We are deeply concerned about the outbreak of leptospirosis in St. Mary, not only for its impact on the immediate victims, but for its contribution to enlarging the not-so-pretty picture of waste management in the country.

And if the authorities do not yet recognise them, there are signs that if we are not careful, Jamaica could face a public health crisis, eroding some of the gains made over the past 40 years or so. We expect, of course, to be branded as alarmist.

The fact, though, is that we do not view the eight cases of leptospirosis now reported in St. Mary or the more than 300 across the island last year in isolation. We read this outbreak together with the incidence of malaria in Kingston's western belt, where more than 100 cases have so far been reported. This has happened 40 years after Jamaica was officially declared free of malaria.

We understand, of course, that in today's world of global movement and easy transportation, it is not particularly difficult for vectors and other forms of pests to find themselves across continents. It is also, indeed, easy for people to transport diseases from one country or region to another.

The challenge to public officials is to have the capacity to react quickly to contain outbreaks when they happen. But perhaps more important is the need to create an environment that prevents pests from flourishing - one that is clean. Unfortunately, we have been found wanting.

The current problem with malaria proves the point. The disease may have been 'imported' or passed on by a single human carrier, and by mosquitoes who arrived in Jamaica and subsequently bred here. The fact, though, is that our environment has made it easy for malaria-carrying or any other type of mosquitoes to breed.

This, in part, is a consequence of our failures as individuals and communities. Indeed, householders often do not properly discard household waste and other refuse, providing the opportunity for vectors and vermin to breed.

The larger problem, however, is with management at the national level and the seeming incapacity of the state to operate in systematic fashion and to respond to anything but crisis. So an organisation such as the National Solid Waste Management Authority (NSWMA), launched with such promise not so long ago, was allowed to become mired in corruption and mismanagement, as was pointed out in 2005 by the Contractor General. The upshot is that public cleansing is largely inadequate. On almost any street in any town or village in Jamaica there are huge mounds of uncollected garbage and other refuse. These are havens for rats, notorious for their role in the spread of leptospirosis.

The local government authorities and the National Works Agency, too, appear incapable of doing the little, inexpensive things which will positively impact on communities and enhance people's lives. The verges are overgrown; gullies and other drains are not cleaned. Small potholes develop into huge craters, which are not only traffic hazards, but are ideal breeding grounds for mosquitoes.

Without putting too fine a point on it, Jamaica has grown dirty. Or as the former Prime Minister, Mr. Patterson, put it, there has been an "uglification" of our country. Our concern is that our leaders appear not to be shamed by what they see.