Woe is we

So, I must say, I do love Emergency Medicine. It definitely suits my personality. There is always constant change with a barrage of new issues to problem-solve.

Emergency Medicine is also dynamic. Aside from seeing, diagnosing, and treating patients, you have to go beyond and also monitor the flow - the number of patients coming in, the amount and type being processed, and the ones awaiting admission to the ward. That is but the internal flow, however.



You have to also look at the flow from the outside. The health care offered in clinics and health centres in primary health impacts on the level of sickness and number of patients coming in. The general health level of the population impacts.

The number of days that the patient stays on the ward impacts. Persons being followed up effectively after discharge and taking their medication and monitoring their health also impacts. When you really look at it all from afar, you recognise it is not linear flow but a circle, all impacting each other.

To have a good flowing emergency department, you also need a strong hospital, a strong public health care and a robust primary health care system. I call it the three-legged race. No matter how good a runner you are, to have a chance to win the race, the person attached to you must also be strong.

Or else, you would just be spinning top in mud. The same interestingly goes for governments and the population they govern. The government is supposed to be separate from the ruling political party with some allowance of degree of overlap.

Often times though that delineation is not clear, and they are significantly interwoven. A political party is elected to form the government and that said government is supposed to represent the entire population. The past few years though has seen increasing complaints by the population.

The lack of impact on the increasing crime situation is probably the main issue that has led to an increasingly frustrated population. The recent forex limitations, including the US$2,000 credit card spending limit imposed by the banks, has severely impacted small businesses and the shrinking middle class population. The recent salary increase accepted for government ministers whilst at the same time rejecting the pay increase for other category of workers has produced significant angst and further frustration with a population faced with an increasing cost of living and increasing food prices.

Persons now, even more than before, are talking about the sameness of the choices of political parties and the sameness of the system where, even if another political party is chosen to govern, there will be more of the same, of nepotism, lack of parity, slowness of change, mismanagement of public funds. More of the same of a perception of lack of representation in geographical areas where the parliamentary representative is not a member of the ruling political party. More of the same of calling each other names in the Parliament, throwing tantrums, opposing just for opposing sake to undermine the government without consideration of the needs of the population.

“What shall we do?” they say, “there is such little choice. Two parties the same. Another run by a crazy man.

Another union based. And another new one, run by an offshoot of one of the two parties. Oh woe, oh woe is we.

What are we to do?” The thing about governments and populations is that it is all also a three-legged race. To have a government actually working effectively for the population at large, the population must actually demand it and want it. The concept and the entities are not separate.

The system is set up to get the outcome it wants. A population gets a government and a government system that it secretly really wants. On some level, many of us support the governing system because we like it.

We like that when our party gets to form the government, it becomes our turn to get contracts, positions, financial gain, favours. When another party is elected that is not ours, we accept that the next few years would be barren with less opportunities. So, we stay patient, waiting our turn to feed at the trough.

It is about individual first, party first and country a far second. The result is minimal growth of the entire system and country, as the pendulum just swings from one team to the other, resources gained then lost, over and over. One solution is to change the system, Matrix style, building stronger public systems that are not majorly impacted by the change of ruling parties and governments.

One solution is to add other advocacy arms or branches of government. We have unions and media as fourth estates or branches. We need further special interest groups to form and advocate, pressure, and represent.

We need an academic arm or branch to train us how to think differently, how to strengthen our systems. To train us to change ourselves I have no religious or political affiliations. I try to be an observational columnist, watching the trends and connections within the system.

I observe and I hurt as I hear the cries and complaints of the population. The first step though is reflection. Do we want to continue to alternately eat at the trough.

Or do we want to eat together at the table, three-legged and all? THE AUTHOR is an Emergency Medicine Lecturer with The UWI.