Tag: health ministry

Government bans smoking in public places

The government has published new regulations to control tobacco, banning smoking inside all government buildings, private restaurants, cafes, teashops and social spaces.

The regulation prohibits smoking at Rehabilitation Centres, children’s parks and places frequently visited by children, aboard ferries and ferry terminals and at any place where people have to wait in a queue to obtain services.

According to the new regulation places such as cafes and restaurants that want to have smoking allowed will have to apply for permission from the Ministry of Health. The permission will be granted to places determined by the Ministry.

Any person who smokes in an area determined to be non-smoking can be fined to MVR 500 (US$32) and the owner of a place that allows smoking in such places without authority can be fined MVR 1000 (US$64) according to the regulation.

The regulation states that if the owner of the premises has not put up the sign board to inform that smoking inside the place is disallowed, the ministry has the authority to fine the venue MVR 500 first time and MVR 5000 (US$3200) on further occasions.

The Centre for Community Health and Disease Control (CCHDC) estimates that the 44 percent of the total population use tobacco, mainly by smoking.

According to the Maldives Demography and Health Survey (MDHS) 2009, 42 percent of people in the age group 20-24 are smokers while 20 percent of 15-19 years age group smoke.

Customs data shows that in 2010 alone 346 million cigarettes were imported into the Maldives at a cost of MVR 124 million (US$8 million) – a disproportionate figure considering the 350,000 populace. In 2009, MVR 110 million was spent to import 348 million cigarettes – mostly included well-known brands such as Marlborough, Camel, and Mild Seven.

The first President of the Maldives Ameen Didi, who assumed office in 1953, banned tobacco in the Maldives. However, people were outraged over this decision and a group of rebellious citizens overthrew his government and lynched Didi in the street.

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Patients to be charged at private clinics under Aasandha from August 1

Treatment from private hospitals and clinics will be covered under the “Aasandha” universal health insurance schemes  from August 1, with an agreed amount to be charged from people going to those clinics.

According to a statement released by the Aasandha Company on Sunday, private clinics are being included in the scheme after they agreed to a revised price list for health services with the National Social Protection Agency (NSPA).

The scheme will cover the treatments from those private clinics based on the revised price list, while the clinics are allowed to charge their patients to cover any additional costs.

“Therefore, patients will likely have to share the costs of outpatient care and other services,” the company adds.

The authorities have not revealed the amount to be charged, but State Health Minister and National Social Protection Agency (NSPA) Board Chairman Thorig Ali Luthfee told local media that the “charge will not be a burden to the patients.”

“In addition to what is being (covered) from Aasandha, they might charge a small amount from the patient. Once they agree to the price with us, they cannot alter that price,” Thorig told Haveeru.

According to Thorig, four clinics have so far agreed to the prices, and Aasandha services will be offered at the clinics as soon as the agreements are signed.

Price negotiations with several other clinics are still reportedly pending as over 60 private healthcare providers have applied for Aasandha coverage.

According to the Aasandha website, the scheme currently covers treatment from IGMH, ADK Hospital, IMDC Hospital in Addu and other hospitals and health centres currently operated by state-owned health corporations.

Thoriq observed that privately-owned ADK, the second largest healthcare provider in the country, will also have to confirm the revised prices agreed with NSPA to keep providing Aasandha services from next month on wards.

Under the parliament-approved scheme which commenced in January, all Maldivian citizens will receive government-sponsored coverage up to Rf100,000 (US$6,500) per year, including further provisions to citizens who require further financial assistance. Expatriate workers are also eligible for coverage providing their employers pay an upfront fee of Rf1,000 (US$65).

MDP’s critical response

Following the decision to charge patients at private health premises, the former ruling Maldivian Democratic Party (MDP) which initiated the universal insurance scheme, under its affordable healthcare pledge, contended that the government’s decision reflects attempts to “restore the tradition of begging to afford health care services”.

According to the statement released by the MDP, the agreement signed between Aasandha company and the government explicitly states that no amount can be charged from the patients.

“The agreement signed by the Finance Ministry, Health Ministry and Aasandha Company explicitly states that no amount should be taken in fees or as any other charge from the people,” the statement reads. “Therefore, we condemn the coup government’s attempts to charge people a fee for healthcare services.”

The party also accused the government aligned Progressive Party of the Maldives (PPM) and coalition alliance of deliberately attempting to sabotage the health insurance scheme.

The MDP noted that while the party was in power it had regularly made the payments to Aasandha company as per the agreement, however, the incoming government of President Dr Mohamed Waheed Hassan Manik had not made the payments, pushing the scheme to the brink of collapse.

Aasandha is a public-private partnership with Allied Insurance. Under the agreement, Allied splits the scheme 60-40 with the government. The actual insurance premium is paid by the government, while claims, billing and public awareness is handled by the private partner.

Aasandha Managing Director Mohamed Shafaz told Minivan News last week that the government had failed to cover weekly premium payments as agreed under the Aasandha contract since March 2012.

He alleged that while the scheme was continuing to run, the shortfall in state funding was creating some difficulties for service providers such as hospitals and pharmacies both in the Maldives and outside the country in the wider South Asia region.

Without detailing specifics, State Health Minister Luthfee said that the government was presently involved in consultations to clear outstanding bills. He added that a target of 30 days had been set to try and settle outstanding debts to creditors.

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Interpol Red Notice issued for F-Tech fraud case suspect

Interpol has issued a red notice for Mohamed Abdullah, wanted by Maldives Police in connection to the charges of defrauding the health ministry out of Rf 11.8 million (US$761, 290).

The 41 year-old was identified as the Managing Director of F-Tech Solutions, the company which allegedly doctored invoices and delivery notes and forged signatures to collect payment on medical supplies that have not been received by the health ministry to this day.

According to the Interpol website, Abullah is wanted for “Fraud, Counterfeiting/forgery”.

Auditor General Ibrahim Niyaz requested police investigate the fraud charges on April 12, following a special audit into the medical supply procurement agreement signed with F-Tech solutions in 2010.

Under the agreement, F-Tech Solutions was supposed to supply medical consumables and laboratory equipment worth Rf 12.8 million (US$831,169) but the audit revealed that the company had only supplied Rf 930, 512 (US$60,033) worth of goods.

Meanwhile, auditors found that the company forged signatures on delivery notes and invoices claiming goods had been supplied to the health ministry. Even on the instances goods were delivered, the prices listed for goods were much higher than those pledged in the contract.

“This office notes that F- Tech Solutions forged signatures on some delivery notes and invoices. Furthermore, the health ministry, hospitals and health centres have not received any of the goods said to have been delivered on the delivery notes. While the health ministry’s supply department has received goods noted on one invoice, the prices noted on the invoice are extraordinarily higher than prices pledged in the contract document,” the report said.

According to the Auditor General, tender evaluation board awarded the contract to F- Tech Solutions even though the company had no prior experience in supplying medical equipment, had lied about previously supplying medical equipment to the health ministry in bidding documents, and had no import licenses or permits from the Maldives Food and Drug Authority to distribute medical supplies.

The contract was also signed against the  advice of Anti Corruption Commission’s (ACC), which at the time had raised concerns over F-Tech’s lack of necessary licenses and permits.

The tender evaluation board awarded the contract to F- Tech Solutions even though the company had no prior experience in supplying medical equipment, had lied about previously supplying medical equipment to the health ministry in bidding documents, and had no import licenses or permits from the Maldives Food and Drug Authority to distribute medical supplies, the report noted.

According to the report, the State Minister of Finance at the time opened a Local Letter of Credit facility (LC) worth the total contract amount for F-Tech Solutions at the State Bank of India (SBI). The Auditor General said the move contravened the Maldives Finance Act which states only 15 percent of total contract value can be paid out in advance.

Further, although the contract was made between F-Tech and the health ministry, the state minister for finance authorised finance ministry staff instead of health ministry staff to sign delivery notes, the report said.

Niyaz said the state minister’s decision to establish a LC facility “opened up the opportunity” for payments to be made for unsupplied goods and “weakened the state’s internal control mechanisms.”

A Deputy Director General at the Ministry of Finance and Treasury authorised payment to F-Tech without confirming receipt of goods with the health ministry, even though SBI had noted discrepancies between the invoices and delivery notes. Nine of the 21 invoices were issued a month before the date printed on delivery notes, the report said.

Moreover, the Health Ministry did not annul the contract with F- Tech Solutions as per the agreement even though the company had failed to supply medical equipment for the period October – December 2011.

Instead, the ministry had procured the consumables itself and told F- Tech the amount would be deducted from the total payment to the company. However, no such deduction took place.

Niyaz recommends filing fraud charges against F- Tech Solutions, and filing negligence charges against the Tender Evaluation Board, and relevant Health Ministry and Finance Ministry officials. The report does not name the accused.

However, according to local media, F–Tech has six directors: MD Mohamed Abdulla, Director of Operations Abdulla Rashid; Director of Administrations Abdulla Shafeeg; Director of Sales and Marketing Ahuyad Hisaan; Director of Logistics Rilwan Shareef and Director of Human Resources Fathimath Shiuna.

Of the six, Shareef and Shiuna are prominent activists of the former ruling Maldivian Democratic Party (MDP) activists.

Police Sub-Inpector Hassan Haneef today confirmed that an Interpol notice was issued for Abdullah after attempts made by local police to find him were unsuccessful.

When asked if any one has been arrested in relation to the case Haneef responded:  “We have questioned some people regarding this case. But no arrests have been made so far.”

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Health ministry audit reveals Rf11.8 million (US$761,290) fraud

A local company charged with procuring medical consumables and laboratory equipment for Malé and regional hospitals has defrauded the health ministry out of Rf 11.8 million (US$ 761, 290), an audit report has revealed.

F- Tech Solutions Pvt. Ltd doctored invoices and delivery notes and forged signatures to collect payment on goods that have not been supplied to the health ministry to this day, Auditor General Niyaz Ibrahim claimed.

The company had only supplied Rf 930, 512 (US$ 60,033) worth of medical consumables and laboratory equipment to the government, the report said.

The tender evaluation board awarded the contract to F- Tech Solutions even though the company had no prior experience in supplying medical equipment, had lied about previously supplying medical equipment to the health ministry in bidding documents, and had no import licenses or permits from the Maldives Food and Drug Authority to distribute medical supplies, the report noted.

The Rf 12.8 million (US$ 831,169) contract was awarded to F-Tech in September 2010 against the Anti Corruption Commission’s (ACC) advice at the time. The ACC had raised concerns over F-Tech’s lack of necessary licenses and permits.

According to the report, the State Minister of Finance at the time opened a Local Letter of Credit facility (LC) worth the total contract amount for F-Tech Solutions at the State Bank of India (SBI). The Auditor General said the move contravened the Maldives Finance Act which states only 15 percent of total contract value can be paid out in advance.

Further, although the contract was made between F-Tech and the health ministry, the state minister for finance authorised finance ministry staff instead of health ministry staff to sign delivery notes, the report said.

Niyaz said the state minister’s decision to establish a LC facility “opened up the opportunity” for payments to be made for unsupplied goods and “weakened the state’s internal control mechanisms.”

A Deputy Director General at the Ministry of Finance and Treasury authorised payment to F-Tech without confirming receipt of goods with the health ministry, even though SBI had noted discrepancies between the invoices and delivery notes. Nine of the 21 invoices were issued a month before the date printed on delivery notes, the report said.

Moreover, the Health Ministry did not annul the contract with F- Tech Solutions as per the agreement even though the company had failed to supply medical equipment for the period October – December 2011.

Instead, the ministry had procured the consumables itself and told F- Tech the amount would be deducted from the total payment to the company. However, no such deduction took place.

Niyaz recommends filing fraud charges against F- Tech Solutions, and filing negligence charges against the Tender Evaluation Board, and relevant Health Ministry and Finance Ministry officials. The report does not name the accused.

Niyaz has asked the police to investigate the case on April 18.

Doctored invoices

The report, published on April 19, said F – Tech Solutions had forged signatures on delivery notes and invoices claiming goods had been supplied to the health ministry. Even on the instances goods were delivered, the prices listed for goods were much higher than that pledged in the contract.

“This office notes that F- Tech Solutions forged signatures on some delivery notes and invoices. Further, the health ministry, hospitals and health centers have not received any of the goods said to have been delivered on the delivery notes. While the health ministry’s supply department has received goods noted on one invoice, the prices noted on the invoice are extraordinarily higher than prices pledged in the contract document,” the report said.

Nine of the 21 delivery notes worth Rf 5,787,272 (US$ 373, 372) were signed by a health ministry procurement officer. However, “the procurement officer in a statement to the office said the signature on the delivery notes were not his, that he had not signed the delivery notes, and that he had not claimed said medical supplies.”

Further, the procurement officer noted he was not authorized to receive medical supplies on behalf of the health ministry, and had not done so previously.

Two of the 21 delivery notes worth Rf 4, 215,642 (US$ 271, 977) were signed by a health ministry staff that did not exist in the health ministry records. However, the name matched the nickname of the ministry staff, but the staff told the Audit Office he had not signed or received goods on behalf of the ministry.

On the instances F – Tech Solutions had supplied goods, the company defrauded the ministry of Rf 1,816,793 (US$ 117, 212). The company had claimed Rf 2,368,954 (US$ 152, 836) on goods that were only worth Rf 522,161 (US$ 33,687).

The Maldives Customs Services has confirmed that F – Tech Solutions has never imported medical consumables and laboratory equipment, the report said. The goods that were supplied to the health ministry were bought on credit from a separate private company.

Further, even though F – Tech had agreed to import Rf 12.8 million (US$ 831,169) worth of goods, the import license approved to the company from the Economic Ministry was only worth Rf 500,000 (US$ 32,258).

According to local media Haveeru, F – Tech’s six directors are: Managing Director: Mohamed Abdulla, Director of Operations: Abdulla Rashid, Director of Administrations: Abdulla Shafeeg, Director of Sales and Marketing: Ahuyad Hisaan, Director of Logistics: Rilwan Shareef, and Director of Human Resources: Fathimath Shiuna.

Of the six, Haveeru notes Shareef and Shiuna are prominent former ruling Maldivian Democratic Party (MDP) activists.

The Supreme Court disqualified MP Ismail Abdul Hameed in February 2012 for authorising payment for goods before delivery while he was director at the Malé Municipalty in 2008. Hameed was sentenced to one year six months banishment.

Meanwhile, Deputy Speaker Ahmed Nazim was acquitted of four counts of fraud in February. The charges against Nazim concerned public procurement tenders of the former Atolls Ministry secured through fraudulent documents and paper companies.

MP ‘Redwave’ Ahmed Saleem was also cleared of corruption charges in February. The state has charged Saleem with the conspiracy to defraud the former Atolls Ministry in the purchase of the mosque sound systems.

In addition, the State Trading Organisation (STO) has withdrawn a a case worth more than a million US dollars lodged against Dhivehi Qaumee Party (DQP) MP Riyaz Rasheed’s Meridian Services Private limited. The case concerned an unpaid sum of money worth Rf 19,333,671.20 (US$1,253,804.88) regarding Meridian’s use of the STO’s credit facilities.

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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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12-year-old girl found pregnant after disappearance

A 12-year-old girl reported missing last week in capital Male has been found two months pregnant.

The girl was found severely dehydrated and taken to Indira Gandhi Memorial Hospital (IGMH). Her family, however, took her home in spite of IGMH staff requests that she stay at the medical facility, reports Haveeru.

No information has been released regarding the girl’s disappearance or her pregnancy.

The case is expected to fall under the remit of the Health Ministry’s Gender Department.

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Saudi Fund gives US$12.5 million to Hithadhoo hospital

A US$12.5 million (Rf192.7 million) has been given to develop Hithadhoo Regional Hospital in Addu by the Saudi Fund for Development.

Finance Minister Ahmed Inaz and Saudi Fund’s Vice Chairman and Managing Director Yousef Ibrahim Al-Bassam signed the agreement yesterday. Health Minister Dr Aminath Jameel and Islamic Minister Dr Abdul Majeed Abdul Bari were in attendance.

The loan carries a one percent interest rate and a five year grace period. It is expected to be repaid within 20 years.

The project, which will be supported by loans from the Saudi Fund and the OPEC Fund, has not yet been opened for bidding.

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Reported increase in practice of female circumcision raises alarm

Claims that female circumcision is rising in practice in the Maldives have triggered alarm across the government and NGO sector.

“We are beginning to hear reports of this occurring, and I have heard on radio and television people justifying the practice. It is quite disheartening,” said Vice President Dr Mohamed Waheed Hassan, speaking at a UN event last week.

Then-Attorney General Husnu Suood raised concern in December 2009 that female circumcision in the name of Islam had been revived in Addu Atoll, claiming that religious scholars “are going around to midwives giving fatwas that girls have to be circumcised. They’re giving fatwas saying it is religiously compulsory. According to my information, the circumcising of girls has started and is going on with a new spirit.”

Minivan News subsequently traveled to Addu to investigate the matter and meet with sources, but was unable to determine if the practice was indeed occurring.

Speaking last week, Dr Waheed did not pinpoint a specific area where female circumcision was taking place, but attributed the “general trend” to “rising conservatism and traditional values imported from other parts of the world.”

“Mostly this is a failure of education – there are not enough opportunities for higher education and many students receive free offers to go to madrassas in places like Pakistan, where they learn very traditional values,” Dr Waheed said.

A source from the Health Ministry’s Department of Gender and Family Protection told Minivan News that while female circumcision was widely known to have occurred in the Maldives, it stopped in the 80s and 90s but “now we are hearing media reports that it is happening again.”

The Ministry was not aware where the practice was occurring, but said it intended to investigate.

“There is no formal reporting happening in the islands,” she said. “We have been trying to get reports but health facilities are not aware of the situation.”

Deputy Health Minister Fathimath Afiya meanwhile confirmed that the Ministry was sufficiently concerned to launch a study seeking to identify where female circumcision was occuring.

“There are no reports but NGOs have been talking about it,” she said, stating the Ministry had held a series of meetings on the subject after it received a letter voicing concern from NGO ‘Hope for Women’.

Interim President of that NGO, former Gender Minister Aneesa Ahmed, confirmed to Minivan News today that “some Islamic organisations are advocating this and people are having girls circumcised. I don’t know where and when, but I have heard people say on various programs including Raajje radio.

“I heard two Islamic scholars speaking, and this woman called the radio station and asked two Islamic scholars on the program what Islam said about [female circumcision], and the scholar said yes, that the Prophet Mohamed advocated that girls be circumcised. My concern is that scholars are advocating this has to be done according to Islam, people will not question it and start circumcising girls.”

Aneesa said a representative from the NGO had met with State Minister for Islamic Affairs, Sheikh Hussein Rasheed, who said there was “no question about it: that girls had to be circumcised.”

When Minivan News spoke to Sheikh Rasheed today, he said he did not wish to comment on the matter as he had a meeting scheduled with the Health Ministry regarding the issue.

”If I say anything people might assume it was said on behalf of the Islamic Ministry, or that it was the ruling of the Ministry, so I will not say anything for the time being,” he said.

According to Aneesa, the concern was not whether female circumcision was indeed Islamic.
“I am not a scholar, I am not arguing whether it is right under Islam. If that is the case, we should not stop talking about it. We must undo conventions to which the Maldives is party.
“I don’t want girls to go through the negative complications such as infections and bleeding. I am not questioning whether it is Islamic, but if it is, then people need to be properly trained to do it. Some people are asking if boys are circumcised, why not girls? I am not questioning Islam, my concern is the negative [health] impact.”

According to information from the World Health Organisation (WHO), female genital mutilation is divided into four types: “clitoridectomy, the partial or total removal of the clitoris; excision, partial or total removal of the clitoris and the labia minora; infibulation, the narrowing of the vaginal opening through the creation of a covering seal by cutting and repositioning the inner or outer labia, with or without removal of the clitoris; and all other harmful procedures to the female genitalia for non-medical purposes.”

Dr Akjemal Magtymova of the WHO’s Maldives country office told Minivan News that from her limited research into the practice in the Maldives, “it looks like this is not a very intrusive form practiced here. It is more just a following of tradition, a show to a higher power that something has been done about it and the responsibility has been fulfilled.”

Unlike male circumcision there was, she said, “no health benefit to female circumcision.”

“There are risks including infection, infertility, and complications during pregnancy and birth when the wounds are not healed or where there is scar tissue,” she explained.

According to the WHO, girls undergoing the procedure also risk cysts and recurrent bladder and urinary tract infections, as well as more immediate complications including severe pain, shock, haemorrhage, tetanus or sepsis, urine retention, open sores in the genital region and injury to nearby genital tissue.
It was, observed Dr Akjemal, an ethical dilemma around whether to train doctors to perform the operation safely.

“I am not sure about it – if you train doctors to perform the operation, you open it up to business and supply-induced demand. Rather than a practice isolated to traditional healers, it becomes a lucrative business,” she suggested.

Female genital mutilation is widely practiced in Africa with an estimated three million girls undergoing the proceedure each year, the WHO reports. Across Asia only Indonesia reports the practice although it is also believed to be performed in Malaysia.

In 1997, the World Health Organisation (WHO) issued a joint statement with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA) against the practice, and in February 2008 received wider UN support to increase advocacy against it.

“Female genital mutilation is recognised internationally as a violation of the human rights of girls and women,” the WHO advises. “It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.”

Former State Islamic Minister Sheikh Mohamed Shaheem Ali Saeed, now the Dean of Villa College’s Faculty of Islamic Sharia, said he had studied the issue and determined that there was no valid hadith demanding females be circumcised.

”All scholars who say it is something that Muslim females should do are citing invalid hadiths,” Sheikh Shaheem said, calling for the practice to be stopped.

”Currently it is uncommon in the Maldives. When I was young I used to hear that it was something done, but now it is very uncommon and I think it was carried to this generation more as a cultural thing,” he said.

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Maldives holds regional record as malaria-free zone

The Maldives holds South-East Asia’s record for being malaria-free. Meanwhile, the region is falling behind as one-third of affected countries show signs of eliminating the vector-borne disease over the next ten years.

Dr Robert Newman, director of the Global Malaria Program of World Health Organisation (WHO) said malaria control has improved significantly. “The world has made remarkable progress with malaria control. Better diagnostic testing and surveillance has shown that there are countries eliminating malaria in all endemic regions of the world.”

Malaria affects 40 percent of the world population. While the Maldives had a volatile track record in the 1970s, peaking at 1100 cases in 1976, virtually no cases of local origins have been reported since 1984.

Director General of Health Services Dr. Ibrahim Yasir said the only malaria cases have involved foreigners or Maldivians who have traveled to regions where the disease is endemic.

“A few times a year a foreigner might come who has been infected elsewhere, or in a recent case a Maldivian boat capsized near Africa and those on board contracted malaria and were treated here,” he said.

Yasir noted that the interiors of transport vehicles coming from malaria-infected locations are sprayed with a disinfectant to prevent accidental importing of the bug.

Certain countries that share regular traffic with the Maldives are showing worrisome resistance to malaria elimination.

According to an article published by Times of India today, Roll Back Malaria Partnership (RBM)’s latest report says that high rates in India, Indonesia and Myanmar have kept South East Asia’s malaria report rate stable while other regions see a declining report rate.

RBM’s report compares 5,200,000 probable and confirmed cases of malaria in 2000 in India against 5,000,000 in 2010. A WHO fact sheet, however, notes that 2 million fewer cases of death due to malaria were reported for the same time period.

Sri Lanka and Korea are in the pre-elimination phase.

Malaria elimination – the deliberate prevention of mosquito-borne malaria transmission resulting in zero incidence of infection in a defined geographical area – was first attempted at large scale during the Global Malaria Eradication Program from 1955 to 1972.

WHO certified 20 countries as malaria-free during this time, however in the 30 years that followed efforts to control the disease deteriorated and only four countries were certified.

During the 1970s, the Maldives successfully eliminated the malaria-carrying mosquito. It continues to combat the dengue-carrying mosquito, however, and several outbreaks have claimed 11 lives this year, making 2011 the worst year on record for dengue fatalities.

Among the factors that prevent the elimination of malaria, dengue and other viral diseases is the over-use of antibiotics. At the 64th meeting of the Regional Committee for South-East Asia in September, members suggested that overuse of antibiotics was making diseases harder to treat.

In 2010, WHO introduced a program combatting the reflexive practice of prescribing anti-malarials to any child with a fever. “Anti-malarial treatment without diagnostic confirmation means poor care for patients. It masks other deadly childhood illnesses, wastes precious medicines, hastens the inevitable emergence of drug-resistant parasites and makes it impossible to know the actual burden of malaria.”

In a previous interview with Minivan News, ADK Chief Operating Officer Ahmed Jamsheed called antibiotics “the most misused drug in the Maldives,” and warned that the trend could put Maldivians more at risk for dengue fever and chikungunya, as well as viral diseases.

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