Home' Trinidad and Tobago Guardian : November 18th 2015 Contents That Prime Minister Keith Rowley
recognises something ought to be done
about our health service delivery
should be lauded. But that commen-
dation is not from the point of view
of recognition of the inherent non-
systems---we who access public service
health could each write a volume---but
it s that in his capacity as PM he is
I should be optimistic about the news
that the RHAs are to be reviewed and
that doctors who straddle both private
and public care should have some kind
of code of governance. Really, I should
be gathering my years of notes and begin
preparing for the national consultations
that must come from such an exercise.
I do not profess to know much of
anything about the committee leadership
and members but I trust the decision-
making of Dr Rowley unambiguously.
I congratulate chairman Dr Winston
Welch, on his appointment. I m certain
that T&T s own Howard University pres-
ident Dr Wayne Frederick will bring the
appropriate perspective in the male-
dominated team---one woman included
to talk about nationally healthcare.
So why do I feel so heavy-hearted?
First, because whenever the emphasis
on health does not include mental health
with parity to physical health it is always
The WHO says: "Mental health and
well-being are fundamental to our col-
lective and individual ability as humans
to think, emote, interact with each other,
earn a living and enjoy life. On this basis,
the promotion, protection and restoration
of mental health can be regarded as a
vital concern of individuals, communities
and societies throughout the world."
It could be that in the remit of the
committee mental health reform is
entrenched and I m going to be accused
of speaking out of turn.
But I speak from the past experience
of every other health review in this coun-
try and I suspect without seeing efforts
towards gathering the required evi-
dence/statistics, the "burden of mental
disorders is likely to be underestimated
because of inadequate appreciation of
the connectedness between mental ill-
ness and other health conditions" and
Secondly, Gerry Kangalee, writing for
the National Workers Union, listed some
of my health sector burnout and others
from before my time, all of which I m
sure is/was necessary so that someday,
sometime, hopefully in my lifetime, we d
get it right.
I was around for The Toby Commis-
sion Report of 1982, and the Gafoor
Commission of 2006 of which Kangalee
made mention. The decentralisation of
public health system in the 1990s as "a
condition of the health sector loan
(US$192 million) (which) the government
accessed from the Inter-American Devel-
opment Bank (IDB)," was in my time
The latter saw the birth of the regional
health authorities, a concept that never
evolved into better healthcare and one
which totally tossed mental health as
the responsibility of no one in particular
For my 50-odd years here, there s
really been no positive difference in the
delivery of care for all kinds of reasons
and under all kinds of administrations
and that accounts for my committee
More than that, is an underlying griev-
ance for the lack of prominence of public
mental healthcare in all of the permu-
tations, an error we may well repeat in
2015 given the main focus enunciated
for this health review committee.
I need to be optimistic but I may be
having a mood swing to the "south pole"
of my emotions with the pressures I feel
from my own life circumstances.
T&T has never once bothered with
mental healthcare and if we think the
pint-size efforts here and there by those
who do not hold the power of a Rowley,
Deyalsingh, and Khan et al, before them
would get us to a better place, we may
end up disappointed.
Mental healthcare would have done
well to feature as a separate issue of
equal prominence when the Welsh com-
mittee was presented with its RHA
reform and doctors private/public care
It may well be in the committee s
remit, but I daresay, if it s there, it should
been a headliner in 2015. Then we would
know that we are being governed by
people with an understanding of the
clear and present danger of sweeping
mental healthcare under the rug. Or
simply walking over and talking over it
hoping somehow it would get some
I wish I did not feel as humdrum as
I do but I constantly carry the anxiety
that I will have to live here without the
enshrined rights and freedom that my
constitution promises; that in a country
of equal place I ll remain less equal and
people would continue to take oppor-
tunity to let me know either by com-
mission or by omission.
In this country of put-downs, this
contemplation may also just be put down
to a "mad man rant."
Again, I may be heading off the dis-
course but I take that risk to say that
there is no health without mental health
and therefore there is no health reform
without proper mental health reform.
Not tokenism. Reform.
I wait with bated breath.
Guardian www.guardian.co.tt Wednesday, November 18, 2015
St Ann's, on
No health without mental health
MENTAL HEALTH MATTERS
The WHO says: "Mental health and well-being are fundamental
to our collective and individual ability as humans to think, emote,
interact with each other, earn a living and enjoy life. On this
basis, the promotion, protection and restoration of mental health
can be regarded as a vital concern of individuals, communities
and societies throughout the world."
Links Archive November 17th 2015 November 19th 2015 Navigation Previous Page Next Page