The Pacific Islands

So! You’d like to know about health and surgery in the Pacific Islands!

Here are the vital statistics:

The Pacific Islands comprise 20,000 to 30,000 islands in the Pacific Ocean. The islands are also sometimes collectively called Oceania.

The Pacific Islands lying south of the tropic of Cancer are traditionally grouped into the three divisions of Melanesia, Micronesia, and Polynesia:

  • Melanesia means black islands. These include New Guinea (the largest Pacific island, which is divided into the sovereign nation of Papua New Guinea and the Indonesian provinces of Maluku, Papua and West Papua), New Caledonia, Zenadh Kes (Torres Strait Islands), Vanuatu, Fiji, and the Solomon Islands.
  • Micronesia means small islands. These include the Marianas, Guam, Wake Island, Palau, the Marshall Islands, Kiribati, Nauru, and the Federated States of Micronesia. Most of these lie north of the equator.
  • Polynesia means many islands. These include New Zealand, the Hawaiian Islands, Rotuma, the Midway Islands, Samoa, American Samoa, Tonga, Tuvalu, the Cook Islands, Wallis and Futuna, Tokelau, Niue, French Polynesia, and Easter Island. It is the largest of the three zones.

Surgeons in the Pacific Islands

The Fiji National University (FNU) began postgraduate training in surgery in 1998. From 2002, FNU also began to graduate MMeds in Surgery. To the end of 2015, FNU has trained 80 doctors to Diploma of Surgery (1 year) and 34 to Masters level (4 years).

Other qualified surgeons in the Pacific Islands region are mainly expatriates on contract, many recruited by individual departments of health or through international development programs. In many parts of the Pacific, surgery is performed by doctors with limited training, who rely on experience to perform life-saving procedures. Kiribati and the Solomons, like Timor Leste, have recently recruited Cuban doctors to compensate for their workforce shortages.

Endemic Health Problems

Communicable diseases continue to contribute to ill health in many Pacific Islands Countries and Territories (PICTs), with the greatest burden falling on poorer countries of the region.

Malaria is endemic in 2 PICTs, namely Vanuatu and the Solomon Islands. In the past decade, national health authorities in these countries have made considerable progress in reducing malaria morbidity and mortality.

Dengue fever is a growing problem in the region. A number of people still live in poor housing with lack of proper waste disposal and inadequate drainage, creating favourable breeding conditions for the mosquito vectors of dengue. Dengue occurs in most of the PICTs, inflicting severe health and financial tolls on the populations affected. With appropriate levels of support, the risk of transmission can be reduced and with it the associated morbidity and mortality.

Lymphatic Filariasis is one of the world’s leading causes of permanent and long-term disability and is currently endemic in 11 PICTs. The disease can cause serious impact on the health and socioeconomic status of the people affected.

In at least 10 Pacific island countries, more than 50% (and in some, up to 90%) of the population is overweight according to World Health Organization (WHO) surveys. More seriously, obesity prevalence ranges from more than 30% in Fiji to 80% among women in American Samoa, a territory of the United States of America (USA).

Micronutrient deficiencies are also common in this region. In 15 of 16 countries surveyed, more than one fifth of children and pregnant women were anaemic. In Fiji, Papua New Guinea and Vanuatu, iodine deficiency and related goitre are endemic although, in Fiji and Papua New Guinea, great progress was made recently through salt iodization. In many other Pacific countries and territories the situation is yet to be assessed. Vitamin A deficiency is also a significant public health risk in Kiribati, the Marshall Islands, the Federated States of Micronesia and Papua New Guinea.

About 40% of the Pacific island region’s population of 9.7 million has been diagnosed with a noncommunicable disease, notably cardiovascular disease, diabetes and hypertension. These diseases account for three quarters of all deaths across the Pacific archipelago and 40–60% of total health-care expenditure, according to a meeting on obesity prevention and control strategies in the Pacific held in Samoa in September 2000.

FOR MORE INFORMATION:

WHO Western Pacific:

http://www.wpro.who.int/southpacific/en/

Fiji National University:

http://www.fsm.ac.fj/

DFAT Pacific Regional Activities:

http://dfat.gov.au/geo/pacific/development-assistance/Pages/health-assistance-pacific-regional.aspx

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