Imani Tafari-Ama | People-first approach to healthcare | In Focus

The US presidential debate is interesting beyond the borders of the country. This is because the tentacles of American political influence reach far across the globe. The public jury declared Kamala Harris the winner over Donald Trump, just a few weeks before the November elections. The issue of public health, in particular sexual and reproductive health and rights, was one of the main agenda items. The abortion issue undermines the power of the state to regulate people’s personal body politics. This ongoing dispute is being answered by activists for social change who advocate for a woman’s right to choose what to do with her body.

Donald Trump is responsible for overthrowing the decades-old Roe vs. Wade ruling, which protected women’s rights to control their bodies. Now, states have put the abortion issue on the ballot and are voting accordingly. Leaving the decision to the states is likely to result in a conservative backlash, entrenching state regulation of embodied law, which holds women accountable for their reproductive choices.

Sexual and reproductive health and rights have become a flashpoint for conservative voters and justice advocates. Being pro-life is seen as conservative and influenced by (evangelical) Christian beliefs. Harris scored points by stating that if she won, she would support reducing state interference in women’s reproductive decisions. She advocates giving this agency back to women and their partners.

Of course, that’s easier said than done. Affordability barriers prevent many women from accessing health care in general. Abortion, being socially stigmatized, also carries connotations of being a privilege rather than a right.

On the other hand, abortion advocates are characterized as cunning and morally deficient. A class-specific line has been drawn in the sand of these polar positions. Under current arrangements, only those who can afford to pay the cost of crossing state lines can terminate a pregnancy in supportive states without endangering their health and that of the unborn. Safe abortions are thus available only to the few, not the many.

POWER TO REGULATE

Should the state decide? Is it the business of the church? In light of widespread problems such as sexual abuse, incest, child trafficking and exploitation, which can lead to unwanted pregnancies, who should retain the power to regulate the sexual and reproductive health and rights frameworks that should govern the abortion arena?

The Jamaican state’s refusal to legalize abortion has perpetuated the life-threatening practice of unsafe abortions. This risk is compounded by cultural taboos such as calling childless women “mules” and those who terminate pregnancies “graveyards.” This taboo ultimately leads to the punishment of women who interrupt the childbearing process in any way.

Health is also a hot topic in Jamaica, following the bizarre death of a traveler at Sangster International Airport. Leroy Smith, 71, who was visiting the island to attend a funeral, was about to check in for a JetBlue flight to Orlando, where he lives, when he fell and hit his head. Due to unsatisfactory administrative and medical responses, he eventually died on the airport floor.

In a video that went viral on social media, an eyewitness, Celia Foster, recounted the tragic incident. According to Foster, the unavailability of an ambulance to respond to the emergency was a major factor in Smith’s death. Mrs Foster’s account reveals that she was standing next to the unfortunate man when he fell and hit his head. The authorities’ clumsy response revealed the dysfunction that plagues the health sector in the island’s tourist capital.

There was marked inactivity from airport staff for approximately half an hour after the tragedy occurred. No working ambulance could be identified at Cornwall Regional Hospital (CRH) to deal with the emergency. After Mrs Foster located Mr Smith’s phone and identified and contacted one of the last people called, she was, incredibly, asked to confirm whether that person could afford the US$400 charge for obtaining the services of a private ambulance.

This person turned out to be Mr. Smith’s cousin, who agreed to the compensation. However, he had to pay J$10,000 because although the ambulance arrived, it did not arrive until after Smith had already died.

HUGE INVESTMENT

The huge investment in the infrastructural development of the CRH, the main health facility in Jamaica’s tourist hub, was initially estimated at just over $5 billion. Today, the cost of improving the hospital has risen to $21.5 billion. In light of this escalation, it is shocking to learn that someone could have died because of the lack of an ambulance. The nearby fire department, which should also have an ambulance available to supplement the CRH’s service, did not have one.

Therefore, one must ask what resources were allocated in the $21.5 billion budget to enable the expansion of the CRH. Did the planning not take into account state-of-the-art facilities such as ambulances? What are the indicators of a well-resourced city when it comes to providing assistance to those facing medical emergencies?

Prime Minister Andrew Holness and Health Minister Christopher Tufton agreed that the cost of international inflation was responsible for the exorbitant expenditure on the rehabilitation of the CRH. However, Mrs Foster also reported that as Smith lay bleeding on the hospital floor, there were no medical staff at the airport to address the crisis or provide a solution. It also raised the question, as the eyewitness did, of whether the response would have been different had it been a white tourist visiting Jamaica’s shores and experiencing such an unfortunate incident. The current US advisory against Jamaica warns visitors of the availability of a responsive health sector, so this is not a good picture.

Mr. Smith’s nephew claimed in a radio interview that someone should take responsibility for the negligence that resulted in his uncle’s death. It is certainly an eye-opener about the erosion of access to adequate health care that citizens should take for granted.

These shortcomings are the glaring results of the neglected balance of payments approach to the economy under agreements with institutions such as the International Monetary Fund. The health sector has been in decline for decades as services were sacrificed for debt payments. It is time for Jamaica to come full circle and show regulators such as the US that it can stand on its own two feet in this fundamental arena. This comes from a people-first approach to policy and development.

Imani Tafari-Ama, PhD, is a Pan-African advocate and gender and development specialist. Send feedback to [email protected] and [email protected].