Nottage Addresses Suspended House On Malaria Scare:

By Candia Dames -
Nassau, Bahamas:

After strong objections from Opposition members of parliament, led by former Prime Minister Hubert Ingraham, Minister of Health Senator Dr. Bernard Nottage addressed a suspended House of Assembly on the recent malaria scare yesterday, assuring again that the spread of the disease had been interrupted.

Minutes later, Prime Minister Perry Christie, who expressed deep disappointment that Dr. Nottage was not able to address the House while it was in session, said he had received reports of "alarming" cancellations at hotel properties on Exuma, where the 16 cases of malaria had been found.

Before Dr. Nottage delivered his report in the presence of members of his health team, Mr. Ingraham said the Official Opposition was absolutely opposed to the minister addressing the House while it was in session, and noted that rules provided for the prime minister to address the House on behalf of a minister who is not an MP, and also empower him to designate another minister who is a sitting MP to do so.

The whole matter forced a delay of at least an hour on a day when House members were attempting to complete debate on the 2006/2007 budget so that the spending plan could be passed sometime over night.

Conscious of the plan for the body of former cabinet minister and MP Livingstone Coakley to lie in state today, government members said there was a need to have the budget passed.

Without the unanimous consent of MPs for Dr. Nottage to address the House while it was in session, House Speaker Oswald Ingraham suspended proceedings for half an hour to allow Dr. Nottage to speak. The speaker then left the chamber.

The Official Opposition also objected to Dr. Nottage’s address being carried live on the parliamentary channel, but it was still carried on television as ZNS broke away from its regular programming to accommodate the request.

"From the beginning, my ministry treated this matter with the utmost urgency and sensitivity," Dr. Nottage said when he finally got an opportunity to speak. "We were aware, firstly, of the potential danger to the public’s health and the need to prevent any widespread dissemination of malaria among the residents and visitors of Exuma."

He also said, "I am happy…to confirm that local transmission of malaria on the island of Exuma has been successfully interrupted. We have found no new cases for the last eight days and we are optimistic that we now have the matter under control."

The health minister also reported that more than 600 specimens were taken for testing and he reiterated that experts found both evidence of recent infections and old infections in 16 cases. A total of twelve cases had recent infections and four had old infections, he told MPs.

Dr. Nottage said health officials were about to begin a study in order to establish to some degree of certainty the likely source of the infection.

"We are certain that the parasite [that] caused this cluster of malaria was imported," he said. "Someone brought the parasite to Exuma. The determination of the source will be the result of our intense investigations, which are ongoing.

"We have already identified several locations in Exuma where the few adult Anopheles mosquitoes and larvae have been found. We are monitoring the movement of persons and conducting sero-prevalence surveys in those areas. This will ultimately reveal the source."

Dr. Nottage said once the source is found, health officials will offer treatment to any person who resides in or frequents such areas or who is identified as a potential risk for the transmission of malaria.

"Based on the findings of the sero-prevalence surveys and in consultation with our international partners, we will formulate and introduce policies to minimize any recurrence of such an event in the future. Such policies will not be limited to Exuma. It will be necessary to introduce them throughout the entire Bahamas, having regard to the growing economy of New Providence and the Family Islands," he said.

The victims of malaria included two Uraguayans who worked on Exuma and a Haitian national, who was also employed there. Subsequently, one additional Bahamian was diagnosed in Canada.

While indicating that testing has found the Anopheles population of Exuma to be "extremely low" in some locations and non-existent in others, Dr. Nottage said it should be remembered that there are other types of mosquitoes on Exuma which are regarded as nuisance mosquitoes, but are unable to transmit the malaria parasite.

Dr. Nottage said the Environmental Health team is continuing the heightened mosquito control activities for as long as is necessary.

He said Bahamians are assured that they may visit Exuma without fear or concern for their health.

"I wish to state emphatically and unequivocally that it is not considered necessary for anyone who visits Exuma to take antimalarials," Dr. Nottage said.

"We had only a cluster of cases. The disease is not endemic here. The local transmission has been interrupted. The vector management has been successful and we are certain that we will find the source."

The Centers for Disease Control (CDC) and the Public Health Agency of Canada had both advised persons traveling to Exuma to take anti-malarials.

Dr. Nottage said dealing with the international health agencies has been very challenging.

"Once it became known that cases of malaria had been discovered and were being treated we received enquiries regarding the risk to visitors," he said.

Reading from a portion of an e-mail from the CDC which he said was forwarded to his ministry on Tuesday, Dr. Nottage said, "Congratulations to the Ministry of Health of the Bahamas and to PAHO for a textbook demonstration of outbreak containment."

The statement drew applause from House members, most of whom appeared to be listening intently to Dr. Nottage’s address.


22 June 2006

malaria

Ingraham Points To Budgetary “Illusions”:

By Candia Dames -
Nassau, Bahamas:

Despite government talk of unrivaled economic performance and unprecedented levels of foreign investment, former Prime Minister Hubert Ingraham said Wednesday evening that two critical measures of economic welfare and fiscal health have deteriorated – the budget deficit and the employment figure.

"How do you explain this increase in government debt and this deterioration in employment numbers in the face of this supposed unrivaled economic performance to which the prime minister refers?" asked Mr. Ingraham, who was contributing to debate on the 2006/2007 budget in the House of Assembly.

In his budget communication at the end of last month, Prime Minister Perry Christie declared that unemployment is declining and will decline "dramatically" further when the major tourism projects in the pipeline reach full stream.

The prime minister also said that the GFS deficit is "firmly under control and we have placed it on a declining trajectory." He said the GFS deficit will be 1.9 percent of GDP in 2006/2007 as compared with 3.1 percent in 2001/2002.

And Mr. Christie declared, "Any objective observer would be bound to agree that my government team has brought the Bahamian economy from its low point of 2001/2002 when all of these indicators were negative to the present stage where the Bahamian economy has already reached the takeoff point into what could be the longest, highest, and most sustainable economic expansion in the history of the Commonwealth of the Bahamas."

But Mr. Ingraham sees things differently.

"The welfare of the Bahamian people and the true economic situation [are] not improving," the former prime minister said. "Economic frenzy is not economic growth."

Under the Christie Administration’s four years of "so-called unequalled economic growth", the accumulated GFS deficit amounted to 11.5 percent of GDP, he said.

"This is unequalled in recent history," Mr. Ingraham said. "During the period of truly unrivaled economic growth in 1996 to 1999 the accumulated GFS deficit amounted to 6.9 percent of GDP."

"On the other hand," he added, "during the period of this administration’s supposed unrivaled economic growth, employment actually increased by 1.1 percent. This according to the information contained in the budget statement."

He noted that between 1996 and 1999 unemployment dropped by 3.1 percent.

"This is the true measure of real economic growth," Mr. Ingraham said.

He said that at the end of 2001 unemployment stood at 6.8 percent and government debt was 31 percent of GDP.

At the end of 2005, according to the Department of Statistics, unemployment stood at 10.2 percent.

"That is an additional 2,000 souls!" Mr. Ingraham declared.

He added that government debt was 37 percent of GDP last year as compared to 31 percent in 2002. Mr. Ingraham said that is a difference of $434 million.

"In fact, government debt is projected to rise further to 38.8 percent of GDP by the end of this year," Mr. Ingraham said.

"One of the critical issues in the major increase in government borrowing over the past four years is that it was not primarily for capital development. In point of fact, it was the financing of a huge recurrent deficit, that is, for the financing of recurrent expenses."

He also told House members that in the last four years, the recurrent deficit [added] $346 million to the government debt.

Mr. Ingraham said, "There is to a very great extent the illusion of high economic growth led by a constant reference to projected investments, investments in train, or investments shortly to be in train; the foreign sales of considerable amounts of Bahamian land without the associated investment project, and excessive credit growth."

The former prime minister added, "Investments which will shortly be in train do not create employment. The sale of Bahamian land does not of itself create economic growth; it increases the price of land, but it does not expand the economy."

He asserted that much information has been uttered in relation to the government’s deficit, government borrowing, the state of the public finances and the economy.

"Honourable members who choose to be informed, to be knowledgeable about these matters may easily do so," Mr. Ingraham said. "All they have to do is read, and, if they do not understand, ask questions of those who know."

22 June 2006

bahamian politics

New Immigration Policies Would Deal With Malaria:

By Quincy Parker -
Nassau, Bahamas:


The Ministry of Health is reviewing its policies with respect to requirements of immigrants from malaria endemic areas. That pronouncement came from Health Minister Dr. Bernard Nottage late Monday afternoon, though he did not elaborate.

Seven days have now passed since the identification of new cases of malaria. Each day with no new cases reduces the likelihood that transmission of the disease will resume, officials said.

The ministry held a press conference on Monday to announce the interruption of local transmission of "plasmodium falciparum" malaria on Exuma. "Falciparum," as the officials referred to it, is a potentially fatal strain of malaria, responsible for two million deaths a year, mostly in Africa.

However, officials said swift diagnosis and treatment would prevent serious illness. And in fact, none of the 16 identified cases grew seriously ill, and none died.

Health officials also sought to deal with the reports that tourists had contracted the disease. Press reports stated that a Canadian traveler and an American had contracted the disease. Dr. Nottage sought to clarify the information about the Canadian traveler.

"I am able to report that the person concerned is a Bahamian student who returned to Ottowa after spending a period of time in Exuma. The time he spent there corresponds with the time of the local transmission," he said.

Dr. Nottage said he spoke with the young man’s doctor, and he was apparently fine and attending classes. The other case, the American, was explained by the ministry’s Chief Medical Officer Dr. Merceline Dahl-Regis.

She said the ministry was informed that there was an individual who visited Exuma in early May, and was symptomatic when he was in Exuma. On May 24, he reportedly showed up at a US emergency room, suffering from malaria and another medical condition.

"This person has traveled, but according to the history (retrieved from the Centers for Disease Control), denied travel to any endemic areas," Dr. Dahl-Regis said.

Also, on the international publicity the cluster of malaria cases received, Dr. Nottage explained how the ministry got its message out.

"From the very beginning we have had the value of use of the Ministry of Tourism’s public relations firm, and they have been issuing information to the travel agencies," Dr. Nottage said.

"Additionally, we have been in touch with the (Centers for Disease Control) and others who have made inquiries, and we have asked the Ministry of Foreign Affairs to make the necessary contacts and make sure that the information coming from us is being widely disseminated."

Dr. Nottage explained some of the steps his team took to arrest the spread of the disease.

After identification of persons suffering from malaria on Exuma, a surveillance team made up of officials from the ministry and the Pan American Health Organization (PAHO) went door to door in a one-mile radius of where each malaria victim lives or works.

This phase of the ministry’s response to the first cluster of malaria cases in The Bahamas in at least 40 years is 90 percent complete, and Dr. Nottage reported that none of the people tested had contracted the flu-like illness.

As for how the outbreak started, PAHO’s regional malaria advisor reiterated that the Anopheles mosquito is not born with the "falciparum" parasite – it has to bite an infected human before it can infect anyone else.

"So the problem with malaria transmission is the problem of human beings infecting mosquitoes initially, and then those mosquitoes subsequently move on to (infect) persons, so we have the source being…most likely an imported case from an endemic country," Dr. Carter said.

Dr. Dahl-Regis explained the heightened surveillance efforts.

"First of all there was a review of all the log books from the clinics. Then there was inquiry from anyone who came to the clinic with a history of fever…and so we cast the net pretty wide in looking for possible cases," she said.

"In fact, to date we have interviewed or reviewed 600 possible (cases, including a review of) charts and spoken with individuals."

Dr. Nottage explained that 12 of the 16 malaria victims had recently contracted the disease – the other four were old cases. Of the 12 recent cases, nine were Bahamian, two were from Uruguay and one was from Haiti.

There is no malaria transmission in Uruguay, according to Dr. Carter. But while the disease is endemic to Haiti, Dr. Carter hastened to point out that there are 21 endemic countries in the region, with nationals who visit The Bahamas regularly.

Also, health officials were not sure that the rise in the number of cases was due to the disease spreading rapidly.

"I am not sure that we are speaking of (a rapid spreading) – we may have had a number of people infected who we had not detected," Dr. Carter explained.

"So I think what might be a fairer statement is that, having detected the first case, the Ministry of Health went ahead and started seeking cases, any possible source of infection and/or symptomatic person."

Among the ways the surveillance team sought the Anopheles mosquitoes was a technique the minister described as "human baiting" – officials from the ministry and PAHO sat out in the open, simply waiting for the mosquitoes to bite them.

"Results of these activities indicated that the Anopheles population is extremely low and non-existent in most of the surveyed locations. These findings are consistent with increased vector control activities in the form of fogging and larviciding conducted by the (Department of Environmental Health Services) after the report of the (first) case," Dr. Nottage said.

21 June 2006

malaria

Officials Say Malaria Situation Under Control:

By Quincy Parker -
Nassau, Bahamas:

Health Minister Dr. Bernard Nottage announced late Monday that malaria transmission on Exuma has been interrupted, suggesting that the disease is finally under control.

There have been no new cases of malaria identified in six days, and in another three days the incubation period for Anopheles mosquitoes, which carry the disease, would have passed.

This means that the flu-like disease is unlikely to recur, officials said.

The minister also clarified reports that a Canadian traveler had contracted malaria while on Exuma – it appears that the individual was a Bahamian student who returned to school in Canada. He was reportedly in Exuma during active transmission.

The other case, the American, is still under investigation, according to Chief Medical Officer Dr. Merceline Dahl-Regis.

Dr. Dahl-Regis explained that the man visited the Bahamas in early May, and presented himself to a US emergency room on May 24 with malaria and other ailments.

It has yet to be determined whether the man contracted the disease while he was in The Bahamas.

The "plasmodium falciparum" strain of malaria – the one found on Exuma – is responsible for two million deaths each year, mostly in Africa, and mostly due to lack of access to diagnosis and treatment.

The Pan American Health Organization (PAHO) Regional Advisor on Malaria Dr. Keith Carter explained that it is unlikely that the Ministry of Health will be able to pinpoint the source of the disease.

Dr. Nottage suggested that malaria was imported into The Bahamas from an endemic country, a suggestion Dr. Carter supported.

"We have really not yet identified the source of the infection, but we presume that – given the fact that we have not had transmission in The Bahamas for…at least 40 years – the source of the infection should be an imported case," Dr. Carter said.

Of the 12 persons identified with recent malaria cases (four of the total 16 were identified as having "old" malaria cases), Dr. Nottage revealed that nine were Bahamian, two were from Uruguay and one was from Haiti.

Health officials said that, once treated, there is little likelihood of relapse of the "falciparum" malaria, and no lasting side effects.

Backed by heavyweights from the health sector, Dr. Nottage sought to assure that there were no more Anopheles mosquitoes on Exuma, and that none had been found anywhere else in the country.

Dr. Christian Frederickson, medical entomologist with PAHO, explained that he had only found two adult Anopheles mosquitoes on June 9, and no adults since then. He said he had discovered, and destroyed, at most five Anopheles larvae.

Dr. Carter explained that tracing the source of the disease would not be as simple as saying that since malaria is endemic in Haiti and a Haitian national was among those with recent cases of malaria, Haiti is the source of the disease. He pointed out that there are 21 endemic countries in the region, from which any number of nationals visit The Bahamas.

Health officials disputed the suggestion that the disease had spread rapidly, with Dr. Dahl-Regis suggesting that increased surveillance and testing once the first case was identified on June 9 allowed the Ministry of Health to identify cases that had gone undiagnosed.

20 June 2006

malaria

BDM Declares War:

By Quincy Parker -
Nassau, Bahamas:

The Bahamas Democratic Movement (BDM) has declared war on both the Progressive Liberal Party and the Free National Movement, at the same time dismissing the Coalition for Democratic Reform as "defunct" and its members as "political prostitutes…who seek to serve (only) themselves."

In a scathing diatribe issued over the weekend, BDM leader Cassius Stuart continued to harangue the leadership of the political establishment, questioning the character of two men in particular – former prime minister Hubert Ingraham and Health Minister and former leader of the CDR Dr. Bernard Nottage.

In his release, Mr. Stuart accused Mr. Ingraham of perpetrating a "political hi-jacking" and "back-stabbing" his "protégé" – FNM Senate Leader and former party leader Tommy Turnquest - by returning to the leadership of the FNM.

However, FNM chairman Desmond Bannister told the Journal recently that despite perceptions of disunity in the party, the FNM is united behind Mr. Ingraham.

Mr. Bannister pointed out that in the elections for party leader, Mr. Ingraham received an overwhelming majority of the votes.

According to Mr. Stuart, Mr. Ingraham’s reemergence is "a clear indication that the FNM is bankrupt of ideas and leadership." In his opinion, after Mr. Ingraham’s political demise, the FNM will wander for 20 years in the political wilderness "and die in the process."

"Besides Mr. Ingraham leading the FNM, who is there?" he asks. "The FNM has no future because Hubert Ingraham’s leadership is a big failure."

"The next political betrayal," Mr. Staurt charged, "was the abandonment of his party members by Dr. Bernard Nottage who "jumped right back into the PLP like a dog going back to his own vomit."

"To make matters worse, the remaining leaders of the CDR joined the FNM. What a disgrace," Mr. Stuart said. "What is puzzling is (that) the leader of the CDR went into one party and the deputy leader went into another and both are claiming that their new parties are the best thing since sliced bread."

Mr. Stuart vehemently denounced the recent decision by nearly 40 members of the CDR to join the FNM, some with the intention to seek to run in the general elections on the FNM ticket.

The flow of invective continued as Mr. Stuart continued to castigate those he saw as leading the political establishment.

After stating a firm resolution not to be "bought," Mr. Stuart continued "the BDM declares war on the FNM and the PLP. We will not stop fighting until this lousy PLP government is gone forever."

In a parting shot at Mr. Ingraham, Mr. Stuart urged him to "resign now or face the wrath of the BDM."

Mr. Ingraham, Dr. Nottage and Mr. Maynard could not be reached for comment over the weekend.

19 June 2006

bahamian politics