Transcript
"It's not a good thing to have not a doctor. We really need a doctor here to take over the doctor's work because I believe that the nurses can't do the doctor's work sometimes."
Mangaia's mayor Tere Atariki agrees there is a need for a doctor to care for the island's 460 strong population of mainly old and young people.
He says everyone is concerned by the departure of their doctor and they've written to the Health Ministry about it.
But Health Secretary Elizabeth Iro says she's told those who've raised concerns they've been very well taken care of by their nurses and there are systems in place to support them.
"These nurse practitioners and these nurses in these remote areas are actually not in isolation. They have the skill set and the knowledge that enables them to take care of the population out there. They have access to the doctors on Rarotonga for any support they require and there is a continuous professional development programme that's in place for them."
The Health Secretary says most of the outer islands do not have a doctor but that does not put patients at greater risk in an emergency.
"Emergency flights can happen whether you have a doctor on the ground or not. What has happened for the Cook Islands is that actually having early identification of high risk cases and trying to manage that in advance. The emergency situations through trauma, appendicitis can happen and that will need to be referred to Rarotonga, and that's how we've been managing the health care services in all the islands in the Cook Islands."
Elizabeth Iro says specialists also visit the outer islands for screening and case reviews and she's confident they have the right people working there.
World Health Organisation technical officer Erica Reeve says nurses have been providing care on sparsely populated remote Pacific islands for many years and have an important role to play.
"The loss of a doctor to one of the islands does not necessarily mean that mortality and morbidity will go up in that particular area. The most important thing is that adequate primary and secondary health care are available, things like immunisations for children, antibiotics, good antenatal care, management of NCD risk factors. Nurses are perfectly capable of managing those."
But the WHO officer concedes there is a greater risk in an emergency for people on very remote islands who don't have good transport links to tertiary services.
"Yeah definitely there would be for some emergencies. The nurses can't be trained up to cover all emergencies perfectly well and it's not necessarily the capacity, it's also the technology that they have available to them, the tools and the access to particular medicines. And you can't expect them to cover to the degree a doctor would be able to."
Cook Islands Health Secretary Elizabeth Iro says it's not simply a case that having a doctor on each island would take care of business.
She says its about identifying what type of health professionals can best serve the country within budget considerations.
This is Jo O'Brien
