Right Steps & Poui Trees


Ministry of Health Jamaica: 6 weeks of #zika numbers

On July 5, the Ministry of Health (MOH) in Jamaica began posting updates on its website regarding the number of zika cases. The first update was for data as of June 25, 2016 and since then the MOH has posted a further 6 updates, the most recent of which was posted on August 8 and contained the numbers up to August 5, 2016. All 7 updates are currently available on the MOH website, but for easy review I have included the chart below:

MOH zika updates June 25 - August 5 2016

One of the questions which remains for me is why there have been so few confirmed cases, given the steadily increasing numbers of reported and suspected cases. It would be useful for the MOH to publish data regarding the number of samples submitted for testing, the number of tests completed and the outcomes of these tests.

It would also be useful for the MOH to make public any reports on any problems being experienced with the testing that has been and is being done. I had asked some time ago, for example, about a doctor’s comment on having heard from two sources that a lack of a reagent had been hampering the testing of samples.

Sloper on FB

Dr Tufton had said via Twitter that he would check on that report. I haven’t heard an update from Dr Tufton on that reported lack of reagent, but it is entirely possible that I missed his update.

I heard CMO Dr De La Haye saying on a radio programme this morning (Nationwide News Network) that routine testing of all pregnant women could cost as much as J$100 million. If such an expenditure is being contemplated, it would be good to have an assurance that the process would be reliable.

The zika outbreak and its impacts continue to unfold, and the provision of information continues to be an important aspect of the government response.

 


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350 Words or Less: Classifying the Ministry of National Security Budget

Last week (July 7) at a post-sectoral debate press briefing, Minister of National Security Robert Montague said that he intends to have his ministry’sbudget classified, thus making it unavailable publicly.The reason given for this is to prevent information within the budget being used by people with criminal intentions.Montague press conference 7-7-16 (2)

“The era of announcing details of our security programmes is over. And it is over to the extent that I am bringing a submission to Cabinet seeking to remove the National Security budget from the printed information within the national budget. And the reason for it, we have seen on our website a lot of traffic from countries and from organizations that we too have an interest in, trying to find out the size of the budget and what you spending on. And it is an intelligence gathering. We are providing those who wish to cause mayhem with vital information and this ministry is trying to cease and desist.” – Minister of National Security, Robert Montague (Transcribed from recording of Nationwide News Network newscast July 7, 2016)

The Minister says he will be taking this proposal to Cabinet, where I hope it will be reconsidered.

Openness and transparency are important and prized characteristics of governance in a modern democracy. I cannot in that context see any reason to justify the blanket withholding of the entire budget of the Ministry of National Security from public access. The majority of that budget couldn’t possibly pose any risk to national security by being in the public arena. Pages like this, for example:MNS Budget 2016-2017 - sample page

If there were a genuine and substantiated risk posed by public access to any particular items within the budget, the appropriate approach could only be to redact specific, limited items.

Does the level of information given in the budget reach the kind of operational detail that would provide useful information for criminal organizations? Page after page of the document that I looked at could never justifiably be exempt from public access. You can have a look at the budget now posted on the Ministry of Finance’s website – Estimates of Expenditure 2016-2017 – and see what you think.

MNS Budget 2016-2017 - 1st page

 

 


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Jamaica: #Zika Update…On the Ministry of Health Website, No Less!

Christopher-Tufton-WebListening to the news at midday today, I heard a report of an update given by Minister of Health Christopher Tufton about the current situation with the zika virus here in Jamaica. As the news report was read, I madly tried to scribble down the figures being given…number of reported, suspected and confirmed cases, etc. I was particularly interested in the number of pregnant women reported with suspected cases of zika. I thought I heard 88, and began to comb the news sites online and on social media to see if I could track down the figure. No luck. I was about to send Minister Tufton a tweet or to call Power 106 to see if I could speak with someone in their news room.

And then I decided to check the Ministry of Health website, though I had little hope of finding any current figures there, based on past experience.

Eureka! Look what I found! A downloadable, written document entitled “Zika update as at June 25, 2016“, posted on the website today, July 5, 2016! Hallelujah!MOH zika update 25-6-16

 

Seriously though, this is a significant development in keeping the public informed, that on the same day the Minister gives an update to the media, a document containing the figures is posted on the MOH website. I sincerely hope that this is the beginning of a trend.

The full document (3 pages long) is available on the website and I have included it here: MOH Zika-update-of-as-at-June-25

Of particular note are the general update regarding number of cases, with 24 confirmed cases as of June 25, 2016:

MOH zika cases 25-6-16

and the number of pregnant women with suspected cases of zika:

MOH zika and pregnancy 24-6-16

Providing reliable, easily accessible official information to the public on a regular basis is essential during a public health situation such as this.

 

 

 


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350 Words Or Less: Where Are We With #Zika Outbreak in #Jamaica?

Last night I was very puzzled when I took a look at PAHO/WHO’s Zika – Epidemiological Update  for April 28, 2016. These updates are posted weekly on their website.

paho who zika alerts page with border

PAHO/WHO Epidemiological Alerts and Updates

In the section on Incidence and Trends, the April 28 Update had the following about Jamaica:

paho who update 28-4-16 jamaica border

paho who update 28-4-16 jamaica A with border

Where exactly do we stand in terms of the Zika outbreak in Jamaica? This report seems to be saying that the outbreak here began in October 2015 (EW 39), when there was one reported suspected case. The highest number of suspected cases (162) was reported in the first week of February 2016 (EW5), with decreasing numbers of suspected cases susequently. Is this pattern agreed by the Ministry of Health (MOH)? If so, what does this mean in terms of expected incidence of zika? And if not, what does the MOH say about where we are in terms of the outbreak?

The number of suspected cases I have mentioned are taken from an interactive graph on the PAHO/WHO site. Pointing to each bar in the graph  gives the number of confirmed and suspected cases reported for that week.  PAHO/WHO interactive chart of suspected & confirmed Zika cases 

 

 

paho who interactive chart 28-4-16 update with borders

Unfortunately the MOH website doesn’t provide any such data. In a situation as rapidly changing as the zika outbreak is, it isn’t acceptable that the Ministry’s website isn’t being updated regularly in respect of this and other viruses (dengue and H1N1 influenza in particular) now circulating in Jamaica.

MOH representatives, including Minister Tufton, CMO Dr De La Haye and Director of Health Promotion and Protection Dr Copeland, seem to be readily available to the media, and are often heard giving updates. They share data about samples for testing and confirmed cases, etc. But this data is not posted to the website, where it can be accessed in more permanent form. The MOH website should be the go-to source for this kind of information.

NB As of today, there are still only 8 confirmed zika cases for Jamaica. But how many suspected cases are there? You can find a news report on Irie FM, for example, but not on the MOH website.

irie fm zika 5-5-16 copeland

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ChikV in Jamaica: Research & Information Needed – (And ATI Request)

This Gleaner’s online headline yesterday caught my eye; stories about ChikV tend to.

Gleaner ChikV headline 26-11-15

The article was about a study recently published in Neurology Journal, which looked at a particular aspect of “Chikungunya virus (CHIKV)–associated CNS [Central Nervous System] disease during the La Réunion outbreak, and assess[ed] the disease burden and patient outcome after 3 years.”

I would obviously want someone with the appropriate medical/scientific expertise to explain the relevance of this study to us in post-ChikV epidemic Jamaica.

Two statements particularly interested me, one from the Gleaner article & the other from the Neurology Journal abstract:

  • “…the infected persons with encephalitis had persisting disabilities. The disabilities included behavioral changes and problems with thinking and memory skills in infants and post-infectious dementia in previously healthy adults.” (Gleaner)

and

  • “In the context of a large outbreak, CHIKV is a significant cause of CNS disease.” (Neurology Journal)

Like hundreds of thousands of other Jamaicans, I had ChikV last year and know of many relatives, friends and acquaintances who also had the disease, with varying levels of severity. I had had dengue the previous year and was struck by the fact that the effects of ChikV lasted far beyond the acute phase, whereas I recovered from dengue relatively quickly. I also learned, mainly via online sources, of the medium and long term effects that ChikV can have, something which the Ministry of Health (MOH) seemed to downplay at the start.

I wanted to find out whether there was ongoing or planned tracking of medium and long term effects of ChikV  being experienced by people in Jamaica following the 2014 epidemic. So on April 18 this year, I made an Access to Information (ATI) request to the Ministry of Health and on May 14 received 11 documents from the Ministry.

MOH ATI (2)

The related documents ranged from Notes of Research Meeting held on Chikungunya November 20, 2014 at PAHO Building , UWI to notes of Chikungunya Research Working Group Meeting  Held at PAHO Building dated 29 April 2015. All the documents can be accessed here. (MOH ATI all chikv)

It is time, perhaps, for me to do some follow-up ATI requests, to see what has taken place in the intervening 7 months.

But the real request is for the MOH and the various other local and regional bodies to track, to do research and to keep us informed. ChikV is here to stay, we are told, and we need to know as much as possible about its effects and how they can be prevented and treated.


What You Can Find on the Internet: Thistlewood’s Diaries

The internet still astounds me. Its range, what it makes possible. And I know only a microscopic part of its uses and possibilities. This morning I had one of those moments which highlights/encapsulates for me this remarkable phenomenon and tool. (Forgive me, but I grew up in a world without the internet…)

I was up early & was on Twitter, when I saw this post by historian Gad Heuman:

Gad Heuman tweet

I followed the link to the Yale University Library Beinecke Rare Book & Manuscript Library page detailing the digitization of the papers of Thomas Thistlewood. (Click here)

Thistlewood diaries library link

And a few clicks later (click here), I was looking at reproductions of actual pages of his notorious diaries…

Thistlewood July 1751

Many people would know of the diaries from Douglas Hall’s book “In Miserable Slavery: Thomas Thistlewood in Jamaica, 1750-86”, sections of which are available on Google Books (click here), for those who don’t have access to a physical copy.

Thistlewood - Hall inside title pageThistlewood - Hall back cover 1

Thistlewood’s diaries are difficult to read – the physical script and some of the disturbing content, but their increased availability illustrates one of the real values of the internet – increased access to information.


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A Bruised Access to Information Act?

I am glad that Minister of Health, Dr Fenton Ferguson, changed his mind and is now going to release to the public the long-withheld health facilities audit report. It is the right decision and should have been his position from the start.

But I have some concerns.

I am concerned that the Minister initially felt it was acceptable to withhold the full report from the public, as this doesn’t fit within the access to information paradigm which is supposed to operate in Jamaica.

I am concerned that the individuals and organizations (including media houses) who made applications for the audit report using the provisions of the Access to Information (ATI) Act hadn’t received the report as of Monday (Nov 2). Applicants have said they were beyond the original 30 day period and were at or approaching the end of the 30 day extension that can be requested under the Act. The reason the Ministry of Health (MOH) gave for the delay was that it had asked the Attorney General (AG) for legal advice regarding releasing the report.

A number of the individuals and organizations said that the MOH wrote to them on Monday saying that it was still awaiting the AG’s response, and so wouldn’t be releasing the document at that time. The MOH also advised applicants that they could appeal the decision, using Part 5 of the Act.

So basically, as of Monday the MOH was not prepared to release the report to those who had applied for it using the designated law for this purpose.

And then on Tuesday morning (Nov 3), the Minister reversed his decision and said that he would be releasing the audit report after all.

MOH ATI release of audit tweet Nov 3 2015

What changed the Minister’s mind? Consultations, said the Minister at a public function on Tuesday. Consultations with whom and of what nature?

Was the Minister’s decision to release the audit report based on the principles and provisions of the law, the ATI Act? Or was it the public pressure? The mounting political pressure? The intervention of the private sector organizations? The continued media scrutiny? The likelihood that the full report had already been leaked & the details were beginning to make their way into the public sphere?

So where does this leave the ATI Act? What happens when there is no public, political, private sector or media interest and pressure? When it is just you the citizen, a Ministry of Government and the Access to Information Act? We don’t know how long the appeal process would have taken or what the outcome would have been. But we do know it would have been a lot longer than 24 hours and would have fit the delay-and-frustrate model far better than the public outcry did.

I am concerned that more than 10 years after the ATI Act came into being, Ministers and Ministries do not respond as quickly as they ought to, given the objects and provisions of the Act.

ATI Act objects


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The Unelected Majority & the Elected Minority

The majority of us will never hold public office or lead the country or head a government ministry. We know the challenges faced by those who do are often great. But that doesn’t mean we must sit down and shut up in the arena of public discourse.

There are those who say that unless you can tell how to solve the problem at hand, you have no right to criticize. That would mean that most of us wouldn’t be able to say anything about the outbreak of infection in health care facilities or fires at open garbage dumps or the emptying of untreated sewage into our waterways. The thing is, we see and feel the effects of these things and as citizens in a democracy we have the right (the duty?) to speak out and ask questions; the right to indicate that we are not happy – are very distressed, actually – with what is happening.

We have a right to ask questions, to expect answers, to be told what happened, what went wrong and what is being done to correct the problem and prevent reoccurrences. We should expect journalists to have more than 5 minutes of answers. We should expect access to information contained in audits done of our health facilities. These are hardly unreasonable expectations.

We are the unelected majority, who have every right to ask questions of the elected minority and our public servants. And every right to expect forthright, accurate, comprehensive and timely answers.