Swine Flu in Mauritius: A Tale of Mismanagement

by
Inf

By now, all Mauritius should be aware that there is Swine Flu – AH1N1 in Mauritius, and that there have been more than 5 deaths. I might be blogging this article a bit late, but I wanted to keep a record for myself, and everybody else about how this crisis was handled. I shouldn’t say “was” I think, since the worse may still have yet to come. But anyway, let’s be optimist for a tiny fraction of a second, and keep the “was” there.

I’ll start at the very beginning, and illustrate some points as to how the crisis was mismanaged, and what possible solutions existed if there was a possible solution to begin with. Let’s start where it all began:

1. No Disease Warning System in Mauritius

At first, when the first case was reported, people didn’t really know if there was AH1N1 in Mauritius or not. All we heard was “suspicious case” and nothing about a confirmation. People just casually brushed off the issue, saying “Bah! One case in a million. Probably a tourist somewhere in a hotel. I shouldn’t be worried”, and continued their lives. No communique was issued about any warnings, or precautions to take. A simple “Possible Swine Flu case in Mauritius. Take appropriate precautions.” would be enough. But wait? What is “appropriate precautions”? We don’t have any warning system here. After Chikungunya, we should have one already, but no, we have no warning system for diseases! If we had one, the communique could have said “Possible Swine Flu case in Mauritius. Take Level 1 Precautions” and it’d be a lot clearer, like “Class 1 in Mauritius”!

2. People flocking to hospitals

As soon as the first few deaths were reported, people flocked en mass to hospitals to get themselves diagnosed. At that time, people were not very well informed about how the disease spread. If you have ever been to a hospital in Mauritius, you know how they function: you sit in the Casualty/Waiting Room until you get your turn to see a GP and move on to a specialist if needs be. You should also know that the estimated waiting time is usually more than 1 hr in the best of cases.

People, infected with Swine Flu and Seasonan Flu sat together in a waiting room, for long durations and packed close together. Can you tell me of a better way to spread a disease fast? The disease can move around an estimated 2 meters, and stay active for around 6 hours outside a host. (That’s what the Govt. said.) Now imagine the number of people that could have caught the disease. I know, a flu-reserved area was setup at the hospitals, but it didn’t come immediately, did it?

What could have been done? Virtually nothing. As soon as people felt they had flu, they panicked and ran to hospitals. I understand them, it’s difficult to distinguish between AH1N1 and the seasonal flu. A possible solution would be to use smaller, but more numerous waiting rooms, so the risk of contaminating a big crowd is minimized, but I don’t know if it’d have worked.

3. Not monitoring the stock of Tamiflu (or its alternatives)

I thought it was the job of the Ministry of Health to keep an eye on our stocks of medicines. After a while, what do we hear? The Tamiflu was expired! So for this whole time, people were consuming expired stuff. As a counter-argument, the Min. of Health contacted the Tamiflu agency or something and got the information that the pills were still good for two years after expiration. I agree, it may still be good, but is it still as effective? It may be safe for consumption, but I guess its effectiveness decreases with time. Else, it wouldn’t need an expiration date, would it?

What should have been done is monitoring of the stocks! Come’on! We got a worldwide Swine Flu outbreak, and nobody thought of checking our Tamiflu, our sole line of defense, to see if it’s still good?

Also, there is this rumor that Tamiflu is being reserved for tourists and other folks, and also, that the stock of Tamiflu is running out faster than expected. So unlike UK, where Tamiflu is given over phone.

4. Information and Misinformation

I remember the first announces that said: “Masks are not effective. No need to wear them. They may even be more dangerous for you”. Then recently, “Wear masks if possible”. What the hell? What should I do? Wear them or don’t wear them? Also, let’s consider France, since our Minister of Education, Hon. Bunwaree, considered France when closing down schools (more on that below). France recently made an order of more than $35 million for  protective masks. If those were not effective, would France have ordered those? This raises the existing $112 million investment in masks.  UK bought 60 million masks. I ask you, if those masks were not useful, why would those big guys import tons of them? France also ordered 94 million doses of vaccine plus 28 million doses as reserve. That’s what I call preparation! Sources: 1, 2, 3.

Till now, I haven’t seen a single person wearing a mask in Mauritius and at the University of Mauritius. I may have missed some of course. My point is that the majority were not mask-protected.

5. Information Hiding and Overflow

I can agree that hiding information from the general public can prevent mass panic. I’ll let you decide if this information should be hidden or not: The number of confirmed deaths due to AH1N1. I ask you: do you know how many people died? 5? 6? 7? I don’t know. I couldn’t keep up with the flow of information. We hear about a “possible death” but then, nothing about whether it was confirmed or not. In my opinion, letting people know how many deaths there are serves to boost up their awareness and their will to protect themselves. I got nothing more to say about this, except that I think people deserve to know what’s actually happening about a disease.

I’ll dump another issue here: not enough campaigning early during the crisis. People knew that some kind of flu was there, that it was possibly fatal for people with weak immune systems or have a special condition: pregnancy, heart diseases or other chronic diseases. But we were not told, until somewhat late, what we should do. The “wash hands often, avoid handshakes, avoid kisses, use hankies” etc came too late! If there had been a warning system, this issue would not have arisen.

6. Yet more backtracking

On Tuesday 18th Aug 2009, we got a press conference from our Prime Minister, Min. of Education and Min. of Health, saying that schools will not be closed yet because the situation seems to be under control, and not alarming enough yet. Or in simple terms “wait and see”.

Just two days later, new press conference by I don’t know who: “Schools will be closed for 10 days, and be re-opened on the 31st Aug.” Huh? I thought that the situation was under control! What just happened? Apparently, absenteeism climbed to 50% or more in schools. Parents didn’t want their kids to go to schools, ill or not. The risk was too great, specially considering that the 6 or so deaths included children.

But why the delay? Why the backtracking only 2 days after? I’ll let you conclude.

I say that, as soon as Swine Flu was confirmed among students, schools should have been closed. I don’t care which schools the cases were from, schools should have been shut down.  Hon. Bunwaree quoted the French example: 3 cases before the school closes down. But sir! In France, they don’t have private tuition where students are packed in tiny rooms for hours on! If some dude at a school in Rose Hill contracted Swine Flu, and comes to tuition in Port Louis, you just got a case of disease migration. The dude from RH just contaminated the dudes of PL, who’d contaminate the dudes of elsewhere! That’s why schools should have closed as soon as AH1N1 was confirmed among students. Same applies for tuition. Teachers should have halted their after-hours classes until the 31st. But I guess, some of them won’t comply. $$ before health for them. If you are a responsible parent, you know what you must do: keep your kids at home, and go kick the rear of that teacher for irresponsibility.

By the way, no one seemed to have considered University of Mauritius, and its packed lecture theaters, labs and every other nameable place. Aren’t those good for swine flu spreading? Go figure.

7. Schools!

This is a whole topic in itself! Too bad it comes 7th in my trying-to-be chronological list. Let’s see the problem with schools. Firstly, they took a hell of a lot of time to close down. Students were not wearing masks until very late. Even then, it was only those with possible flu symptoms that were given masks, and not everybody. I guess there weren’t enough masks. Proper sanitation is non-existent most of the time. Tell me, when there is no AH1N1 in Mauritius, do you think liquid soap is available to students in primary schools and colleges? No! For a whole long while, students were playing around, possibly contaminating each other.

Before closing down schools, our brains in the country thought of disinfecting the schools. But earlier they told everybody that the disease can only last 6 hours outside a host. Logically, when the students head home after school, and the school re-opens the next day at 8am something, I believe it makes more than 6 hours right? Do we need disinfectant then? Who knows… but the Ministries concerned think so, despite what they said themselves.

Finally the schools closed for 10 days! But wait, is it really 10 days? Who the hell came up with that figure? Because, you Mr. or Ma’am, don’t know your maths! 10 days? You included the Ganesh Chaturti public holiday,  and the 2 weekends! I never knew schools were opened on public holidays and weekends. In fact, schools will be closed for just 5 days:  21, 25, 26, 27, 28 of August! Count yourself. May I then know, why everybody keeps saying “Schools will close for 10 days” when in fact, students will only miss 5 days of class?

For those 5 days, the amount of drama being done, I can only say wow! Firstly, parents will need to go fetch their students’ work from their schools. Secondly, educational shows will be done on TV and Radios. Thirdly, there will be catch up classes. Seriously?? Do we really need all that? What happens when schools close down for 5-6 days due to cyclones in the 3rd trimester? I know the 3rd trimester is very important, but it doesn’t require so much show! Parents don’t go fetch their kids’ work during cyclones! So why now? It’s just 5 days, parents could just tell the students to do their work, or read and plan the coming chapters, and do their work. After school resumes, teachers could be handed the work for correction and clarifications if needs be. It’s that simple: home-schooling for 5 days! Not too tough, is it?

A comical thing I noted: parents have to go to the schools to get their kids’ works. Some of them had to sit down and copy the work off the board. Schools were closed so that students do not come in close proximity to each other. But when the parents are sitting down and copying work, the problem is not resolved. If one parent has the AH1N1 flu, s/he could very well contaminate other people in the classroom or schools, and finally bring the disease home and contaminate their family. Min. of Edu. has brilliant ideas I tell you.

8. The Media

I tend to like the frankness and openness of the private medias in Mauritius. The private radios do a fantastic job in delivering us information and quality content. But here, I’m pointing a blaming finger at them: people you may have exaggerated the danger of the flu crisis. I will agree that they did what they could to help and inform, but the emphasis with which they commented on the deaths and the flu as a whole served to cause quite some panic among the population. Everyday people were listening in to know how many new cases and new deaths were reported, and this fueled the frenzy. They did their job at informing people what was happening and what to do, but maybe with too much insistence. For the past week, whenever I switched on to a private radio, all I heard was swine flu stuff: debates, the news, the general public commenting on swine flu, the ministries’ inaction and what should have been done. Swine flu is an important issue, but it was over-exploited in a way. After all, swine flu is supposedly no more dangerous than seasonal flu. Or so “they” say. Nevertheless cheers to the private radios, you did a good job at keeping informed throughout the crisis.

That is where we have reached till now in the crisis. Schools will be closed for another 4 days, there will be lot of talking about classes being missed or whatnot. The progression of the disease will be observed closely, and we’ll see what happens. I end here, awaiting for new information to share with you readers. Let’s see how the mismanagement goes on.

Hope you don’t get the AH1N1 flu. Comments, suggestions and criticism awaited. Comment box is below.

  • http://www.beautedemaman.com Dr. Michele Brown

    My name is Dr. Michele Brown and I am an OB/GYN in Stamford, CT. On my website I have written three articles on pregnancy and swine flu. This is a very important issue for pregnant women in the upcoming flu season.

    http://www.beautedemaman.com/blog/

  • http://www.geekscribes.net InF

    Dr. Brown, you have some good and informative articles at your blog.

    But the way you post comments makes them sound awfully like spam comments. You might want to try working on those comments a bit. :)

  • Hans

    I was doing some researches for my assignment and Suddenly I saw your article and read it. Good point. This shows how our systems are weak. We are not po active at all. Surely the government did not want to panick the whole population, nut what would have happen if this would have become worst…