The Maldivian delegation to the World Health Organisation’s (WHO) 136th executive board meeting have held talks with the Chinese and Lithuanian governments on aiding the development of the Maldivian health care system, the health ministry reveals.
In a statement by the ministry it was revealed that discussions with the Chinese delegation had resulted in commitments to provide the Maldives with medical equipment and doctors.
Further, in accordance with the MoU signed between the governments, the Chinese government agreed to expedite scholarships for Maldivian medical students, along with increased efforts to boost Chinese alternative forms of medicine in the Maldives.
The Lithuanian delegation agreed to provide training, expert advice, and technical support to developing specific fields in medicine in accordance with the findings a team of neurosurgeons from the country who visited the Maldives last year.
The Maldivian delegation in the talks was led by Minister at the President’s Office Mohamed Hussain Shareef who was accompanied by State Minister for Health Hussain Rasheed, Deputy Director of Health Aishath Samiya, and Director of the Health Protection Agency Maimoona Abubakr.
Minister at the President’s Office Mohamed ‘Mundhu’ Hussain Shareef has been appointed Chairman of WHO Executive Board Committee.
He becomes the second Maldivian to hold the post, with former health minister Dr Mariyam Shakeela appointed to the role before leaving her cabinet position last year.
The WHO Executive Board is composed of 34 persons who are technically qualified in the field of health, each designated by a member state that has been elected to serve a three-year term. The Maldives’ term concludes this year.
Mundhu has previously served as President’ Office spokesman and minister of youth and sports.
The WHO Executive Board’s 136th session is taking place in Geneva from today (January 26) until February 3, and will agree upon the agenda for the May 2015 World Health Assembly.
Priority issues to be discussed are communicable and noncommunicable diseases; promoting health through the life course; preparedness, surveillance and response; and health systems as well as matters relating to programme, budget, management and governance, and WHO reform.
Dr Poonam Khetrapal Singh is WHO Regional Director for South-East Asia. As Deputy Regional Director (2002-2012)-she was overall lead in the Tsunami 2004 response. She is a staunch advocate and practitioner of emergency risk management in the health sector.
Documentation and publications of the tsunami 2004 and its lessons available at www.searo.who.int
There is debate among language scholars on the two Chinese language characters for the word crisis; one represents danger and the other possibility or opportunity. This has led to the often quoted cliché that “In every crisis, there is opportunity” when in fact these two characters define a crisis: the opportunity or the possibility of danger.
Recalling that late morning of 26 December 2004, when the Asian tsunami hit some countries of WHO’s South-East Asia Region, I remember receiving phone calls from our country offices in the Region describing the emergency as water entering the office compound in Maldives to waves rising as high as 40 meters lashing Sumatra, Indonesia, Andaman, sea coast area of Thailand, Myanmar, the eastern shoreline of Sri Lanka and South India.
What was common about their stories was that the water receded from the shores till as far as the eye could see before it all struck back with a vengeance. From all the reports, it seemed only Indonesia felt an earthquake. The story evolved quickly for the world to see – the final death toll reached close to 200 000; around 800 primary and secondary health facilities were destroyed; coastal villages and people’s livelihoods were wiped out; the tourism sector suffered a major blow in Maldives and Thailand. The total damage was estimated at US$11 billion.
The response to the health needs was overwhelming—there was no recollection of a tsunami in recent times so there was no preparation. Coordination of response was rushed. For many countries systems were built as we responded. Donations in cash and in kind from individuals to governments became an event in itself and hard to manage. The WHO Regional Office for South East Asia deployed over 160 people over a period of three months to respond to the initial health needs. Every essential public health function – surveillance, maternal child health services, immunization, psychosocial support, management of dead bodies – was conducted on a massive scale tailored to the needs of each of the affected countries. Field offices were set-up, logistic requirements put in place and technical experts were deployed wherever needed. It was a response and recovery operation WHO had not seen or committed to in its history.
Today, a decade later, the important question before us is: how do we prepare ourselves for such an event? More importantly, how prepared is prepared? Measuring preparedness should be the basis for addressing risks, no matter what the cause. A series of lessons learnt meetings, evaluations, review of responses, culminated in 2005 with a set of Benchmarks for Emergency Preparedness and Response which includes standards, indicators and guide questions.
This tool intended to measure in detail what is in place for legal frameworks, plans, finance, coordination mechanisms, community capacities, and early warning for health events. The rest of the humanitarian and development actors were also looking to advance in this direction. The Hyogo Framework for Action (HFA) was developed in 2005 along with the UN Humanitarian Reform. This brought about a better approach to coordination in response, accountability and rapid predictable funding.
Indeed, we can do better and we can measure our actions so we can objectively identify gaps and address them. Countries have used the WHO South-East Asia benchmarks for capacity assessments and development for better risk management in the health sector.
This also helped countries that were not affected by the tsunami. The tsunami was the turning point for countries to see that risk management is an essential public health function and crucial for protecting people’s health and investments. Countries also use HFA targets across sectors. Humanitarian reform has been applied in several emergencies with varying success but with systematic documentation of gains and gaps providing a clearer way for corrective action. Even with all these tools, investments, new plans and building back better – the only proof of effective preparedness would be another event.
On 11 April 2012 an earthquake of 8.7 on the Richter scale rocked Aceh in Indonesia for four minutes. Tremors were also felt in neighbouring countries. It seemed like a repeat of 2004. But certain specific actions of that day clearly demonstrated that we had learned since then. There was evacuation to higher ground by all coastal communities from Aceh, Nias Island, Sri Lanka, Maldives and Thailand.
The clear link of the tsunami warning system (now in place in the Indian Ocean) and community relay of the communication was seen in many coastal areas such as Chennai where loudspeakers from local government representatives informed everyone to move to safer locations and heed the warning. Eight were reported dead and those injured were treated promptly and were accounted for. Hospitals in Banda Aceh evacuated their patients in an orderly manner- a result of their preparedness plans and drills. Although some health posts were damaged, the city infrastructure did not suffer from major destruction, in fact very few were damaged. The tourism sector in Sri Lanka was very organized in moving resort guests to higher ground.
Those initial 6 hours of response on 11 April proved that we have learnt what our risks are and know how to manage and continue confidently to live with them. Indeed, it pays to invest in making risk management capacities pervasive in all levels of society – in all sectors. We have seen India, Indonesia, Maldives, Sri Lanka and Thailand continue to improve systems they set-up with knowledge and tools developed through the lessons of the tsunami. Other countries have also done so using the same knowledge. The death tolls in various events have decreased over the past years as preparedness and response capacities have increased phenomenally. Today, as we look back at the devastating tsunami, we can say that it taught us valuable lessons. .
To further build on these lessons, we must remain insightful of the linkages of hazards, risks and capacities. Reducing our vulnerabilities require an iterative, honest process of correction in what we invest in, where we invest and what we do to further decrease the risks to our people. Why? Because, even though our capacities increase, so do our risks. We are facing new risks today. Cities are sprouting unplanned, extreme weather events due to climate change are occurring with regularity; people are moving globally with much more ease – all of which contribute to another “perfect storm”.
Maybe our current capacities will not be enough for the next event so we need to keep questioning our status in order to improve. Global tools and mechanisms like the WHO South-East Asia Benchmarks will undergo regular use and review, the HFA will be updated in March 2015 and humanitarian reform has given way to the transformative agenda for the UN and partners to respond to mega-disasters.
It seems though that no effort is ever enough, the world is facing another global health emergency requiring resources from everywhere –Ebola is an old disease in new places. An event where there is no obvious physical proof of destruction but it is just as destructive to individuals, families, societies and nations. The Ebola outbreak is another event we need to learn from. We must continue to invest in prevention and preparedness to save more lives. This will eventually decrease the resources needed for the response and recovery in a future event.
Meanwhile, what is clear is that both statements are true- we live in a world where there is always a possibility for danger; and in every crisis there is an opportunity. Knowing what we know now, we must look ahead and use that knowledge as an opportunity to keep getting better in saving lives, preventing diseases, and protecting health.
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The Human Rights Commission of Maldives (HRCM) has asked the government to address problems in the water and sewerage system Guraidhoo’s Centre for People with Special Needs.
The directive calls upon the ministry to immediately introduce temporary facilities which will provide clean water for basic needs, and requests detailed plans for dealing with the facility’s water and sewerage problems by October 19.
The centre, in Kaafu atoll, is the only facility for Maldivians suffering from mental disabilities and currently falls under the remit of the Ministry of Law and Gender.
The commission states that the government has failed to take action despite repeated appeals from the HRCM over the past 5 years.
Today’s directive was released based on observations made by a team from the commission which visited the centre on September 16.
The HRCM revealed in a statement that tests conducted on the water used for sanitation purposes in the centre showed a high presence of e-coli bacteria, in contravention of World Health Organisation (WHO) approved standards.
Doctors who joined the observation team suggested that using the water could lead to diarrhoea, skin diseases, and urine infections among other ailments.
The statement further noted that medical records from the centre showed a large number of patients were already suffering from skin diseases.
The HRCM stated that it had been repeatedly calling on the government to solve the issues regarding the water supply of since 2009. A report released that year stated that approximately MVR9,000 (US$583) was spent each week on purchasing bottled water for drinking purposes alone.
While Tuesday’s statement calls on the government to provide clean drinking water, it does not specify whether the centre was continuing to supply mineral water to residents.
The commission also conducted tests on the water in 2011, after complaints it had a foul smell. Three of four samples taken from the centre proved to be below WHO approval standards.
Minister of State for Law and Gender Dr Hala Hameed was not responding to calls at the time of press, while an official of the Ministry of Law and Gender who requested to be unnamed declined from commenting on the matter.
The Ministry of Law and Gender has the mandate to oversee all government functions related to families, children, women, people with special needs, and human rights.
The Malé Water and Sewerage Company last year signed an agreement with Kandooma resort to provide a 30 tonne water plant to nearby Guraidhoo as part of a MVR1.5 million (US$97,600) investment.
The Ministry of Health has issued a health alert regarding the Ebola outbreak in West Africa, although the Health Protection Agency (HPA) has said the risk is minimal for the Maldives.
“We have discussed this with the WHO as well, the risk is minimal for Maldives,” said Dr Aishath Aroona, an epidemiologist at the HPA.
” It is very unlikely as there are very few people going or coming from these three countries to Maldives, and infection control in the Maldives is very effective,” she said.
The health ministry has warned against travelling to the three countries in which the disease have been found – Guinea, Liberia, and Sierra Leone.
The ministry requested anyone who has travelled to these countries to look for symptoms of the disease for 21 days and to seek medical assistance should any be recognised.
Meanwhile, the Health Protection Agency (HPA) is working with the Department of Immigration and Emigration to identify people arriving in the Maldives from these countries.
These people will be checked at the airport’s health counter and released if the virus is not found. The HPA will keep track of those released, advising them to report immediately if any symptoms are found. In this event, the agency recommends people visit the major tertiary hospitals rather that health centers and clinics.
Additionally, the agency has sent infection control guidelines to to all health service providers around the country – including those at tourist resorts – to ensure the safety of patients and staff. Doctors are asked to take great care and proper measures to avoid infection, including the use of gloves and waterproof clothing.
Dr Aroona said that WHO is working in these countries to ensure no infected person travels abroad in order to minimise the risk of a global outbreak.
The health ministry alert referred to WHO warnings regarding the virus noting that, while it is currently known to be transmitted only through direct contact and bodily fluids of an infected person, the possibility of the virus being transmitted through other means is still under investigation.
The WHO has reported total of 1,603 cases and 887 deaths since March in the three afflicted West African countries. While Nigeria has reported three probable cases there is no outbreak in the country, with further information revealing that one of the three had come to the country from Liberia.
The incubation period between infection and the onset of symptoms can last from two to 21 days.
After this period the first symptoms of the disease which become visible include fever, intense weakness, muscle pain, headache, and a sore throat. This is followed by diarrhoea and vomitting.
The disease can impair the functioning of organs such as the kidneys and liver and can results in internal and external bleeding. Currently there is no vaccine or cure for Ebola and past outbreaks have had fatality rates of up to 90 percent.
More information on the Ebola virus disease have been provided by the WHO here.
The Minister of Health and Gender Dr Mariyam Shakeela has been appointed as the Chairperson of the Executive Board of World Health Organisation (WHO).
This appointment took place at a meeting of the WHO Executive Board following the World Health Assembly in Geneva today (May 26), and will be the first time the Maldives has received this title, local media Sun Online reported.
The WHO Executive Board is composed of 34 persons who are technically qualified in the field of health, each designated by a member state who has been elected to serve by the World Health Assembly.
Member states are elected for three-year terms, and Maldives was elected in 2012.
To commemorate this year’s World Health Day (April 7 2014), local NGO Advocating the Rights of Children (ARC) has organised a number of activities to promote healthy eating and active lifestyles for children.
According to an ARC press release, today is the official release of animated Sing-Along song ‘Eat a Rainbow’. The song illustrates the benefits of eating different coloured fruits and vegetables.
This Friday (April 11) will also be the official book launch for the 2nd storybook in the HEAL series. The event will be held at the Raalhugandu Helipad Area, from 16:30 until 18:00.
In addition, ARC will be running healthy eating awareness sessions for school children in the local area. ARC’s senior consultant on nutrition will conduct interactive sessions for children at Billabong International High School and Kalaafaanu School.
At the HEAL campaign information sessions children are encouraged to eat different coloured fruits and vegetables everyday, to choose water first to quench their thirst, to avoid junk food, to eat healthy snacks and to stay active.
The sessions will be continued for other schools in Malé and in other islands throughout the year.
Minister of Health and Family Dr Mariyam Shakeela has said the state will cover all expenses of all children of the woman infected with HIV due to the negligence of state hospital IGMH up until the completion of their studies.
However, details of how many children the woman has or to what standard the government will sponsor their studies and livelihood were not provided.
Shakeela further stated that the unborn child of the pregnant woman is of “good health” and that the baby is “showing a good response” to medication.
“God willing the baby’s progress is good, and is under continued supervision,” she told media after a press conference held together with the World Health Organization (WHO) on Wednesday.
Shakeela confirmed that the baby is receiving the “best treatment for HIV that is given by the WHO”, adding that the organisation’s head office in Geneva and the Health Ministry is continuing to hold daily teleconferences on the status of the mother and her unborn baby.
WHO Regional Director for South East Asia Dr Poonam Khetrapal Singh reiterated that the organisation is extending assistance, and applauded the Maldives government for having taken “productive action” following the incident.
“As a result of the investigation launched by the government, other such issues in the Health Sector will come to light and incidents like this can be avoided in future. Together with this, the capacity of the laboratory can be increased,” Singh said, mentioning that she had visited the IGMH laboratory on Tuesday.
WHO pledges assistance to the health sector
Today’s press conference was officially held to mark the end of Dr Singh’s two day visit to the Maldives. Dr Singh commended the government for its “commitment and vision for universal health coverage for all its citizens”.
Last week, President Abdulla Yameen’s administration announced the introduction of universal healthcare, maintaining that the enhanced coverage – previously capped at MVR100,000 – was financially sustainable.
“The most major challenges faced by the Maldives, like many other countries in the region, is the issue of having sufficient human resources, and the procurement of medicine,” Singh noted.
She said that the WHO was currently working with the government to explore ways in which to ease the procurement of medicines, adding that some initiatives include purchasing generic medicine instead of patented ones, and promoting bulk purchase of medicines – both of which would bring down costs considerably.
Health Minister Shakeela further stated that the government is paying special attention to training more locals to work as nurses and doctors, stating that this would bring down the number of foreign nationals working in the health sector.
Singh further noted that the Maldives has achieved much on the front of strengthening its disease surveillance, response,and case management capacity for dengue control.
“Despite challenges such as high turnover of doctors in the islands, and difficulty in retaining experience and expertise, Maldives has maintained a low case-fatality rate for dengue.”
“This is a country whose collective efforts and strong determination have successfully eliminated malaria and has sustained this remarkable achievement. Maldives is the only country in WHO’s South- East Asia Region to achieve this goal,” she continued.
“We would like Maldives to reflect on the malaria experience and use their expertise to prevent dengue which poses a major public health risk to its citizens.”
Dr Singh also met with Vice President Dr Mohamed Jameel Ahmed on Tuesday and congratulated him on Maldives’ achievements made towards the Millenium Development Goals and what she termed as “gains in public health more broadly over the past decade”.