Why we need to act now

Andrew Peteru

Pioneering health educators in the Pacific region will recall a time, be it ever too brief, when a globally endorsed philosophy termed Health Promotion entered the Public Health scene.

It spelt the move from Health Education to Health Promotion, or as some saw it, a change from the classroom-type setting to community initiative, or from theory to action.

As it turned out, the concept of Health Promotion seemed very familiar. It appeared that pre-colonial traditional public health practices of community involvement and equal partnerships in particular, had made a come-back, only packaged differently, and from outside our region.

In 1995, governments of several Pacific Islands Countries and Territories endorsed a concept called Healthy Islands, the unifying theme for health promotion and health protection for the 21st Century.

In even greater regional unity, the Ministers of Health meeting in Apia this year, re-emphasised the Healthy Islands key components.

“Where children are nurtured in body and mind, environments invite learning and leisure, people work and age with dignity, ecological balance is a source of pride, and the ocean which sustains us is protected.”

Pioneering health educators within the Pacific Islands will remember a time during the early 1990s when it was all about Health Promotion, and when WHO, SPC, UNSW, and Victoria Health, to name a few, provided generous support.

The Healthy Settings approach saw great enthusiasm amongst health professionals, communities, and a number of government ministries working collaboratively to establish health promoting schools, healthy markets, healthy villages, and healthy hospitals.

Within the hospital and health ministry setting for some countries, it set the stage where environmental health officers, community nurses, dentists, emergency, out-patient, and medical-based nurses would talk enthusiastically about issues that covered quality assurance, OHS procedures, and policy issues that were required to achieve for example, a healthy hospital ward.

In the market places targeted for healthy settings such as Madang, vendors started taking responsibility for cleaning up and discouraging littering.

In Apia, vendors also started dressing up more neatly and took more pride in the presentation of their products. Fiji established its very own Health Promotion Centre.

The spin-offs were often both intuitive and unexpected. Then one day, for reasons still unclear to many, the support, the enthusiasm and the activities, stopped.

Sure, there are isolated examples of health promotion continuing or being taken up by other ministries and NGOs in a handful of countries, but in comparison to the enthusiasm of the early to mid-1990s,

Health Promotion today is practised by only a few. It is in danger of being significant only in theory and not in practice, despite high level references and calls for action. In fact Health Promotion only works when everyone is involved.

Health Promotion in other regions of the world continues to be an academic discussion amongst scholars and health service providers alike, and as a result prompted great change especially through the development and adoption of good health policies.

Here in the Pacific, Health Promotion is still only truly understood by a small number of health personnel. It has thus remained an almost stagnant and regrettably under-utilised catalyst for change.

Within Health Promotion exists the principles of governance, community development, equality, and good policy.

From a Pacific Islands perspective, it gives us the opportunity and freedom to address our health issues, taking the best from both traditional and modern medicine and practices.
In essence, it calls for US to act using our OWN initiatives. So what are we waiting for?


Andrew Peteru is the Regional Health Programme Manager at the Foundation of the Peoples of the South Pacific International.