Tag: maldives

Antibiotics “most misused drug in the Maldives”: ADK COO

Over-prescription and sale of over-the-counter antibiotics is leading to a rise of resistant super-bugs, the World Health Organisation (WHO) has warned, with the Maldives no exception.

“Antibiotics are the most misused drugs in the country,” ADK Chief Operating Officer Ahmed Jamsheed told Minivan News today. “People are becoming resistant, and in certain cases they might not even need the antiobiotics.”

The WHO is discussing the overuse of antibiotics and growth of superbugs at the 64th meeting of the Regional Committee for South-East Asia, in Jaipur this week.

Director General Dr Margaret Chan said, “we have taken antibiotics and other antimicrobials for granted. And we have failed to handle these precious, yet fragile medicines with appropriate care. The message is clear. The world is on the brink of losing its miracle cures.”

Jamsheed said he has seen patients with headaches prescribed with powerful antibiotics, such as ciprofloxacin. He says a lack of systematic supervision allows pharmacists, who are not educated in medicine, to give antibiotics to anyone who asks regardless of a prescription.

“We have a very rudimentary diagnostic capacity in the Maldives,” said Jamsheed. “Hospitals and physicians are not properly monitored, and patients have a lot of independence to choose the drug they want. There are few national guidelines.”

According to Jamsheed, hospital diagnoses are compromised by inadequate facilities. He said that as organisms  mutate, doctors are not able to keep up. Bacteria samples are usually outsourced, and communication can take weeks. “In some cases, we may not be able to recognise and diagnose a disease until we’ve already lost a few patients,” he said.

Superbugs, or super bacterium, are bacteria that carry several resistant genes and are difficult to treat. When a disease is inappropriately or excessively treated with antibiotics, the body develops an immunity which encourages the bacteria to grow stronger.

Dr Chan said many non-communicable diseases, such as heart disease and cancers, are triggered by “population ageing, rapid unplanned urbanization, and the globalisation of unhealthy lifestyles.”

Chan also noted that “irrational and inappropriate use of antimicrobials is by far the biggest driver of drug resistance.” As communities become more drug resistant, treatments could become more complicated and costly.

ADK Managing Director Ahmed Affal said education was important. “There is an increasing number of antibiotics being prescribed in the Maldives, and we need to talk more. Research shows that there will be problems, as organisms become more resistant.”

Affal said that the majority of cases at ADK are fevers and infections, although heart disease, hypertension, and renal infections are on the rise. “Antibiotics are commonly used for lung infections, and sometimes are given as a preventative measure,” he said.

Speakers at the WHO conference suggested that climate change could accelerate the growth of superbugs. Jamsheed told Minivan News that Maldivians could be more at risk for dengue fever and chikungunya, as well as viral diseases. He predicted that if these diseases were to become more common, the misuse of antibiotics would increase as well and people would become more drug resistant.

“The Maldives is not isolated,” Jamsheed said. “We import almost everything, and any bacteria that is growing elsewhere in the region and the world will certainly be transmitted here.”

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Civil Court to hold passport of 82 year old historian Shafeeg

A Civil Court Judge overseeing a defamation case filed by former President Maumoon Abdul Gayoom today ordered that the passport of 82 year-old historian Ahmed Shafeeg be held.

The judge said the court would seize Shafeeg’s his passport after Gayoom’s lawyer said he had information that Shafeeg was about to leave the country.

Shafeeg was unable to appear at today’s hearing, with media reporting that it was the sixth hearing that had to be cancelled because Shafeeg could not attend the court because of his medical condition.

A medical certificate was presented to the court today by Shafeeg, which Gayoom’s lawyer said was against procedure and that Shefeeg would have to fill a form stating that he could not appear at court due to his medical condition.

Gayoom’s lawyer told the judge that Shafeeg was intentionally dismissing the summons “because he has been attending other functions.”

The lawyer requested the judge summon the doctor who had issued the medical certificate, citing an the incident where former president of Egypt Hosni Mubarak was summoned to the court despite his weak medical condition, and requested the judge to apply the same procedure to Shafeeg’s case.

According to daily newspaper Haveeru, before dismissing today’s hearing the judge said that Shafeeg’s doctor would be summoned to the next hearing.

A spokesperson of the Civil Court confirmed that the media reports were correct and that the judge has ordered Shafeeg’s passport held.

‘’I can confirm that the reports about his passport detention is correct. The judge also said that Shafeeg’s medical service provider will be summoned to the court during the next hearing,’’ he said.

The former President sued Shafeeg after he published a book alleging that 111 inmates disappeared in custody during Gayoom’s administration.

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Education Ministry to appoint LS Construction to rebuild Arabiyya School

Director General of the Education Ministry Mohamed Yousuf has said the ministry will soon sign an agreement with LS Construction to complete the seven-storey Arabiyya school building in eight months, reports Haveeru.

Six companies had expressed interest in the project after Maalaa Highrising pulled out of the project following the rufiya devaluation.

The school is expected to open in mid-2012.

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Air Seychelles crew subdued attempted hijacker in Maldives in 2002: Wikileaks

The crew of an Air Seychelles flight flying from Mumbai to Seychelles via Male in 2002 subdued a passenger armed with a knife who attempted to enter the cockpit, according to a US Embassy cable leaked by Wikileaks.

The confidential cable claimed the attempted hijacker “who looks as if he could be an Indian or Bangladeshi”, was carrying a forged passport identifying him as Chandra Babu Sasi.

The full Wikileaks archive was released on Friday. Of the 3325 documents leaked from the US Embassy in Colombo, 150 concern the Maldives.

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Prisons burdened with small crimes and poor management, report finds

The Maldivian prison population could be reduced by up to two-thirds if the government would “de-criminalise the offence of drug usage and propose mandatory rehabilitation”, according a report by the government and the United Nations Development Program (UNDP). The reform could reduce the number of youth incarcerated for minor offences, the report suggested.

The report also found that “the existing legislative framework and the current penal system does not support the human rights guaranteed under the Constitution, nor is it compatible with best practices outlined in the UN Standard Minimum Rules on Treatment of Prisoners.”

The “Prison Assessment and Proposed Rehabilitation and Reintegration of Offenders Report“, published on September 5, was conducted by Dr Aishath Ali Naaz and UNDP program specialist Naaz Aminath. The report surveyed 60 percent of the prison population as of February 2011 to assess current prison conditions and make recommendations.

It is the first report of this scope to be done in the Maldives.

Aminath said the report took five months to prepare. “It involved very consistent record-taking and visits to prisons. About part way through we realized that we needed a legal framework to make a more comprehensive report, so we met with MPs across the board to understand the strengths and weaknesses.” The team had met with government officials throughout the project.

Aminath said timing the release of the report was difficult after the release of prisoners from Maafushi prison in July.

Key issues identified in the report were a lack of legislative framework to support rehabilitation and reintegration programs; widespread accusations of corruption and inappropriate political influence among institutions; poor prison design; and inadequate budgeting and human resources.

The report’s first recommendation for reform was to “de-criminalise the offense of drug usage” and require rehabilitation, according to the offender’s criminal record.

A second recommendation to “establish a restorative justice program to minimize offenders being incarcerated for minor offences” would regulate the currently heavy flow of Maldivian youth into the prison system.

Of prisoners in the Maldives, the majority are males under 30 years of age who are educated below O-levels. At the time of the report, 66 percent of inmates polled were in jail for drug use or possession.

“There are small time drug users of 23 years of age who are being being sentenced for 70 years in prison,” said Aminath. “When you visit other countries, the jails are divided between minimum and maximum security according to the sentence. You know that criminals in maximum security areas are really hard-core. You also find that drug trafficking is a serious offense in most countries, and traffickers do the most time in jail. But here, traffickers get 25 years while small-time users get 60 to 80 years. These are not hard-core criminals, but they’re put away for almost their entire lives.”

Aminath noted that in the past, drug users who test positive for drugs were given two charges: one for using drugs, and another for testing positive. At present, only individuals in possession of a prohibited drug are prosecuted.”

“I’m not condoning drugs,” said Aminath, “but I think we need to help.”

The report criticised Maldivian prisons for being understaffed and poorly managed.

“The problem in the Maldives is that there aren’t proper prisons,” said Aminath. “It’s hard to even say what the capacity of these facilities is.”

After the fires in 2009, Maafushi prison in March and October 2009, Aminath said that basic living equipment like mattresses were not replaced. Maafushi and Male prisons do not have kitchens, and “there is no structure to support the prisoners who are there,” she said.

Asseyri prison was originally designed as a juvenile rehabilitation center. But Aminath noted that it remained empty until this past year, and since then has been filled with inmates of all ages. She said individuals she asked regarding it’s changed purpose were uniformed.

Inmates surveyed said medical services were inadequate. An investigation found that Maafushi prison compensated by sending an average of ten people to Male each day for medical purposes–an excursion which opens opportunities for smuggling good into prison.

Inmates also complained about a lack of structure in prison life. The report lists claims of torture, inhumane treatment, drug availability and false messages of hope from politicians as examples.

Prison regulations also make it difficult for inmates to develop their own structure. Aside from the Qur’an, inmates are not allowed to have any reading material. Only Asseyri and Maafushi prisons have ‘libraries’–rooms with a few books located outside the gated complex. “It’s risky to go there because it’s not within a protected area, and there simply aren’t enough staff to organise daily library trips,” said Aminath. “Plus, there isn’t much to read there. Really, I wouldn’t even call it a library.”

Naaz and Aminath asked prisoners to describe the types of rehab programs they felt were needed. Most recommended religious education (86.4 percent), counseling therapies (76.1 percent) and life skills (75.1 percent).

Among the report’s recommendations for reform is the development of a Mental Health act. It also encourages Parliament to pass legislation that was proposed 3 years ago, including a criminal procedure code, a penal code, an evidence act, and a parole bill.

Another suggestion is to establish a prison industry to train prisoners in vocational skills, a program that would directly support rehabilitation and reintegration programs.

Aminath said the research team is in conversation with the State Minister, and the Home Minister supports the recommendations.

Speaking at a press conference yesterday, Home Minister Hassan Afeef said, “the Government is committed to improving the rehabilitation system, given
how large a problem drugs are for our community.”

But change won’t happen overnight, Aminath cautioned. She said all institutions “need to strengthen the legal framework and get more involved with the community to make these changes. This applies to all institutions across the board here.”

Correction: A previous version of this story stated that the UNDP team had “‘met with government officials across the board to understand the strengths and weaknesses.'” It should have stated that the UNDP team had “met with MPs across the board to understand the strengths and weaknesses and advocate passing legislative framework bills.” The UNDP team had been in correspondence with government officials from the beginning of the project.

The previous version of the story also stated that, “Aminath noted that drug users who test positive for drugs are given two charges: one for using drugs, and another for testing positive.” It should have stated that “Aminath noted that in the past, drug users who test positive for drugs were given two charges: one for using drugs, and another for testing positive. At present, only individuals in possession of a prohibited drug are prosecuted.”

The previous version also stated that “Asseyri prison was originally designed as a juvenile detention center.” It should have stated that “Asseyri prison was originally designed as a juvenile rehabilitation center. Also, individuals who Aminath asked about its current use as a standard detention center were uninformed. Minivan News apologises for any confusion.”

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Wikileaks releases details of Maldivian national’s detention in Guantanamo

Recently-released Wikileaks cables reveal that the Maldivian government in 2004 assured the United States that former Guantanamo prisoner Ibrahim Fauzee would not be able to leave the Maldives.

In a cable dated 2 August 2004, then Deputy Foreign Minister Hussain Shihab told then-US Ambassador Jeffrey Lunstead that the Maldives was “prepared to cooperate fully with [the US] in dealing with the detainee,” and at a minimum, the Maldivian government would put Fauzee under “close surveillance” and “on a watch list to ensure that he could not leave the country.”

The cable added: “Shihab noted that with the Maldives as an island nation, this would be effective in preventing him from traveling, unless, Shihab said, ‘he is very good at rowing.'”

Fauzee, of Thudhaadhoo island in Baa atoll, was originally arrested in Karachi, Pakistan during a raid on his landlord’s house. Files accessed through a collection of Wikileaks documents at UK’s The Guardian said the raid “just missed a group of Al Qaeda members who had gathered at the home for a meeting.”

Fauzee was then sent to Afghanistan, where he was handed over to US forces. According to a US Department of Defense file published by UK’s The Telegraph, Fauzee was identified as a “medium threat to the US, its interests, and its allies” when he arrived at Guantanamo Bay prison in Cuba on August 5 2002.

The Telegraph Online published a document from the Department of Defense, dated 11 November 2003, suggested that suspicion of terrorist involvement was based on Fauzee’s recent travel and expenditure record. “[Fauzee] has traveled extensively in spite of his limited income and has failed to explain adequately the source(s) of the funds he used for travel. Detainee also attended a fundamentalist madrassa.”

The New York Times also published a document from the Combatant Status Review Board dated 13 December 2004. The document claims that Fauzy was detained at Guantanamo because his telephone number was discovered in another terrorist detainee’s pocket. The number was allegedly associated with “a Sudanese teacher who assisted Arabs traveling to training camps in Afghanistan.”

The cables

According to the cables, Maldivian Permanent Secretary Ahmed Shaheed requested that the United States share any intelligence it had gained from Fauzee on 5 November 2002. The cable noted that the Maldivian government “may have made similar requests via other channels”, but there is no evidence of any response to these requests.

“Shaheed specifically asked for any information on ties Fauzee may have with other Maldivian nationals,” read the cable. “In this regard, Shaheed also requested that the Maldivian government be permitted to conduct its own intelligence interview of Fauzee.”

Eighteen days later, cables show that Shaheed wrote to US officials requesting Fauzee’s release.

By August 2003, Maldivian government personnel were granted a visit to Guantanamo and an interview with Fauzee. The government’s assessment found Fauzee an unlikely threat, and after further investigation the Maldivian government requested his release on 5 November 2003.

No action was taken, although cables indicate at least one more request for Fauzee’s return was made on 11 May 2004.

By late 2004, the US government had agreed to return Fauzee to the Maldives under certain conditions. A cable dated 13 December of that year shows the Maldivian Foreign Ministry was interested in cooperating with these conditions, which included humane treatment upon release.

“Following the release of Mr. Ibrahim Fauzee from US military detention in Guantanamo Bay and upon his return to the Maldives, the Government of Maldives undertakes to treat him humanely in accordance with the laws, and its international obligations.”

The Maldivian government also agreed to enter Fauzee “into relevant national and international watch lists and to apply every measure consistent with its laws to keep him under surveillance, to monitor his movements, and if necessary and appropriate, to restrict them, in order to prevent him from actively engaging in terrorism related activities or associating himself with terrorist organizations.”

On the same date, the US Combatant Status Review Board offered Fauzee a chance to contest his status as an enemy combatant.

Three and a half months later, the US government determined Fauzee “to no longer be an enemy combatant.” Fauzee was extradited to the Maldives on 11 March 2005, where he is currently president of local religious NGO, the Islamic Foundation.

Fauzee is the only Maldivian on record to be detained at Guantanamo Bay. After his release from Guantanamo, Fauzee discovered that his vital documents, which Pakistani authorities had seized during his arrest in 2002, were not in his possession. Since May 2005, the Maldivian government and Human Rights Commission have requested their return from the US government. Fauzee told Minivan News today that his documents were returned to him, but declined to comment on the release of the Wikileaks cables.

The cables were released on Friday, September 2 along with tens of thousands from countries with which the US has difficult relationships, including Afghanistan, Pakistan and Iran. Files on Guantanamo prisoners were among those released. Since the release, the Wikileaks website has crashed repeatedly due to high traffic.

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Contentious religious unity regulations polarise religious factions

Press Secretary for the President Mohamed Zuhair has denied that the President’s Office brought any changes to the religious unity regulations drafted by the Islamic Mnistry, refuting allegations made by the Islamic Minister Dr Abdul Majeed Abdul Bari.

Islamic Minster Bari had told local media that the religious unity regulations were sent to the President’s Office and changed “the way they want it”, and that the ministry was now revising the regulation.

He also said that the Ministry would not give consent for the regulations to be gazetted before revising it thoroughly.

Zuhair said that Dr Bari had made his remarks not in the capacity of a cabinet minister, “but more as an ally of the Adhaalath Party.”

“We did not bring any changes to the religious unity regulations,” he said. “The first half of it was drafted by the then State Islamic Minister Sheikh Mohamed Shaheem Ali Saeed and the other half by current State Islamic Minister Sheikh Hussein Rasheed.”

He said there were rules in the regulation that were inconsistent with the government’s policy and had asked the Ministry to comply with that policy.

“It is a responsibility of all the government ministries to uphold the government’s policy,” he said. “There should be no ministry that has to go against the policy.”

Minivan News understands that certain high-profile persons met with the President prior to the commencement of drafting the regulations and requested the President support the drafting of the regulations in a way that would stop the Maldives National Broadcasting Commission (MNBC) from broadcasting live sermons of Sheikh Ibrahim Fareed.

The President reportedly stated that freedom of speech was vital in a democracy and dismissed the idea.

Recently local religious NGOs Jamiyyathul Salaf and the Islamic Foundation of the Maldives requested the President not to gazette the religious unity the way it was drafted, citing concerns that the new regulations could be employed to silence religious NGOs.

The Islamic Foundation has also filed a case in the High Court, claiming that the Religious Unity Act of 1994 was inconsistent with the constitution of the Maldives and should be invalidated.

“How can a regulation enacted under an unlawful Act be valid, there is a case we have filed in the High Court to invalidate the Act,” said Ibrahim Fauzee, president of the NGO. “We call on the government to wait until the case in High Court reaches a conclusion.”

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Comment: A paradigm shift in health care

More than a quarter of the global population lives in eleven countries in South-East Asia. These eleven countries which include Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Thailand, Sri Lanka and Timor-Leste also bear 28 percent of global disease burden. Government expenditure for health is lowest in this Region compared to all other  WHO Regions.

This means that people in these countries have the highest out-of-pocket expenditure on health. Health care in these countries drives people into poverty and the poor into a vicious poverty trap.

How can South-East Asia maximise resources and ensure that their people remain healthy and productive? This would require a paradigm shift in health policies in favor of preventive care and public health services.  Countries have the power to prevent disease through effective public health interventions. Unfortunately most countries invest heavily on Medicine and curative care in institutions – all of which focus on the person after they develop an ailment. Countries need to empower  people  through health education and preventive care to enable them to  protect themselves from disease and maintain good health.

In these times of economic crunch, focusing on development of positive health while dealing with negative health would be a long term and cost effective intervention.  Instead of waiting for people to get sick we need to reorient ourselves to protecting the health of people, especially those who do not yet show obvious signs of disease.

Community health workers can be the catalysts for such a shift. These are workers come from the communities and act as agents of change for promoting healthy behaviors and reduce health inequities at a relatively lower cost. Nations need to review and redefine the role of these community health workers and make them an integral part of the referral chain within the health system.

Every year millions of children’s lives can be saved by vaccination. Immunisation prevents diseases and contributes to the quality of life. Access to safe and effective vaccines is a basic right of all children. Yet about 10 million vulnerable children in these countries do not receive Diphtheria, Tetanus, Pertussis (DTP3) vaccination during their first year of life. While each year an estimated number of 1.5 to 2 million children die due to vaccine preventable diseases world wide; 25-30% deaths occur in these South-East Asian countries.

Every minute one child under the age of five dies of pneumonia in WHO’s South-East Asia Region. Diarrhoea kills 6-7 under-five children every 5 minutes. These lives can be saved through simple interventions. By improving child nutrition, exclusive breastfeeding up to the age of 6 months, continued breastfeeding, zinc supplementation, expansion of immunisation coverage, promotion of hand-washing and provision of safe drinking water and sanitation can prevent these diseases and deaths.

Seventy percent of the world’s malnourished children reside in WHO’s South-East Asia Region. Most of them suffer from anaemia, including deficiency of iron and Vitamin A.  While many children die due to severe malnutrition, a larger number of deaths occur among the less severely malnourished. The consequences of malnutrition are inter-generational and besides health it can affect intellectual capacity and work capacity in adulthood.  Unfortunately the same countries also suffer from unhealthy diets, obesity and a higher risk of chronic non communicable diseases. The cost of medical care for these diseases will impoverish their populations further.. .  Countries need to bring together sectors like education, agriculture, fisheries, food processing, media and members of parliament to successfully meet nutrition challenges.

The disease burden in our countries can be effectively prevented through public health programs that strengthen primary health centers to educate communities about prevention.

Not all of the disease burden can be prevented. We are talking about a proactive health strategy. We are talking about a positive health approach. We are talking about a well informed public that know how to prevent, protect and maintain good health.

Countries in South-East Asia need to achieve a better balance between preventive and curative care. This balance in health care will reduce health-care cost and ensure better health and better quality of life of all people.

Dr Samlee Plianbangchang is the Regional Director of the World Health Organisation for South-East Asia

<em>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]</em>

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RaajjeTV condemns newly formed PPM for barring journalist from press conference

Private broadcasting television RaajjeTV has condemned the newly formed Progressive Party of Maldives (PPM), led by former President Maumoon Abdul Gayoom, after senior officials of the party denied entrance to  a journalist from RaajjeTV to a press conference held by the party yesterday.

In a statement, RaajjeTV said that the action of PPM senior officials was undemocratic and uncivilised, and claimed that the PPM has boycotted the TV channel.

‘’To date, Raajje TV was never invited to any event organised by PPM, and has constantly refused to provide any information to us,’’ the statement said. ‘’It is questionable whether a party formed for the benefit of the citizens would do something that would destroy democracy while it is still in its infant stage.’’

RaajjeTV said that it would try to bring “true news” to the citizens of the Maldives, despite the situation.

The TV channel also called on the former President and his family to share information to the media equally and to be consistent in its words and deeds.

MP Ahmed Nihan, who is the current Media Coordinator of PPM, today told Minivan News that he knew about the incident last night and said that it was regrettable.

‘’We do not have any issues with the TV channel, but there might be some individuals in the party that have issues with it,’’ Nihan said. ‘’We have not made any decision to boycott RaajjeTV.’’

Nihan said he personally had given two live interviews to RaajjeTV and has been sharing information equally.

‘’We give very high priority to the media because it is the fourth pillar of democracy,’’ he said adding that the reports broadcasted on RaajjeTV were “usually against former President Gayoom”.

‘’Although they air such reports, we do not have any issue with that as long as they keep to the laws,’’ Nihan said.

Spokesperson of PPM Ahmed Mahlouf did not respond to Minivan News at time of press.

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