DR MALA MODUN-BISSESSUR
(LRCP.LRCS,I. DU(PUBLIC HEALTH)

Mauritius has faced several major health concerns since its early period of colonization. All who came or were brought here, a previously uninhabited place, were from Europe, Africa, Madagascar, Asia and along with them came diseases prevalent in their own native country. In those days Tuberculosis and Leprosy were as common in Europe as in Africa. The physical fitness of the manpower needed to develop the island was a major criterion for recruitment of the individuals but under the deplorable travelling conditions, chained and packed like animals in a restricted place below deck, no fresh air, inadequate food and water supply, unhygienic conditions for days, many of those healthy persons whether slaves or indentured labourers were overtaken by diseases. Inland, unavailable and or inaccessible health care facilities, lack of food, no decent housing, no safe drinking water, no proper waste disposal facilities, physical exhaustion from overwork worsened their situation resulting in frequent outbreaks of diseases with high morbidity and mortality. Cases of leprosy, cholera were noted in 1775. Upon a formal request from Pierre Poivre, French Administrator, nuns of the Saint Paul de Chartres congregation from France came over in 1775 to care for the sick. The arrival of indentured immigrant workers from early 1800 recruited from the poor regions of India increased the burden of disease where again no appropriate infrastructure were in place to deal with the matter. Outbreaks and deaths from cholera, smallpox on board led to quarantine of several shipments in the surrounding islands before clearance for landing in mainland Mauritius was given. As Mauritius was an important port of call on the East West route in the Indian Ocean, rats also landed and introduced plague which flared into an epidemic in 1899. The prevalence of diseases among these TB, dysentery, malaria, beri-beri, Spanish flu both at epidemic and non-epidemic levels had a serious impact on the economy and called for strong action from the authorities. The development of a free health service available and accessible to all sections of the population, especially for the working class, started under British colonial rule. Several measures were introduced among which the setting up of a hospital in each sugar estate, the obligatory presence of qualified health staff on site 24/7 and weekly visits of a medical officer, village dispensaries and a district hospital with separate isolation ward in each district. At the landing site of the workers from India, at Pointe aux Canonniers a quarantine hospital was built. Specialized hospitals for Psychiatric Orthopaedic, ENT problems also saw the day.

21st Century

The standard and quality of life has greatly improved, the health services have come a long way, but Mauritius still remains a vulnerable spot for transmissible diseases more so with rapid globalization and emerging infections. The new, the latest affliction is the Coronavirus from the East. Mauritius owns several small inhabited islands in its wide territorial economic zone and the welfare of all its citizens is its responsibility. It has a well-established network of public and private health care points, provides from primary to tertiary level service and also subsidises treatment abroad. It has links with health sciences institutions in the five continents, together locally it trains undergraduate and postgraduate medical officers including in Public Health studies. It has the ability to respond energetically to difficult situations as it did for malaria, TB, polio, chikungunya, schistosomiasis, neonatal tetanus…and the establishment of its own “Public Health Surveillance Institute” would be a further step in its health services development. This scientific body staffed with public health professionals should have as mission the constant monitoring of the public health status of the local population, those in our islands, to be aware of regional international related matter; to timely inform, alert and advise the authorities, the Ministry of Health, the Government on appropriate actions and precautionary measures to put in place directly in the health sector and through inter and intra sectoral “droit de regard” collaboration in the State altogether. It should work in close partnership with local, regional and international scientific bodies for exchange of info, embark on research programs to enlighten us amongst others on the characteristics of the causative organism, its mode of action and effects in our dense population with already a high prevalence of non-communicable diseases in both gender from late youth; its trend, eventually aim to find an antidote. Mauritius has no shortage of brain and manpower to ensure continuity of activities in and outside crisis situations.

Our country has the privilege of being a small isolated island protected by sea from many health scourges yet this same situation can well be the other side of the coin and calls for vigilance action cooperation collaboration among all of us.