Friday 25 September 2009

Guns, People, and Nations: The Universal Healthcare




Louis Egbe Mbua

As to whether a nation may save itself from a catastrophe may depend on the nature of that incident; the scale of the devastation; the tenacity of the people;and the speed of the devastation; and how quickly the leadership reacts to counter the unfortunate event. Above all, the resources available at that time; and at the right place. Nations with enlightened leadership prepare themselves 50 years in advance while those that make darkness their abode, save divine intervention, always find themselves spending as much energy and resources as they were wont in 50 years of fruitless labour. The rational for this two totally different approaches may be closely linked to the judgment of its leadership over a long period; and the consquent resultant thinking that permeates that society.

A society built on compassion and human values; moral obligation and the greater good almost certainly always ends up doing what is right to save the nation. On the other hand, a nation that may begin with the former values as their foundation may decide to deviate along the way on the road to nation building. In this scenario, compassion and human values may take a twisted turn for the worse. That this occurs does not mean that Amargedon has arrived but that the trumpet sound of warning is always heard from East to West; and from North to South. Granted, the recent arguments, especially in Obama's American tenue, as to whether a nation is entitled to free health care or not can only be viewed from the practical successes and failures of the different nations involved; and specific experiences of the different peoples. In that manner, therefore, one may be in pole position to make sound judgments as to the importance of Universal Health Care in a modern nation in the 21st century. A a nation populated by the ill can never prosper.

The year is 2005; and the entire world is transfixed onto their television screen to fully examine the unfortunate cataclysm of Hurricane Katrina that devastated the east Coast of the United States almost four years after the horrific terrorist attack of the United States East Coast of New York killing about 3000 innocent people. In Europe, a significant majority were questioning how a nation, so powerful and rich, were to allow herself to be viewed with such a faded lamp in humanity as regards the Hurricaine Katrina. We all watched as the poor and needy were in such squalor in a land of plenty. More strikingly, it would appear that the long suffering people of Louisiana had not had proper medical care -- judging from their physical appearance. Is it right for the richest nation on earth or even one of the man-made poorest like Cameroon to allow their own citizens to languish in poor health while the privileged moneyed class enjoy stratospheric health care? This writer takes a close examination of the practicalities and consequences of a system that prefers to spend on guns and missiles rather than invest on the health of the same people who should defend the nation with the same guns.

I had just arrived Buea at dusk, the Capital of today South West Region of Cameroon and the former Capital of Southern Cameroons and the colonial German Kamerun. The atmosphere was heavy with fog from Bokoango down to Great Soppo; but the bustling Molyko and Muea dual-town were spared the heavy mist the nexte day. The Chariot of the Gods, Mount Cameroon, stood majestically on the background like a heavy mass of dark blue rock that appears to stretch to the skies from its deep foundations; at the same time extends from East to West like an ancient pyramid.

The following few days were of excellent weather with clear blue sky and beautiful weather; the modifying mountain climate providing a perfect moderating effect on the tropical African heat prevalent in Tiko and Douala. Terrific, I thought. This is like living in Wales, London or Switzerland! I am going to enjoy myself during this period in homeland Africa! I will go out, visit old friends, travel around the villages, and socialise with my relatives. Not until my Grandmother fell ill. We are in Wales, are we not? Surely, there is no problem. There is the NHS, I mused dreamily. And it is free! But this was a short term thinking of a complete stranger in his own land. It was not long before I was reminded of the realities of my own country; and that I may have been thinking of the non-existing utopia of Sangria Land.

Let’s take her to the hospital, I proposed with detached confidence. No, they said, we must take her but to a private clinic. Why? I demanded. Surely, a hospital is much more equipped since there are better facilities and many specialist doctors? No answer. So, I went with the idea of taking her to the clinic. What is the name of this clinic and where exactly is it located, I asked. The medical facility is called Solidarity. Thank Goodness, I exclaimed. If it is named Solidarity then we will be saved! Grand ma will be well and back home immediately; and then the enjoyment will continue until I return to England. Is it a good place with a reputation? Of course, yes was the reply. Where is it? It is just off the University Junction up the road; about ten minutes drive from home after the Mile 17 roundabout. Great! Surely this is a good place; since it is near the University. I was aware that University of Buea had begun a medical school about two years ago amidst raging controversy; arguments between the Anglophones students and the Francophone elite lodged in Yaounde in an alleged fraud as to the admission of students. In the event, students were gunned downby the Cameroon authorities. However, I thought there would be trained doctors who may be working in the clinic in Solidarity with the denizens of Buea. Was my assumption guided by sound judgment or was it convoluted by my earlier delusion of being in Wales? Let’s see.

We made a swift curve north from home, turned into the Mile 17 junction to Molyko, drove passed the University and arrived the University Junction. Turned left, passed a series of landmark two or three storey buildings (most buildings in Buea are not more than three storeys due to the active Volcano, Mount Cameroon, that can roar and erupt without warning causing the entire town to sway from left to right, up and down like a rocking ship caught in a huge tidal wave) and arrived the said clinic. We have arrived, my relative said. Although the building was small, it was well kept and neatly painted with a car park at the front and a gate that secluded the clinic from the local environs. Is this Solidarity? I asked , so as to obtain cast-iron validation and verification. Yes, was the answer. So we went in with my Grandmother. A nurse met us at the entrance or was it the reception? I explained the problem and she were admitted. Now comes the moment of truth as to whether I was still dreaming in Wales or I was living the hard reality of Cameroon.

Can I see the doctor? I inquired of the nurse. Well, he will arrive shortly. I waited and waited but there was no doctor forth-coming. I looked at the nurse and she looked at me. Every person was looking at any other person. What is going on? Anyway I decided to take a short walk within the clinic believing that by the time I returned, treatment should have started. When I returned, I noticed a young man whom I assume was the doctor. I said my Hellos and Good mornings which he returned very politely. Yet nothing was happening; remotely resembling treatment. I looked at them; they also looked at me in a kind of strange silence: again. Is this a new kind of medical consultation or what? Well, I have never been to medical school. Who knows, perhaps there is new kind of telepathic medicine in Cameroon? Or is it some sort of African medicine? Chinese medicine, perhaps? I understand the Chinese have a strong presence in Cameroon; and that they built a modern hospital in genuine Solidarity with the Cameroon people in general and the Buea population in particular. Is Solidarity a Chinese invention-cum-invasion? I looked around but no Chinese person was in sight. I was perplexed by all this. I therefore made a decision, again, to take a walk; but this time in the surrounding locality, hoping that on my re-return , full treatment must have begun, and to fully verify that this was, in actual fact, the famed Solidarity clinic. There we go again.

I went round the corner, crossed a small bridge that spans a small stream and Helas! I was standing in front of a huge – painted yellow, I presume, as one is colour blind -- three storey building that dominated the landscape just off the University Junction. Is this Solidarity? I questioned myself. I decided to investigate. As it appears there were businesses operating on the ground floor of the building, I went to one of the shops, exchanged pleasantries with the supposed owner and began my somewhat inquisition. What is this building for, especially the first and second floors, I enquired. This is a mini-cite (Students’ Hostel). We are merely renting the ground floor for our businesses, was the gentleman’s succinct reply. I see. Who owns this building? The gentleman looked at me with pronounced astonishment; his eyes diving up and down at my demeanour. Are you from Mbengue? The new interrogator asked. Well, yes, I stammered. Where? Europe? America? Europe, I answered. Where, exactly, in Europe, he questioned; and when was the last time you visited Buea – I mean Cameroon? Well, this is my second visit in three months from London. And you do not know who owns this building? No. I replied. This building is owned by Pius. Who is Pius? I interjected. The gentleman didn’t answer. At this juncture, he picked up his glass of what I suppose must have contained Cameroon beer, took a sizeable sip and gulped it down in a go. Put down the glass in satisfaction and then said: “ Ndeifi Pius, the Cameroon football star of the Indomitable Lions.” Picked up his glass again and downed the rest of the three-quarter full glass of beer in one single swoop: with pride. I thanked him; made my polite excuses and left to return to the clinic.

At the entrance, I saw an assignation on a sign board but was not sure as I didn’t bring my glasses. When I arrived at the clinic I met a nurse and the doctor on the hallway. I asked: “What is the name of this clinic again?” So-lid-ar-ity, they answered in resonance and unison: a chorus resembling a choir derived straight out from the local hue. Now, if the name may fit its meaning, would they mind beginning the business of treating my Grandmother? She is ill and requires immediate medical attention. The two looked at me in surprise. What exactly is going on, I reflected. There must be something I appear not to understand here.

So, I went around the hall way and saw another nurse in what looked like a counter. I realised that she was smiling. Why is she smiling? Let me approach her and see. She may have the key to this mystifying medical visit. So, I asked her: “Why is nobody treating my Grandmother; I thought this is a clinic founded on solidarity with the people?” Well, yes but have you got any money with you? You are right; we are Solidarity but to be quite honest, you have to make a down payment before any kind of treatment can be administered onto her. We assure you that the service will be first class, she continued; and that we have first class doctors. How much is the deposit then? CFA 26, 500 frs (£35), she answered quickly. In a second, the Sangrian mystery was decoded, presumably, so I thought. In this case of life, therefore, I took out my wallet, extracted the amount stipulated and handed the cash to the nurse; and waited curiously to see what will happen. She counted the money; gave a nod and proclaimed in a reasonably loud voice: “Treatment”. To my ultimate dismay, the treatment began immediately and in earnest. I will like to state that the clinic has an excellent service and my Grandmother recovered within two days. Is this Solidarity? I questioned inwardly.

In Sangria land, one has to live on his wits’ ends. A system that has no National Health Service in place but relies solely on private health care, where money is the key to good health, is a benighted society doomed to fail. In the yesteryears, this part of contemporary Cameroon had a Department of Social Welfare that played a national role in the health of the West Cameroon people from the young to the old. Today that system has been destroyed with the elderly, the young and the poor subjected to ill-health due to lack of money. When we have a system where an elderly person who has spent all their youthful lives serving the nation are asked to pay up to £35, a sum close to the average monthly wage, to receive medical consultation, then one is inclined to believe that it is better to leave such a place and relocate where leaders are rational and responsible. This amy account for reasons as to why Africans will risk their lives to cross the daunting and unforgiving Sahara Desert; and to travel or swim through the Mediterranean Sea under dreadful conditions at sea to reach Europe where health care is free. Not so in my country where the ruling class themselves also prefer, paradoxically, to fly to Europe by business class for medical treatment on state funds rather than develop and maintain a national health service for the benefit of their own people; and the benevolent result that may ensue in terms of tangible peace and prosperity.
President Obama is right in proposing a Bill to extend healthcare to at least 40 million excluded American people who have been negelected for more than 200 years. His decision to halt the prohibitively expensive Bush-era Star Wars missile adventure in Poland and the former Eastern Block is both wise and pragmatic. It is grand and grotesque folly in a large scale to spend mind-blowing money on weapons that would be manned by the sick; or worse still, no man to use these guns and missiles. A Universal Health Service is a fundamental right for all men; and a pre-requisite to prosperity. African (and other world leaders of the same mould) should emulate President Obama; halt their deadly weapons and gun buying obsession to defend their corrupt and ignorant governments; and instead invest in the health of their people. There lies the secret of progress.

Thursday 3 September 2009

A Visit to Southern Cameroons

River Mungo: International Boundary between the two Cameroons (http://www.postnewsline.com/)
Louis Egbe Mbua

It is unclear how a people so subjected to the vestiges of totalitarian colonial relics manage to rise up to the challenge so as to compete in a world of discrimination and authoritarian socio-political dogma. The matter is sometimes so worrying that many throw their hats into the fighting ring; throw their hands in the air and surrender. Others so oppressed, make a decision to join the oppressor; not out of malice but out of desperation.

There seems to be a kind of schadenfreude psychological factor to this effect. This, the writer does not believe, is down to the Stockholm syndrome, whereby the captured unwittingly falls in love with the kidnapper. More to it, one believes, is a search for the meaning of all the oppression and why it occurs in the first place; and an identity finder on a second count. Perhaps, one may suppose, that the victims are in want of recognition as an equal to the coloniser; so decide to join the colonist to further oppress their own people in search of equality -- if not superiority in relation to the colonised. In due course, one can infer, the pretender and the oppressor reach an uneasy agreement, fuse their incompatible and dissonant aims, objectives and wants; and then subject the entire population to poverty, want, disease, hunger and destitution to realise these wants.

On the other hand, there are a few good men on both sides of the Treaty of Doom, a pact with the adversary of the people, who have taken upon themselves to do what is right and just so that advancement of all the people is realised. This brings us to the question: can a few good men deliver the people from bondage or does it have to include the entire oppressed to provide the final hammer blow to unbar the wheels of the vehicle to certain oblivion? This is the Cameroon Anglophone story in particular and the Cameroon problem in general from a practical and realistic eye witness account.

I had just spent three to four days in Douala, Cameroon’s economic capital. What was observed was not very encouraging although there are huge potential for the City. Now, I have to go to the other side of Cameroon – Anglophone Cameroon or Southern Cameroons the other part of the former UN Trust Territories that constitute contemporary Cameroon. Jumped into the car and off we went. Having traversed the maelstrom of cars, chaotic maze of motorcycles complete with pedestrian traders trying to earn a living: selling everything imaginable, crossed the one mile long Bonaberi bridge that spans the Wouri estuary, we arrived at the road leading to Anglophone Cameroon. This is the only road that leads to the South-West Province in Cameroon, my brother remarked. It is so narrow and in disrepair, he added. Why is that, I asked. Well, it seems it is political, he answered. How is that? I questioned. I never received an answer so I was forced to think on my feet. The most likely reason is, I thought, the Cameroon government, dominated by Francophone elite, do not consider that part of Cameroon as worthy of development as long as they can wrestle resources from the area at the minimum cost. On the other hand, evidence in Douala suggests that they hardly employ these vast resources to develop their own area. So, one must conclude that the country is run by an incompetent junta?

On this small patch of road could be seen huge vehicles travelling from both directions transporting all kinds of goods and commodities from Anglophone Cameroon to Francophone Cameroon and vice versa. There were oil tankers, Lorries transporting agricultural products, machines and passenger vehicles together with private cars. Every single vehicle: competing for space on this narrow and dilapidated stretch of road in Bonaberi. On both sides of the road are dilapidated buildings and depravation of all kinds with poverty steering us in the face. Who are these people living here? Well, most people who live here are Anglophones was the answer. Since this is close to Anglophone Cameroon, they have settled here. Further down, are industries and factories – some, such as Canada Company of Cameroon -- that processes hardwood for foreign export one must suppose -- are foreign-owned. This stretch of road continues until we arrive at the Bekoko junction; where the road splits to Bafoussam in La Republique du Cameroun and to Tiko, the first major town in Anglophone Cameroon. We are now on the Tiko-Douala road and to give credit where it is due, the road is excellently maintained. We now approach the Mungo Bridge, that spans the Mungo River for about 100 m; and which is the internationally recognised boundary between the two Cameroons. Now, this bridge had collapsed about three years ago (some claim it was bombed by an angry Anglophone Cameroonian who detested the vast exploitation and subjugation of Southern Cameroons) thus causing economic chaos in Cameroon. The old bridge was a design and an architectural classic with tall bars on both sides and a network of steel that connected the steel sides forming an architectural roof: symbolising the Cameroon Federation that began in 1961; and which is now illegally dissolved by short-sighted politicians. To show more contempt for the original Federation, the new Bridge that has been put up has no architectural merit. A trainee architect or civil engineer might have come up with a better and much more aesthetic and symbolic design. Again, to place credit in its right doors, the Bridge has been reconstructed.

We crossed the bridge, met a toll gate where a CFA 500 frs levy is charged for all vehicles going to Tiko. What happens to this fund, nobody can tell as even the small office that serves to administer this charge is extremely wretched. Can’t the Tiko Council or whoever is in charge, improve this office to make it more presentable? What about installing a computerised electronic system of ticketing? So, there we go, money paid and nothing done. At least the office is manned and all drivers act as good citizens, paying up their levy. A few miles down the line in Anglophone Cameroon are Police men in patrol, stopping all vehicles. I didn’t see this in the Francophone part of the road before the Mungo Bridge. So why are these Policemen here? To make sure that people do not bring in dangerous goods to Anglophone Cameroon from Douala was the answer. What about people living Anglophone Cameroon to Douala at the other end? Again, no answer was forth coming. Anyway we went through the motion of checking the books. Everybody was asked to produce their National Identity card. I do not have one, I said. I do not live in Cameroon. Where then do you live? The Officier de Police demanded looking at me with obvious suspicion. Well, I live in London. Okay, where is your passport? Again, I put it that, it was in my suitcase at the back of the car while behaving as nothing was happening. Now, said the Police Officer, are you saying you have no document to identify yourself? I have my bank cards, if you would want to take a look. The Policeman was surprised. What are bank cards? We do not use these things here. Please, produce an ID. You must identify yourself, his voice turning into a mild growl. I had my dark glasses (short-sighted) on. So, the Officier watched me carefully and closely with utmost suspicion. Perhaps, he thought I was a terrorist from Bakassi who had arrived to bomb parts of the Cameroon infrastructure – a few months back Commandos had arrived Victoria on flying boats from Nigeria, took over the City and stole half a million dollars in a daring raid and then vanished into the Atlantic.
On the other hand, I came through Douala; and only the most daring terrorist will attempt to enter Southern Cameroons from Francophone Douala. So, to create a bit of confusion, I decided to take off my glasses and demanded the Officier to produce his own ID. Please, produce your own ID. My junior brother who was at the driving seat was shocked. They looked at themselves, and then at looked at me in consternation. I pretended not to notice. Attend, je me reviens, the Officier uttered. Monsieur Le Commissaire lui-meme was brought to the spot. I could see his four gold stars on his epaulet indicating his high rank. Monsieur, Les pieces, s'il vous plait! He said. As I did not desire a scene, I produced my old British driving licence. He took it, inspected it and gave it back to me without uttering a word; and then waved his hand indicating that we may go. I took my old Licence, put it back in my wallet and we resumed our journey to Tiko. The CDC plantations of rubber, bananas and palms are still there in their hectares upon hectares, rows upon rows. Although one could detect a sense of small neglect, the plantations appeared well-kept; and hopefully there would be a trickle-down of benefits to the ordinary man and worker, so I supposed. We drove past a few new houses and I heard a person saying while pointing to an edifice of a building “That is 3813”; and immediately arrived the Likomba round-about where we stopped for some refreshment. At least one was a little bit encouraged that certain aspects of Cameroon were kept in order and maintained. Why this is the case; and why it occurred in the Southern Cameroons will be the subject of the next article on this matter.