Health for all |20 November 2010

To speed up progress the global decision was taken to add All for Health in the hope that people would contribute towards their own welfare and help the effort.

For many, however, that soon meant only those who had the means could get healthcare. We read with pity how doctors abroad put retrieved foreign objects back into children’s noses because the parents cannot afford to pay for the removal, and how people die in hospital waiting rooms after learning that even emergency care is beyond reach if they cannot pay.
This is exactly where we would have been, had we not changed course.

Things were bad and could only have got worse, as they have done elsewhere, if the government had not stepped in when many Seychellois babies and mothers were dying from disease and malnutrition.

Under its three-class system, Victoria hospital and the handful of other health facilities that existed soon after independence gave unequal medical services with unaffordable user-fees.

They were no-go areas for most ordinary Seychellois in need of medical help.

An earlier writer once said: “Scenes of children with bloated bellies spewing intestinal parasites in insanitary areas of play, and adults with bones distorted from childhood malnutrition and occupational hazards, were everywhere.”

He said these images are still riveted in the minds of many who bore testimony to that sorry state of social, physical and mental helplessness.

More than 32 children out of 1,000 died during their first year of life, yet we know today that Seychelles is the healthiest place in the African region in which a baby can be born.

This is certainly not by chance, for the Ministry of Finance yesterday said healthcare takes the biggest chunk of the budget, with Health and Social Development being allocated 24% of the total funds this year.

The infant mortality rate has been gradually brought down, and since 2005 has stood at about 10 to the 1,000. We confirmed yesterday that the figure for last year was 10.8.

As life expectancy continues to drop in countries that were in the same category as us a few decades ago, ours has continued to rise and we have seen many of our citizens marking their 100th birthday recently.

On average our women now reach 78 years and men 68, making Seychelles’ overall life expectancy an enviable 73 years.
At independence, most men and women living in Seychelles expected to live only 50 or 60 years. Today’s life expectancy means every Seychellois has gained up to 15 extra years.

A better infant mortality rate and life expectancy figures are just two of the many achievements of the public health sector during the past 33 years. Improvements in this sector are too many, varied and far-reaching to be summed up in one article.

Being healthy has helped us boost our economy, which we recently saw withstand pressures others have succumbed to.

The association between health and prosperity is indisputable. Everyone agrees that a sick man or woman cannot work to earn his keep. Over 30 years ago, afflicted by diseases and with no real sense of purpose to their lives, workers lived by the day and tended to shun their responsibilities, so productivity in Seychelles was at its lowest.

The continually rising health status after independence accompanied an increase in per capita income and in gross domestic product.

“No one can deny that the good health status of the Seychellois has, indeed, contributed to creating prosperity in our country,” said special adviser for health Dr Bernard Valentin. Earlier he said the huge investment in the health system is about the best and wisest the government has made in the last 30 years, and one can only agree.

Our ratio of doctors and nurses to the number of patients is among the highest in the world, and the distances we have to travel to reach a health facility shorter than most people elsewhere can even imagine.

The number of doctors and nurses per capita in Seychelles is even higher than that of several emerging European countries.

Fostering a culture of putting people at the forefront of development, the government has also wisely invested in human resources development, broadening the areas of training to encompass many more disciplines than 30 years ago.

Since 1998, over 300 candidates have benefited from long and short-term training costing the country millions of rupees annually.

Many countries with whom we were on a par 30 years ago were spending 2% of their national budget on public health.
Ours soon rose to 12% a few years ago and again to the current 23%.

When African countries were struggling to spend US $12 per person per year on health, Seychelles has been spending US $500, and the figure is now nearly double.

We are now so far ahead that many people are saying we should stop comparing ourselves with our mainland cousins and use European countries as our yardsticks.

In its 2008-2013 Country Cooperation Strategy document, the World Health Organisation says: “Over the last four decades Seychelles has made remarkable progress in health development through comprehensive healthcare infrastructure.

“Located throughout the country on the basis of equity and access, healthcare reaches people in all the districts.”

It says one of our key strengths has been the commitment of the government to raise the human development standards of its people to the highest levels through primary healthcare strategies.

An earlier document said Seychelles “has achieved rather impressive healthcare indicators similar to those of countries like Singapore and New Zealand”. 

Whatever yardstick we use to measure our health, it is only with flying colours that we can represent our success. We have moved from being a small, insignificant country with a rudimentary health service to a healthy middle-income country with extremely good health infrastructure, extremely good health programmes and extremely good health outcomes.

The technological advances made at Victoria hospital and other health facilities are living proof of this success.