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Pacific region’s serious health issues in the spotlight

Dutch Ambassador Rob Zaagman (left) , Tongan health minister Dr Saia Piukala and Massey University Vice-Chancellor Steve Maharey at the Pasifika Health Research Forum.

Guests listen to a speaker at the Pasifika Health Research Forumheld in
the ballroom of the Dutch Embassy, Wellngton.

Serious under-resourcing of the health work force in the Pacific Islands has been identified as one of the greatest challenges facing the region.

Academics, Pacific health researchers and leaders, and members of the diplomatic community, gathered in Wellington last week to discuss the best way to address health issues in the region. These include high rates of cancer and health and environmental effects of uncontrolled and misuse of fertilisers and pesticides.

Numerous speakers at the event, hosted at the Dutch Embassy and organised by Massey University, said more health professionals and medical equipment are needed for the region too.

Dutch Ambassador Rob Zaagman told guests that his Embassy has a special interest in the issues as it is officially accredited to Fiji, Samoa, Kiribati, Tuvalu and Tonga.

Vice-Chancellor Steve Maharey described the forum as a “unique gathering” of the diplomatic and Pacific communities.

Solutions to its myriad health issues lay with both securing more specialist support from outside the region and a commitment from the Pasifika community to addressing areas of concern, guests were told

International health consultant Professor Don Matheson said in Papua New Guinea up to five million people did not have access to a doctor - with nearly half of all its districts without medical practitioner support.

Despite these shortages some provinces - such as Milne Bay, were demonstrating remarkable improvements in the care of women during pregnancy. Improving health services in the Pacific needs to be informed by an understanding of these local successful models of care, he said.

Addressing issues in the wider Pacific region, Professor Matheson said a combination of slow economic growth; an increased availability of poor quality food and a failure to deliver basic health services had been compounded by a lack of resources.

Cuban ambassador Mario Alzugaray also identified a shortage of doctors as exacerbating health problems while Mr Maharey said one way to build capacity was through further education.

Associate director for Massey’s Centre for Public Health Research, Associate Professor Barry Borman, said researchers were increasingly “data rich” about Pasifika health issues but “information poor” when it came to identifying effective solutions.

With research officer Ridvan Firestone, Dr Borman is seeking research partners in the Pacific Islands to develop a hub for environmental health indicators across the region. Such a programme, similar to one already underway in New Zealand, would provide statistics about how the environment affects the health of Pasifika people including traditional health indicators such as air and water quality.

College of Health Pro Vice-Chancellor, Professor Paul McDonald, said while improved life expectancy showed progress had been made with health care in the Pacific in the last 20 years, the attitude of “business as usual was just not going to get it done unfortunately”.

Centre director, Professor Jeroen Douwes, hopes the forum may lead to a wider call to action from the international community to get involved in addressing certain health issues in the region that have not had the priority of others. A World Health Organisation non-communicable diseases action plan for 2013 -2020 proposes a series of targets including the reduction by 25 per cent of mortality from cardiovascular disease, diabetes, chronic respiratory illnesses and cancer.

Colleague Dr Sunia Foliaki says the focus on cancer is particularly pertinent to Pasifika nations that lack both data and effective screening processes for prevention and control of the deadly disease. Cancer has been the second leading cause of death in the majority of Pacific Island countries for more than a decade.

“There is little reliable data on cancer, and cancer registries in the Pacific Islands are either lacking or inadequate. But there is a need to identify how cancer is tracking in the Pacific and tailor research funding applications to that,” he says.

Similarly, pesticide use is another issue that requires urgent attention.

Tonga’s deputy director for the Ministry of Agriculture and Food, Forest and Fisheries, Dr Sione Foliaki said in his country the misuse of pesticides was contaminating food crops and affecting the health of farmers – sometimes with fatal consequences.

Demand for increased production helped by the use of agrochemicals had to be weighed against the risk of farmers’ health, consumers eating their product and the environment into which the chemicals are applied, Dr Foliaki said.

Tonga required effective national pesticide management with an action plan, including a pesticide registration scheme, that sought to reduce health and environmental risk associated with the use, trade and disposal of pesticides, he said.

Dr Foliaki from the Centre for Public Health Research said studies undertaken in other countries such as Mexico showed severely reduced neuropsychological development among children exposed unnecessarily to such chemicals, though it was still unknown how big an issue it is in the Pacific Islands.

Fonterra senior research scientist Dr Palatasa Havea gave data demonstrating that squash pumpkin farmers in Tonga applied fertiliser and pesticides far more than necessary. Heavy rains wash off the extra agrichemicals during growing seasons polluting the environment and wasting money.

An assessment tool was devised to help the Tongan farmers make informed decisions on the amount and timing of fertiliser application to ensure greater responsibility of use.

Tonga’s Minister of Health, Dr Saia Piukala, also voiced concern about the availability and safety of water sources that is now increasingly threatened by natural disasters and climate change as well as by environmental pollution from agricultural, population and economic developments

Echoing the sentiments of other speakers, Professor Douwes stressed there is a need to train locals more and encourage the emergence of international mentors for a new generation of health professionals.

“We need cooperation from international countries. If they can find funding for such issues then such a development becomes permanent and it’s possible to make change.”

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