The Aotearoa New Zealand government is being accused of sacrificing peoples’ lives for ideology by delaying bowel cancer screening for Māori and Pacific people from 50 to 58.

Pacific doctors say Health Minister Simeon Brown’s decision to make bowel screening free at the universal age of 58 for all New Zealanders goes against research data and evidence.

Sir Collin Tukuitonga, co-director of the Centre for Pacific and Global Health at Auckland University, said the policy change for the bowel cancer screening age was unsophisticated and deeply flawed.

• READ MORE: Other Māori and Pacific health reports

Bowel screening age for Māori and Pacific people at the age of 50 was based on need, he said.

“Here is one time where we actually have good data to show that Māori and Pasifika people are at risk of bowel cancer at an earlier age,” Sir Collin said.

“In other words a clear demonstration of need and yet they’ve gone and dismantled a perfectly data-driven evidence-based policy. It’s a vote grab I think. It’s deeply flawed.”

When changing the bowel screening age to 58, the Health Minister said the incidence rate of bowel cancer was similar across all population groups in New Zealand, but Sir Collin said it occurred more among Māori and Pacific people.

Rate of Pacific occurrence higher
“For the bowel cancer incidence rate to be the same across ethnic groups, it tells me that for the minority groups the incidence is higher. In other words the rate of occurrence in Māori and Pacific adults is higher.

“That’s why you end up with the comparable occurrence. So clearly as I say this is a policy that is deeply flawed, relatively unsophisticated, driven by ideology not facts or evidence.”

Otago University research fellow and lecturer Dr Viliami Puloka said the government was putting business ahead of thousands of people’s lives by removing the earlier bowel screen age of 50 for Māori and Pacific people.

Early detection was the marker by which the bowel screening programme’s strength was measured, he said.

“Eight years — as they’re proposing for us to wait — by then we may not be able to do anything. We’ll just tell them to ‘Prepare your funeral because you’re already been developing the cancer for the five, eight years before we find out.’

“By the time it’s been diagnosed it’s too late for any intervention of any importance to be able to address that and that’s really the issue here.”

Dr Puloka predicted the new policy would see thousands of New Zealanders not receiving bowel screening, and most would be Māori and Pacific people.

“It is a matter of fact genetics is important. Social environment is important,” he said.

‘Ethnicity definitely major factor’
“There are a lot of social determinants of health and what might cause one to develop a disease even though they are living in the same country or even if they’re born of the same ethnicity, but ethnicity definitely is a major factor.”

Bowel Cancer New Zealand board member Rachel Afeaki knows the impact of bowel cancer screening.

Her mother died of bowel cancer and five years later her father was diagnosed with bowel cancer after a colonoscopy. He survived.

Afeaki called the government dropping the overall age of screening to 58 a “token move”.

“In 2023 the Census shows that there’s just over 38,000 Pasifika between the ages of 50 to 59 that were set to benefit from the age extension, and around 30,000 of these people will no longer be eligible as a result of these changes.

“And Pasifika people face a 63 percent higher mortality rate from bowel cancer than non-Māori non-Pacific people and it’s really important that this government recognises that a one size fits all screening age doesn’t work for a quarter of New Zealanders with Māori and Pacific peoples having been failed by this approach,” Afeaki said.

Bowel Cancer New Zealand would like to work with the health minister to try and meet the prime minister’s promise to screen from age 45, and screen 10 years earlier for Māori and Pasifika peoples, Afeaki said.

Timely, quality healthcare
In his response, Simeon Brown said that as Minister of Health, his priority was ensuring all New Zealanders had access to timely, quality healthcare.

“That means ensuring we can do the greatest number of treatments and preventions with the resources we have.”

Bowel cancer risk is similar across all population groups at the same age, he said.

“Advice from the Ministry of Health shows that by lowering the age of eligibility from 60 to 58 for all New Zealanders, we will be able do an extra 8479 tests and save an additional 176 lives over the next 25 years than would be the case if we only lowered eligibility for Māori and Pasifika from 60 to 50.

“Our government has also made a significant investment of $19 million over four years to make sure that we are targeting those population groups who have lower rates of screening, like Māori and Pasifika.

“This is a game changer and will save lives,” Brown said.

This article is republished under a community partnership agreement with RNZ.

Tonga’s new Minister of Agriculture, Food and Forests, Viliami Hingano, is currently in New Zealand for medical tests after the Vaiola hospital’s computerised tomography (CT) scanner stopped working, a government spokesperson has told Kaniva News.

The former government approved his travel last year in his capacity as Ha’apai Governor, the spokesman said.

The minister’s flight to New Zealand was repeatedly postponed by Tonga’s current volcanic eruptions which started in December.

“It was important for him to be taken overseas and get his scan done so that his condition could be identified before he was given the right medical treatment,” the spokesperson said in Tongan.

The spokesperson was responding after Kaniva News wanted to confirm that the minister was in Auckland for medical treatment.

Kaniva News reported this week that Hingano’s family had sent him love and support after a photo of him and a cousin was shared on Facebook last week.

The family urged Hingano to be courageous and prayed that God would help him through his medical treatment in New Zealand.

The former governor of Ha’apai was elected MP for Ha’apai 12 on November 18, and appointed by Prime Minister Siaosi Sovaleni on December 29, before he left for Auckland.

Medical issues divide community
The Kaniva Tonga report earlier this week about Hingano has divided the Tongan online community.

Some people were surprised to find out that instead of the minister being expected to meet his staff as the first thing he should do after his appointment, he was sent overseas for medical assistance.

Some criticised the Prime Minister for appointing someone who appeared to be a burden on taxpayers.

Some were irked by the fact that the minister’s travel and all his medical costs must be paid by the government because it was his ministerial entitlement.

Others believed it was time to review the overseas medical treatment policy.

Many suggested that all candidates who ran for Parliament must show evidence they were healthy and did not suffer from any chronic disease that would be a financial burden for the country.

Some raised the fact that the policy only applied to government senior officers, leaders and the royals. Commoners who become chronically ill can only be treated in Tonga with the limited medical resources and doctors available at the Vaiola hospital.

History of treatment
Most Tongan public servants, politicians and royals who have been sent overseas on medical grounds suffered from conditions that were serious and could not be treated in Tonga.

While many were fortunate to be cured in New Zealand or Australia and returned home, some did not.

Two recent former Deputy Prime Ministers, Lord Ma’afu and Sione Vuna Fā’otusia, were treated in New Zealand, but eventually died from their sicknesses.

A fierce online furore erupted in 2019 after the government hired an air ambulance which airlifted Lord Fusitu’a to a hospital in New Zealand.

At the time, those who opposed the overseas medical policy protested on Facebook, rejecting the payment of costs from taxpayer’s money.

The king’s noble was still in New Zealand and it appeared that he was still receiving medical assistance for his illness.

Former MPs’ medical expenses
Former Prime Minister Lord Tu’ivakanō was regularly sent to New Zealand for checkups after he suffered a minor stroke while in New York attending the UN General Assembly in 2013.

His medical expenses and flights were paid from taxpayers’ money.

The government also sent former Prime Minister Pōhiva Tu’ionetoa to Australia for medical treatment after having an injury while being an MP. He received spinal surgery at the St George Private Hospital in Sydney.

Kaniva News understands a former Prime Minister, who was wheelchair-bound, died after being sick and spending about a year or more in an Auckland hospital. While he was in New Zealand all his expenses, including the staff looking after him, were paid from taxpayers’ money.

A former Minister of Police was flown to New Zealand on a medical flight while he was seriously ill, but died during the flight. All expenses were paid from the taxpayers’ coffers.

Late Opposition Leader and Prime Minister ‘Akilisi Pōhiva was also sent to Auckland for medical treatment during his tenure. He died in an Auckland hospital.

However, he paid for his travel and accommodation expenses in New Zealand with his own money.

Kalino Latu is editor of Kaniva News. Republished with permission as community partners.

The warning is stark — New Zealand is on the verge of a “tsunami” of dementia cases and the government can ill-afford to merely acknowledge the University of Auckland’s Dementia Economic Impact Report 2020.

And while it may not receive the priority which goes to dealing with the covid-19 pandemic, it is nonetheless a concern.

The report found an estimated 69,713 people — or 1.4 percent of the population — were living with dementia in 2020 and that number is projected to more than double to 167,483 — or 2.7 percent of the population — by 2050.

• READ MORE: Number of New Zealanders with dementia will increase in 30 years — report — RNZ Checkpoint

The alarming statistic is that the number of Māori, Pacific and Asian people with dementia is expected to triple, while the number of Europeans with dementia is expected to double.

“This is the fourth dementia report we’ve written and the last three reports have all talked about the baby boomer generation coming up to retirement age and people living longer,” says Dr Etuine Ma’u, lead author of the report and a Tongan.

“So we have this massive bulge of 65-year-olds coming through since 2011. This report now is saying, look at the tsunami, the surge of cases that is here now,” the senior lecturer at the University of Auckland and consultant psychiatrist at Waikato hospital says, sounded a stark warning.

“It is concerning because at the moment we’re sitting at about 15 percent of the population of people with dementia being Māori, Pasifika and Asian and that is going to rise to a quarter and they are growing a lot quicker because the population is ageing a lot quicker.

Worry that it’s an underestimate
“The worry is that it is an underestimate and that is because we had a paper out earlier this year looking at the risk factors for dementia and what is shown is that, particularly for Māori and Pacific, their risk factor burden is a lot higher than European which means that they are probably at a higher risk of developing dementia anyway,” Dr Ma’u says.

At the same time that the report was launched, an updated action plan was also presented to Associate Health Minister Dr Ayesha Verrall.

“The plan is really a call to action for the government, the plan is really trying to highlight to the ministry the urgency of addressing dementia,” Dr Ma’u says.

While the reports have all been acknowledged, nothing further has been done since 2008.

“I don’t think that they have (the past four governments) paid attention to them in any practical sense. They’ve always acknowledged the reports when they have come out and they’ve always acknowledged that the problem is coming,” Dr Ma’u says.

“I think what is urgent about the current report is that it really shows the problem is here right now.”

Closer to home
For report co-author Auckland University of Technology associate professor Dr Rita Krishnamurthi, a stroke and dementia researcher, it is much closer to home.

Her father, Venkata Chalam, died in July 2014 from dementia and that proved a spur to her studies into dementia.

“That was my motivation to do something about this insidious disease because in the last years of his life it was particularly bad,” she says.

“Culturally too, we weren’t going to put him in aged residential care (ARC) where he wouldn’t get the comforts of home, like food and company that he was comfortable with.

“My mother (Sita) wouldn’t hear it; she insisted that he was cared for at home.”

Cultural and social norms were the primary reasons Māori, Pasifika and the Asian communities were hesitant to make use of the ARC.

“The other problem is that because Europeans (or Pakeha) make up the overwhelming majority of the population over 65 with dementia, all of the interventions and services are pitched at that group,” Dr Ma’u says.

Not culturally appropriate
“So they are not culturally appropriate, they are not really acceptable particularly to Māori, Pasifika and many Asian populations. They are not using those services and that means that they are carrying the burden of care and the cost associated with it themselves.

“And that is what the report shows quite strongly.

“We need tailored services, we need tailored intervention and what we need the Ministry of Health and the government to wake up to is that if in the next 20 years non-European people with dementia are going to make up a quarter of all the people with dementia then we are going to have to start targeting services and developing services and targeting policy that is acceptable and appropriate to these different groups.

“There is no one size fits all approach,” he says bluntly.

A year ago research into dementia found 12 significant risk factors that brought the onset of dementia into people.

“There was a big paper that came out a year ago with The Lancet which identified 12 potentially modifiable risk factors for dementia and they calculated what is called the population attributable fraction which is effectively the amount of dementia you could potentially prevent if you could completely get rid of those risk factors,” Dr Ma’u says.

“The risk factors broadly speaking fall into two categories — those that increase the risk of damage to the brain like high blood pressure, diabetes, smoking, alcohol, physical activity and diet and then there are factors that impact on your competent reserve, which is basically your brain’s ability to cope and to compensate for any damage.

Active social network
“That is around maintaining a healthy and active social network, your level of education because it challenges the brain more.

“Hearing is a massive one because people who have difficulty hearing have a problem with socialising.”

The cost of hearing aids in New Zealand is a major prohibiting factor, he says.

“We’re hearing things like funding hearing aids is going to make a massive difference but in New Zealand, they are horrendously expensive.”

He makes it clear that the health industry is not geared up to deal with the wave of dementia cases that is impending.

“Are we ready, the short answer is ‘no’, it is the message that Alzheimer’s New Zealand wanted to push across when they presented their dementia plan to the Associate Minister for Health,” he says.

“I don’t think we are prepared: based on the dementia report the costs are really high, estimated at $2.5 billion. Because we are looking at an extra 30,000 people with dementia in the next 10 years and an extra 100,000 people in the next 30 years, even based on today’s dollars, the cost per person is around $30,000-$35,000.

“So we are looking at an extra billion dollars that the government is going to have to find in the next 10 years alone just for dementia and I don’t think the health budget can sustain that.

No cure for dementia
“There is no cure for dementia at the moment, and the only way we can reduce cost is by reducing the prevalence, reducing the number of people.”

He says what is more disquieting is that no studies of the disease have been done in the wider Pacific.

“I don’t know,” he says when asked if studies have been done in the Pacific.

“I can only speak from the Tongan point of view and I can say there are no studies and I’m pretty sure that there aren’t any in Samoa and Fiji either,” Dr Ma’u says impassively.

“Based on the work we did earlier on the risk factors for dementia in different populations in New Zealand I suspect the prevalence of dementia in the Pacific is going to be quite high, the risk factor burdens are going to mirror those of the Pacific population in New Zealand so I think it is going to be high.”

While it isn’t getting the daily headlines that covid-19 is, and he acknowledges that the pandemic deserves the attention, as opposed to dementia which is a silent creep.

“Covid-19 is a huge problem, you just have to look at Auckland to see how massive it is, but dementia is an insidious problem that is just going to keep getting bigger if we don’t do anything about it now,” he says.

Costs of healthcare
“The earlier people get diagnosed, the earlier they put interventions in place, the longer they can live well at home and the longer you can delay things like entry to aged residential care (ARC)… and residential care in New Zealand is where most of the costs of healthcare and the cost of dementia sit.

“We have shown in our report over half of the economic costs of dementia is around social care, predominantly paying for residential care and paying for community care. If we can reduce the number of people entering residential care by supporting them better at home then ultimately you will reduce the costs.

“That’s why personally my big push is around dementia prevention and that is ultimately going to be the way we reduce the costs.

“We are also talking about the need for tailored intervention, the tailored services that Māori, Pasifika and Asian populations are actually going to find acceptable.

“I don’t think we provide the level of service and interventions to people with dementia that they need, there is a deficit all the way across and from my point of view there is a difference in uptake that Europeans use compared to Non-Europeans.

“The report shows that Europeans are using $5000-$8000 more of social care which shows that Māori, Pasifika and Asians don’t go into aged care as much as Europeans do.
“Maori, Pasifika and Asians aren’t wanting to put their loved ones into care because they don’t see it as a place that will meet the needs of their loved ones and that has to change,” Dr Ma’u says.

Awareness of dementia is a problem too, how does one discuss a family member suffering from this disease?

Awareness slowly growing
“It is slowly coming to the public’s attention and the awareness is slowly growing,” he says.

“There is a lot of stigma associated with dementia particularly in Pacific cultures, there is a really poor understanding of what dementia is and the names that are used for it.

“The way it is understood varies from being a part of normal ageing and something just happens and you just have to accept it and deal with it.

“Or through it being something of punishment or karma for bad things done in earlier life.

“We need to shift that mentality to reduce that stigma so that people understand that the changes that are happening in someone’s cognition needs to be looked at, needs to be assessed and diagnosed so we can get the interventions early to provide as much support as possible”

The irony is there is no term to describe dementia in the Islands.

“In Tongan, there is no specific term for dementia. In Tonga the psychiatrist (Dr Mapa Puloka) is trying to get a definition as catastrophic decline “Holo Tamaki’’, effectively trying to describe the deterioration in someone, otherwise, it’s called “Loto Ngalongalo” which means forgetful or they call it “Alasaima’.

“General understanding, they call it crazy ‘fakasesele’.”

The stigma is such that people don’t talk about the deterioration in one’s mental capacity once caught in its vice-like grip that there is no escape from.

When it becomes real

This is where it becomes real. Helen Reddy, daughter of the former leader of the National Federation Party, the perennial opposition in Fiji, Jai Ram Reddy comes into focus.

Jai Ram Reddy is currently in Auckland, at an ARC, suffering from Alzheimer’s disease. Gone is the charisma, the magnetism and the flamboyance of the once-proud politician and lawyer who revelled in reciting verse and chapter the works of Shakespeare.

He served as the Minister of Justice and Attorney-General in the coup-stricken Dr Timoci Bavadra government in 1987.

He was the first Indo-Fijian that was accorded the right to address Fiji’s Great Council of Chiefs and at the zenith of his powers in 2003, was elected to the International Criminal Tribunal for Rwanda in Tanzania.

Sadly, however, when Helen, herself a lawyer and a senior crown prosecutor in London, endured the MIQ system in Auckland to get to see her father he was a mere shadow of his former self.

That didn’t deter Helen, on one occasion during her visits to see her dad she played a ghazal (old Indian song) from Jagjit Singh.

The lyrics read:

“Hmm hmm hmm … ha ha ha
Hmm hmm hmm … ha ha ha
Hoshwalon ko khabar kya bekhudi kya cheez hai
Mindful people don’t know about senselessness
Hoshwalon ko khabar kya bekhudi kya cheez hai
Mindful people don’t know about senselessness
Ishq kijiye phir samajhiye
Fall in love, then you’ll understand…
Ishq kijiye phir samajhiye zindagi kya cheez hai…”

As Helen relays wistfully:

“I saw dad again today. Moments of lucidity. I played the first song on this Jagjit Singh track and he stroked my face so lovingly xx”.

Papua New Guinea is unsure of what message the government is trying to convey over the latest covid-19 pandemic surge — effectively creating a state of confusion.

In the midst of a dire healthcare crisis in the Eastern Highland’s capital Goroka, Prime Minister James Marape recently travelled to neighbouring Morobe Province’s remote Menyamya district to launch projects related to health care among other things.

This would have been truly uplifting given the times, if not for the apparent disregard for recently reemphasised covid-19 measures that were displayed during this visit.

• READ MORE: PNG’s covid crisis swamps Highlands hospitals
• Other PNG covid crisis reports

Photos from the event showed hundreds of mask-less people gathered to welcome the arrival of Marape and government MPs namely Minister for Education Jimmy Uguro, Menyamya MP Benjamin Phillip and Morobe Governor Ginson Saonu, making it seem like there was no surge in covid-19 cases affecting the country.

At face value, the project launching and visit by the PM was a typical political event with the big song and dance. But, given the context of the country’s surge in covid-19 cases stressing major hospitals, the event reeked of bad taste.

This comes just as Morobe’s capital Lae has begun clamping down on non-mask wearing persons in the hopes of steering clear of a possible Goroka kind of surge.

The Morobe provincial administration, in a recent joint statement with the Morobe Provincial Health Authority and Northern Command of the Royal PNG Constabulary, instructed that there would be a no mask, no entry requirement for business houses and government facilities.

Conflicting policies
The confusion arises when on one side, Pandemic Controller David Manning, has issued measures banning gatherings of more than 20 people, but on the other side — and as if fully indifferent to the covid-19 orders — the PM is traveling around the country attracting large crowds in excess of 20 people.

In fact, many members of parliament have not slowed down on grand openings and ground breakings since the start of the pandemic, which arguably is acting as a catalyst for spreading covid-19.

In April, this masthead raised the same issue regarding the PM’s official visit to Kikori district in Gulf province.

Six months later it seems not much has changed other than an increase of gatherings from 10 to 20 people.

At the time the Post-Courier reported: “In the official statement from the PM’s office, it stated ‘Thousands of people arrived to welcome Prime Minister Marape and his delegation’.”

But this goes against measure nine – business and social where measure two states: “An immediate ban is placed on gatherings of over 10 people.”

“While the government continues to push the adherence of nuipelapasin, it seems they have failed to implement the nuipelapasin for launchings of projects.”

Criticism on social media
Marape’s recent visit has received criticism on social media, with one person saying:

“This is infuriating to see.

“No wonder people don’t follow niupelapasin if the people making the mandates about it keep hosting events like this!”

Another comment described it as “100 percent irresponsible behaviour”.

On Sunday, the country officially lodged a “request for assistance” with the Emergency Medical Teams (EMT) Secretariat in the World Health Organisation.

The request called on any international EMT capable of assisting to help PNG with the surge in covid-19 cases, another indication of the bad state of the health system.

The request stated: “From September 20-26, there were 600 newly confirmed cases in PNG, including 17 deaths.

Cases, deaths underreported
“New cases and deaths are significantly underreported in PNG due to the very limited testing across the country and inconsistent reporting from several provinces”.

It also stated that PNG has the lowest vaccine coverage in the Western Pacific with less than 1 percent of the population fully vaccinated.

As Parliament resumes yesterday, it was certain that many MPs would also be returning from their districts after launching and attending similar events over the break.

While it may be an important display of their leadership duties, such events are potentially thwarting the efforts of the tired, exhausted and under-resourced doctors and nurses of the country – making the problem worse.

Published by the PNG Post-Courier on its front page today.

New Zealand is scrapping district health boards and creating a new Māori health agency in a radical “fairer and smarter” shake-up of the medical system.

Health Minister Andrew Little announced details to health leaders at Parliament today.

The 20 district health boards which run services for individual areas around the country will be replaced by one new body, Health NZ, which will instead plan services for the whole population.

• READ MORE: ‘Clear’ inequity for Māori in health care – report

Health NZ will have four regional divisions but also district offices.

It will delegate authority to local levels so regional services have a say in what they need and how they work, Little said.

“The system must work in true partnership with Māori… Māori still suffer, on average, worse health than others.”

There will also be a new Māori Health Authority, sitting alongside that, to both set policies for Māori health and to decide and fund those who will deliver services.

Direct commission
The new authority will “have the power to directly commission health services for Māori”.

“There are other equity challenges as well … the system must listen to the voice of Pacific people, disable people, rainbow … and all other people,” Little said.

“We can and must do better.”

The country’s 30 primary health organisations – large regional networks of GPs and primary care – will also be ditched.

And, on the back of covid-19, there will be a new Public Health Agency which will target widespread health problems – like smoking – and try to prepare for pandemics and epidemics.

• WATCH:

RNZ News video of the national health shake-up announcement.

Little said today’s announcement was a plan to create a “truly national health service” that “draws on the best that we have now” but reduces pressure on healthcare workers and hospitals and specialist services.

“By making the changes I am announcing today, we will have the chance to put the focus on primary health care,” he said.

“We can start giving true effect to tino rangatiratanga and our obligations under Te Tiriti O Waitangi.

‘System under stress’
“It’s a system under stress. Our health and care workers strive every day … but demand is growing … and the job is getting harder.”

The changes being announced go further than the Health and Disability System Review, the basis for today’s plan.

That recommended halving the DHBs, and having a Māori health authority but with fewer powers and less autonomy that the one announced today.

The changes have been made to try to stop what is called the “post code lottery of care”, where people get different care – or have different changes of survival – depending on which DHB area they live in.

The report released today says a lot of those problems are caused by the fact that hospitals and specialist care are often managed in isolation from each other, not in a coherent network.

Instead of district health boards, the new Health NZ, will oversee the health needs of four regions.

And there is an increased focused on primary – or GP-level community care.

Primary care funding
The report says at the moment specialist or hospital care draws away a lot of primary care funding and it wants that to stop.

It also wants those community services – including GPs, midwives and pharmacists, to work more together

And the Māori Health Authority is aimed at overcoming the huge health disparities for Māori as a whole, with lower life expectancy and higher rates of disease in many areas.

Associate Health Minister (Māori Health) Peeni Henare said many Māori did not like going to the doctor because their experiences of the health system is negative.

“This authority will drive hauroa Māori and make real change,” he said.

It would represent Māori from all iwi.

“This is where we make a start,” Henare said.

Public health units
“Regional public health units, long underfunded, will stay but under the new Health NZ entity.

Little said he had heard calls for change, quickly.

“The current system no longer serves our needs well. Our goal is a health system that helps all New Zealanders to live longer in good health,” he said.

“We need a system that is not only fairer but also smarter.”

Smarter means making the most of the money and resources available, Little said.

He was not underestimating the challenges faced, he said.

“Our system has become overly complex. It is too complicated for a small nation.

‘Operate as one system’
“We need to operate as one system. Organisations working together should be the norm, not the exception.”

The Ministry of Health would be strengthened, Little said.

But it will no longer directly fund and commission health services.

Health New Zealand – a new Crown entity – will run hospitals and commission primary health care.

It will replace the existing 20 health boards, Little said.

“DHBs have served their communities well.”

But they have their failings, he said.

‘About doing better’
“I want to stress this reform is about doing better with what we have. It is not about cutting services,” Little said.

Little said the fourth element of the announcement was about public health, including “Pacific people, disabled people, rainbow … and all other people”.

“Disability issues span the full range of issues any community faces. That’s why I have more work being done in this area,” he said.

Little said technology would play a part in the new system.

That would include improving access to things like virtual diagnostic tools.

“Health NZ will work with communities … to develop the priorities for their areas, making sure people have a say in the services they get.”

“You should be able to turn up anywhere in the health service and know the health professional has access to information relevant to you.”

New health charter
There will also be a new health charter.

“We will start work on this soon.”

Some aspects of change would take years, not months, Little said.

He acknowledged the challenge of making change during a global pandemic.

He was confident they could safely take place at the same time.

“Covid-19 is not a reason to preserve a system that is not fit for purpose,” he said.

“I am mindful we need to proceed carefully and not disrupt day-to-day services.

“I expect the new system to come into effect in July 2022.”

Establishing interim versions
In coming weeks, work will begin on establishing interim versions of Health NZ and the Māori Health Authority.

New legislation for them will be worked on and Little expects that legislation to be passed by April 2022.

“Together we have an opportunity to make a once in a lifetime change, to put in a new system and improve the health of this, and future, generations.”

DHBs will continue in their roles for now.

“I want to reassure new Zealanders that the care they rely upon will still be available.”

The changes are overdue, and “this time, it must be different”, Little said.

During the process of the reform plan, Little said he had been thinking of those working in the system, and those who needed healthcare.

“We are a small nation, and we can make this change working together, and we can make this change in the spirit of Te Tiriti (O Waitangi).”

This article is republished under a community partnership agreement with RNZ.

A Fijian psychologist is calling on people in Fiji to work together to tackle issues associated with mental health amid the covid-19 pandemic.

Addressing a prayer vigil to remember the victims of suicide in Suva, Dr Selina Kuruleca said people must assist one another and reach out to those struggling due to the pandemic.

The Health Ministry says about 90 Fijians have died from suicide this year while there have been 82 attempted suicides.

Dr Kuruleca, who is chair of the National Committee on Prevention of Suicide in Fiji, said suicides were responsible for the majority of deaths of younger Fijians.

“The highest number of deaths in young people or youths between the ages of 15 to 29 is deaths by suicide. These are preventable deaths. There are more deaths from suicides than there are from road accidents or drowning,” Dr Kuruleca said.

Dr Kuruleca urged community and church leaders to reach out to their members and help those suffering depression or other mental health-related issues.

Fiji marked International Suicide Prevention Day last week with September named the country’s Mental Health month.

Traumatic for those left behind
Last week’s vigil was organised by Lifeline and supported by Psychiatric Survivors Association, Youth Champs for Mental Health and the Fiji Council of Social Services.

Speaking at the vigil, Dr Kuruleca said death from suicide was traumatic for all those left behind and it should never be an option.

She encouraged those present at the event to support those families that had been impacted by the suicide of a loved one.

Dr Kuruleca urged people not to judge but show action that they cared for them.

“Make a commitment today to be persistent in your compassion, to be genuine in your advocacy and to be mindful of our realities,” she said.

“Everyone needs to work together – from Empower Pacific, Lifeline, youth champs for mental health, medical services pacific, women’s crisis centre, women’s rights movement, the LGBTQI community and of course, our faith-based organisations.

“We all have a part to play and we must play it.”

The theme of the Mental Health Month is Working Together, she said.

• Fijians who need help can call the 24-hour child helpline on 1325, domestic violence on 1560, Lifeline on 132454 and Empower Pacific on 7765626 if they need counselling or want to talk to a counsellor.

This article is republished by the Pacific Media Centre under a partnership agreement with RNZ.

David Clark is out and Chris Hipkins is in as New Zealand’s new Health Minister until the election in September.

Hipkins told RNZ Checkpoint he got the job last night.

He had conversations with Prime Minister Jacinda Ardern regarding the portfolio over the past week but could not say whether he was the PM’s first choice.

Ardern received Clark’s resignation yesterday. He will not be reappointed next term.

“While Minister Clark made this decision, it is one I agree with,” she said.

Clark formally resigned today as minister after controversies over his handling of the covid-19 response.

Hipkins is also the Minister of Education and State Services; the leader of the House and the minister responsible for Ministerial Services.

‘Up for a challenge’
He said education and health were both big roles and he was “up for a challenge”.

“It’s a really important job clearly in the context of covid-19. We’ve got a lot of work ahead of us.”

He could do both jobs justice, he said, but not “forever”.

“I will need support in the role from associate ministers and staff and I’m confident that I’ll be able to get all of the support I need to be able to do the job effectively.”

From the get-go, he said health would take up more time as he was satisfied with how education was currently placed.

“It is possible to do both jobs. I don’t think it would be sustainable over many years but in the three months in the run-up to the election I think it is certainly doable.”

He said covid-19 had shown cracks in the health system but he was pleased with the way Housing Minister Megan Woods was managing the borders, while he planned to focus on testing and contact tracing.

Also on his list was to have a “good, solid government response” to the health and disability system review led by Heather Simpson.

He got his first briefing on the health portfolio this afternoon.

Hipkins said Clark was a good friend and he supported his decision. “I think David has made a really tough call.”

This article is republished by the Pacific Media Centre under a partnership agreement with RNZ.

The covid-19 coronavirus pandemic and subsequent lockdown has been tough on the mental wellbeing of Asian New Zealanders, according to new research.

The New Zealand Asian Mental Health and Well-being report, commissioned by charity Asian Family Services, found high levels of anxiety and nervousness, as well as racism.

The research surveyed 580 Asian New Zealanders across the country and found almost 44 percent of them experienced some form of mental distress since level 4 lockdown.

READ MORE: Al Jazeera coronavirus live updates – Global death toll passes half a million

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Nervousness and anxiety are the most widely experienced (57 percent), followed by little interest or pleasure in doing things (55.2 percent), uncontrollable worrying (47.4 percent) and feeling down and hopeless (44 percent).

Asian Family Services director Kelly Feng said isolation, lack of support, family issues, academic or work pressure, new migrants adjusting to a new environment can all cause mental stress.

She said the findings correlate to what they were seeing on the ground.

“That’s quite true when over the lockdown, our service has also experienced high demand about emotional support and counselling services.”

Help primarily from friends
The report also finds that Asians primarily seek help from friends (44.1 percent) and family (42.6 percent), with just over a quarter (28.3 percent) saying they would see their doctor, comparing with the national figure of 69 percent according to the Health Promotion Agency.

A small portion (13.8 percent) did not seek any support at all, and Feng said it was concerning.

“That gives me an indication that we really need to promote or even do a campaign about mental wellbeing and addiction issues and raise awareness among Asian communities so people can seek help in the early stage and get a bit of early intervention rather than at the bottom of the cliff,” she said.

Just over 16 percent of respondents reported experiencing racial discrimination during the pandemic, and those who faced discrimination were also more likely to have mental health concerns.

Race Relations Commissioner Meng Foon said the findings were alarming.

“I feel gutted and sad that people are receiving discrimination and racism. It doesn’t matter what the numbers are. It’s really important that we continue to try and implement progress in systems and education to eliminate racism,” he said.

“It’s good to have an analysis report on mental health and discrimination. I think there’s a lot of work to do ahead of us. It’s good to know where we can actually target our resources to support mental health.”

Kindness message helped
The study said the overall messaging of being kind to one another during the pandemic has likely contributed to the relatively low percentage of discrimination.

But Dr Andrew Zhu, director of Trace Research which carried out the study, said it was still serious.

“On a percentage base, it’s relatively small which means we’re on the way to achieving racial harmony, however if you translate this number into a population-based number, that’s around 84,000 adult population of Asian ethnicity which could still be counted as serious,” he said.

Koreans reported to have experienced discrimination the most, with 30 percent of those surveyed saying they’ve been discriminated against, followed by Chinese at just over 22 percent.

However, Chinese accounted for nearly half of the overall discrimination cases as it has the largest population base among all Asian ethnicities.

Data for this study was collected online between May 22 and June 3, and quota sampling was used to ensure representativeness of all Asian ethnic groups according to the 2018 census of Asian adult population distribution.

This article is republished by the Pacific Media Centre under a partnership agreement with RNZ.

Most people think or at least hope their government is doing a good job in the face of covid-19, according to the polls. But there can be no doubt that governments around the world were ill-prepared for this pandemic.

Country after country has been locking their citizens in their homes to slow the spread of the virus for fear that their health systems get overwhelmed, as has happened in Italy. The lack of ventilators and protective equipment are a particular problem, despite the fact that scientists have called for years for governments to stockpile these life-saving machines and protective equipment.

How is it possible that we were not ready? Not only had Bill Gates been banging on about this for a long time, but pandemics also featured strongly on regional and national risk registers produced by governments and bureaucrats, as well as international registers from non-governmental organisations.

READ MORE: ‘If you want to die, don’t come to Papua,’ warns response team doctor

These administrative tools, highlight the most likely and impactful events that could befall societies, from earthquakes to terrorism, and including influenza and novel pandemics.

Reasons for failure to act
Despite all the effort that has gone into developing these tools, governments around the world have been bad at acting on their warnings about a pandemic. We see at least six possible reasons for this.

First, some policymakers, at least in the west, did not believe the magnitude of the problem. This was because comparable events were beyond memory, like the 1918 “Spanish” flu; or were not that severe, like Sars, bird flu and swine flu.

Even Ebola was contained and subdued with relative ease, other than in west Africa where it originated. There was a sense that modern medicine, at least in advanced countries, could cope with anything the microbiotic world threw at it.

Second, some sceptical politicians and the commentators they listen to thought that risk analysts and scientists cried wolf over past viral threats like swine flu and bird flu, and thought some of the risks seemed overstated or even incredible. It does not help that pandemics often appear on the same graphs as issues like space weather, which, while a real and pressing issue, is not widely understood and sounds like something out of a Star Trek episode.

Third, because electoral cycles are short, politicians tend to focus more on the short term. This is a common human trait, but the ramifications are more severe for politicians. Areas of public policy that require long-term investment, especially intangibles such as disaster planning, tend to be lower priority. Politicians either think that the public does not know about the risks or that they do not care.

Fourth, as a species we are good at rewarding people who fix problems, but terrible at acknowledging a problem averted. For example, former US Transport Secretary Norm Mineta received much praise for insisting that cockpit doors should be bulletproof after 9/11. How much praise would he have received if he had done it before 9/11? Consequently, government interest tends to focus on events that have already occurred such as floods or earthquakes.

Fifth, risk registers are confusing. They can feature an overwhelming amount of information, including long lists of many hazards and risks, and large scatter graphs like the one below linking the likelihood of an event with its impact.

The illusions of comprehensiveness, precision and control can lull readers into a false sense of security. But given that the registers are calculated using many assumptions, they can also be seen as inherently speculative, hypothetical and even discountable to politicians.

Global risks in 2020

Sixth, risk registers, if taken as providing guidance and accountability, can become politically risky if an event happens and governments have not been prepared. This is why some countries, for example New Zealand, have not published their risk registers despite the obvious value of developing a common understanding about risks and helping various societal sectors to prepare for them.

Those that don’t publish their registers come under less pressure to act on them.

What to do next time
Given all these problems, what could be done differently to make sure we are better prepared for such crises in future?

To start with, risk registers need to be produced largely outside the political process through a partnership between experts and policymakers. But they should also involve input from a diverse range of groups, for example indigenous people or key workers, so their interests are included in both identifying risks and planning responses.

Each country needs to understand and learn from how others are analysing, planning and have dealt with similar emergencies in the past. It is worth noting that parts of the world most affected by Sars appear to have handled the current pandemic with more urgency and success.

Risk registers should also be published to build trust and consensus in government preparations. This would also allow sections of society, including local government, businesses, charities and individuals, to take their own appropriate actions.

However, registers should not be seen as an end in themselves but rather as live documents against which governments and agencies constantly test themselves to make sure that they are doing enough.

Practice trials, as happen in the UK, are essential but need to be followed up with action to improve future responses. Simply acknowledging that we are not prepared for a pandemic is not enough.

Dr Chris Tyler is associate professor in Science Policy and Knowledge Infrastructure, UCL and Dr Peter Gluckman is director of Koi Tū, the Centre for Informed Futures, and former Chief Science Adviser to the Prime Minister of New Zealand. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

The sluggish delivery of crucial social assistance funds by Indonesia’s capital Jakarta administration in response to the Covid-19 outbreak is putting the city’s underprivileged citizens at a higher risk of slipping into destitution the longer the crisis stretches on.

On March 20, five days after the city started closing down schools and tourist destinations to curb the spread of the disease, Jakarta Governor Anies Baswedan said that the administration would be disbursing social assistance to 1.1 million registered beneficiaries.

At the time, Jakarta officials were still formulating the amount and method of disbursement.

READ MORE: 70 million informal workers most vulnerable during pandemic

Fast forward to last Thursday, at a teleconference meeting with Vice-President Ma’ruf Amin, Anies announced that the number of beneficiaries had jumped to 3.7 million people due to a greater share of the population, comprising poor and vulnerable groups, dropping deeper into poverty.

“They [people in the vulnerable bracket] still earn a living, but once the economy contracts, they will have lost all of their income,” he said, pointing to street vendors and ojek (motorcycle taxi) drivers as prime examples of this group.

The governor has revealed that beneficiaries would be receiving Rp 1 million (US$60.45) in subsidies per household per month for April and May. The Social Affairs Ministry, which is set to allocate Rp. 4.57 trillion to the social assistance program, would be footing a larger chunk of each subsidy of Rp 880,000, while the remainder will be taken out of the city’s budget.

But with an additional 2.6 million recipients added to the tally, Anies said the administration would require approximately 10 days to complete their credentials – another massive undertaking.

Jakarta identity card
“Not all of them have a Jakarta identity card. Some are not even registered as beneficiaries of the social assistance programme,” he said, adding that the administration would use data it had been collecting through the One Jakarta programme, which employs the Family Welfare Movement (PKK) to collect household data.

Meanwhile, the Social Affairs Ministry’s director general for social empowerment, Pepen Nazarudin, said the ministry was still waiting on the details of the beneficiaries.

“The Jakarta administration is to inform us about the data before we will review it. We’ll convey the data to the President as soon as possible,” Pepen said.

The disbursement mechanism remains unclear but Pepen insisted it would abide by the physical distancing rules mandated by the government, hopeful of avoiding the rush and the long lines that often come with the distribution of staple food packages.

Flora Aninditya, a researcher at the University of Indonesia Economics and Business School’s Demographics Institute, emphasised that while speeding up the collection of data was important, the safety of the officers should be of utmost importance during an outbreak.

“There should be a protocol to ensure the safety of data collectors who go out into the field, while operational incentives like covered transportation costs or phone credits should also be provided,” she told the Post on Friday.

Separately, Foundation of the Indonesian Legal Aid Institute (YLBHI) chairwoman Asfinawati deplored the Jakarta government’s “late” decision to set up a social safety net one month after the first COVID-19 infection was confirmed in the capital.

Falling deeper into poverty
She claimed that many people had lost income and could potentially fall deeper into poverty due to the government’s failure to identify risks and prepare mitigation strategies before measures to curb the spread of the virus were put in place.

“The risks should have been identified well in advance,” she said.

Jakarta RT/RW Forum chairman Muhammad Irsyad said he was worried that low-income groups would no longer heed the government’s call to stay indoors as uncertainty over their basic needs are thrown into doubt.

“Though I’ve seen residents obey the call [for physical distancing] for the past two weeks, they will eventually want to go out to find ways [to make money],” he said. “But residents may feel more at ease if they know it [social assistance] is available.”

The severity of the Covid-19 outbreak in the capital has triggered an outpouring of solidarity from individuals, community organisations, companies and government agencies that have gathered donations for the poor and provided protective gear for medical workers on the frontline.

Meanwhile, communities in Jakarta’s slums have reportedly begun producing their own antiseptic liquid for local use.

“These are truly very good initiatives to have as a nation, but they could also be seen as a corrective measure to make up for the failure of the state,” Asfinawati said.

Collective efforts
Wahyudi Djafar, deputy director of the Institute for Policy Research and Advocacy (ELSAM), said that collective efforts to handle the outbreak should always be led by the government.

“The government should have been able to produce a map for people to track, for instance, where there is a shortage of protective equipment, so donations and other resources can be equally distributed,” he said.

Jakarta, currently the country’s epicenter of the Covid-19 outbreak, had reported 958 confirmed cases and 96 deaths as of Friday afternoon.

Sausan Atika is a journalist with The Jakarta Post.

• Indonesia’s strategy to combat COVID-19: What we know so far

Indonesia’s first two confirmed Covid-19 coronavirus patients claim that media coverage and discussion on social media have taken a greater toll on them than the disease itself, saying that numerous breaches of privacy and the resulting stigma have left them “mentally drained”.

Some people went so far as to directly attack one of the patients, known as Case 1, through social media.

A message saying “You have been warned by the government to be vigilant of foreigners but you were stubborn” was sent to her over Instagram, a screenshot of which was shown to The Jakarta Post on Wednesday.

READ MORE: Indonesia to test more people for the Covid-19 virus

Earlier, personal details of the two patients comprising their initials, ages and home address popped up on WhatsApp groups and other social media from an unclear source not long after the news about the confirmed cases broke on Monday.

President Joko “Jokowi” Widodo announced that a 31-year-old woman (Case 1) and her 64-year-old mother (Case 2), both residents of Depok, West Java, had tested positive for Covid-19 after coming into contact with a Japanese woman who later tested positive in Malaysia.

The President’s announcement came as a surprise to the patients themselves.

“We had not been [officially told that we had tested positive],” Case 2 told kompas.com on Tuesday.

Patients’ house swarmed
Ever since the announcement, reporters have swarmed the patients’ house. In social media, photographs of the patients also spread like wildfire.

Some internet users questioned the younger patient’s profession, correlating it with how she might have contracted the virus.

Health Minister Terawan Agus Putranto said on Monday that Case 1 was a dance teacher and had danced with the Japanese citizen, whom he described as a close friend of the woman, in a club in Kemang, South Jakarta.

In a statement made on Wednesday, Case 1 shared how she might have contracted the virus and what she did afterward — which differed from the account released by the authorities.

Case 1 said she had started coughing and having a fever on Feb. 16 and decided to visit a private hospital along with her mother last Thursday. There, she was diagnosed with bronchopneumonia and her mother with typhus.

The following day, a friend in Malaysia called to let her know a Japanese woman who had tested positive for Covid-19 on Feb. 26 had visited the restaurant in Jakarta where she had been hosting on Feb. 15.

“For the sake of national security and health, I informed the doctor that I needed to be tested and that’s why I’ve been isolated since Sunday. I don’t even know nor am I acquainted with the Japanese citizen,” she said.

Japanese citizen a woman
She further emphasised the Japanese citizen was a woman, not a man who “rented” her like the gossip said. “I was just in a room with the Japanese woman without knowing who she was.”

“Please respect me and my family’s privacy, stop spreading our photos and fake news about us,” she said in a statement.

The breach of the patients’ personal data also affected their neighbours. Anis Hidayah of Migrant Care, one of the neighbours, said media coverage had disrupted their activities: some were not allowed by their employers to work and app-based motorcycle taxi drivers were adamant about not accepting orders from the housing complex.

“What I regret the most is it has framed people I know personally in unfavorable ways,” Hidayah said.

Institute for Policy Research and Advocacy researcher Wahyudi Djafar said the recent case of privacy breach was due to the absence of legislation on personal data protection and the lack of respect for privacy in society.

Unlike Singapore with its 2012 Data Protection Act, Indonesia has no specific law stipulating what makes data private, the rights of data owners, the duties of the data processors, or the mechanisms for processing such data.

“Even if some laws regulate about privacy, the material is limited and often contradictory because they don’t follow the same principle of personal data protection,” he said.

Data protection bill
He urged that a data protection bill be discussed, although he warned the public to keep an eye on the deliberations as there was potential for abuse of power in the current draft. The draft only imposes administrative sanctions on the government for possible wrongdoing.

Jokowi requested people respect the Covid-19 patients’ privacy following his announcement. He also asked that his ministers and the hospitals involved in treating the patients avoid disclosing the patients’ private information.

In a statement issued on Monday, the Alliance of Independent Journalists (AJI) called on members of the press to be more considerate in their reporting by speaking to the most credible sources on the issue, as opposed to publishing “sensationalised” pieces on the patients and their families.

Lawmaker Charles Honoris has urged the government to ensure the privacy of its citizens in relation to the spread of the coronavirus.

“Mass disclosure of Covid-19 patients’ private information should be taken seriously as a violation of citizens’ privacy,” he said.

He said the government must learn from Singapore and Japan in this regard, specifically about how the two countries had implemented a zero-tolerance privacy policy to protect the personal lives of its confirmed Covid-19 patients.

The writers are staff reporters of The Jakarta Post.

• Coronavirus global updates

Japan’s candidate, Dr Takeshi Kasai, has been elected as the next World Health Organisation (WHO) Regional Director for the Western Pacific.

Health ministers and other senior officials from 30 countries voted yesterday during the 69th session of the WHO Regional Committee for the Western Pacific in Manila, Philippines.

Dr Kasai’s nomination will be submitted for appointment to the 114th session of the WHO executive board to take place in January 2019 in Geneva, Switzerland.

READ MORE: Tukuitonga goes into battle on behalf of Pacific

The new regional director will take office on 1 February for a term of five years. Regional directors may serve up to two terms.

Current regional director Dr Shin Young-soo, who has served since 2009, offered best wishes to his successor.

“I warmly congratulate and sincerely wish Dr Kasai the very best as the next regional director,” he said.

“When he takes the reins in February, he will inherit a strong and robust organisation, and the honour of working with a diverse group of countries joined by a formidable bond of solidarity and an unwavering commitment to delivering better health for all.”

New Zealand campaign
New Zealand campaigned in support of Dr Colin Tukuitonga for the position and he came second out of the four candidates in the running. The other chief candidates were from the Philippines and Malaysia.

If successful, Dr Tukuitonga would have been the first Regional Director from New Zealand and the first of Pacific descent.

Dr Tukuitonga was unanimously nominated by Pacific health ministers in 2017 as their candidate for the Regional Director position. New Zealand subsequently supported Dr Tukuitonga, who is a New Zealander of Niuean origin.

“Although we are disappointed with the result, we are pleased that we fought a good campaign and can hold our heads high,” said Associate Health Minister Jenny Salesa, who was in Manila to support New Zealand’s candidate in the election.

“The region has made its decision and they have chosen to elect the Japanese candidate. We wish him well in his new role and look forward to working with him in the future.”

Later this week, the regional committee will adopt action plans to address a variety of health issues affecting the region’s nearly 1.9 billion people. They include:

• Fighting neglected tropical diseases;
• Strengthening rehabilitation services;’
• Improving hospital planning and management;
• Harnessing e-health for improved service delivery; and
• Strengthening legal frameworks for health in the Sustainable Development Goals.

The Regional Committee will also discuss progress on health security, infectious and noncommunicable diseases, and environmental health.

• Japanese aid funding splits Pacific unity

All the headlines at the recent Pacific Islands Forum in Nauru were political so the upcoming nomination for the election next month for the key role of World Health Organisation regional director for the Western Pacific went largely unnoticed.

The Pacific’s endorsement of Colin Tukuitonga, a New Zealander of Niuean descent and proposed by New Zealand, was resounding and support for his nomination from all countries had seemed to be a fait accompli.

He along with three others – Dr Narimah Awin, proposed by Malaysia; Dr Takeshi Kasai, proposed by Japan; Dr Susan Mercado, proposed by the Philippines – were then in the running for the nomination which will take place during the 69th session of the Regional Committee for the Western Pacific in Manila, Philippines, on October 8-13.

READ MORE: Building healthy communities on the Pacific

“Yes, all health ministers agreed and endorsed me at the WHO Regional Committee Meeting held in Brisbane in October 2017.

“They agreed to have one candidate and five ministers approached me to stand,” Tukuitonga told Asia-Pacific Report.

At the forum in Nauru he learned that the endorsement from the Pacific Island states was not as united as first thought.

“Since then, we are aware that Papua New Guinea and Solomon Islands have expressed public support for the Japanese candidate [Dr Kasai],” he says.

Most of Pacific supportive
“We understand that this is in exchange for Japan paying for developments in country. We also understand that Vanuatu has made the same decision.”

“We understand that all other Pacific nations remain supportive, including New Zealand and Australia as well as other nations.”

The Director-General of the Secretariat of the Pacific Community says it is a positive for the role being at the PIF, it provided an opportunity to network with the leaders.

“All regional agencies – the council for regional organisations in the Pacific (CROP) decisions and priorities are influenced by forum leaders decisions. It is also a good opportunity to meet Pacific leaders and others.

“PIF presents a lot of opportunities to meet bilaterally with donors and those that are present. It also a critical forum”.

He does have a view on the 120 children in the detention camps on Nauru and their mental state but does not want to air it publicly.

But he is happy to voice his concerns about the health of Pacific people.

Diabetes, heart disease major problem
“Non-communicable diseases (NCD) such as diabetes and heart disease are the major cause of death and disease,” says the former chief executive of NZ’s Ministry for Pacific Island Affairs.

“NCDs are fuelled by poor diets, low levels of physical activity, high rates of smoking and high prevalence of obesity.

“In some Pacific nations, child health diseases remain high due to lack of clean water and sanitation. All Pacific health systems are fragile and underfunded leading to high preventable deaths and disabilities.

“Continuing high fertility rates putting pressure on government services in all Pacific countries. PNG also has high rates of HIV/AIDS, TB and malaria,” says Dr Tukuitonga.

Making matters worse for the people of the Pacific is the very realistic issue of climate change.

“A clear and present danger for all Island nations, threatening lives and livelihoods, we have five of the 15 countries most vulnerable to disasters are in Pacific,’’ he says.

“Climate change causes less dramatic impacts such as ocean acidification, causing coral bleaching and threatening the food chain and it provides 80 percent of the protein source for Pacific communities which come from fish and seafood.

Big deal
“Threats on food security is a big deal for the Pacific. Significant negative health impacts such as spread of mosquito-borne dengue fever and other diseases.

“Climate change aggravates existing problems, so preparedness is key for example, outbreaks post disaster is the result of existing organisms, not new organisms.”

He has worked for WHO before and finds it “challenging” but not a mission impossible.

Sri Krishnamurthi is a journalist and Postgraduate Diploma in Communication Studies student at Auckland University of Technology. He is attached to the University of the South Pacific’s Journalism Programme, filing for USP’s Wansolwara News and the AUT Pacific Media Centre’s Asia Pacific Report.

When Max Manape received the confirmation in Papua New Guinea his heart sank. A 22-month-old girl had been diagnosed with polio. She was paralysed.

A few days later, another confirmation came. A two-year-old boy had been taken to a clinic with weakness in his legs. Workers sent away for testing and he, too, was found to have polio. He’s undergoing physio treatment, but the virus is incurable.

“When the polio was identified, oh it was quite worrying,” Dr Manape sighed down the phone. “We thought we had eradicated it.”

READ MORE: A ‘lurking beast’: Polio casts shadow over PNG independence day

Dr Manape, who is the head of the Eastern Highlands Provincial Health Authority, has since received confirmation that four children in his province have polio.

In all, 12 children across Papua New Guinea have been diagnosed since it was rediscovered in July. The debilitating disease is in five provinces, including the capital, Port Moresby.

Polio, an incurable virus which causes paralysis in children, has been nearly eradicated from the face of the earth. Only three countries – Pakistan, Afghanistan and Nigeria – are still known to harbour wild polio virus, according to the Global Polio Eradication Initiative.

In 2017, only 22 cases of polio came to the attention of authorities worldwide. Papua New Guinea’s latest outbreak has already confirmed 12, and officials there say several more are likely to be found.

3 other countries
Syria, Somalia and Democratic Republic of Congo are the only other countries to have seen a return of polio in the past couple of years.

The government and health officials, in a series of statements and television appearances, have sought to allay fears, saying the outbreak can still be contained by the intensive isolation and vaccination campaign that is underway.

But as confirmed polio cases skip from province to province, many are asking how Papua New Guinea has become one of the few countries to buck the international trend of eradicating polio.

“Everyone’s asking that question,” said Luo Dapeng, the World Health Organisation’s representative in PNG. “I think there’s a multitude of reasons.”

Papua New Guinea, along with the rest of the Western Pacific, was declared free of polio in 2000. Its last confirmed case was in 1996, after decades of intensive vaccinations across the country – and the world.

“I think we got a bit more relaxed in terms of our vaccine programme,” said Dr Manape.

But that confidence was shattered in May when a 6-year-old boy from Lufa Mountain, a settlement in the northern city of Lae, became paralysed in his lower limbs.

Vaccine-derived form
Samples were sent to the United States for testing, and in June, fears were confirmed: Polio was back.

The Lae case is what is known as a vaccine-derived form of polio, where the weakened form of the virus used in vaccinations mutates and spreads. Samples of other children in Lufa Mountain confirmed they had the strain in their systems.

Often, one confirmed case of paralysis is considered a polio outbreak, as doctors assume hundreds of others would have been exposed to the virus.

Lufa Mountain, like much of Papua New Guinea, had the perfect conditions for an outbreak. Few children are immunised against polio, and the water supply and sanitation systems are largely non-existent.

Authorities suspect the outbreak started when the water supply was contaminated by faeces which contained the mutated virus.

Since then, the disease has skipped from Morobe province to neighbouring Madang. It’s spread up the rugged Highland interior to Enga and Eastern Highlands provinces. Last week, the first case was confirmed in the capital, Port Moresby.

Dr Manape said it was not yet known how the virus managed to skip up to Eastern Highlands from Lufa Mountain. He doesn’t even know if it’s from the same outbreak.

“It’s quite worrying,” he said. “We have low vaccine coverage in the province. When we detect polio, it’s quite worrying.”

Geographic spread
Dr Manape said there was a chance polio had been circulating in his province for some time. The four cases found in Eastern Highlands are geographically spread across the province, and a strain could have been there for “quite a while.” It was only once the case was confirmed in Lufa Mountain that they started testing in his region, he said.

“With poor sanitation and the poor water, we know that this could affect every community,” Dr Manape said. “We’re on our toes trying to get to communities, to mobilise health staff.”

David Mills, a doctor in Enga Province and the president of the Society of Rural and Remote Health, said now an outbreak had started, it would be difficult to contain.

“If you leave the door even just a little bit open it can kick it wide open,” he said. “Once you get one case, then one case is all it takes for it to spread like wildfire and then you’re sort of back to step one again.”

Since the outbreak was confirmed, an army of health professionals have swarmed the country, marching from village to village to vaccinate as many children as possible and contain the outbreak.

The World Health Organisation and the Department of Health have set up containment zones around affected communities, and embarked on mass vaccination campaigns across the provinces with polio.

In some of the provinces, Dr Dapeng said, coverage has already gone from as low as 30 percent to as high as 90 percent.

More than 50 deployed
More than 50 international polio workers have been deployed to the country, according to the World Health Organisation. A vaccination campaign will begin in Port Moresby at the end of the month, while a nationwide campaign will begin in October. Last week, health secretary Pascoe Kase said the immunisation programme would also be expanded to include all Papua New Guineans under the age of 15.

But while the response is being lauded, many are saying it could have been avoided entirely.

“To see this re-emerge is very disappointing,” said Dr Mills. “But perhaps not altogether surprising.”

“When you see these diseases re-emerge, it really is a sign that unfortunately the government has not really invested in these things.”

Polio’s return was years in the making.

In the late 20th century, vaccination programmes were well-funded and regular. Most villages would be visited by specialists who would traverse the country providing children with their three courses of droplets.

But since the eradication declaration in 2000, Dr Manape and Dr Mills both said, that programme has largely fallen by the wayside, replaced by a lackadaisical approach to vaccines. Not just for polio, but for other preventable diseases like measles and whooping cough, too.

Vaccine coverage down
In the past 18 years, nationwide polio vaccine coverage has fallen from about 80 percent to 30 percent. In some provinces, that rate is even lower.

While some children are vaccinated, they don’t receive their full doses, which also creates a danger. To be fully immunised, a child needs three courses of droplets. But Dr Manape said some children had only been receiving one course, which can spread the mutated virus while not fully vaccinating the child.

“The immunity of the population is very low,” said Dr Luo, of the World Health Organisation. “That’s why polio has come back.”

But the campaign is also the victim of the grand promises, failed visions, and savage cuts that have seen the country’s health system hurtle close to the edge of collapse.

In recent months, hospitals and clinics across the country have run out of basic medicines and supplies, the country almost ran out of the antiretrovirals used to treat those living with HIV/AIDS, and doctors have gone without pay for months.

Dr Luo acknowledged that the financial crisis, in part caused by a spending spree that started when the government was confident of a commodities boom that never came, may have had some role in the return of polio.

“PNG’s a commodity income country and they have been struggling to finance some of the health services,” he said.

Easy target for cuts
Dr Manape said it appeared vaccine programmes – especially ones for ailments like polio, thought to have been eradicated – were easy targets for savage cuts.

“Once we eliminated polio in 2000 we needed to maintain the immunisation coverage – that needs to be constant,” he said. “We do a lot of our planning and send the budgets. The government not funding its part of it has really pulled the cap for the polio to pop up.”

In June, health minister Sir Puka Temu told parliament 40 percent of the country’s remote aid posts, small clinics that treat isolated communities and provide vaccinations, had closed. He said many of those that remained had no electricity or running water.

Dr Mills said in some provinces – including those with polio – nearly all the aid posts had closed, which was “outrageous” in a country where 85 percent of the population lived in remote areas.

He said the government’s spending priorities had been in the wrong places for years, with millions of dollars – much of it donated or on loan from countries like Australia and China – had been pumped into hospitals in the big cities.

“What really needs to change is we need to reinvest in getting health workers living in these communities all the time and that’s really what collapsed in PNG,” said Dr Mills.

“You have to have those people there … so that any time they see a patient, or they see someone at the market they can say, ‘hey look come in for your vaccination tomorrow’.”

Lives changed forever
But after 18 years of cuts and neglect, polio is back, and the lives of 12 children have been forever changed.

Authorities are scrambling to contain the outbreak in a response that has been spearheaded by international agencies which has seen millions of dollars flood in.

Dr Mills said eradicating it again is possible, but the teams working across the country – including himself – have their work cut out for them.

“There’s no power supplies in most of the country and, of course, [that] challenge of keeping in place what we call a cold chain to make sure the vaccines stay cold the whole way to the patient, that’s an incredibly difficult task,” he said.

“You may have to travel a long distance just to vaccinate a couple of dozen children. That might involve flying out or walking a day or taking a motorboat ride up the river for a couple of days just to find small groups.”

“It takes will and effort to do it,” Dr Mills said.

Dr Luo said that will and effort was there, and he was confident the polio outbreak could be contained.

Know the strategy
“We know the strategy of how to do it. We know how to do surveillance. We know how to implement the intervention,” he said. “We will someday contain the outbreak.”

Medical workers are already looking beyond the containment effort, and are demanding assurances that the problems that led to polio returning will be fixed, and that vaccinations will be maintained.

“With the WHO resources and funding we’re having coverage of almost 100 percent,” said Dr Manape. “But for our normal routine, that funding was a big problem. What we are learning now is that we need more support from the government.”

Dr Mills said plenty of other countries with similar challenges to PNG had managed to stay on top of polio, and he hoped lessons would be learned.

“Let’s hope this provides the impetus to refocus our attention on these basic things.”

This article is republished under the Pacific Media Centre’s content partnership with Radio New Zealand.

Battlelines are being drawn as New Zealand and Pacific countries lobby for an important appointment at the World Health Organisation.

The region’s health ministers had all agreed to support a Pasifika candidate, but offers of aid and influence from Asian countries have left that in doubt.

Hundreds of millions of health dollars are at stake as the region grapples with a number of crises including diabetes and even the re-emergence of polio.

The regional director nominee, Dr Colin Tukuitonga, says the small island communities do not get a fair deal from the World Health Organisation.

“People complain about resource limitations, there is never enough money. The voice of the islands is often drowned out by the voices of the bigger Asian countries,” he said.

It is why New Zealand has nominated Dr Tukuitonga as the WHO regional director.

At a recent meeting, Pacific health ministers unanimously agreed to support that nomination.

Sudden change
But things suddenly changed. Both the Solomon Islands and Papua New Guinea have gone back on their agreement, publicly expressing commitment to Japan.

“This is an opportunity to remain united and influence a particularly important position for the health of the people of the region. And clearly we have two members who haven’t honoured their commitment to regionalism,” Dr Tukuitonga said.

Foreign Affairs Minister Winston Peters says the government hopes that the Solomon Islands and Papua New Guinea “will this time sign up for their own neighbourhood rather than bargain their vote off somewhere else for alternative reasons”.

Coincidentally, Japan has made aid offers to island countries, including a major international airport extension and rebuild for the Solomon Islands.

“A free airport does not improve the health of the Pacific people,” Peters said.

Dr Tukuitonga said: “Some of our island members are very vulnerable, very susceptible to these offers. And that’s the unfortunate thing I think.”

Nonetheless there’s been solid support for Dr Tukuitonga who’s pledging to fight for a region he’s already dedicated to.

Projected decline
“WHO budget is projected to decline. There’s a lot to be said about getting a fair share for our region because if you do that then you have a better chance of allocating a decent level of resource to our island members,” he said.

Peters said: “We start with a huge asset on our side. We have got the right candidate.”

It would be an historic win for the Pacific as the role has always been held by Asia.

Thirty countries will decide if the time is right for change in October.

Barbara Dreaver is the Pacific affairs correspondent of Television New Zealand. This article is republished with permission.

The estimated financial cost and economic burden of diabetes in Fiji reached a staggering $124 million (NZ$84 million) in 2014 with health experts sounding an urgent need for people to relook at their lifestyles and eating habits.

Dr Jone Hawea, a medical doctor and codirector of the Foundation for Rural Integrated Enterprise and Development, did not mince words when he told participants at the Media and Diabetes Advocacy Workshop in Suva last week about the reality of the disease he tagged as an “ongoing disaster”.

According to Dr Hawea, the total yearly financial cost of diabetes in Fiji in 2014 took into account factors such as the total productivity cost for patients and carers and excluded estimates such as private health care costs, out of pocket expenditures and other tangible indirect costs which were difficult to obtain.

“So you can imagine, the true financial cost is therefore very likely to be higher, a high estimate of about $180.3m,” he said.

“Diabetes has the single highest impact on productivity of all non-communicable diseases in Fiji.”

He said diabetes imposed a huge financial and non-financial burden on Fiji’s economy, adding the latter amounted to more than 56,000 years of life lost because of ill-health, disability or premature death.

“Diabetes is largely preventable, so a large portion of these enormous and unnecessary costs can be averted,” Dr Hawea said.

Tangible solutions
While opening the workshop, Assistant Minister for Health Alex O’Connor said the gathering of media professionals and partners in health and wellness programmes was a platform to find tangible solutions to combat this major health issue.

“About 15 percent of Fiji’s adult population have diabetes and another 15 percent have impaired fasting glucose – these are people who have high blood sugar and are at risk of being diagnosed with diabetes,” O’Connor said.

Journalists from print and broadcast media as well as student journalists from the University of the South Pacific, civil society and non-governmental organisations, and the Fiji National University were part of the one-day event, which was organised by Diabetes Fiji in conjunction with the Ministry of Health.

Adi Ana Civavonovono is a final year journalism student at the University of the South Pacific reporting for Wansolwara News.

The year 2016 was a landmark year for the Philippines with HIV (human immunodeficiency virus) setting annual and monthly records that are the highest since the country started counting HIV incidence 33 years ago.

This coincides with a new development plan for the country that is targeting a reverse trend for the number of new HIV detections in a year, meaning the growth rates of new infections are declining.

The year-end dataset of the Department of Health’s HIV and AIDS (acquired immunodeficiency syndrome) Registry of the Philippines (HARP) noted that there were 750 cases in December 2016 alone, a month’s high.

The year 2016 tallied a total of 9,264 cases (including 1,113 full-blown AIDS cases and 439 deaths). The 33-year-total of recorded HIV cases, including deaths, is already near the 40,000 mark (39,622).

With the 9,264 total in 2016, the DOH said an average of 25.38 Filipinos have contracted HIV in a day. This contrasts with only one person a day in 2008.

Though latest 2017 figures are yet to be released, a Manila social hygiene clinic physician told Asia Pacific Report the unnamed centre had received 31 cases alone last month.

The Philippines passed a reproductive health law five years ago but it has yet to be fully implemented given court cases and strong opposition from the Catholic Church and from pro-life advocates.

Condom distribution plan
Months into the Rodrigo Duterte administration, the president had issued Executive Order 12 calling for the immediate implementation of Republic Act 10354 (Responsible Parenthood and Reproductive Health Act 2012).

Recently, health officials said recently DOH was set to distribute condoms.

Even schools are target distribution centres, say health officials, but Catholic-run schools and universities are vehemently opposing it.

Year-on-year, there were more adolescent deaths in 2016 (88 compared with 64 in 2015). HIV cases reported among Filipinos aged 15-to-24 at the time of their being reported reached 10,720 cases.

But a significant number — more than 60 percent of the 39,622 cases — contracted HIV through homosexual contact.

The Philippines is said to be a “low-prevalence” HIV country, with the 39,622 cases well below one percent of the total Philippine population. However, its annual growth rates of HIV infection rate are among the fastest in the Asia-Pacific region, says a December 2016 report by the US-based Human Rights Watch.

“The country’s growing HIV epidemic has been fuelled by a legal and policy environment hostile to evidence-based policies and interventions proven to help prevent HIV transmission,” HRW said.

HRW criticisms
Human Rights Watch also criticised the Philippine government for “failing to adequately target HIV prevention measures at men who have sex with men (MSM)”, also citing the “woefully inadequate” HIV prevention education in schools and the “non-existent” commercial marketing of condoms to MSM populations.

In reply, Archbishop Socrates Villegas, D.D., president of the Catholic Bishops’ Conference of the Philippines (CBCP), said condom distribution in schools “will stimulate immorality”.

Dr Diana Mendoza, from a Manila-based social hygiene clinic, told Asia Pacific Report the Philippines could prevent an HIV epidemic especially through empowering citizens through awareness and protection.

In Tacloban City, site of supertyphoon Haiyan in 2013, a Catholic parish priest said that instead of condom distribution in schools, an “ABC method” may work: “A – abstinence from sex outside marriage; B – be faithful to one another; and C – conversion of heart to the value of love and sacredness of sex as a gift of God in marriage”.

This “ABC” advice from Father Raymund Sotto of the St. Rafael the Archangel parish in Tacloban City counters the policy advice of the World Health Organisation (WHO): the proper and consistent use of condoms will be “highly effective: in preventing HIV and other sexually-transmitted infections (STIs).

The recently-released 2017-2022 Philippine Development Plan under the Duterte administration noted the “substantial increase” in newly-diagnosed HIV cases since 2010. The report added that the “the increased reported cases may be due to better surveillance and testing methods.”

The Duterte government will also propose to the Philippine legislature to amend the current Philippine HIV and AIDS Prevention and Control Act 1998 (Republic Act 8504) to make the law “more responsive and relevant” to the current rise of HIV cases in the country, the PDP reported.

Jerome Villanueva and Roy Abrahmn Narra are graduate journalism students of the University of Santo Tomas, Manila. Catholic diocesan priest Father Casibjorn Qiua is taking up a graduate degree in communication from the same university.

• The 20177-2022 Philippine Development Plan

According to a PACNEWS report, a three-day meeting hosted by FAO is expected to take place in Suva this week to contribute a resolution to the crisis.

‘Health and wealth’

The report quoted FAO’s Policy Officer in Fiji, Dr Tim Martyn, who said NCDs threatened the health and wealth of the 34 Small Island Developing States.

“In the Pacific alone, on average, NCDs account for 70 percent of all deaths, in Fiji that number is 80 percent. A third of the regional population suffers from anaemia, and a quarter from vitamin A deficiency.”

He said most of the deaths are preventable, but access to nutritious food would need to be made available and affordable for many.

Dr Martyn said almost a quarter of Fiji’s population suffers from diabetes.

“One outcome is an amputation conducted in one of Fiji’s hospitals every 12 hours.  A third of Fiji’s population is now considered obese, which puts many at a health risk.

‘Just as startling’

“In the Pacific Islands the statistics are just as startling.  Fifty percent of the male population of Tonga is estimated to be obese, the highest prevalence out of 188 countries worldwide; and over 45 percent of American Samoa’s population have diabetes. Indeed, the Pacific has the highest rate of diabetes in the world.”

The FAO are expected to host up to 40 representatives from the three geographic SIDS regions: Atlantic, Indian Ocean, Mediterranean and South China Sea (AIMS), the Caribbean, and the Pacific.

The meeting is expected to review and update the draft Action Plan which responds to the food and nutrition challenges faced by SIDS.

• Read the full report on PACNEWS
• FAO’s draft prospectus of this weeks meeting in Suva

With few commitments to curb cigarette consumption, Indonesia is poised to have the largest population of smokers in the world in the next decade.

Currently, the country ranks fourth on the list of countries with the most smokers, behind China, Russia and the US. But while other heavy-smoking countries are enforcing tough tobacco controls, Indonesia is planning to double tobacco production.

Indonesia already has the world’s highest smoking prevalence among males, as 67.4 percent of males over 15 years old smoke. The cost of treating tobacco-related diseases in the country is currently estimated to reach Rp 11 trillion (NZ$1.21 billion) a year, 0.29 percent of the country’s gross domestic product (GDP).

“If we don’t prevent and control the impacts of smoking, then there’s a chance we will become the world’s largest tobacco consumer in the next 10 years,” the Health Ministry’s disease control director general, Muhammad Subuh, said during an event to mark World No Tobacco Day.

The governments of China, Russia and the US have realised that health costs and other hidden expenses resulting from smoking are far higher than the money generated from the tobacco industry.

A study published last year in The Lancet medical journal said that a third of all men currently under the age of 20 in China, the world’s largest tobacco producer and consumer, would die prematurely if they did not give up smoking.

Therefore, China signed the World Health Organisation’s (WHO) Framework Convention on Tobacco Control (FCTC) in 2006. Since then, the Chinese government has worked earnestly to implement the FCTC by adopting a series of measures to control the tobacco epidemic.

Loose controls
Even though tobacco-related diseases claim 200,000 lives in Indonesia every year, the government has refused to sign the FCTC, resulting in loose cigarette controls and the country being dubbed the tobacco industry’s playground.

Like China, Russia and the US have also taken steps to ensure that the tobacco industry does not endanger the future of their young generations.

“We’ve seen changes taking place in countries with very difficult, complex environments. For example, Russia. It now has one of the strongest tobacco control laws in the world. If you had asked us 10 years ago whether Russia would be where they are, we would’ve said it’s very difficult as the industry is very active,” World Lung Foundation senior vice-president of communications Sandra Mullin told The Jakarta Post.

Russia signed the FCTC in 2008 and introduced a comprehensive tobacco control law in 2013, effectively banning advertising of tobacco products as well as sponsorship of events by tobacco companies.

The law aimed to reduce the number of annual tobacco-related deaths from 400,000 to 150,000-200,000.

The US, meanwhile, saw its smoking rates hit an all-time low in 2014, with only 16.8 percent of adults smoking, after it passed the Tobacco Control Act into law in 2009. The law also bans sales of cigarettes to minors and tobacco-brand sponsorship of sports and entertainment events or other social and cultural occasions.

Conversely, the Indonesian government has only made minor efforts to tone down tobacco campaigns. Since 2015, it has banned tobacco advertising in mass media, on public transportation and in all public places. It also bans any form of tobacco advertising aimed at minors.

The government has also been adamant about supporting the tobacco industry by planning to double cigarette production to 524.2 billion cigarettes a year by 2020, the Industry Ministry’s 2015 tobacco industry roadmap states.

“If we see the roadmap, we can just imagine our little children being told to smoke,” the Health Ministry’s director of non- communicable diseases, Lily Sulistyowati, said.

Hans Nicholas Jong is a Jakarta Post reporter.

Fiji is already struggling to cope with the aftermath from the recent tropical cyclone Winston, other storms and the impact of climate change, but suicide among youth is also becoming a major concern for parents and communities.

Suicide became a national issue in Fiji last year when fresh statistics showed worrying trends. Prime Minister Voreqe Bainimarama showed his concern for the increasing rate of suicide cases, especially among youth.

Bainimarama said that counselling services and initiatives already existed in Fiji, but he would ask every branch of government to improve its response to youth suicide.

Last year, there were 89 cases of suicide from January to September, which had 10 cases of children aged under 16. Also, there were more than 20 people aged between 17 and 25 years who had committed suicide during the same time.

However, this issue has some deeper roots back into the 1990s.

Peter M. Forster (UK), Selina C. Kuruleca (Fiji) and C. R. Auxier (USA) published a report named A Note on Recent Trends in Suicide in Fiji in 2007 in the Journal of Pacific Rim Psychology. They collected suicide data from Adinkrah who reported in 1995 and from Booth who reported in the years 1997 and 1999.

They had cited that the “standardised” annual rate of suicide for the year 2002 at 15 per 100,000 population for male and 11 for females.

Current scenario
Government has launched National Child Helpline since last January in partnership with the Medical Services Pacific (MSP).

People in need for counselling are provided a toll free number 1325 to talk with trained counsellors. It is a 24-hour helpline.

“We have got almost 7000 calls since last September,” says Peci Baladrokadroka, a senior counsellor in MSP.

Naina Ragigia, a Fiji Police Force spokesperson, shows her concern because the force receives many calls related to suicide cases as well.

“The Fiji Police Force receives an average of 5 reports of suicide in a month. Most reports of suicide cases received are only attempted suicide, which is much higher than the suicide cases.”

People from different age groups, starting from 5 to 70 are attempting suicide.

“We have noticed young people around the age of 12-23 years are mostly victims of suicide cases,” says Ragigia.

Reasons for suicide
There are so many reasons ranging from child neglect to poverty which are leading people to commit suicide in Fiji.

“In young people, child neglect, sexual abuse and physical abuse are one of the major reasons,” says Peci Baladrokadroka.

Ragigia says that in some cases children are disappointed by his or her own parents.

“A 10-year-old boy was playing outside his home. His mother scolded him to come home and study. But that boy took this in a different way; he locked himself in his room and eventually hanged himself.

“Children from the young ages of 12 years are now committing this offence which is indeed a sad thing,” she said.

Entertainment programmes on television and radio are also contributing.

“Last year we had a case of 12-year-old girl. She was trying to mimic a scene [of a suicide] from the movie, but ended up dead instead,” says Ragigia.

Breaking points
For the young students career and good grade are also one of the major breaking points.

Matthew Galuvakadua works as a volunteer at Youth Champs for Mental Health.

“Family expectations put extreme pressure on young children, especially when exams are a concern,” he says.

Galuvakadua has been working with this organisation for the past four years. The group mainly focuses on suicide prevention for young people in Fiji and tries to reduce the stigma associated with it, especially people living with mental illness.

Apart from this, relationships and family issues are also among major reasons for suicide. Peci says that drugs, alcohol, educational needs and poverty also contribute.

The issue is becoming more serious each year and the government, with the help of local organisations and NGOs, is trying to deal with the suicide cases, but results are disappointing.

Reluctant over information
“When Asia Pacific Report tried to contact different organisations for statistical data and information, they were reluctant to give any details.

Ragigia says suicide is a very sensitive issue and how foreign media might present the scenario is difficult to judge.

“Organisations seem to be reluctant over this particular issue because they don’t want Fiji to be represented in a wrong way.”

Peci says the government is running many awareness programmes with different organisations.

The Fiji police also conducts various awareness programmes for the general community.

They have a fine relationship with the local health authorities.

Frequent check-ups
“The Fiji police is fortunate to have services of our local health authorities for offering a frequent medical check-up for the victims and there are also counselling services offered from local NGOs that we are able to refer to the victims for counselling purposes,” says Ragigia.

However, Galuvakadua thinks that the government should be more involved with mental health organisations.

“Government should work and form better relationships with existing mental health service providers in the community,” he says.

Galuvakadua also shows his concern about lack of rehabilitation centres in Fiji.

“The Community Recovery Outreach Programme is the only functioning rehabilitation programme that refers people at-risk from suicide to people living with mental illness, sending them to St Giles Hospital in Fiji.”

He hopes to see an improvement in the months ahead.

Ami Dhabuwala is a postgraduate student journalist at AUT University. She is reporting on the Asia-Pacific Journalism course and is currently in Fiji.

Fiji’s National Child Helpline – ring 1325

Last week I watched in absolute disgust as MPs in Papua New Guinea giggled and laughed as the Minister for Health made light humour over the fact that the government had slashed funding for Church-run health facilities to the tune of K50 million (about NZ$23 million).

Educator and health policy specialist Dr Audrey Aumua has been appointed as Deputy Director-General of the Pacific Community (SPC), based in Suva, Fiji.

Dr Aumua will lead SPC’s programmes based in Suva, and will be the Director-General’s representative in Fiji.

Dr Aumua is of Fijian descent, and is currently the World Health Organisation (WHO) Resident Representative, based in Honiara, Solomon Islands, where she provides technical and strategic leadership to the government, as well as diplomatic representation for the organisation in Solomon Islands.

Dr Aumua has extensive experience in research, policy development and management in the health and education sectors, in New Zealand, Australia and the Pacific region.

In addition, Dr Aumua has a track record of achievement in the private sector. She was founder and managing director of a large education and training establishment in Auckland, and was director of an economic development initiative for small business with the Government of Samoa.

Prior to her WHO appointment, Dr Aumua was director of the knowledge and innovation hub at the University of Queensland, leading the establishment of a coordination platform for technical partners to regionally collaborate on a joint systems agenda for improving civil registration and vital statistics (CRVS).

She was chief executive officer of a large health trust in Auckland, and previously held the position of chief adviser on Pacific Populations at the New Zealand Ministry of Health.

Dr Aumua holds qualifications from the University of Auckland in English, teaching and business, and completed a Master of Public Policy from Massey University and a PhD from Curtin University. Her PhD thesis was on international public policy reforms in the health sector in the Pacific region.

“I am excited and very honoured to be able to join the largest scientific and technical development organisation in the region at a time when Pacific countries and territories are dealing with significant development challenges, and I look forward to working together with SPC colleagues and with other regional organisations to support the region,” Dr Aumua said.

The Director-General of the Pacific Community, Dr Colin Tukuitonga, welcomed the appointment of Dr Aumua to the role of Deputy Director-General (Suva), which complements the position of Deputy Director-General, Operations and Management Directorate, based at SPC’s Noumea headquarters, in New Caledonia.

“I am delighted that someone with Dr Aumua’s high-level strategic, policy and development experience, particularly in the Pacific region, is joining SPC.

“I am looking forward to working with her to implement the Pacific Community Strategic Plan, and in furthering our collective ambitions for the region,” Dr Tukuitonga said.

Dr Aumua takes up her new role with SPC on 2 March 2016.