Before youth leaves us -- let’s invest in good health!

Health is about not getting sick -- not about getting sick. We all know by now the rising cost of health care around the world and Maldives is not out of this cycle of medicalization of health care. The WTO's Global Agreement on Trade in Services (GATS) bears witness to the rising tide of health care providers moving across national boundaries. All this, together with the portability of medical insurance will ensure that the medical industry survives and grows from day to day. While this has overt benefits, it has its downside too. It would be good to have quality medical care on a competitive footing, but this diversion of national health service approach from disease prevention to treatment leaves the public helpless to help themselves about keeping healthy. In this new business environment, medical service providers soon flock to the private sector at the expense of the public provider space. Health care insurance that has seemingly come to fill this gap of access escalates the cost of care to exponential limits. All this is quite apparent in our own little nation of Maldives also.

This has implications for our future health care. As we may be aware again we are in the midst of an epidemiological transition. Our communicable diseases, in our past colossal efforts of public health based on prevention has put these disease into the closet of the past – tuberculosis, leprosy, filariasis and malaria -- which were the dreaded killers of those days gone by, have given way to another transition -- that of non-communicable diseases. How many of our young people are truly aware of the dangers to their health of smoking, eating all that fatty fried foods, those succulent yet killer sausages, all those preservatives in the packaged foods and even the mere volume of food consumed with little concern for how much stress we are putting our poor body through.

If we think that our affluence is making this happen to us, it’s not quite true; it’s really the globalization frenzy the world is going through. For example, in Maldives it’s not just the rich that develop heart-disease, cancers, diabetes, hypertension and the rest of this smorgasbord of disease conditions. There seems to be a pervasive prevalence. The packaging market has made possible the long keeping quality of foods such that every corner of the country can have these “goodies”. Yes, it’s those thirst enhancing sugary and fizzy drinks that are found all over Maldives, so are the potato-chips, the packaged cakes and chocolates that look so good but at which our bodies wince as if to say "how can I tolerate this onslaught any longer; I might as well just give up and say goodbye to this world". The body’s pleadings and groaning is of course not heard by the youth, the owner of the young resilient body in its relentless search for the fun and frolic of life and is mesmerised by the clever goading of the marketing industry. We keep on guzzling the energy drinks even when we don't need the energy - prodded by the enticing adverts, and like so keep choking our lungs as we lull at the street corner to smoke yet another Lucky Strike, Camel, or Marlboro, as if this doing will clothe that body in importance and be the centre of attraction. Then as the body gets older the breakdown of its organs inevitably begin, slipping from sight would then be the days of the good looks and the pretty girls who seemed at arm’s reach. Now with wife and children and grandchildren we begin to suffer the effects of those carelessly lived robust days. The fool at the other end of the white long cylindrical object that is called the cigarette can no longer yearn for when it should not have been. It would be just too late!

But who will listen to this plea? The vice, voice and visuals of the tobacco company drown my lone voice for conscience or the persuasive power of the small silent message at the street corner "no smoking in these premises".

And so goes life, our cost of health care from this and others rising incrementally or even exponentially. How can we halt this rise -- in our ill health and the stress on our pocket books?  The solution is prevention! That we can do without expensive gyms and costly diets. Just good clean life habits are all what we need. Eating and drinking wisely, spending time on our feet more often, filling our lungs with that God given servings of fresh air rather than be choked by that chemical laden smoke from the cigarette, and spending more time in communing with nature rather than those endless hours of chatter on our mobile phones. But who will listen? For those who would listen, it is the path to happiness and a long life of joy away from the portals of the hospital. We can do it, if we truly have that intension.

When youth is gone who will care? ...

The old man with a week's growth of weak white stubble bristling out untidily from his sweaty face all unkempt and attired in oil-and-dirt stained and crumpled clothes lay asleep at the foot-wide curb that flanks the supreme court building of Maldives on one side and faces the local vegetable market on the other. His back bolstered by the building wall behind him was enough to keep his body stable but his arm had slid off in his sleep onto the road space that was the path of the incoming throng of motorcycles and lorries that made up the mid-morning traffic at that junction. And it was quite probable that these drivers always in their impatience and hurry would not perhaps notice that arm lying in front of them. It was a pathetic sign and sight and a veritable contradiction. The supreme court that meted out justice to the nation on one side and the site that dispensed nutrition to our masses on the other. But this old man of "no means" lay disowned and disdained. Where is justice and where is the municipality that is the physical conscience of our city? 


How can democracy in our new nation be played out this way? Surely, taking care of this man and some others of this same plight that inhabit this space in Male can be taken care of more humanely. Surely a pittance of the stupendous expenditure doled out for those expensive political campaigns in the atolls will be enough to address these pressing social concerns. We seem to be a mesmerized nation attempting to find a servant to look after our house yet being dictated by the terms of the servant.

Gender difference is more than skin-deep

As if you didn't know this!  But seriously this is a very basic issue of a lack of understanding or misunderstanding that is at the root of much of the problems our societies face. As the basic unit of society, the family is what makes society; weak and fragmented families auger for a weak and fragmented society. 

Why do these family issues arise we all ask? It’s because marriages break and even in many cases that don’t, many endure in such anxiety that it seems criminal to bear such misery. Islam of course has such a wonderful leeway given to allay the turmoil and seek other ways. But within many cultures in our world, families keep on living the life of agony just because society would baulk at family break-ups. But why are these cases of unbridgeable difference? Some would say that nothing is really unbridgeable if we step back and observe what's going on. The one in the crowd can only see the way of the crowd. We just need to step back to take time to observe with some detachment. 

Men and women are not just physically different but mentally different too. The physical we can't do much about it and perhaps we don't want to tamper with it either. But the mental dimension is where the real issue is. Actually all our issues in life arise from the mental condition -- the "we are what we think" paradigm. It is said that women are right brained which means they are more the imagining and feeling type whereas men are left brained and thus the logical and set in their logical ways type. Both these have to result in a compromise if life is to go on in harmory. To the degree that it does not indicates the mismatch or the inability to accommodate each other. How was it that the courting days saw harmony and then overtime many marriages became situations of suffering? Yes, somewhere that accommodating spirit had died. The novelty, infatuation or love that was must have evaporated.

But salvage is always possible -- when we can know this differing types of minds we live with and attempt to observe how our inner selves have developed over time to envelope us in cultural sensibilities such as male chauvinism, labeling, stereotyping, cast-bound pigeon-holing, etc that have come to characterize how we and society see ourselves. In this bound up and opinionated mindset, our gender differences will continue to keep us in misery unabated. We can build bridges unto ourselves for sure! --- by attempting to do so not across physical boundaries but across the mental. 

Society can improve only with better stronger families and that can happen only when spouse bridge those differences by learning to respect each other.

Don’t wait only to receive, let’s earn!

While we are fully aware that what someone gives to us is less of worth than something we buy with our hard earned money. However, it is very easy to fall into this trap of expecting for that takes much less effort from us, and as expected, this is the folly we fall into even when our politicians promise us gifts and freebies in the garb of promoting social and economic development. We have grown up over the years, especially as affluence pervades our families to be giving a lot of gifts. The businesses promise it and families lap this up as developmental ethic, and follow the Joneses in mimicking this behavior. This is capitalism in action, tingling the ego strings within us and sparking our competitive spirit as if it is the right thing to do. 

This was sparingly so in the more distant past when we were given our new clothes in alignment with some festival like one of the Eids - to don when we go for the days prayers or a function of the day. It was a moment for celebration and of course valuing this gift also because we knew we would not get another till the Eid next year. But now we get presents whenever we ask for it and even supplemented by the need of parents to allay their increasing neglect of their children of quality time with them, yet without a hope they will value what's given. Boredom soon sets in and they ask for more and the cycle goes on. As adults we don't fare any better.  In such a social habituation politicians make hay by extending that giving to whole communities -- a harbor here, a mosque there, airports, schools, roads, reclamation, and subsidies everywhere, are some of the gimmicks we fall for. Of course behind this culture of political giving and acceptance is our vestige of authoritarian rule of the past - of kings, queens and strong individuals who have used this approach to keep people continuously mesmerized by their benevolence. 

But now in a democracy should this be so? How does this culture of largesse measure up to the democratic principles of independent behavior we need to nurture if we do not want democracy to die on our door-step. By our very acceptance of gifts and largesse we are forfeiting the power given to us by our democratic principle.  By acceptance we acquiesce to the whims of another because we feel indebted and compelled to vote in that direction. How ironical is this situation. We want to eat the cake and still keep it also. We want what gifts we can get but we would like to keep our independent stance also? That is impractical both in reality and in morality. We need to be true to ourselves and learn to live to earn our gifts rather than these to be just offered to us for the taking. Accepting this state of affairs must indicate to us the immaturity of our polity to practice true democracy, rather what we dabble in is self deception.

The ROOTS of ill health

This note is necessary on World No Tobacco day today. 

The burial of a loved one a few days ago dawned on me the atrocity of the practice of selling disease. While the loved one that we buried was a terminal cancer of a type, the cancer and debilitation that cigarettes cause to the human body is in the same vein not just a matter of "someone else's own business" as it is often made out for us to believe. It's truly a crime perpetrated for the promotion of selfish gains. Many a time the seller's own family members maybe in the fry of its dangers. But somehow there seems to be a disconnect between this and the yearning for wealth; it even justifies the forfeiting of our own children's health and well-being. Given that our children make up perhaps 30 percent our nation of Maldives, can't it be surmised that we are hurting ourselves in either ignorance or ignominy. Our leaders too must take heed and not be fooled by the deception of the sellers -- the great cigarette companies of the world and their accomplices - our local sales outlets.

The ROOT of this evil is indeed the sellers and we seem to be condoning this perfidious practice. I repeat again here from an earlier blog the words of a global health leader who said that " the cigarette is the only commodity in the marketplace that when you use it exactly as it is supposed to be used, will kill you". That truth unfortunately takes time to sink in, and by that time it is alas too late for us to do anything much about the ravages it has caused to our body. The disease and morbidity cigarettes create, besides being a financial burden of health costs to the individual, is also a  huge financial burden to the national economy, Expensive hospital systems are needed to address the interim and terminal disease outcomes of cigarette smoking. However much one may talk about private privileges or individual freedom to do what we want, that freedom when not exercised with the requisite responsibility brings national level doom. 

The ROOT of this evil can indeed be addressed if our three powers that lead our nation see that protecting human health and thus our healthy existence on this earth is the real purpose of their being in good governance. 

Democracy is not without its limits!

In a democracy we have freedom yet are bound by some limits. Those are what some call moral boundaries which we cannot infringe; or we should not infringe. We can express our opinions yet cannot go too far to vilify another or spoil another's person in our assumption of unlimited rights. As the anti-tobacco advocacy chants “your freedom ends where my nose begins” or in the case of violence prevention, “your liberty to swing your fist ends just where my nose begins”  depict, freedom has its social limits indeed. 

In life, we are on a leash. In a governance process characterized by autocracy our leash is short and our limits bound by the edict of the perpetrator, whereas in a democracy our leash is longer and bound by moral principles that come from God. These we cannot infringe; if we do, there will be no law or order. In a democracy the rule of law is one of its most revered tenets. How else can we ensure freedom for all when otherwise the strong and powerful in bodily strength or fiduciary influence will make life for the many a continuing nightmare? That is what autocracy does and that is why we shun it and choose democracy instead, for every human being within the depths of his very being, yearns for freedom. But that freedom will cease to be free and turn into violence if we don't exercise our sense of moral responsibility which is characterized by such boundaries. That must be the meaning of democracy.

The players are for the taking!

As the season progresses the players seem to acquire greater skill and nimbleness in their ability to dribble the ball and so their potential value as a play-maker or striker gains increasing promise.

Inter-club transfers are possible even in mid-season. And the club celebrations grow ever more glittery and flamboyant with flags, lights, and floating confetti to give shimmer to the ambiance as the stage lights illuminate them. The garlands put around the neck of new entrants, the hand holdings that accompany victory chants and the time at the podium to voice the rationality of their new decisions -- whether it be their discovery of a new winning formula or philosophy in the present club, or the high decibel affirmation of their secret past yearnings to be amongst those who have proven to be the sustaining force of perseverance, or that the revelation of a past friendship they harboured with the new club’s managers are all expositions of the hypocrisy that are voiced to melt the heart of the followers and propel hurt to the club they left behind.  

All through the glitter of this celebration is the silent message of condoning hypocrisy. That betrayal is all right as long as a rival argument can be voiced with consummate oratory skill. The club members are jubilant and hear the affirmation with delight while some in the spectators are aghast at the unfolding of these events that seem to signal to the next generation of players that everything is fair in life as long as there is possible benefit to the perpetrator to be ferreted out in any way possible. Life is to be lived in the spirit of deceptive competition they say, and the call for perfidy needs to be celebrated -- not shunned.  

With morality of this genre, we can certainly look forward to a governance process not without the trappings of such spirit in the future