allAfrica.com: Mauritius: Beware of free-market economists bearing ideological gifts (Page 1 of 2)

When my family and I were on an extended stay in Mauritius some fourteen years ago I was stung on the hand by a hornet -- en mouche-jaune -- after I accidentally disturbed a nest hanging from a tree in the garden of the house where we were living. I was lucky that it was a single hornet rather than the swarm which attacked me. But the immediate experience was painful enough -- it felt like I'd been hit by a hammer -- and despite having onion rubbed on the site by our maid (I'm sure it did some good) the following day my hand had swelled and I could barely move my fingers.

By the evening the problem seemed to be getting worse rather than better and I was advised by some of my in-laws -- my wife is Mauritian -- not to leave it another night but to go to the local hospital and seek help. So at about nine o'clock I drove from the house where we were staying at La Caverne to the Victoria hospital at Candos and stepped into a very crowded waiting room.

I hadn't brought anything to read and so the prospect of hanging around for several hours before I received attention was not an attractive one. Luckily, I didn't have to wait long as there were only a few people in need of medical care and the rest were their relatives (which taught me something about the strengthand significance of family and kinship patternsin Mauritius).

I saw a doctor who told me to go with two nurses who would give me some injections. I did as I was told and I was given tetanus, steroid and antihistamine shots (which, I later learned, when I returned to the UK is a standard treatment for this sort of thing).

I then had to wait 20 minutes after the injections had been administered in case I had some sort of allergic reaction and passed out. I didn't and instead spent the time talking to the nurses who were interested in my views on Mauritius, how long I was staying, where I was staying, who I was related to and so on. I returned home with a supply of oral antihistamines which I was instructed to take over the next few days. The treatment worked and my hand returned to normal very quickly.

Now all of this was free -- I didn't have to pay anything for the treatment or the medicine. And it is a similar story in the UK. Any local or foreigner suffering from a severe insect sting (or worse) can turn up at the accident and emergency unit of a local hospital and be treated (although it probably won't be as quick as the treatment I received in Mauritius and any medicine has to be paid for albeit at a subsidised rate).

Over the years I like to think I have repaid my debt to the Mauritian taxpayer by telling my British friends about my experience with the mouche-jaune. Put simply, my message to those who can afford it has been: "Why don't you take the opportunity to visit Mauritius some time? It's a great place for a holiday -- very nice people, very interesting cultural mix and fantastic beaches and hotels -- and let me assure you that if something nasty happens to you while you're there, you will be well looked after if my experience with the hornet is anything to go by."

Marketing experts involved in the leisure and tourism industry will tell you that these sorts of personal, word-of-mouth recommendations -- known in the trade as "buzz marketing" -- are worth their weight in gold because of the way they influence people's decision-making. In fact, over the years several of my friends and acquaintances have made the 12-hour flight from Heathrow to Plaisance airport. I like to think that these journeys have been made at least in part because of my enthusiastic storytelling.

So a strict cost-benefit analysis of the sort much favoured by most economists who tend to focus on the immediate transaction rather than the larger context (which takes place in a much longer timeframe) would be a very partial account indeed of my encounter with the mouche-jaune -- in other words, although the burden of my medical treatment fell on the Mauritian health service, it wouldn't reveal anything of my (very modest) contribution to the country's economy by promoting it as a tourist destination.

In any case, I see the type of healthcare provided in Mauritius and the UK as the hallmark of civilised societies. Care and treatment at the point of need rather than on the ability to pay or a function of status is indicative of a culture which has a strong tradition of public service which benefits all citizens and even stretches to incorporate temporary residents and tourists.

Indeed, at the time of my experience with the hornet, I was reminded of a book I was obliged to read as part of my university course, "The Gift Relationship: from Human Blood to Social Policy", by the late Richard Titmuss who was Professor of Social Administration at the London School of Economics. (He also advised the first Mauritian government led by Dr Seewoosagur Ramgoolam on population policy and family planning amongst other things.)

The book was first published in 1971 and has had a huge influence on government policy and the academic community in the UK (and, to some extent, in the US). Titmuss' thesis on blood donation was highly intriguing -- he contrasted the American system where blood donors were often paid for their services with the British system where people donated their blood for nothing (although they were and still are given tea and biscuits afterwards).

Titmuss concluded that the latter system was more efficient because not only was more blood wasted in American hospitals compared to British ones but that, more importantly, blood purchased from poorer American donors was more likely to be contaminated with hepatitis B because the typically poor blood donors -- often drug users -- were only interested in the money they would receive rather than the health benefits to blood receivers. (The book was written, of course, before the era of HIV infection.)

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