Islands Business - We Say: PACIFIC'S HEALTHCARE SYSTEMS MORIBUND

‘The islands’ medical institutions, facilities and personnel are so stretched that their healthcare systems find neither the resources nor the time to concentrate on preventative medicine...'

The state of Pacific Islands Countries’ healthcare system is moribund. In fact in many nations, despite a slow but positive economic growth over the decades, medical facilities have actually regressed. The threadbare infrastructure that exists in most countries is hopelessly outdated and barely capable of treating mainly the simplest of ailments afflicting islanders.

It’s not hard to see that the systems in most countries are in a sharp decline—the reasons ranging from poor planning to inefficient deployment of existing facilities—not to mention the severe scarcity of trained professionals at all levels.

Samoa's Tupua Tamasese Hospital in Apia: medical facilities in the islands are few and far between. Pic: Dev Nadkarni

For many years now, the islands have depended on expatriate doctors, especially from faraway developing countries, to man their medical facilities and on overseas aid for equipment and even their maintenance.

Such stopgap arrangements are never long-term solutions and in most countries the pool of these expatriate doctors and medical professionals continues to be a floating population that must be replaced every few years.

Worse, the islands that are so renowned for the quality of their nursing professionals, end up losing them for that very reason: their quiet and humble efficiency that proves to be such great value for money in the bigger paramedical markets of the developed world.

Every year, nurses who have trained in the Pacific islands and earned their spurs there, leave for greener pastures, literally in droves. It’s exactly like the way most islands lose their finest sportspersons to their metropolitan neighbours–often fighting against their own home teams for their employers.

Poor infrastructure and expertise in most countries often leaves the patients to fend for themselves for relatively preventable diseases that could be easily cured if treated early. Most end up neglecting their ailments until they turns into full blown emergencies which then have to be treated overseas at exorbitant costs added to their travel and stay bills. And that’s for those who manage to cobble up the cash.

The islands’ medical institutions, facilities and personnel are so stretched that their healthcare systems find neither the resources nor the time to concentrate on preventative medicine in segments of the population well identified as susceptible to a number of diseases.

One of these is Rheumatoid Heart Disease that afflicts an alarming number of very young Pacific islanders. This is one disease for the treatment of which there is such a body of knowledge and experience available around the world that in many countries the disease does not even exist anymore.

But a recent report has found the incidence of this easily preventable disease to be alarmingly high in Tonga and the same is feared to be the case across the Pacific islands region.

It a classic disease that plagues poor countries—preventable in its early stages but one that snuffs out life in the prime of youth simply because there is neither the simple infrastructure nor the expertise to detect it early. The irony is that it is preventable with relatively easy, cost effective measures. What is missing is the awareness of this—both within the government and the healthcare system.

Australian hospitals have been reporting a steady increase in the number of breast cancer cases among young women who turn up from Papua New Guinea when it is only too late. Breast cancer is one carcinoma that is definitely detectable at an early stage, provided there is adequate awareness and facilities.

Besides, lifestyle diseases like Type II diabetes, obesity and hypertension have shown an equally alarming trend in recent years, contributing to an increase in the number of young people dying of these controllable and even reversible diseases.

It is not just non-communicable ailments like rheumatoid heart disease that are taking a toll on young islanders. A range of vector borne and contact diseases are raging in many of the isolated communities of the islands. And it’s not just HIV/AIDS, which tends to get most of the media glare (some Australian politicians blamed Papua New Guineans for the higher growth rate of HIV in northern Australia).

Malaria and dengue are coming back with a vengeance and many of the measures against dengue are not proving effective, as health officials in many islands of the northern Pacific like Palau have discovered to their great dismay. Expectedly, they have identified lack of awareness and preventative steps as the main cause for the success of the mosquito-borne microbe.

Another, but less virulent variant of dengue, called the Zika virus, is plaguing nearby Yap. Hundreds of islanders have been reporting to health centres with symptoms of the disease that range from skin rash to joint pain and conjunctivitis.

A ray of hope in this dismal scene comes from a number of small initiatives made possible mostly with participation from private individuals, NGOs and governments of some countries that have begun to see the benefits of pooling resources.

The Pacific Rheumatic Heart Programme—a collaborative effort between the health ministries of Fiji, Samoa and an Australian school of public health—is one such welcome initiative aimed at tackling the wanton spread of that preventable disease with a definitive strategic plan.

A foundation for cardiac patients set up by doctors in New Zealand who were former Fiji citizens have performed nearly two dozen open heart surgeries free of cost in Fiji and are going back to do more.

Islands governments must no longer leave healthcare solely to the generosity of aid donors and charitable institutions under the premise that it is too expensive to upgrade healthcare systems on their own. They must set up programmes to partner with like-minded organisations and trained professionals to raise the bar of healthcare, particularly in the area of preventable and communicable diseases.

In fact the Pacific Islands Forum must pull its weight behind this cause and coordinate a joint effort between islands’ health ministries, funding organisations and healthcare professionals who are willing to contribute their effort and labour—of which there are no small numbers—should there be a system for them to work with.