and high-risk cases. People are quick to be cutting.

Equally the general public should demand good care, and rightly get that care.

We need to work to enhance communication. One of the things I’ve noticed that is quite different from UK is that different departments still work in silos. We’re trying to break down these silos and get people to work across the organisation.

JJR: There has previously been conflict and misunderstandings between Maldivian doctors and foreign doctors working at the hospital, amid the cultural challenges of having a high turnover of foreign medical staff. Is this something you have observed?

CW: It fascinating that the hospitial talks about ‘Maldivian doctors’ and ‘foreign doctors’ as though they are completely different. Part of the problem I think for the Maldivian doctors who are very dedicated and are here for the duration is that they don’t get some of the benefits expatriate doctors get, such as support with their accommodation. Inevitably that brings some degree of conflict.

Expat doctors are also here for a short time, and I’m making a huge generalisation, but the commitment of some of them may not be as high as that of the Maldivian doctors. Some of that is the sort of contract we have for expatriate doctors, and that needs to be reviewed. Some of the expatriate doctors see IGMH as a staging post to get broader experience and go off to somewhere else, which must be quite annoying for the Maldivian doctors.

We’re trying to move to a position where as much of the workforce as possible is Maldivian, but inevitably that takes time.

JJR: What about the training of local staff, such as nurses?

CW: We have a good relationship with the Faculty of Health, and more Maldivian nurses are coming back into the system. Liz [Ambler] is very keen on in-service training to make sure we are training effectively, and Dr Rob [Primhak]’s background is in education so I’m sure he’ll be keen to ensure high standards of education and training when he starts in July. It’s an area we’re developing.

JJR: How have you found living in Male’?

CW: We’ve settled in well. My husband is semi-retired; he used to be a director of Mental Health Services. He’s made a decision not to work at the moment – he’s a diver and he’s doing his diver master training and really enjoying it.

One of my worries at the hospital is that we haven’t got the facilities to care for patients at the acute stages of mental health problems, and we haven’t necessarily got the right staff.

JJR: What do you think of the relationship the hospital has with the community, and what did the outcry over the widely reported ‘baby decapitation’ incident tell you about that relationship (the head of a deceased newborn had to be surgically removed during labour after its shoulders became stuck during delivery, endangering the mother).

CW: I had only been here a few weeks when that happened. Without going into the details, what surprised me was how quickly quite confidential details about the patient and the case were spreading like wildfire across Male’.

Understandably there was a lot of anger and concern, and fear generated. One of the key learning points for IGMH was how we need to handle that more effectively with the media – we didn’t handle that very well at all. It’s in the hands of lawyers now – it was a tragic and very unfortunate case, and a very emotive situation. From the hospital’s perspective we did all the necessary investigations that we needed to do.

JJR: Does it come back to this recurring mistrust of doctors?

CW: That’s one of the things I’ve picked up on – there is this mistrust. We still have to rebuild that, because we have some fantastic doctors and clinical staff in IGMH, and inevitably when we have high profile cases like that it creates more damage for the medical profession, which bore the brunt of that incident. We need to be more proactive about how we talk about some of the great things that happen in the hospital.

I’m not sure Male’ is ready for it, but I’d like to start a patient involvement group – a number of people from the community who work with us to improve what we do in the hospital. We do that a lot in the UK, but I’m not sure people here would be interested in doing that yet. It does help people understand the challenges we face as an organisation on a daily basis.

The President has appointed an envoy to work with the hospital. He has already brought through some significant changes in terms of the environment. It’s looking much better when people come in, and the outpatient area is now air-conditioned.

We need to focus on what we need to do to implement quality of care and improving access – there are hundreds of things need to do, but have to manage expectations.

One of the things we want to introduce is catering – at the moment patients’ relatives have to bring food in for them. That’s so different to the UK – nutrition is so important to a patient’s recovery. We want to try and introduce a catering service before the end of the year, so patients get a better service.

JJR: What are the hospital’s key strengths and weaknesses at the moment, aside from the shortage of mental health support you mentioned earlier?

CW: One area we do need to improve on is diagnostic capacity, and tools for helping diagnose. We are going to get a mammogram machine, which will have the facility to do biopsies, and we are going to get an MRI scanner which will improve diagnostics.

One of the key problems we have is access to equipment and medical consumables. We’ve put new processes and deals in place which will hopefully improve that, but I didn’t realise until I lived here that absolutely everything has to be imported. We are reliant on things coming in a timely way, and I don’t think that just affects us.

We also have a hospital kindly donated by the Indian government, but inevitably the building itself is in need of renovation. It was fit for purpose then but with the influx of people living in Male’ the need for services is huge. We have 500-600 patients a day, sometimes more, and the building is almost too small now. We have to look at how we take care of it and develop a more modern facility.

One of our big concerns in relation to the operating theatre is lack of anaesthetists. We have to pay a premium for them to come, as there’s international shortage. That’s a real problem for delivering key services.

Those are some of the key areas. We have a good team paediatricians, and a very busy but effective neonatal intensive care unit with 20 cots.

JJR: Is it difficult to attract people to come and live and work in the Maldives?

CW: I think it’s becoming more difficult now because of the dollar situation, and the cost of accommodation in Male’. The MHSC provides accommodation to doctors as part of their package, but nevertheless food prices and living expenses are going up.

A big problem is paying people in rufiya – the expats who come and work in the Maldives want to send part of their salary home but banks are struggling to enable them to send dollars. That seems to be a very major problem at the moment.

The big thing is making sure there is the right commitment from expatriates to stay and make a positive difference. There’s got to be some way of making the working conditions right for the Maldivian doctors as well. They are the life of the organisation, and we are dependent on making sure they don’t move elsewhere.

We are in the process of expanding inpatient facilities, and renovating the old staff quarters into more private facilities. We will have 56 beds finished in late summer, and we have also signed an agreement with the 11 storey building next to IGMH to provide 72 beds. This time next year we will have a significant increase in the number of beds, but that brings its own problems, such as where we are going to get staff. We’re trying to make sure there is joined-up thinking going on.

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DRP files case against Z-faction for using its logo and name

The opposition Dhivehi Rayyithunge Party (DRP) led by Ahmed Thasmeen Ali has lodged a complaint with the Elections Commission (EC) alleging that the party’s Z-DRP faction, led by former President Maumoon Abdul Gayoom, had misappropriated DRP’s name and logo to conduct unauthorised political activities, and requested the EC take action against the faction.

DRP Spokesperson Ibrahim ‘Mavota’ Shareef told Minivan News that the party’s real concern was not that the faction was using its logo and name, which DRP MP Nihan has claimed he designed and retained rights to.

‘’It is a much greater concern when people claiming to represent [the party’s] administration and claiming to work to protect the rule of law come out and start violating those laws,’’ said Shareef. ‘’If that is the case, the public might develop a habit of disrespecting the law, and the whole nation may be affected because of this.’’

Shareef explained that the public was “new to democracy” and the principles of it, and said that leaders needed to set an example.

‘’We might think this is very funny and that this is a joke,’’ he said. ‘’But it’s much more dangerous than we thought, and it has more concerns behind it.’’

Shareef said that all political parties should respect their charters and follow it, “for it is not Gayoom’s, Thasmeen’s or my idea.”

‘’Humans do not last forever, and neither does the person in the leadership position, but when people fade away there will be the charter left behind,’’ Shareef said. ‘’That is why people need to follow it, otherwise when the leader dies, the party will die with him.’’

Furthermore, Shareef said that if the country goes on moving in the same direction, “tomorrow one might take an oath and say ‘I am the president now, see I have more supporters than the current president, see all those people who come out for protests whenever I ask.’’’

MP with the Z-DRP faction Ahmed Mahlouf and Umar Naseer did not respond to Minivan News at time of press, while MP Ahmed Nihan was unavailable.

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Court hears Umar Naseer’s dismissal case

The Civil Court has concluded the first hearing of a suit filed against the opposition Dhivehi Rayyithunge Party (DRP) by its former Deputy Leader Umar Naseer.

Naseer’s lawyer claimed that he was dismissed not according to the party’s charter and he had lost the support of many of the public due to the dismissal.

Meanwhile, DRP’s lawyer requested the court allow him to respond to the accusations in written form, a request the court granted.

The next hearing of the case is to be held on May 31.

Umar was dismissed by the Disciplinary Committee of the party after he was accused him of conducting protests without the authorisation of the party’s council.

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IMF pursues government and parliament cost cutting with Maldives mission

The Maldives government has claimed it remains committed to working with the International Monetary Fund (IMF) in addressing its concerns on cutting state expenditure, following protests claimed to have been instigated as part of a “youth movement” concerned over rising living costs.

Press Secretary for the President Mohamed Zuhair told Minivan News that the IMF had travelled to the Maldives this week to meet with various organisations and individuals, including President Mohamed Nasheed and the Majlis’ Public Finance Committee as part of a mission to oversee a national economic recovery plan.

“They were visiting as part of a wider mission in the country including meeting with the president where they retread concerns over plans to reduce state expenditure,” he said.

The government’s fiscal policy has become a major national issue after a week of consecutive protests held earlier this month across Male’, which organisers claimed had been instigated initially by young Maldivians and supported by opposition politicians.

Protesters are said to have been particularly concerned with the government’s controversial decision to last month devalue its currency, allowing the rufiya to be traded within 20 percent of the pegged rate of Rf12.85 to the dollar – a move welcomed by the IMF.

Amidst the backdrop of perceived public and political dissatisfaction with government finances, Zuhair said that the IMF’s meeting with the Public Finance Committee had aimed to encourage parliament to consider government initiatives to try and increase direct state revenues to balance budget deficits.

“There are several bills on taxation currently under consideration in parliament and an amendment to the Tourism Goods and Services Tax (GST) – implemented in January this year on all services and goods purchased by tourists – from 3.5 percent to five percent,” he said. “I think it is interesting to note that there are many resort owners in parliament.”

While supporting initiatives to reduce costs that have led to ongoing public protests in the country, the Treasurer of The Maldives National Chamber of Commerce and Industry (MNCCI), Ahmed Adheeb Abdul Gafoor, said that the the planned addition of a minimum wage and a Goods and Services Tax (GST) on all businesses operating in the country needed to be gradually implemented.

Speaking earlier this month, Abdul Gafoor claimed that gradual introduction would be vital to ensure the nation’s fledgling economy can cope with any potential changes.

Alongside a parallel aim to try and create new job opportunities for young people, Zuhair claimed that the government had in general been closely following the recommendations of the IMF in trying to cut the state’s wage bill for political appointees and civil servants.

To this end, he said that the government had moved to try and reduce the wages of political appointees by 20 percent and civil servants by 15 percent.

“In enacting these cuts we were hoping that the Majlis would follow and also cut wages. The institution failed to do this as well as the judiciary,” he claimed. “The government as a result had to move to reinstate the wages it had cut.”

Zuhair claimed that the government had been working in line with IMF recommendations and had even tried to perform additional cuts unrequested by the finance body in areas such as reducing appointee wage spending.

Despite pushing ahead with its attempted financial reforms, the government has said that it has opted to meet with some of the youth figures said to be at the heart of organising protests seen in Male’ this month.

However, the session held yesterday was reportedly cut short when Finance Minister Ahmed Inaz walked out at the meeting claiming that the youth delegation included the leader of the opposition-allied People’s Alliance (PA) sports wing, and two others he claimed were “new political figures” created by senior party officials.

“I waited in the meeting until we could address the real issues, but they kept on criticising the government policy and some of the government projects,’’ Inaz told Minivan News. ‘’I did not want to have a heated political debate – we went there to negotiate with the youth regarding the dollar issues, not for a political debate.’’

Mohamed Ahsan, a spokesperson from the youth delegation, said the group was unable to clarify information it wanted from the Finance Ministry as the minister had left the meeting, though senior representatives of the Maldives Monetary Authority remained.

“The MMA officials were very cooperative,” he said. “We found out that the government have not been implementing the MMA’s suggestions to its full extent,’’ said Ahsan. “The MMA clarified almost all the information we required.”

He also said the finance minister “took it politically” because a PA member was present at the meeting.

‘’We have decided to recommence the protests, but due to exams we have temporarily delayed it,’’ he said. ‘’Once the examinations are over we will restart the protests.’’

A first round of negotiations held last week were described as “very upsetting” by the opposition’s Gayoom faction after the delegation accused President’s Office representative Shauna Aminath of stating that the “political solution” to the country’s economic woes was the arrest for the former President.

“We met with four people who claimed to represent youth,” Shauna said. “They presented a piece of paper they said was a youth proposal, but there was almost no discussion of what was on it.
“They talked a little about youth unemployment, and the rising price of milk, cooking oil and petrol. They said that young people did not have enough money to pay for coffees or petrol for their motorbikes.”

The group of four had “repeated the same messages being aired by [opposition] political parties: that the government had sold the airport to GMR, Dhiraggu to [Cable and Wireless], and that six people had control of the entire economy.

“Then they said they understood that the government’s [managed float of the rufiya] was necessary, but were concerned the government had not spoken about it beforehand.”

Back in March, MP for the People’s Alliance (PA) party and a member of the Majlis’ Public Finance Committee said that he believed current government policy was ultimately stifling economic development, claiming administrative costs within the civil service remained a notable problem.

“We have small percentage [of funds] to invest in the economy. We cannot move finances to a higher level though as the government doesn’t have the right policies to do this,” he claimed. “For instance, we need to reduce the number of [inhabited] islands by linking them and cutting the overall number of cost centres required for decentralisation.

The comments were made as the IMF claimed that the Maldives economy remained “unsustainable” even after cuts made to the annual 2011 budget, as it concluded its Article IV consultation earlier during the year.

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President’s Office invites Customs Integrity Commission applications

The President’s Office has invited applications for membership of a Customs Integrity Commission (CIC), whose formation will be ultimately approved by parliament.

Under the Maldives Customs Act, five members are required to be appointed by the president to the CIC, with applications remaining open until May 29, 2011.

Application forms and declarations for the CIC memberships are said to be available from the President’s Office website here.

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“If you’re looking to soak up some sun in the Maldives, this isn’t the island you want to be on”

The Maldives’ five-star resorts have turned the Thilafushi reef into a seven-kilometre long dumpsite, Al Jazeera has reported.

“Environmental activists say the bad practices adopted there are causing contaminants to seep into the Indian Ocean nation’s once pristine sea water, and then into the food chain,” journalist Steve Chao reported.

“If you’re looking to soak up some sun in the Maldives, this isn’t the island you want to be on.”

Now a dumpsite for the country’s 1200 islands, Thilafushi hardly resembles the unspoiled coral reef it was 20 years ago, Chao reports, with little of the waste recycled, composted or treated as required by law.

“Nobody is managing this – the tourism industry is not ethically or morally doing their work,” a Maldivian environmental activist tells the news network, adding that every tourist to the country generates 7.2 kilograms of garbage a day.

“The only treatment the mountains of trash gets is Bangladeshi wokers picking through looking for recyclables goods to sell,” Chao reports. “We learn they are also paid by the government to burn the garbage, sending untold toxins into the air. We’ve been here only a few minutes but already the smoke is stinging the eyes and there’s an acrid taste in the mouth.”

Speaking to Al Jazeera, Environment Minister Mohamed Aslam claimed the international community had for years promised to build proper facilities to handle the waste, “but the world does not wiit for these proceedures and processes to be completed. I think this needs to be fast tracked.”

“Although the Maldives is one of the top destination for international tourists, the country remains very poor,” Chao noted.

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MDP condemns PA Shareef’s appointment to Elections Commission

)The Maldivian Democratic Party (MDP) has today issued a statement condemning the Elections Commission (EC)’s decision to appoint former Peoples Alliance Party (PA) Secretary General and Spokesperson Ahmed Shareef as the Secretary General of the EC.

‘’MDP believe that anyone appointed for any position at the Elections Commission shall be a person away from influence, independent, fair and a person that would not protect the interest of a specific person,’’ said MDP in the statement.

MDP said it regretted that the commission would appoint a political figure to the commission and condemned the action “in strongest possible terms.”

Former Spokesperson of MDP Ahmed Haleem told Minivan News that ‘’as long as Shareef is in that position, this country can never hold free and fair elections.’’

Haleem said if he remained in the post, it will cause to “violence following future elections as people to question the fairness of the elections.”

‘’He is a person definitely adapted to a political idea and he will have his own interest,’’ Haleem claimed. ‘’The Elections Commission is the commission that has to be most fair and independent.’’

He also said the new President of MDP Dr Ibrahim Didi “will do anything that he has to, to solve this issue.”

Secretary General of EC Ibrahim Shareef told Minvan News that he had resigned from his post in the PA earlier this month and “resigned from politics.”

‘’My position in PA then was not also a political position, it was more an administrative position and it was my job then, I worked there as an employee,’’ Shareef said. ‘’Now I am in a non-political position and I will work independently.’’

Shareef said he was “very confident” that his actions would not be those claimed by the MDP.

‘’I assure the people that my actions will not be like that,’’ he said. ‘’I will follow the EC rules and regulations as well as the constitution and other laws and continue my work sincerely.’’

President of Elections Commission Fuad Thaufeeq did not respond to Minivan News at times of press.

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Comment: Every person injured in protests leaves behind a trial of bitterness

The last few days have seen bitter times in the republic island of the Maldives. The cost of living has risen heavily, causing thousands to come out on the streets in protest. Street protests are not new to the Maldives; only this time around, the anger is directed against a democratically-elected government rather than a dictatorial regime. This means that irrespective of whether the protests are lawful or not, the police response needs to be lawful.

But the police treatment of demonstrators under the new government has been well below mark. Although MPS is unarmed, excesses committed by police officers, through means such as tear gas, police baton, arbitrary arrests and detention, has been a recurring matter of concern. In October 2010, the Maldives police were alleged to have reacted with excessive force against journalists covering the demonstrations by the main opposition party, the Dhivehi Rayyithunge Party (DRP). In the ongoing ‘cost of living’ protests, the police were alleged to have arrested over 300 people (though the majority were released subsequently) whereas over 75 people were reportedly injured in the span of 10 days of protest.

Notwithstanding the veracity of such claims, it is clear that crowd control is going to remain a challenge for the police. What then are the principles governing public order management?

The starting point for policing public protest is the presumption in favour of facilitating peaceful assembly (Article 21, ICCPR). Public protest is an important democratic activity and peaceful intentions should be presumed unless there is compelling evidence that those organizing or participating in a particular event will themselves use, advocate or incite violence. This places both positive and negative duties on the police (Keeping the Peace: Manual of Guidance, UK).

The negative duty means that the police must not prevent, restrict, or hinder peaceful assembly except to the extent allowed by law. Positive duty entails safeguarding the right to peaceful assembly. In case of a threat of disruption or disorder, the law allows police officers to use force but only when other ‘non-violent means have been tried and proved ineffective’. In other words, force must be used as a last resort.

Once the decision of using force has been taken, the guiding principle is the minimum use of force. This means that any use of force must be reasonable in the circumstances. But what does reasonable mean? As per international law and best practices, reasonable has come to mean the following:

One, the use of force must be proportionate to the lawful objective to be achieved and to the ‘seriousness of the offence’. In any public gathering or protests, the lawful objective is only to minimize chance of violence and not to disperse the crowd.

Second, the use of force by the police must be lawful: necessary for a purpose permitted by law such as self-defense, defense of another, to prevent crime, to protect life, or unlawful action. For this, it is important for the police rules or regulations of any country to provide guidelines on specific circumstances under which the police may carry firearms, warnings to be given before firearms are to be discharged, reporting system whenever officials use firearms in the performance of their duty etc. Such guidelines are important by way of minimizing arbitrariness in police action.

There is little information on whether the MPS has formulated such rules on crowd control. Notably, this is a theme missing in the otherwise comprehensive Strategic Plan 2007-2011 of the Maldives Police Service.

Whenever use of force is necessary, it is the duty of the police to respect and protect human life, minimise damage and injury, provide assistance and aid to those injured and ensure that a relative or close friend of the injured or affected person is notified at the earliest possible opportunity.

Following these guidelines on the ground, however, can be difficult. Determining the import of terms such as ‘seriousness of offence,’ ‘ineffectiveness of non-violent means,’ or even the time of intervention are all, ultimately, matter of discretion. Much depends on the judgment and understanding of the officer on ground. These difficulties are real, but it is precisely to address such challenges that post-incident accountability assumes significance.

For this, the police are required to follow safeguards at the time of use of force such as identify themselves as police, give a clear warning of their intent to use force firearms, and allow enough time for the warning to be observed unless it places the police at risk or creates risk of death or serious harm to others. The use of firearms mandates additional safeguards such as submission of an incident report to the competent authorities (UN Code of Conduct for Law Enforcement Officials, Article 3). Although firearms have not been used in the Maldives in a long time, such safeguards are of equal value even in other forms of force used such as tear gas in this instance. Moreover, to avoid and reduce arbitrariness of officers while in action, the decision to use force must be taken by senior office, adequately trained into making sound judgments.

Often, the police complain that such measures are difficult to follow and situations generally can turn so quickly that not enough room is left for following the standard. However it is exactly these kind of situations for which the police need to equip and train themselves. Training in fact needs to orient police officers to the basic requirement of minimial force and minimal damage rather than the obvious tendency of grave harm. The accountability for actions cannot be avoided and in fact the police should be more open to scrutiny which alone will help build its capability of managing public disorder; and also boost its public image as a force willing to work within the confines of law.

It is, therefore, crucial that the government/MPS conducts an inquiry into the protests to determine whether these guidelines were followed. Every person injured in protests leaves behind a trial of bitterness. This is hardly conducive to gaining trust and confidence of the people, something that the MPS is striving hard to achieve (as is reflected in their Strategic Plans). Officers will do well to remember that their actions in these formative years of democracy in the island will most likely set the tone for its relationship with the community. As such, the development of a comprehensive system for managing public order that accords with international standards is a priority. Legislation that governs the management of public order by the police, and builds a co-operative relationship between the police and the public, is needed.

Navaz Kotwal and Devyani Srivastava work with the Access to Justice Programme, part of the Commonwealth Human Rights Initiative.

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