Usman Bugaje
18 November 2008
opinion
A few months back, when the debate, or is it speculation, was raging over the secrecy in the health of the President, or lack of it, as it were, a lot of the anger was directed to the deliberate cover-up or the hoarding of information, which eroded trust and accentuated the political distance between the president and the citizens he claimed elected him. While this was understandable, considering the cloud of suspicion and mistrust that had embellished the whole electoral process, it was not forgivable that some of the salient issues got buried or glossed over in the frenzy. Conspicuously absent was the voice of the medical professionals, who may have taken cover under the ethics of confidentiality in patient's health.
Yet the best practices around the world, is to promote openness in the health of leaders because of its obvious consequences on peoples and polities. We cannot afford to operate double standards in the competitive global environment of the 21st century; while we strive to meet the best practices around the world in economy, democracy, rule of law, corporate governance, we shrink when it comes to issues of freedom of information and corporate responsibility in governance. The consequences of this duplicity and indeed complicity, is very much with us; stunted growth, stagnation of our educational institutions, deterioration of the quality of life and the spiraling down of the polity to the abyss, where the rot is waiting to explode. That we are today trailing behind in development indices not only countries like Ghana, but even war-torn Sierra Leon, obscure countries like Nicaragua and tiny African islands like Mauritius, ought to provoke our sense of shame and outrage. Yet we sit here, conducting democratic governance in perpetual secrecy, even administering oath of secrecy when the Freedom of Information Bill is awaiting passage in the National Assembly and talk about being among the 20 economies by 2020; certainly someone needs to get his head examined.
When I came across this book written by a brilliant professor of Medicine from a very British conservative medical tradition calling for openness in the medical conditions of people in power, it was difficult to resist sharing its contents with our medical professionals, politicians and the civil society so that we may begin to see the standards around the world in which we have to live and thrive. Dr Hugh L'Etang's, a son of a medical doctor and married to medical doctor, was born and trained in Britain and very early in his career chose to write and edit medical journals and books. He was particularly attracted to the health of leaders, whether of countries or organizations, because of the enormous consequences that these have on the polity/organization, as well as the people under them. In 1969 he wrote his major work in the area titled ' Pathology of Leadership'; in 1980, 11 years later, he wrote another titled, 'Fit to lead'; and in 1995; fifteen years later he wrote the book under review, 'Ailing Leaders in Power'. In between he has edited medical journals and written academic and professional works that received international acclaim. L'Etang, who enjoyed the unflinching support and dedication of his medical doctor wife, was a very diligent researcher, modest in his claims and, as one would discover, a man of not too many words.
The book under review is made up of ten chapters and a conclusion. Right from the preface, L'Etang defined the issue by raising a question: "The subject of this book is of as much importance to the general public as to the medical profession. Most of us are, to some degree, at the mercy of individuals at the apex of some organization whether it be political, commercial, bureaucratic or military. Few would deny that the mental and physical competence of these people is of importance to those in the organizations under their direction. Why then should not the mental and physical condition of those in supreme power be subject to review in so-called democratic societies?" He conceded that, "discussion of such problems could only be permitted in an open democratic society." Lamenting, that, "for those unfortunate subjects of bad, mad or incompetent leadership in an undemocratic society, medical intelligence has little to offer." (P iv)
In his first chapter, titled, 'An Unsolved Problem' the author discussed his methodology in a typical academic fashion, showing that to assess the health of leaders and understand its effect on the decisions they take requires not only medical knowledge but a grasp of historical methods. He also pointed how members of the club, as it were, protect each other denying access to information on health and that "when they break the rules of the club their evidence and opinions are revealing and alarming." (P 1) He anchored his pursuit for the link between decisions and the state of health of leaders to an article which appeared in the Daily Mail of London on May 1, 1957, in which the author Dr. V.V. Tilea argued that, "never had the personal health of world leaders been so uncertain and never had world politics been, ... so troubled and unstable." Dr Tilea argued further that, "it was not the international problems which led to illness in world leaders but that illness itself was the prime cause of political instability. The illness of Eisenhower and Dulles was reflected, in his view, by their foreign policy. Their indecisiveness, postponement of decisions, petulance with awkward allies and lenience with the real trouble-makers resembled that of convalescents whose peace had been disturbed." He proceeded to buttress Dr Tilea's view by bringing numerous incidences and examples, adding that, "swing of mood from elation to depression are usually associated with entertainers but they have occurred with far more serious consequences in political and military leaders, civil servants and even a member of Central Intelligence Agency. Medical students are repeatedly told rare diseases occur but rarely, yet uncommon blood disorders crippled President Pompidou of France and the Shah of Iran." (P 4)
Dr L'Etang lamented that "judging by the number of sick leaders since 1957 it is unlikely that Tilea's warning had any influence. An ambitious leader, greedy for power, regards illness as just another obstacle to be overcome and, if necessary, concealed. Disability in leaders can be hidden from the public by totalitarian regimes yet even in democracies, and despite widespread rumors or leaks, the electorate rarely expresses deep or lasting concern. Indeed, even when the details of disability in a leader merit serious attention, immediate measures to avoid either the repetition or the consequences of future ill-health are rarely demanded." (p 2) In rounding up his first chapter, he therefore demanded that "Steps must surely be taken to ensure that the subject of impaired leadership is taken out of the realm of medical curiosities and taught at Business Schools and Staff Colleges. An increasingly educated public throughout the world must be better informed by investigative rather than deferential journalists." (P 5) He concluded emphatically, "Public curiosity in their (electorate's) leaders should be encouraged and not suppressed since heads of state can plunge their people into disasters. ... Our fate is in the hands, hearts, glands, blood and brains of our leaders. Curiosity about them is very necessary for individual survival." (P 5)
(To be continued)
Bugaje is National Secretary of the Action Congress (AC). This article is a review of 'Ailing Leaders in Power 1914-1994' by Hugh L'Etang (London) the Royal Society of Medicine Press Ltd, 1995 (Pp 162+vi).
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