Comment: Let them eat cake

As the world watches the escalation of violence in the Maldives, the media, both nationally and internationally, has focused on the major characters in this unfolding drama. A corrupt government headed by an aging dictator was, for a short period, defeated by a popular movement led by a relentless activist, recognised for his fearless and uncompromising struggle to change the system.

However, the old regime was returned to power by the coup on February 7, barely four years after the previous government was established through a popular democratic movement. This is the stuff of Hollywood movies, but the script is still being written…

Democracy or Oligarchy? The dictionary definitions of these conflicting ideologies do not clearly reflect the real reasons behind the political struggle and the recent coup in the Maldives. It is not primarily a drama of personalities, as some of the media interviewers have portrayed it. It is a struggle between an oligarchy doggedly maintaining its privileges and a growing number of Maldivians who refuse to be beaten or intimidated into submission. Baton clashes with belief. Power clashes with powerlessness. And most importantly, privilege for the few clashes with justice for all.

For centuries, pre-eminence in government has been synonymous with privilege in the Maldives; and the privileged few used their power to do little other than to preserve their position and lifestyle. Gayoom, who was educated in the Middle East, came to power with such promise of change, but managed only to perpetuate an Arabian Nights style of governance.

Under him, the Maldivian government continued to be inward looking. The rule of the privileged few continued to be the norm. Thirty years of exploitation and repression under Gayoom left the country economically and emotionally bankrupt. The social results of this are seen in the plethora of problems that the Maldives faces today. One outstanding example is the neglect of the atolls- the economic backbone of the country.

While members of the privileged oligarchy lived the lifestyle of the rich and famous funded by the country’s earnings and the aid that was poured into the country to assist its development, there was a deliberate neglect of the islands outside the capital Male and their need for education, health care, and employment. This neglect led directly to the beleaguered state of Male today. Thousands upon thousands of Maldivians go to live in Male, to work and educate their children. Today, Male is one of the most crowded and polluted cities in the world. Privilege, married to self- interest, leaves long, dark shadows.

Privilege also goes hand in hand with exclusiveness and a strong sense of entitlement as evidenced by Gayoom’s regime. State money that was the right of all citizens was spent on personal aggrandizement. ‘Theemuge’- Gayoom’s presidential palace- and the millions of public money spent on it, is a symbol of corruption and excess that will stay with us for many years. However, the platoon of luxury yachts and the lifestyle enjoyed by his family and friends were not seen by them as a result of embezzlement, but a reflection of what they were justifiably entitled to.

Such self-deceit went further. Just as the colonial powers and the Christian missionaries of the past justified their dealings with the indigenous people of the colonies as humanitarian and ethically sound, the regime justified its way of doing things as enlightened and for the public good. For years, the old regime has argued that the Maldives was not ready for Democracy; this became a self-fulfilling prophecy.

This style of archaic thinking assumes that change for the better can only happen when it follows a time line that suits those who are opposed to any change which threatens their privileged lifestyle. The return to that regime suggests that Gayoom is of the belief that the country will not be ready for such a change in the life time of his children either! The truth is that any major progress in human history, such as the growth of Islam in its early years, the development of the parliamentary system or the emancipation of women in the West, is achieved with pain and commitment. When the oligarchy takes the moral high ground, it asserts that the ordinary public is at a lower level of evolution- incapable of rational or intelligent behaviour. Will the regime now destroy the schools, keep economic power in the hands of the few, and then tell the many that they are too ignorant for Democracy?

“Let them eat cake” is a well-known quotation possibly misattributed to Marie Antoinette, the wife of Louis XVI, whose regime was toppled in the French Revolution. The queen, who had indulged in a lifestyle of huge affluence was told that the peasants had no bread; bread being the staple food of the French peasantry and the only food they could afford. The queen’s reply illustrates her lack of understanding of the predicament of the poverty-stricken population.

Privilege is characterised by this sheer obliviousness to the concerns and opinions of the less fortunate. Thus the February 7 coup in the Maldives is not merely the effort of an old regime to reinvent itself, but it is a deliberate and belligerent signal that the privileged regime and its supporters can do what they please regardless of what the ordinary citizen feels. It is an overwhelming show of strength: they can depose a legitimately elected president, they can beat people, including elected representatives, on the street and they can wipe the slate clean for those who have stolen from the country or committed grave crimes against the Maldivian people. It is a show of huge indifference.

There is nothing that testifies to this attitude more than the employment of Abdulla Riyaz as Police Commissioner and Hussain Waheed as his deputy. Even the least informed of the Maldivians understand that these people were the driving force behind the horrifying escalation of police brutality under Gayoom.

An oligarchy, such as the one in power in the Maldives, is unable to sustain itself on its own. Maintaining antiquated rules of behaviour and supressing the beliefs of the populace is increasingly difficult in the age of the internet and social networking. Unholy alliances have to be made and the regime under Gayoom relied on the police to stay in power.

In the minds of many Maldivians, the name Gayoom is synonymous with police brutality and torture and ill treatment of political prisoners. It is not surprising that the most committed detractors of Gayoom’s regime and its scarcely disguised puppets in the present administration are those who have been at the receiving end of the inhumane treatment. In the short period of time when Maldives was ruled by a democratically elected president, this reliance on the police to enforce compliance disappeared. It is possible, given time, it may have changed not only the way the people perceive the police, but also the way the police saw their own place in the community – perhaps as the caretakers of a more humane and compassionate society.

However, the February coup has introduced a more sinister note into this unholy alliance between those in power and those who help uphold this power through the use of fear and force. This time, the allegiance of a number of police and military has been purchased. It is not difficult to conceive of a future Maldivian police force, with shifting allegiances and well-honed negotiating powers, cutting the best deal for themselves. Less obvious, but yet more insidious, is the effect of using the police to uphold the rule of the few. T

The Maldives is a small country, and much of its social functioning is based on connectedness; the type of face to face relationships which unite and hold small communities together. Senior police officers, bribed by a handful of rich supporters of the regime, have ordered the juniors officers to beat their sisters, brothers, uncles and aunts. These are ordinary people who have little to gain by the power-play of their superiors.

Recent events in the Maldives also highlight another of the problems that privileged oligarchies have to address. No modern oligarchy has managed to completely obliterate social mobility. The ambitions of small groups of people who fight their way up the through private enterprise have to be addressed. The nouveaux riches of the Maldives have reached a stage where some of them are starting to question years of hard work which has not afforded them the privileges and influence to which they have aspired. Although oligarchies, such as the present regime, do not welcome new blood with open arms, they do manipulate it.

The coup represents an outcome of synchronicity – where the needs of the oligarchy and the aspirations of a small group of rich resort owners struck a meeting point. When in power, the Maldivian Democratic Party introduced a system of taxation that did not please some of the wealthy resort owners as well as low end tourism that would open up the industry to ordinary Maldivians. These efforts by a people’s government to improve the lot of the ordinary Maldivians were a huge threat to a small group of the rich who have enjoyed a monopoly of wealth alongside their friends in the regime.

The possibility of a law that would ensure that tourism profits in fact trickled down to the local economy by putting it through local banks, was another affront to some of the powerful resort owners. Like the members of the regime, they too have an interest in maintaining the status quo, so that both sides can continue building their own empires, be it based on power, money or influence. In aligning themselves with a cruel regime, they have tarnished their own names and become traitors to their nation.

However, oligarchic governments are also invariably threatened by a more fundamental force that is not so easily manipulated. This is the inevitable state of conflict which ensues between the power of the few and the needs of the many. Eventually, the down -trodden simply refuse to be part of the narrative and mythology perpetuated by the privileged few.

Some of the greatest upheavals of human history are testimony to this simmering sense of resentment. The French Revolution, The Russian Revolution, and the Chinese Revolution are all well documented examples of how the masses revolt against such inequalities. Inevitably the people find their voice in the figure of an individual who is prepared to be the punching bag of the powerful bureaucracies. A brown man with spindly legs wearing a dhoti makes an appearance. A black man insists that he wants his children to be judged by the strength of their character and not by the colour of their skin. An old woman refuses to sit at the back of bus and decides to break the law. An Anni appears…

Justice is a powerful threat to privileged oligarchies. Some two thousand years ago, Aristotle argued that the ordering of a society is centred on justice. No oligarchy has yet managed to convince the under-privileged majority of a nation that what is justice for the minority is also justice for the masses. And justice matters. The fundamental search of the human spirit is not, as advertisers would have us believe, to holiday on ‘the sunny side of life’. Nor is it money. It is a search for the confirmation that each individual life has meaning and each individual has a right to live in dignity. This is the point of civilised society. This is why, justice is central to the smooth functioning of any society. This is why one of the most enduring symbols of the anger against the coup of February 7 is a T-shirt that simply asks, “Where is my vote?”

This is why injustice penetrates deep into the human psyche. There is nothing that unites people more than a shared list of grievances. In more recent years, Martin Luther King Junior echoed these sentiments when he argued that, “Law and order exist for the purpose of establishing justice and when they fail in this purpose they become the dangerously structured dams that block the flow of social progress.” Indeed, we need to worry when law and order have been unable to function effectively in the Maldives for over thirty years, due to the self-interest of a small minority of people.

Democracy or Oligarchy? This is no longer a political question. Nor is it an issue about two strong individuals. It has become a moral and ethical judgment that every Maldivian has to make. We must decide whether we are brave enough to choose ‘the road less travelled ’, make mistakes, take risks and grow towards maturity as a nation, or continue to be bullied by an oligarchy which, by its very definition, is focused on its own survival at the expense of the population.

The rest of the world also has to make a decision; the well- known words of Edmund Burke are hugely relevant to the situation in the Maldives: “All that is required for evil to prosper is for good men to do nothing.”

It is time for good men and women, both nationally and internationally, to stand by the Maldivian Democratic Party and help write the script for a new and more enlightened age of Maldivian history.
The time for action is now.

All comment pieces are the sole view of the author and do not reflect the editorial policy of Minivan News. If you would like to write an opinion piece, please send proposals to [email protected]

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Sri Lankan vessel apprehended within EEZ

A Sri Lankan vessel was apprehended yesterday within the Maldives’ Exclusive Economic Zone (EEZ), the Maldives National Defence Force (MNDF) has confirmed.

The ship was first spotted by the Maldives National Defence Force (MNDF) 26 nautical miles from Addu Atoll yesterday, before being reported to police.

The coastguard eventually apprehended the vessel around 35 nautical miles from Addu Atoll, where it is today being brought.

This is the third time that foreign ships have entered Maldivian territorial waters in recent weeks. Just over two weeks ago, a Bolivian vessel on route to Iran was hijacked  by Somali pirates, the first such attack to take place within Maldivian waters.

One week later, the coast guard was again dispatched after an unidentified vessel was spotted 77 miles from Alif Alif Atoll.

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SAARC Secretary General meets with President Waheed

South Asian Association for Regional Cooperation (SAARC) Secretary General Ahmed Saleem has met with President Mohamed Waheed Hassan in Male’ for discussions on implementing the regional body’s development aims.

During discussions that took place in the capital yesterday afternoon, President Waheed was updated on the progress of agreements made during the SAARC summit held last year in Addu Atoll.

According to the President’s Office website, Saleem said that more was needed to be done to meet the goals outlined by SAARC in a bid to strengthen trade and diplomatic relations between its member states.

Health ministers and secretaries from a number of SAARC member states are gathering at the Maldives’ Paradise Island Resort from today for three days of development talks.

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Sri Lankan diplomats make first Maldives visit since power transfer

Sri Lankan External Affairs Minister Professor G L Peiris has become the first official from the country to travel to the Maldives since the controversial transfer of power that saw President Mohamed Waheed Hassan take office in February.

The External Affairs Minister was in Male’ as part of a four-day visit to hold bilateral talks with his Maldivian counterpart, Dr Abdul Samad Abdullah.

During the talks, Professor Peiris pledged ongoing support and assistance to developments in the Maldives. Meanwhile, Maldives Foreign Minister Abdul Samad Abdullah reiterated the importance of contributions made by Sri Lanka relating to socio-economic developments in the Maldives.  Samad welcomed contributions to the development of  “human resources” in particular, the Ceylon Daily News reported.

“The talks were also attended by the Foreign Affairs State Minister Hassan Saeed Hussain, Foreign Secretary Mohamed Naseer, MP Sajin De Vass Gunawardena, Sri Lankan High Commissioner to Maldives Dickson Dela and senior official of the Sri Lankan delegation,” the newspaper added.

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“No Islamic fundamentalism in the Maldives”: Foreign Minister

The Indian government’s biggest concern is the internal stability of the Maldives,  Foreign Minister Abdul Samad Abdulla said today.

In a press briefing to brief media about his official visit to neighboring India, and his recent meeting with Sri Lanka’s Minister of External Affairs, Dr Samad, said the Indian government was eager to know how the Maldives had been progressing after the transfer of power that took place on February 7.

“The officials of the Indian government were concerned with the country’s internal stability after the events that unfolded on February 7,” he said.

Samad also said that India was concerned about whether the events that unfolded on February 7 involved Islamic fundamentalists, but he said he assured them that Islamic fundamentalism had no part to play in the events.

He expressed disappointment over statements made by officials of Nasheed’s government that the Maldives had a growing issue with Islamic radicalism and fundamentalism.

Samad further went onto dismiss such claims and said that religious fundamentalism did not exist in the country, and said he had assured Indian authorities that neither the transfer of power nor the vandalism of Buddhist relics in the National Museum on February 7 had involved any religious sentiment.

Speaking to Minivan News at the time, a museum official said that a group of five to six men stormed into the building twice, and “deliberately targeted the Buddhist relics and ruins of monasteries exhibited in the pre-Islamic collection”, destroying most items “beyond repair”.

A journalist asked Samad about the 2007 bombing of Sultan Park and the government’s subsequent clash with radical Islamists on the island of Himandhoo – footage of which later appeared in an Al Qaeda training video – to which the foreign minister replied “That was in the past.”

Dr Samad stated that he had met all key officials of Indian foreign affairs including the Minister of External Affairs, S M Krishna, and Indian Foreign Secretary Ranjan Mathai. Samad said he briefed them about the events of February 7, the works of the Commission of National Inquiry (CNI), and the all party talks.

Samad also acknowledged support from Indian High Commissioner to the Maldives, Dnyaneshwar Mulay.

“I especially thank Indian High Commissioner Mulay for briefing them about what happened in Maldives. Mulay, who was there during my meetings with Indian officials, observed the events very closely and even former President Nasheed was talking to him,” Samad said.

Samad also stressed that the Indian government was a “reliable and loyal” neighbor which had always been there for the Maldives, regardless of which government was in power.

He said that the main purpose of the trip was to get assurance of Indian support for the current government, which he claimed had been “very positive”.

India was initially concerned of the safety of Indian investments in the country, Samad said – Indian infrastructure giant GMR is currently redeveloping Ibrahim Nasir International Airport (INIA), the single largest foreign investment in the Maldives. Samad  said he had assured Indian officials that the current government of the Maldives will give the “utmost priority” in protecting Indian investments.

“Several Indian companies have huge investments in the Maldives. They have been involved in housing projects and as well as the privatisation agreement of INIA with GMR. The Indian government was concerned about these investments and we assured them that it remains safe,” Samad added.

Last week, Finance Minister Abdulla Jihad declared that the Maldives Airport Company Limited (MACL) would be unable to pay the disputed airport development tax (ADC) without risking bankruptcy – a US$25 fee that was to be charged to outgoing passengers, as stipulated in the contract signed with in GMR in 2010. The government was to pay the fee from airport revenues after its collection was blocked by the Civil Court.

Samad also said that the safety of the Indian ocean was a priority for India.

“We are at the center of a very internationally strategic area and the Indian Ocean is a huge shipping lane as well.  The recent hijacking of a foreign vessel by Somalia pirates is a concern as well. India is highly concerned about the security of the Indian Ocean.”

Samad said he had discussed strengthening bilateral relations with India and had discussed in finding solutions the difficulty in obtaining visas for Maldivians travelling to India.

He also claimed that India would soon provide the Maldives government with land in Delhi to build a Maldivian Embassy, in the heart of diplomatic area.

Sri Lanka

Regarding the meeting held with the Minister of External Affairs of Sri Lanka, Professor GL Peiris, Samad said that he had briefed the Sri Lankan minister regarding the events of February 7.

He also said that the ministers had discussed resolving visa issues and complications faced by Maldivians travelling to Sri Lanka, particularly students, to which he said the Sri Lankan minister had been very positive.

Regarding the transfer of power in February 7, Samad claimed that the government had not changed on February 7 and that “technically” it was the same government and that only the president had changed.

“If you look at our constitution, we have a presidential system. This is not a parliamentary system to say that the government belonged to the Maldivian Democratic Party (MDP). People voted both Nasheed and Waheed in the elections. Nasheed did not win the election on his own. Nasheed and Waheed got less than 25 percent of the votes in the first round [of the presidential elections 2008]. He won the presidency with the support of Gasim Ibrahim and Dr Hassan Saeed,” Samad contended.

“So if you say its Nasheed’s government that means its Gasim’s government as well, it’s even Umar Naseer’s government,” he claimed.

The MDP has contended that nearly all political appointments have been replaced with supporters of former President Maumoon Abdul Gayoom, who was voted out in 2008.

He also revealed that former government had not built any ‘special’ diplomatic relations with Israel.

“I don’t think what some people speak on political podiums is the real foreign policy. From the documents that I have, Naseem [referring to former Minister of Foreign affairs, Ahmed Naseem] did not build any special diplomatic relations with Israel like he has been saying,” Samad claimed.

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Plans to develop residential homes for the elderly stalled

The planned development of private residential homes for the elderly has been temporarily stalled, the Ministry of Health and Family said today.

Director of the Department of Gender and Family Hafeesa Ali confirmed that work on establishing private care homes for the elderly had currently been halted with the change of the government in February.

“There were plans last year to develop residential care homes due to the increasing number of requests to transfer old people to Guraidhoo center. But as you know, several projects from last year have come to a halt now [after the change of government on February 7]. The discussions are ongoing, but I can say it is not progressing as fast as we had hoped,” Ali told Minivan News.

The cabinet of former President Mohamed Nasheed decided in July 2011 to establish private residential homes under its Public Private Partnerships (PPP) scheme.  The pledge for residential homes was made owing to concerns over the increasing number of elderly people being transferred to the state-run Guraidhoo Special Care Centre, which was found by the government to have insufficient space and facilities to accept new charges.

The PPP scheme was shut down last month by the present government, reportedly over concerns sbout the legal processes behind certain privatisation projects.

Beyond the issue of setting up residential homes,  Hafeesa Ali noted that the gender and family department’s wider work to provide shelter and care to the elderly Maldivians had been further obstructed by a limited budget and resources.

“Several elderly people are wait listed to be accepted into the Guraidhoo centre even now. Some of them don’t have any relative or caregiver. But there is no space at the centre and we do not have the capacity to provide alternative housing,” she observed.

According to Health Ministry figures released on April 7 to mark the occasion of World Health Day, 49 people aged between 75 and 80 were found to be living at the Guradhoo center. Among the 49 residents at Guradhoo, eighteen are women and 31 men. Thirteen of them are bedridden, while another thirteen remain in wheelchairs, the statement read.

Most of residents do not have any legal guardian or have been neglected by relatives with no where to live, the ministry added.

According to the statement, only a few family members were reported to have visited elderly relatives at the centre or made attempts to check up on them by phone.

Hafeesa Ali says that the most challenging factor for the department is providing care to the old people under the same roof as people with disabilities or mental illnesses.  Over a 100 people with special needs are receiving treatment at the Guraidhoo facility.

According to recently released ministry figures, Rf12,000 is spent on every resident per month.

Minivan News reported in January of an increasing number of elderly people being abandoned or forced out of family homes to live on the streets.

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Q&A: Former CEO of IGMH Cathy waters

CEO of Indira Gandhi Memorial Hosptial (IGMH), Cathy Waters, left the Maldives on Friday after more than a year at the helm of the country’s largest hospital. Waters, along with Nursing Director Liz Ambler and Medical Director Rob Primhak were recruited in January 2011 by UK-based NGO Friends of Maldives (FOM) and the Maldives High Commission to improve the quality of local healthcare. Ambler and Primhak have also left. Minivan News spoke to Waters prior to her departure.

Waters provided detailed briefing notes on the state of the hospital to accompany this interview (English)

JJ Robinson: What was the state of the hospital at the time of your departure?

Cathy Waters: There are now systems and processes in place so key decisions can be made. People know how to make those decisions and know where the systems and accountability now lie. Patients may not see that initially as a benefit, but we were making sure the foundation and systems were right.

I’m confident those in now in place. Clinical systems to ensure patient care are now there, and there are things such as a proper patient complaint system.

Equally we have introduced a zero tolerance policy to protect staff. We’ve noticed the number of verbal and violent attacks against staff has gone up. I don’t know why – but certainly over the last few months we’ve seen an increase in violence against staff. Now if you go into IGMH you’ll see posters and leaflets in Dhivehi and English.

JJ: One of your main innovations was the introduction of triage. Was this a hard concept to introduce?

CW: Maldivians tend to panic about things you or I would describe as fairly minor healthcare issues. If you were to cut your finger and it bled, you would probably hold a tissue on it, wrap something around it and deal with it yourself. Here, people panic at the slightest bit of blood.

A really good example of this was when we had some of the casualties coming in from the recent protests. A little bit of blood and people wanted to bypass the triage and go straight into the emergency room, when perhaps all they needed was to put a wad of padding over it and have it stitched up in time. There was no urgency about it, but people panic.

The most challenging part has been persuading people that they don’t need to be in the actual emergency room – that it’s acceptable to wait if it’s not something urgent. That has been so difficult to get across. But it is working, and was brought into place in November 2011. Now it’s been in place for a few months we know there are alternations we need to make it more effective.

JJ: You said earlier that you’ve had politicians ringing you up to bypass triage and go straight to emergency?

CW: Absolutely. I think they see it as their right to get access to treatment and the [in-patient] rooms really quickly, and I think in the past that’s why the triage system has failed, because people back down and say ‘OK, come straight to the emergency room.’

We’ve stuck to our principles and said we have to do this properly, because if we start letting politicians in or whoever just because they think they should be in, the whole purpose falls apart. very clear stick to principles.

JJ: Were you able to train triage staff to the point where they could resist that pressure?

CW: Yes, we had to do quite a lot of work, and there’s still a lot to do. We had instances when there were quite a few people waiting and instead of being triaged, they were just waiting for treatment. Then the doctors said let’s just cancel triage and let people into the emergency room. That defeats the whole purpose.

It’s about explaining to people. The most difficult area was when parents come in with children they believe are very sick, when actually it’s not urgent and they just need to see a doctor. But they panic, and that’s the area with the biggest problems. A lot of it is education and helping people realise that they don’t always need to come to hospital – that there are straightforward, basic things they can do.

JJ: How has the Aasandha scheme (universal healthcare) impacted IGMH?

CW: Now Ashanda has been opened to ADK and private health clinics, it’s created major problems for IGMH, because we still have loads of patients coming to IGMH, but we also know that those patients are also going to ADK and private clinics. The dilemma for us is that a lot of the private clinics are run by doctors who work in IGMH. That a fairly difficult area.

JJ: So the doctors end up working less at IGMH?

CW: They would probably argue this, but I would say the difficulty for us is commitment. The average Maldivian doctor will get a third of his income from IGMH, and two thirds from a private clinic. There is a huge incentive for them to do more and more private clinics.

For example, anecdotally a doctor in IGMH may see 6-20 patients in a clinic session. Apparently some of those doctors are seeing 70-75 patients in the same session at a private clinic.

It’s a big problem and the government needs to think about it. If you want doctors to be 100 percent committed to IGMH, you need to do something about increasing their salaries or minimising the amount of time they can do private work.

JJ: How sustainable do you think universal healthcare is in its current incarnation? Does there need to be a monetary barrier to entry?

CW: My view is that it was introduced far too quickly without thinking about what checks and balances needed to be in place. Some patients have already spent their Rf 100,000 (US$6500) entitlement. People see it as their right to spend Rf 100,000, and there wasn’t a public education campaign beforehand so people understand how to use it properly.

There are reports of people going from clinic to clinic and seeing more than one doctor in a day. If they’re not quite happy with what they got from one doctor, they’ll go to the next.

At IGMH the number of non-attendances for appointments has increased because people aren’t paying for it any longer. The patient doesn’t feel they are losing anything, although they are because they are using up their Rf 100,000. We have gaps in our clinics because patients have suddenly got an appointment at a private clinic quicker. And of course we have to work on our appointment system and how people access the hospital.

JJ: We have previously reported on tensions between local and foreign doctors over pay and allowances, such as accommodation. Were these resolved?

CW: It’s still an issue. The problem is that there are lots of inequities. Expat doctors get accommodation, Maldivian doctors don’t. But Maldivian doctors have the ability to do private work, which the expat doctors don’t, so there are some tensions.

Having said that, there are teams of doctors who work really well together. One of the things we have been doing is making sure the clinical heads of department meet once a fortnight, to try and make sure people are working together.

JJ: You have spoken about a contract IGMH had with the State Trading Organisation (STO) to supply medical equipment and consumables, at four times the going rate. What was behind this?

CW: The contract was initiated well before I started at IGMH. It was done for good reasons because there were huge problems with supplying medical equipment, but what we found was that we were paying hugely over the odds for goods we were receiving. Some of the issues with supply are still there, but generally speaking it has radically improved.

We had to do a lot of work on our side. Doctors had been stockpiling, so we have to educate them now that there is no need to stockpile, because it is increasing our expenditure.

It was also a major battle to understand our financial situation. When I first started people were spending money left, right and centre, and there was no financial control. Now we are are very clear about where we are – we don’t like where we are, because it’s not a very good financial position – but at least we know where we are. We are trying to enact a financial recovery plan, but we haven’t been able to go as far with it as we’d like.

JJ: What about the Indian promises to pump money into IGMH? Did you feel they were persistently interested in it?

CW: They came and pledged this money a considerable time ago. The project was supposed to start in April, but it slipped and slipped. It desperately needs to happen. The building is old and bursting at the seams, it is not able to cater to the needs of patients it has, and when it rains it leaks like a sieve. Things like the electric wiring are very old – it all needs to be redone.

JJ: You initially signed for another year, but mentioned concerns about job stability. How did things change at the hospital after the recent political turmoil? Should that be affecting a hospital?

CW: I don’t think it is – the Finance Ministry said, the same as the previous government, that we could not change salaries or appoint new people. So we have vacancies and we have to hold those [closed], with the exception of clinical staff. We argued that we needed to replace senior doctors if they leave. But we are carrying an excess of admin staff we desperately need to reduce. But the previous government stopped us doing that. To enable us to become a more effective organisation we need to do that.

JJ: What was it like working at the hospital, personally? Did you face challenges as a foreigner?

CW: Our chairman said it was not about me as a foreigner, it was about management. There was a general resistance to administration, which I detest. We have tried to bring together management and clinical staff, so we have a stronger team. What was happening before was that you would have different departments working in silos. Yes there’s been resistance – I came in with different ideas, trying to bring in a different style of working, empower staff to make decisions and come up with the solutions. They have the answers.

The language barrier was very frustrating. I was very vocal about not being politically driven, and saying what I thought. But at senior meetings in the Ministry of Finance they would always make a big thing about saying ‘Sorry, we are holding this meeting in Dhivehi’ – even though these were senior people with a good understanding of English.

At one particular meeting they spent most of the meeting slagging off IGMH. Fortunately I had taken another member of staff who was frantically writing things down. They would ask for a response but I couldn’t argue as I didn’t know what had been said. I found it really frustrating and I felt they used it sometimes.

JJ: You said you were keen for a Maldivian to take over after your departure? Is that capacity available locally?

CW: I think that given another six months we would have had a number of people ready to take it on. I had appointed a director of operations, who potentially could.

I made clear in my final comments to the new health ministers that they need to get the right person, and not necessarily make a political appointment, because it is such a key job driving change in the health system. Ultimately it’s their choice, though.

JJ: What do you feel like you’ve got out of the experience personally?

CW: I think I’ve become much more tolerant and patient, and politically aware – with a small and a large ‘P’. Diplomacy skills have been honed greatly. I also had my eyes opened about living in a small place where everyone knows everyone else. If someone was in the same classroom as the President, they think nothing about calling the President and telling him what they think of you.

It also really opened my eyes to the complete lack of confidentiality. People don’t think twice about leaking highly confidential information to whomever.

JJ: What are the top three areas the hospital needs to focus on right now?

CW: Firstly, getting to a stable financial footing, be that through the health insurance scheme, although it is not bringing in enough to allow IGMH to stand on its own two feet.

Secondly, the government needs to decide whether IGMH is a public or a private hospital. That’s a fairly difficult tension they need to resolve.

Third, let whoever is running IGMH run it, and have the confidence to run it, and stop all the political interference. That was the number one frustration – not being allowed to get on and do my job. We’d have a plan, then something completely unrelated would come in from the side and stop something I tried to enact. It was so difficult to keep people motivated when that happened.

There are some fantastic staff at IGMH. Liz the nursing director was also leaving, and we had an amazing leaving do, in traditional Maldivian dress. There are some really special people there.

If I can add a fourth priority: to continue to try and change the work ethic so people only take sick leave when they are genuinely sick.

Some of the senior team are very good, and have taken no sick leave – I haven’t had a day off sick the whole time I’ve been at IGMH. It never crossed my mind to take sick leave unless I was genuinely sick. But people just take loads of sick leave – they see it as their right.

I will miss it. It’s been a fascinating experience.

Biographical note: Cathy Waters arrived at IGMH in Feburary 2011, first as General Manager, and then CEO. In June/July 2011 she was asked to take on the role of Managing Director of the Male’ Health Services Corporation (MHSC). She has 32 years experience working in health care and health care systems, and has previously worked in the UK’s NHS as a CEO and as a Director of a small consultancy company specialising in organisational development and change management.

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Police raid residences of 2007 Sultan Park bomb suspect

Police have raided the home of the wife of suspected Sultan Park bomber Mohamed Ameen. The blast, five years ago, caused injury to tourists. Another former residence of the accused was raided by police. Items were confiscated during Friday’s operation, although the police have yet to reveal what they were.

“Both houses were raided to find further proof to prove his participation in the plot. Police had confiscated several items from both houses,” a police media official told Haveeru.

Ameen was abroad at the time of the explosion and was not apprehended until October 2011 when Maldivian and Sri Lankan forces combined.

Ameen was a member of the extremist group Jama’athul Muslimeen, the leader of whom died in a suicide attack on the Pakistan Inter-Services Intelligence in 2009.

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PG seeks to charge gang member with terror offence

The state has presented evidence in court as it seeks to bring charges of terrorism against Ibrahim Shahum.

Shahum is charged with the murder 17-year old Mohamed Hussein in a gang-related incident in Male’.

The Prosecutor General is bringing charges based on Article 6 of the Terrorism Prevention Act which calls for the execution, banishment, or life imprisonment of any person found guilty of an act of terrorism that causes the death of the victim.

The secret testimony of six witnesses were taken at the Criminal Court today.

The accused, already found guilty of murdering 21-year old Ahusan Basheer, did not have legal representation in court although he informed the judge that he had submitted the necessary documents.

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