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For our younger readers, Venezuela may only have a distant image comprising oilfields and offshore drilling that many have only seen pictures of. Venezuela’s second image may be the beautiful entrants in Miss World or Miss Universe. In these days of modern air travel there are only three convenient routes; one via Miami; one via Panama; or one via Trinidad.

So for most Jamaicans it seems to be a long trip to a vast country that holds no memories for the under 60”s, and it was never taught in schools in a serious way in either history or geography. So our relationship remains remote (except for the few who know that the South American liberator Simon Bolivar was exiled for a time in Jamaica).

The development of the oil industry from about 1902 was interrupted by the two World Wars that increased the demand but also created shortages of capital equipment. The eventual proving of the world’s largest reserves created an economic inequity often referred to as “the Dutch disease” that widened the gap between the rich and the poor that has lingered until today and has been at the base of revolutionary upheavals (and seems set to do the same very soon). Agricultural production fell from over 30% to 10% of total production and the consequences are massive food shortages and growing unrest.

“Ten years from now, twenty years from now… oil will bring us ruin; it is the devil’s excrement” (J.P Perez Alfonzo former Venezuelan Oil Minister and founding member of OPEC).

Migration to Venezuela encompassed Haiti, Barbados, Trinidad and Tobago, Grenada, Dominica, Dutch Antilles, Cuba, Guyana, Suriname, French Guiana, among others. Many women left to work in domestic services for the new oil-wealthy expatriates.

In the 1950’s and 60’s many Venezuelans came to Jamaican high schools as boarders in order to become fluent in English. These schools included Immaculate, St. Andrews, Wolmer’s, Jamaica College, Munro, Hampton, among others. This fostered good friendships and even marriages, and this has lingered with the older generation of Jamaicans. So for many of us, the current situation of deprivation and hunger is of importance to us, while others say keep quiet because we owe them money through Petrocaribe.

The latter attitude is sheer ignorance, and I hope that a better understanding will improve our humanitarianism that we have lost to callous and selfish monetary influences. The essential move for us is to repay part of our debt through the export of many items urgently needed in Venezuela and reduce our debt to them.

 This largely involves the private sector capacity, the government as an entrée facilitator, and an agreed incentive to promote debt repayment through export. It will produce jobs as a direct stimulus to our economy; it will expand our strategic approach to exporting; it will require greater US$ to purchase needed raw materials. Most of all it requires discipline (which can’t do us any harm).

The private sector has over 50% unused capacity (at 2 shifts) and about 70% (at 3 shifts). Assuming some volume efficiencies this could produce 20-40% more direct jobs, and others within their supply chain. My recommendation would be to start with food proteins that require no refrigeration, and sanitary paper products. The sheer volumes could encourage appropriate re-tooling.

A necessary caution has to be shipping, as many ships await payment releases before unloading at Venezuela’s ports. The fact that the Petrocaribe dollars are here and available for immediate local payment, may in fact be a comparative advantage.  This could be a cheap warmup match for the Global Export World Cup.

Our succeeding Governments have been very cagey with regard to “their friends/comrades” in Venezuela. One side is swayed by the USA’s policies on Venezuela which have been largely political/economic reasons masked in democracy. The other has warmed to the old socialist glamour of “the revolutionary” and their love for those old images.

 An old quotation: “what if I told you that the left wing and the right wing belong to the same bird?”

“America has no permanent friends or enemies; only interests” Henry Kissinger.

 John Wayne on a horse and Che Guevara on a T-shirt rekindles their political fervor, not realizing that both are dead. Our politicians have no inclination to be dead heroes or heroines.

“Ghetto superstar what a way yu reach far; every lyrics whey u have mi seh a pure war; how yu tell a man fi lick shot; and yu neva get a lick fi feel how it hot” (Valton VC Craigie).

People have friends; and for many of us we have Venezuelan friends. They assisted us when they could and now is the time for reciprocation. There are major challenges that face Venezuela and member states within the Organization of American States (OAS), but the voices of the CARICOM are deafeningly silent. We cannot agree that punishment for the attempts to curtail human rights in Venezuela by their government, should demand the sentence of starvation and failing health and medical facilities. Say something Jamaica.

 

In my inner mind I can hear the whistling that starts Dionne Warwick and friends singing: “that’s what friends are for”. This is a human sentiment that speaks to the victory of good over evil, and right over wrong. It should distinguish us as Jamaicans.

 

Executive Insights                                              
James Moss- Solomon
Executive in Residence
Mona School of Business and Management

April 3, 2017

 

The concept of healthcare and its real or perceived efficacy has been a challenge for developed and developing societies for a long time. For the very poor countries it does not exist except for humanitarian aid; and in remote indigenous societies they use natural tribal practices that have been handed down over thousands of years.

The developed and the developing countries have escalated a contentious attitude that has taken on wide ranging political debates, disagreements, and have grown to include the general population in these struggles that have toppled governments. Yet, an individual survey of politicians and citizens would probably find common ground on similar objectives, and short and long term goals with the mantra “affordable care for all”.

The developed and the developing countries have failed to accept that modern medicine has advanced at a much higher rate that their own economies have grown, and therefore they are unable to pay the costs associated with better but more expensive methods of diagnostics and treatment regimes. Even in the world’s richest nation the USA, “Obamacare” featured heavily in the Presidential race and debates.

The cost of dialysis was a major factor leading New York towards bankruptcy, as it was a lifesaving but expensive treatment, and prior to that invention we just died. It seems cold hearted to mention it in this way, but the reality is that before this development and successful organ transplants there were no viable life-extending treatments.

Modern communications has empowered a greater number of persons to investigate the latest treatments and even some cures, and many go to the doctor with questions based on what they have read. So expectations are high, and when patients and their loved ones are faced with “inadequate facilities” their anger factors rise and they find people on whom to vent their frustrations, usually politicians.

This would not have been so if those same politicians had held fast to a realistic script instead of the “promise the world” while on the hustings. But practicality and brutal honesty do not seem to be important job criteria for politicians worldwide. Feel good and unrealistic dreams seem to be their common fodder.

Coming back to Jamaica, our population is so closely connected to the Diaspora in North America and Britain, that the expectations of modern medicine are high from both sides.

Johnny in deep rural Jamaica calls his bredda in Nu Yaak and says “Jocko Mama well sick an har head no stap hurt har fi two weeks and she nah eat”. Jocko replies “mi a go send you some maney by WU timarrow and you take her hup to Pleasant Valley haspidal and mek she get a MRHi”.

This will not happen, and if Mama passes on Jocko will call the Consulate, write the newspapers, call the talk shows, and vent the grief; and he does not remember that these were the very conditions that made him choose to migrate in the first place. There has never been an ambulance or MRI in Pleasant Valley and perhaps there never will be, and the road to the nearest Type A hospital may be impassable.

Mama, Johnny, and Jocko, are merely victims of a system that promises much but fails to deliver. Words are nine day wonders, and most people choose to forget them and move along merrily until the disastrous reality comes to their homes. It is a scenario set up to accommodate wastefulness, incompetence, and fraud.

But healthcare does not have to be a part of this system. The promises to improve health services cannot be lost in “free healthcare” but at a very low standard. This cannot happen as long as Johnny and Jocko are in instant communication and are able to compare Jamaica with the first world. Improvements to human care cannot be subservient to the IMF dictates, and before we give in to inhumanity, something else has to give (like expensive office buildings for inefficient government departments, or retaining incompetent staff, or wasteful spending).

We can achieve targets without sacrificing health and education. The methodology is called non-partisanship, and in the immediate case of Cornwall Regional Hospital, Messrs. Tufton and Dalley have taken a good first step and I commend them. Illness is not a political disease and the treatment is medical not partisan, antibiotics not antagonism, surgery not chopping up one another.

Our instant case is the possible fallout that 16.5% GCT on health schemes may have, and some of the unanticipated outcomes; and some of these are:

  1. Companies may continue to pay increased premiums for employees as this is a next transaction (revenue neutral) that is passed on and may not affect corporate cash flows
  2. The company premiums cover the employees only (usually).
  3.  The extension to dependents is usually at the expense of the employee so they will pay 16.5% more than they currently pay.
  4. The employee may consider stopping family coverage leaving some members of their family exposed.
  5. If that is the case then Government hospitals (no fee paying) will likely see a surge of new patients in already overcrowded and poorly equipped facilities.
  6.  The self-employed person who has taken an individual or family plan will pay 16.5% more.

Deterioration in health must play a major factor in productivity, work and school attendance, thus affecting the future ambitions of 5 in 4, and the 2030 vision. We could be condemning ourselves to being sick and uneducated, and this is a recipe for poverty.

There must be other areas for containing costs or collecting from evaders who exist quite happily in the shadows of the informal and illegal economy. ( Oh dear there I go dreaming again for these are some of the very people who generously fund party campaigns. Silly me!)

We should be concerned as not all of our citizens can afford air ambulances, and First World hospitals, and if we fail to call for a policy that allows the improvement in the healthcare system then we are doomed.

 

Whose responsibility is it to set the conditions for the advancement of wellness for our population?

 

Executive Insights                                              
James Moss- Solomon
Executive in Residence
Mona School of Business and Management
March 15, 2017

 

Our Jamaican language is replete with words that are used in a different way to Standard English and can mean the opposite; for example “soon come” has no definitive time constraint. Also having “a few friends over” could be a party with 300 people in attendance.

As an extension to the above there are words used in both languages that have no meaning in the other. I choose not to write some of my Jamaican words in this medium, but suffice it to say that in a fit of anger, my range of expressions far surpasses the British, American, and Canadian repertoire by a long way.

My word of the “misunderstood in translation” is Maintenance. It has no meaning in Jamaican that resembles a noun, or an action word. It is used without any intention leading to action or intervention in our country, and is not even a subject of interrogation for the common complaint “it nah wuk, it bruk down”. This misunderstanding goes from the very small to the very large issues.

If we accept that a motor car and a house are major personal investments then in the case of the former, why would we choose to insure a J$ 10 million investment as a third party risk knowing full well that there is an illegal taxi waiting around the corner to crash into you, and you do not have the 10 million to replace you vehicle? In addition, with our notoriously bad roads we fail to check tire pressure, engine oil, coolants, and front end alignment as we fall into craters every 100 meters.

Most home-owners are blissfully unaware of the electrical wiring in their own homes. Copper wires meet aluminum wires and conduct and vibrate at different frequencies causing joints to become loose and sparks are generated that cause fires (in the panel box and at the pot head). They have no idea of the paste to retard the chemical breakdown or that lugs in the panel box need to be tightened at least twice per annum.

Therefore at the individual level our two largest personal investments in capital are at risk because “mi neva know” is not a valid response to required regular servicing and maintenance. The relationship between electricity and flammable material does not require a PhD in physics or chemistry.

This exact condition is to be found in commercial buildings whether owned, leased, or rented, and in Jamaica few businesses include the cost of preventative maintenance in their annual budgets. In fact the line item Repairs and Maintenance only means repairs. It is like budgeting for legal fees that will only occur if we get in trouble with the law.

These are simply numbers that go into the budget so that if they are avoided our performance will be rewarded by a bonus. We face no consequences if the building burns down as that will be, from our myopic perspective, “an Act of God” and we will be totally absolved. I call it “creative accounting”.

In the recent crisis the Cornwall Regional Hospital is under the microscope. It may be the most publicized example of a “sick building” when that investigation is concluded and the cost of rehabilitation or rebuilding becomes a budget reality. As it is a hospital designed to “heal the sick not make them sick” it has great media attention at this time.

If the diagnosis of fiberglass dust in the air-conditioning system is the correct source of the fumes, then we have a complication in the steps towards rehabilitation. Firstly, if the action previously taken in cleaning caused the shedding, then perhaps the entire system is compromised. Secondly, if the entire system is compromised, is it sufficiently discreet so as to allow replacement without compromising other sections, and what are those sections? Thirdly, if the system design is no longer appropriate for a modern infection control of airborne infections, should it be repaired or abandoned?

If I were to hazard a guess I would suggest that a closure of the hospital for major overhaul would be a likely action that would address a number of issues. The staff and patient safety cannot be compromised under any circumstance. The closure could allow a really complete overhaul and ensure that Cornwall Regional returns as a really first class facility that could increase their surgical capability, train Consultants, increase ICU capabilities, and increase their Accident and Emergency potential. If accomplished this could truly become an international standard hospital allowing for treatment of local and foreign patients due to the close access to and from the airport.

However a close inspection of many Government-owned offices and private commercial offices will reveal a high percentage of hazardous construction resulting in mold in air-conditioning and walls, sewage defects, and the use of asbestos or fiberglass. The slavish use of rectangular ducting often means that modern cleaning robots cannot be used, and there is no other method that allows for minimizing regular cleaning cost and time. Clean air and low or no contamination is essential for a modern hospital.

In nearly every case there is a design flaw, and a careful back-tracking of the process will reveal that safety logic has been over-ruled by “creative accounting control” to contain estimated construction costs within the approved budget. In many cases this is merely an attempt for the financial gurus to try to establish themselves as a higher order species than scientific and technical experts in the pecking order. The financial decision makers therefore hope that there is sufficient time to enjoy their rewards and bonuses, and then they either retire or die before their poor decisions are discovered.

Going back to Cornwall Regional, I would be willing to bet that the design of the airflow processes had not been done in accordance with modern requirements such as segregated air directions that minimize air-borne infection, fresh air changes per hour in operating theatres, and completely segregated systems for isolation units may not have been part of the final approved design.

Secondly the frequent inspection of the facilities that would entail measurements of air quality and other sources of contamination would not have met the rigorous and costly public health requirements due to lack of money, personnel and the non- enforcement of standards.

However there is the golden opportunity for the Minister and Ministry of Health to forget the blame game, and to take a careful look at all the health facilities so as to identify other faults. The sheer enormity of the problems may be beyond the immediate ability of the Government to resolve in one year. However it will provide an accurate estimate of remedial capital expenditure that can be prioritized and funded in future budgets. At least the public could understand the situation in a fully transparent manner and support the efforts required to save their own lives and those of their loved ones.

The two major Political Parties must agree, in this context, to share the culpabilities of neglect; to avoid useless political finger-pointing; and agree to become technological watchdogs and avoid awarding future contracts to incompetent persons. This is an essential function of a Parliament.

It is important that we all explain technical issues in a simple way, and be truthful about what can be accomplished in the short term, as in this approach we will gather support rather than anger. This is the hand of friendship based on truth, which we all must extend to the staff and patients of Cornwall Regional Hospital, with the hope that in like circumstances they would do the same.

We have been saying for a number of years (probably greater than a decade) that we intend to implement an Occupational Safety and Health Act (OSHA) in Jamaica. This is admirable when attempting to achieve or maintain international standards of operations. Some industries will soon find that access to international markets will be conditional on meeting and maintaining those standards, just as they now have to do with HAACP (Hazard Analysis and Critical Control Points).

Many Jamaican businesses and Government operated companies have found that the cost and discipline of attaining HACCP or ISO certification has been an onerous undertaking, but one that we cannot ignore in the global markets.

Hotels, airlines, shipping lines, and the food exporting industries have had to bite the bullet and take the plunge and for them these are the rules of the game. So they have adapted and now budget for the real cost of certification.

OSHA will be more difficult as it is not solely externally mandated, and therefore we have the conditions of our own local workforce to attend to, in addition to the international demands. This introduces the ability of our local Trade Unions, Staff Associations, and individuals to take legal action against non-compliance.

This is an entirely unknown topic for the nation as a whole and has cost implications for  both  inspection  and  compliance  that  will  impact  budgets.  If these are misunderstood then disputes will contribute extreme pressure on an already over- burdened court system.

Whose responsibility is it to introduce transparency as a way of governance and public understanding?

 

Executive Insights
James Moss- Solomon
Executive in Residence
Mona School of Business and Management
February 27, 2017
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