Afaal’s Column

Everyday people queue up to take a token in the morning, at noon and in the afternoon. Almost five queues are formed everyday at different times. The number of people in the queue depends very much on the doctor on duty and the times when the doctor starts appointments. Tokens for a particular doctor’s duty get released an hour before the consultation time. In order to get a token people start to queue up as early as two or even three hours before the token release time. And the worst part is that tokens for a doctor may run out without everyone in the queue getting one. It is a hassle and it is annoying!

It is also difficult administratively. A staff member has to monitor the queue every time and also have to hand over an additional identification token to each person in the queue for each doctor separately. This way the people waiting would know that that they would not get a token on that day. Anyway, as I said before it is an annoying situation.

So what can we do to stop this form happening? Well we have already done some work on this. For example for the gynecology department, after the first contact, appointments are set for the rest of the nine months. Some other departments are also practicing this system now. This is a relief for these patients and also well appreciated when customer relations call to remind them the appointment. This is why for some doctors the number of tokens release for queue on a particular day varies. The doctor still consults the average standard of 35 or more patients a day.

We are contemplating to totally abolish the queue. How? By introducing phone and email appointments. But we will have to be well prepared and the mechanism needs to be tested before full implementation. We are also trying to work on a more interactive token machine.

Some people suggest starting to release the tokens in the morning for the doctors who will be on duty that day. My view on this is it will not solve the problem since then there will be a long long long long queue in the morning.

Irony is, even if we have a queue or appointments, we will not be able to give a token to each and every one on the same day they require it. The solutions to this would perhaps be increasing the number of doctors and consultation rooms. There is a difficulty with this also at the moment since there is no space and the scarcity of doctors applying for even available vacancies.

I feel that there should many ways by which a patient can get a doctor’s appointment. Walk-in, phone, email and by website too. I am very determined to get these conveniences to the care seekers and hope to make amends to make it easier for you to get an appointment. I feel for you all waiting in the queue.

All bright ideas are welcome and we will try to learn from shared experiences.

Many people still ask me about the change in the Hospital logo. It’s been over an year since the logo has been changed through a process of corporate rebranding that all the companies in the ADK Group went through. This article was previously published in my old blog and now I republish it for those who keep asking the question.

“Rebranding is the process by which a product or service developed with one brand, company or product line affiliation is marketed or distributed with a different identity. This may involve radical changes to the brand’s logo, brand name, image, marketing strategy, and advertising themes. These changes are typically aimed at the repositioning of the brand/company, usually in an attempt to distance itself from certain negative connotations of the previous branding, or to move the brand upmarket.” (Wikipedia the free Encyclopedia)

Today many corporates are rebranding themselves for many reasons. Some companies rebrand themselves to renew its publicity and acceptability to the public. Others do it to establish themselves in the market with business growth and some others do it to get a new vibe to the business.

Many people ask me about the change of ADK hospital logo. One of the first tasks that I took up when I joined the hospital was to rebrand it. But then this came as a combined effort from all other ADK businesses with an internal reform process of the ADK structure. The prominent ADK letters in a triangle is a simple and nice logo, but it did not seem appealing that all ADK companies use the same logo since it kind or devalues it. The younger companies of the ADK umbrella, namely ADK Travels and ADK Trade and Shipping both came up with new logos. Hospital and ADK Company as well as the parent company ADK Enterprises were using the triangular logo. Thus, to give the prominence to the original ADK logo, the restructuring process made this the identity for the parent company, i.e. ADK Enterprises Pvt. Ltd. Hospital and Company went for rebranding.

The things we looked for when getting a new logo was for it to be modern, soft and acceptable and catchy to the general public. Also we looked at the meaning of the logo, what the logo depicts.

Designers came up with over twenty possible logos for the hospital. A panel of judges selected the top five among those. The staff of ADK Hospital decided the final logo. Once we got the top five, we conducted a poll among all the staff of the hospital. This was very exciting for them since this was the first time that they got to participate in such a decision. The reason I did it was to get staff motivated by indicating to them that they have a say in things we do. Also it gave ownership of the new brand to the staff. Some 42% of the staff voted to adapt the current logo.

Finally coming to the logo, the logo depicts the following meaning.

The snake wrapped around the wand represents the rod of Asclepius used as the international medical symbol, depicting healing through medicine. The apple denotes health and well being as well as prevention. This is used in modern subtle way to reflect the artistic features that we looked for.

In the recent past, many employers are paying for medical insurance of their employees. I have to say that most of major companies have now done this for their employees or are on the verge of doing it. It is of course to the benefit of those people who are enrolled. But unfortunately some people try to take undue advantage of these packages. I have come across few incidences where people have tried to cheat on their schemes.

After all, who are they trying to cheat? Themselves!

“This article was first published at Dr. Abdullah Waheed’s Blog on Monday, November 24, 2008. This is a slightly controversial article representing my views. There were some very strong comments to the article. If you would like to see the comments please visit this article at Dr Waheed’s blog. I have brought it to my blog so that I will have an archive of all what I have written.”

On October 8, 2008 and on October 28, 2008 the Maldives underwent arguably the most democratic, the freest and the fairest elections in her entire history. This paves the new direction for future elections in the country.

Among the elections held in the country, the upcoming parliamentary election would be one that needs to be watched very carefully. In the past parliamentary elections have been influenced by money, and people with high governmental influence. Maldives went through a stage where the people were, in my words “made corrupt” by persuading them to accept money, goods and many other favours. This lead to a mass corruption where votes were given in return for something, i.e. votes were bought and many people still think that this perhaps is the norm.

Given this, during the last two parliamentary elections a large number of new faces came into both the Special Majlis and the Majlis. Their intentions were clear from what they have done so far. They have fought definitely on behalf of the people in a way that no previous parliament has ever done. They have passed the new constitution that is modern and people friendly. Many laws, most of them good and some with flaws while other laws contradicting each other were also passed.

No one in the country can deny that the current parliament’s achievement in facilitating the democratic process, making the government more accountable, and the contributions to the special Majlis in the separation of powers is historic. The achievement of the outgoing Special Majlis in getting a new constitution needs mentioning.

Ironically, the sad truth though is, in order to bring this to the people, powerful business people and other influential people had to, in my words “further corrupt the citizens” by pumping more money and doing more favours to get votes. Votes were sold to the highest bidder last time around. Perhaps this was the only way that these members could have penetrated into the parliament.

Question now is that are the same parliamentarians going to come out this election and advocate that what they did was wrong? Would they come out clean?

Maldivians will definitely watch the actions of these people carefully. Especially these were the very people during the last presidential election, were most vocal and critical about this issue targeting it to the then ruling party’s actions. Also, though we have a presidential system, parties will be fighting to get as many members in. Are there going to be totally new politicians who will defy the odds? Will there be those who have the courage to stand up to make the election clean? Would there be those who would and could educate and persuade the public to go on the right path? Only time will tell. We will have to hope that this endemic does not blow into an epidemic but rather get eradicated.

“This article was first published at Dr. Abdullah Waheed’s Blog on Friday, November 14, 2008 after President Nasheed was sworn in. This article got a large number of responses from readers and with mixed views. If you would like to see the comments please visit this article at Dr Waheed’s blog. I have brought it to my blog so that I will have an archive of all what I have written.”

After a long and hard struggle to attain democracy in the Maldives, 28 October 2008 marked a historic day that led to the end of a 30 year long presidency followed by a courageous display of democratic transition from both the out going and in coming presidents. Like the vast majority of people who voted for change, I waited anxiously for the new beginning. Finally on 11 November 2008, a moment long awaited, a new chapter headlined in the Maldivian democracy, a new president was sworn in.

Now comes the time of delivery. The first impressions are always important. I was one eager listener to the first Presidential Address from a different person in my whole life. I had a lot of expectations. What directions are we going to take? After listening to the Address, it took some time for me to really think about what was said. What was the message? Keeping what I thought for myself, I asked around a lot of people what they thought of the speech. Many were unable to say something concrete but most of the intellectual people that I asked were not really impressed with it. One of them told me that, and I quote “The campaign is now over, why he delivered another campaign speech after being sworn in!” Well I felt kind of the same.

So what shall a good presidential address do? In 1946 George Orwell published an essay “Politics and the English Language” that describes some insight into good political speeches. Many of the American analysts still use this assay as a baseline for speech assessment. Though the speech was not in English, the inaugural address of the President exhibited some staleness and vagueness which according to Orwell, lacks the strength of such a speech. Also the address didn’t meet Orwell’s criteria for an effective political speech because it was filled with the same political slogans that had been in the media and campaign speeches for the last four or so years. The strategic directions rolling over to the implementation of the slogans were lacking.

As for me I felt that the President delivered a vision statement. I agree that the promises need to be renewed but that renewal shall now come with strategic direction. I was expecting elaborations on the current economic situation of the country and specific strategies to address it. Elaborations on the ‘how’ of tackling the drug situation, health care, education and the rest of the five pledges would have been included. What actions would the President put immediately to overcome the challenges he faced and so forth.

Does this mean that the strategic communication unit of the President was up to par? Did the president do his own speech? Or did he miss to deliver part of the Address? Wasn’t it analyzed critically before delivery? Who gave the technical inputs to the Address? These are some questions among many that people may have in their minds.

Ironically, the Maldivian media also did not give a good analysis of the speech. Not surprisingly they only knew to repeat what the President said on their headlines. Rich critical analysis of such Addresses shall now be presented by the media for the benefit of the public.

“This article was first published at Dr. Abdullah Waheed’s Blog on Wednesday, October 29, 2008 after the second round of the elections. If you would like to see the comments please visit this article at Dr Waheed’s blog. I have brought it to my blog so that I will have an archive of all what I have written.”

On October 11, 2008 I submitted an article on very simple mathematics of the possibilities for swing votes in the second run of the election. In that I made a number of assumptions that would make the suggested scenarios possible.

Usually simple mathematics works. And in this case some assumptions that I made was true.

Voter turnout:

The most important assumption that I made was that voter turnout should be as high as that of the first run. In the first run the total turnout was 176,567 voters. This time around the number in fact was higher at 179,343.

Voter who voted for DRP and MDP at the first round remain constant:

Although this may not be exactly true the following math suggests that it is very close to the assumption. In the first round MDP got 44,293 votes and DRP got 71,731 votes. My calculations were based on 3 scenarios, i.e. 10% swing, 15% swing and 20% swing. I also suggested that it would be difficult to get a 20% swing. (Please read previous article I submitted to this blog for details).

So with a 15% swing my estimated numbers were, 94,889 for MDP and 81,678 for DRP. Of course these numbers are subject to a margin of error. The actual numbers attained are 97,222 for MDP and 82,121 for DRP. For an estimate I would say a close figure. The reason for saying that is if you look carefully, my estimate for a 15% swing resulted in an increase of 12.18% of votes for DRP from the first round. The actual increase is 12.65%. And the rest voted for MDP.

Comments:

I also agree that all the assumptions that I made in the previous analysis may not be true. But what I see here is that it is important that intellectual mathematical analyses are used by the media and even political parties in understanding the real voting scenarios. I encourage that media and political advisors to undertake such analysis during election times so that more objective ideas maybe obtained about the situations at hand.

Though I am not an election statistical expert, I have some academic background on statistics and also worked a large part of my working like producing statistics and using statistics for planning purposes. What I have presented in the October 11^th article and this one are just simple mathematical analysis based on the little statistical experience I have and what I read from the Internet about voting, elections and mathematical analyses elsewhere.

Please do not consider the previous article as well as this article “political” but an intellectual piece of work by an independent (which I am still) citizen of the Maldives.

Note: All figures used for the calculations are taken from the Elections Commission Website

“This article was first published at Dr. Abdullah Waheed’s Blog on Saturday, October 11, 2008. There was a very rich and heated discussion about it in that blog. If you want to see those comments please visit this article at Dr Waheed’s blog. I have brought it to my blog so that I will have an archive of all what I have written.”

Now that the first round of the election is over and everyone is gearing towards the run-off, just how big is it a task for the ruling party to swing the votes to attain a majority? I have made some assumptions on the possible scenarios on swinging the votes.

The first round showed that over 59% of the voters voted for a change in leadership. So in order for DRP to attain a majority in the run-off they will have to persuade at least over 20% of voters from each of the 3 candidates who have formed an alliance with MDP. Since IDP has bailed out of the coalition, I assume that at the most 50% will swing to DRP (may be unlikely but for argument sake). Also assuming that none of the DRP and MDP voter will swing any way, I present the following analysis (see table above).

Based on the above analysis with a 10%, 15% and 20% swing voters from each of the 3 aligning candidates give the following results (IDP swing is kept constant at 50% for above explained reasons for all calculations).
10% Swing
DRP: 78,774 votes (45%)
MDP Coalition: 97,793 votes (55%)

15% Swing
DRP: 81,678 votes (46%)
MDP Coalition: 94,889 votes (54%)

20% Swing
DRP: 84,581 votes (48%)
MDP Coalition: 91,986 votes (52%)

Question is, is it an attainable task to get such a drastic swing in the remaining couple of weeks? It is up to the voters to decide! And of course the final assumption is that the voter turn out should also remain equally high as the first round of the elections.

“Patients as consumers have the right to make their own choices and the ability to act upon them” (Wikipedia – The free encyclopedia)

The outcome of successful service depends on empowering the patient. The patient shall be considered an equal member of the health care team. It is a responsibility of the care providers to provide complete information and communicate with the patient regarding diagnoses, treatment and procedures. Such relations would help towards smooth and successful outcomes. It is generally believed in the management community that consumers (patients) are very powerful in defining relationships and too often such relationships favour the provision of services and the provider.

There are two important and key processes for empowering patients. First, provision of information and then communication, consultation and partnership. In order to do so we as healthcare providers need to first understand and acknowledge that patients do have some rights and of course, some responsibilities too. It is equally important to ensure that patients understand the same as well. Once the patient and the provider are in harmony on these issues, health care provision will have very good outcomes with the best of satisfaction. Such harmony is the hardest to achieve.

Patients should have easy access to information kept about them in the hospital and be helped to understand it. In addition hospital staff shall be empowered to share such information and help the patients and family understand them. Patients should also be given information about the treatment planed for them and the possible side-effects and/or other risks that may result from such treatment. The choice of a patient to decline or refuse any treatment shall also be respected without prejudice and the patient shall not be deprived of their access to any other service offered by the institution as a result. Thus, provision of proper and complete information gives the patient a sense of their participation in care and increases their confidence in the professionals as well as the institution.

The first step to developing such harmony is to start informing the patients of their rights and responsibilities when seeking care. In addition an environment conducive to hear their views and use them is most critical for improved outcome in service.