Health Ministry conducts “routine” TB screening at Maafushi prison after inmate diagnosed

The Ministry of Health today confirmed it has conducted a routine tuberculosis (TB) screening of staff and inmates at Maafushi prison after a single case of the disease was diagnosed at the facility.

Health Minister Dr Ahmed Jamsheed Mohamed today told Minivan News that a screening for TB had been undertaken at the prison, but added that just a single inmate had tested positive and been diagnosed with the disease.

The screening comes a month after the country’s Health Protection Agency (HPA) warned that a drug resistant strain of TB had been found in the Maldives, posing a “quite a serious” health threat for authorities to deal with.

However, Dr Jamsheed said today that there was no information at present to suggest the single case of TB detected at Maafushi Prison was a drug resistant form of the disease.

According to the World Health Organisation (WHO), TB is an infectious bacterial disease that can be transmitted via droplets in the throat and lungs of an infected person.

Despite praising authorities for their efforts to eradicate the disease across the Maldives in recent years, the WHO has expressed concern that drug-resistant strains of TB have become a major public health problem resulting from patients not fully completing the recommended six-month course of treatment.

New challenges

The Ministry of Health released a report earlier this year concluding that authorities in the Maldives were facing new challenges controlling the disease.

HPA Public Health Program Officer Shina Ahmed told Minivan News shortly after the report’s publication in March 2013 that although the new strain of TB was “quite serious”, thus far cases of the disease in the Maldives were not resistant to every drug available to patients.

“We have had a few cases come in now with the new strain. The most important thing we have to do is to continue and complete the course of treatment,” Shina said at the time.

“Most of these drug-resistant strains are caused by patients stopping the treatment. We have enough drug supplies to give to them, but because the course goes on for six months, patients tend to go off taking the treatment towards the end.”

In April 2012, staff at the Maldives Criminal Court were screened by health authorities for TB after an employee was found to have tested positive for the disease.

Control programs

International health authorities have previously observed that the Maldives had achieved notable success in TB control since the establishment of a national control program by the Department of Public Health in 1976.

Maldives has an estimated incidence of 47 per 100,000 population of all forms of TB and has sustained meeting the global targets for TB control since 1996, according to the WHO’s communicable disease department for South East Asia.

Tuberculosis, which had a prevalence in the Maldives of 35 cases per thousand people in 1974, declined to about 0.66 per 1000 by 1996, according to the findings.

However, last year the Health Ministry raised concerns over the growing number of multidrug-resistant tuberculosis (MDR-TB) cases in the Maldives.

The rate of TB prevalence among the country’s expatriate population is also reportedly on the rise as well.  “A large migrant workforce from high TB-burden countries,” continues to identified by the WHO as major challenge for local health bodies.


Health Minister says compassion can cure sector’s ills

Minister of Health Dr Ahmed Jamsheed has told local media that 80 percent of the problems in the healthcare sector could be resolved if patients were spoken to in a more compassionate manner.

“We have to keep in mind that patients are usually worried. They don’t go to the doctor for fun. We have to provide patient-focused services,” he told Sun Online.

He said that one bad experience by a patient can affect an entire community.

Referring to issues regarding the payment of salaries in the sector, Jamsheed said that these concerns were related to problems in the Finance Ministry.

“Problems with receiving salaries should not affect their work. That should not be the attitude of health sector employees,” he said.

Sun Online also reported that Minister of State for Health Lubna Zahir had stated that the HIV spreading behaviour was on the rise in the Maldives.

Speaking at the closing of the Enhancing the Response to HIV/AIDS in the Maldives project, Lubna said that the risk was highest amongst drug users.

“We have collected information that shows that behaviours that contribute to the spread of HIV are increasing at an alarming rate. The risk of HIV spreading fast in the Maldives is extremely high,” Lubna is quoted as saying.


Issue of unratified cabinet members on Majlis agenda

The People’s Majlis will on Monday consider the appointment of the three cabinet members who failed to gain the approval of the Government Accountability Committee last month, local media has reported.

On June 11, Dr Mohamed Muiz, Dr Mariyam Shakeela, and Dr Ahmed Jamsheed failed to gain the approval of the 11 member committee, despite it being dominated by parties from the unity government, although the committee did approve Dhiyana Saeed as the Minister for Gender.

The posts for the new portfolios with the Ministries of Health, Housing, and Environment were left to the full Majlis to deliberate upon after pro-government Jumhoory Party (JP) MP Alhan Fahmy voted with the Maldivian Democratic Party committee members.

Just before the June vote, the JP announced its intention to forward its new President Dr Ibrahim Didi as Health Minister, the post currently held by Jamsheed whilst he awaits his re-appointment to the slightly altered post.


Government-majority committee rejects cabinet appointees

The Majlis’s Government Accountability Committee yesterday approved only one of four proposed cabinet members after half of the government coalition’s committee members failed to vote for them.

The governing coalition holds a majority of seats on the committee, with eight members compared to the opposition Maldivian Democratic Party’s (MDP) three.

At yesterday’s committee meeting, only the proposed appointee for the Ministry of Gender, Dhiyana Saeed of the Jumhooree Party (JP), was approved by those present.

After the MDP members voted against Dhiyana’s appointment, the Chair of the committee and Progressive Party of Maldives (PPM) MP Mohamed Mujuthaz cast the deciding vote in her favour.
The other  nominees – Dr Mohamed Muiz as Mohamed as Minister of Housing and Infrastructure, Dr Mariyam Shakeela as Minister of Environment and Energy, and Dr Ahmed Jamsheed Minister of Health – failed to get the required votes.

Three of the pro-government members of the committee failed to attend yesterday’s vote whilst another voted against the appointments, resulting in the failure to gain the votes required to approve three of the government’s candidates.

Following the government’s re-structuring of cabinet, two new members required parliamentary approval, whilst two others required the Majlis’s confirmation after changes to their ministerial portfolios.

MP for Feydhoo constituency Alhan Fahmy is reported by Haveeru to have voted alongside the three MDP members against the unsuccessful government nominees.

Fahmy now represents the Jumhoree Party (JP) in the Majlis after his recent defection from the MDP.

The Jumhoree Party held a council meeting yesterday evening during which it elected Dr Ibrahim Didi, another recent arrival from the MDP, at the party’s President following his uncontested candidacy.

Dr Didi, who was President of the MDP until its National Council voted him out on April 30, told Haveeru yesterday the appointment was “the happiest day of my political career.”

The JP has also announced that its council had backed Dr Didi to be the Health Minister – a position currently held by Dr Ahmed Jamsheed, whose appointment was one of those voted on earlier in the day.

Fahmy, who was unavailable for comment at the time of press, is said to have abstained from the vote concerning his fellow JP colleague Dhiyana, leaving only seven members to vote on her appointment.

Haveeru reported that the JP party leader Ibrahim Gasim will now talk to President Waheed about this proposed change to the cabinet.

The decision on these appointees will now move to the floor of the Majlis where President’s Office Spokesman Abbas Adil Riza is confident that they will still be approved.

Asked by Minivan News if the problems with the ministers’ approvals was indicative of greater problems within the governing coalition, Abbas responded, “no, it’s nothing like that”.

The cabinet changes entailed the division of the ‘Ministry of Health and Family’ into the ‘Ministry of Health’ and the ‘Ministry of Gender, Family and Human Rights’.

The ‘Ministry of Housing and Environment’ has now become the ‘Ministry of Housing and Infrastructure’ and the ‘Ministry of Environment and Energy’.


President establishes two new ministries in healthcare shake-up

President Mohamed Waheed Hassan has  abolished the Ministry of Health and Family in favour of two new separate ministerial bodies.

The Ministry of Health and the Ministry of Gender, Family and Human Rights have both now been established following the abolition of the previous healthcare body.

Under these two new bodies, Dr Ahmed Jamsheed Mohamed will retain his post as Minister of Health, while Dhiyana Saeed will head the Ministry of Gender, Family and Human Rights.

Saeed, former SAARC Secretary General and wife of recently-elected Jumhoree Party (JP) MP for Kaashidhoo, Abdulla Jabir, resigned from her SAARC position after criticising former President Mohamed Nasheed for the arrest of Chief Criminal Court judge, Abdulla Mohamed. Saeed was youngest SAARC Secretary General ever appointed and the first female.

Both new ministers conducted their respective oath of office today in-front of Supreme Court Judge Abdulla Areef, according to the President’s Office.

The ministerial changes were made a week after the government announced the abolition of the country’s Health Service Corporations. President Waheed said the service facilities provided by the corporations would be brought under control of the Ministry of Health.

The decision was taken by the cabinet based on the experiences of previous government health policy over the last three years, the government stated. The government claimed that a number of “challenges” needed to be faced in providing healthcare across the country’s atolls.

Just last month, the government announced that 30 state companies providing provincial health and utility services would be abolished to try and streamline various public services.

Seven health corporations charged with overseeing regional medical services were also dissolved in favour of returning their functions to the Ministry of Health and Family.

The now opposition Maldivan Democratic Party (MDP) criticised the decision as reversing the decentralisation policy that had been undertaken in recent years.

“Maldives’ geographical fragmentation means one central board or company will find it impossible to effectively monitor and deliver services in an equitable manner,” former President Nasheed’s former Policy Undersecretary Aminath Shauna told Minivan News at the time.

Regional hospitals

Mohammed Abdul Samad, temporary manager for Gan Regional Hospital in Addu Atoll, told Minivan News Thursday that he personally welcomed the decision to abolish the Health Service Corperations.

Samad claimed that despite the relative success in recent years of Maldives health policy in areas such as cutting infant mortality rates, the quality of health services had been generally declining.

“We are desperately in need for urgent supplies like certain injections. We have so many pending bills and the government has had to arrange money for us,” he said.

Samad, who said he was temporarily overseeing operations at Gan Regional Hospital, added that he therefore welcomed the decision to have the Ministry of Health oversee the former Health Service Corporations’ work.

He also claimed that the government would be better able to provide more technically-experienced health staff rather businessmen to oversee hospital operations.

Samad added that Gan Regional Hospital presently faced significant problems in paying off debts relating to much needed drug supplies.

He claimed that the Health Ministry faced major challenges in relation to hiring trained medical staff at hospitals around the country. Taking the example of Gan Regional Hospital alone, Samad said the site presently had the need to employ additional specialist staff like a second gynaecologist to meet local patient demand, though added that management were unable to find suitable candidates.