It is more than a little bit ironic that with deepening global fears of a swine flu pandemic, the most immediate advice by the experts to an increasingly frightened world to avoid the virus is to go back to basics.

Sure, there is discussion about the availability and use of anti-flu vaccine to combat the H1N1 virus, which is the current culprit of focus. This, though, is primarily for the rich world. But, even there, the fundamental offering is decidedly low-tech.

Generally, people are being told to cover their mouths when they cough, to wash their hands frequently and, if possible, to avoid crowds. If people show symptoms of infection with the virus, the suggestion, obviously, is that they remove themselves from others.

This is sound advice that ought to be vigorously followed in Jamaica as we attempt to keep at bay this potential epidemic. At the same time, they provide a context or, more accurately, perhaps a reminder of another way we can think about public-health policy in Jamaica.

Woefully short

For the current fiscal year, the Government has allocated around four per cent of its approximately $55.7-billion Budget for health care, which critics say is woefully short of the amount required if the administration is to maintain adequately its policy of free care at public institutions. Even proponents of the system concede that delivery on the promise is under stress. Not only are there long waits at public health institutions, but patients complain of the inadequate availability of drugs at free surgeries.

It is perhaps true, as government spokesmen have stressed, that part of the issue is that pent-up demand for health services has become apparent now that the system is 'free' to all. But it is obvious, too, that much of the debate over health care and health-care policy in Jamaica is over secondary- and tertiary-delivery services, including what hospitals and equipment are available. These things, we know and accept, are important. Nonetheless, we do not believe that there is sufficient focus on prevention - and not in the way of the promotions to prevent lifestyle diseases.

Major focus

Our contention is for a major focus on the most basic, with a system adept at promoting hygiene as a critical part of the public-health effort. Of course, we might be reminded that life expectancy in Jamaica, at over 70 years, is at developed-world standards. We fear, however, that in the current global economic crisis, which is not leaving Jamaica unscarred, and with the worsening economic situation for individuals here, there could be slippage.

Indeed, the housing minister, Dr Horace Chang, recently highlighted the dilemma of squatter settlements across Jamaica and the inadequate living conditions of too many people and the pressure this put on the physical, social and, potentially, health environment. Public-health education is critical.

As we move to fix those problems, it also makes sense for policy to focus on basic and primary health care and, in the short term, the thing is to keep swine flu away and our tourism and other markets open.

We should remind people to cover their mouths when coughing, to wash their hands regularly, and to stay away from crowds when they have infections that are contagious. The advice is good for more than swine flu.

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