Is Covid-19 bringing out the inequalities in the delivery of health services in Mauritius?

Author: Ashwanee Budoo-Scholtz
Programme Manager of the Master’s in Human Rights and Democratisation in Africa, Centre for Human Rights, University of Pretoria

Introduction

When Mauritius recorded its first Covid-19 case on 18 March 2020, the country already had the strong backbone of the ‘solid social protection system’ to ensure that affected sections of the society are supported. In the area of health, in 2011, it was estimated that Mauritius had 3.4 hospital beds per 1000 population which was better than most sub-Saharan African countries. Hence, one could assume that the government of Mauritius would not face the failure of countries such as South Africa when it came to the provision of health care services for those affected by Covid-19.

As of 1 October 2021, Mauritius had a total of 15,695 confirmed Covid-19 cases, with 84 deaths. This was after the country relaxed its lockdown restrictions at the national level. The government has time and again spoken with pride of it being a best practice when it comes to preparedness for dealing with the Covid-19 virus. Indeed, once the country was hit by its first case of COVID-19, it started taking all measures possible to make sure it deals with the provision of health care services. To begin with, in the initial stages, it identified the New Souillac hospital and the New Ear Nose and Throat Hospital (New ENT Hospital) as a quarantine and isolation centre for those showing moderate to severe symptoms of Covid-19. For those with mild symptoms, they were isolated in make-shift treatment centres free of charge with regular follow-up. As the pandemic evolved, the country designated the New ENT Hospital, ‘equipped with the latest modern equipment and technology’ as the facility for treating Covid-19. Hence, anyone testing positive for Covid-19 with symptoms would be transferred to the New ENT Hospital. The country has also fully vaccinated more than half of the population.

Laws on the delivery of equitable healthcare services

According to international human rights instruments such as the African Charter on Human and Peoples’ Rights and the International Covenant on Economic, Social and Cultural Rights that have been ratified by Mauritius, states have the obligation to ensure that everyone without any discrimination has access to the highest attainable standard of health. This implies that the government of Mauritius must ensure that everyone in Mauritius, irrespective of whether they can afford it or not, benefits from health care services.

At the domestic level, usually countries’ Constitutions protect such rights. However, Mauritius’ Constitution does not include socio-economic rights as the right to health and the same is provided by Acts of Parliament. The country has ‘universal social programs such as health, education, pensions and transport’ where such services are provided for free to everyone without any discrimination. The welfare system of Mauritius has been considered as ‘a comprehensive social welfare system to which all Mauritians have universal access’ and as an example to the world.

The issues

Despite the steps taken to combat Covid-19 and Mauritius’ welfare system, there has been an outcry by the population of the unpreparedness and insufficiency to cater for everyone on an equal basis in the health sector, especially since the travel to India of the former prime minister of Mauritius and the leader of the Labour Party, Naveen Ramgoolam. The latter was admitted to a private hospital after being tested positive for COVID-19. Since then, upon the advice of his medical panel, he flew to India for medical treatment to avoid any medical complications that may arise, with the Prime Minister’s Office in Mauritius facilitating the trip and his political party’s financial support. The consideration of such a trip, with the Office of the Prime Minister assisting him, demonstrates that the government is not confident in the measures taken. It also means that the non-discrimination principle in the Constitution is not applied since he is benefiting from preferential treatment from the government based on his social status. Other Mauritians who were seriously affected and who lost their lives, including children, were not considered for such overseas treatment, demonstrating that some Mauritians are more equal than others and that those who have the financial means and political connections may obtain better healthcare than others. This begs the question whether the well-praised welfare system of Mauritius struggles to ensure equitable delivery of health care services, more so during the Covid-19 pandemic.

While Mauritius has a strong health system for the provision of basic health care services, the country still does not have high-tech medical devices for complicated surgeries. For instance, many Mauritians travel to countries such as India, South Africa or Reunion in cases of complicated tumours, cancers, and neurological issues, amongst others. While the government assists the patients with some of the costs, the patients must fundraise for part of the costs of such treatment, with those who are unable to raise funds being left without treatment. With this background, one can deduce that while the New ENT Hospital has modern equipment and technology, it might not be the best place in the world to deal with Covid-19 complications, thus explaining the trip of the former prime minister to India.

Way forward

To ensure that Mauritius delivers equitable health services, the government needs to invest more in new technologies and medical devices so that it can treat those with complicated sickness within its territories without the patient having to fundraise and travel to other countries for treatment. This will be in line with Mauritius’ international obligations to realise the right to health. Moreover, the government needs to review its Constitution to include socio-economic rights such as the right to health to show its commitment to such rights. This will allow the citizens to hold the government accountable in the domestic courts in the event the government is not taking steps to equitably deliver the highest standard of health.

About the Author:
Ashwanee Budoo-Scholtz is the Programme Manager of the LLM (in Human Rights and Democratisation in Africa)  at the Centre for Human Rights, University of Pretoria. She holds the degrees LLB from University of Mauritius, LLM and LLD from University of Pretoria.