13 Jul 2014

Pacific health problems worsening

8:09 am on 13 July 2014

Poor governance, growing populations and poor health conditions in general are resulting in severe health problems across much of the Pacific.

Making matters worse, healthcare is lacking, with a severe shortage of doctors in the region, and some hospitals are on the brink of collapse.

Most people in most Pacific countries lack access to even the most basic of primary health care, according to the World Health Organisation, and if they do have access, hospitals and clinics are severely under-resourced.

Infant mortality remains stubbornly high, and life expectancies remain low, with the rate of non-communicable diseases being described as a crisis in some countries.

Angau Hospital, Lae, Papua New Guinea

Angau Hospital, Lae, Papua New Guinea Photo: RNZI

Malnutrition widespread

New Zealand-based paediatrician Dr Teuila Percival said severe malnutrition was widespread, and some countries had seen an increase in the problem.

Dr Percival blames widespread poverty, which she said was leading to childhood deaths and stunted growth in children.

"Children who are stunted have survived long enough to actually grow and be measured," she said. "But underneath, you'll have a number of children who die in hospital in the first year of life with malnutrition and diahorrea. It's not surprising."

In Samoa, 72 children have been admitted to hospital suffering the effects of severe malnutrition in the past year, while in Papua New Guinea, one in 13 children will die before they reach the age of five.

Dr Percival said such malnutrition was part of a vicious cycle that left people in the Pacific more vulnerable.

"It tells us about our health system and how it's meeting the needs of populations, particularly children and women; it tells us about the environment in terms of poverty and access to resources to be able to bring children up successfully. It's a huge issue, I think, not just for health but for the countries as a whole," said Dr Percival.

A director at Unicef, Yoka Brandt

A director at Unicef, Yoka Brandt Photo: Supplied

A director at the United Nations children's agency, UNICEF, Yoka Brandt, has recently returned from Solomon Islands where she said she was shocked by some of the poor indicators of health and well-being for children.

"About 33 percent of the children are actually stunted which is the result of chronic under nutrition and things like, for instance, low immunisation rates."

Ms Brandt said she would have expected those indicators to be better.

A technical officer at The World Health Organisation in Suva, Dr Wendy Snowden, said the region was facing a combination of malnutrition and obesity, which she said would create a double burden for the Pacific, and have severe consequences.

Hospitals lack resources

The Melanesian countries, particularly, have ongoing issues with malaria and tuberculosis (TB), and increasing numbers of TB sufferers have a drug-resistant strain.

Low immunisation rates, often poor sanitation and seasonal diseases like dengue fever put extra strain on under-resourced hospitals, which in some countries, are on the brink of collapse.

Hanuabada, the original village of Papua New Guinea's capital city Port Moresby inhabited by the Motuan people; with the CBD in the background.

Living in crowded, unsanitary conditions is putting extra strain on under-resourced hospitals Photo: RNZI / Johnny Blades

In Vanuatu's capital, Port Vila, authorities are working out what to do after Vila Central Hospital managed to blow its annual budget within six months.

Reports suggest consideration is being given to closing the intensive care unit, and doctors and nurses may have to limit their hours of work.

This follows a recent dispute in Vanuatu where some nurses complained that they hadn't been paid in up to a year.

Hospitals in the Marshall Islands, Guam and the Northern Marianas have also hit headlines recently for struggling to stay afloat, while American Samoa's sole hospital was recently put on notice that it faces losing accreditation.

In Papua New Guinea, a group representing doctors says a critical shortage in rural areas is putting peoples' lives at risk.

PNG Society of Rural and Remote Health president David Mills said there was no hard data on the distribution of doctors in PNG, but a vast majority of the country's 89 districts didn't have a resident doctor.

"For those of us who live here in PNG it's unfortunately common knowledge that the vast bulk of the population doesn't have access to meaningful health services and that can mean the most basic of medicines; anti-malarials or antibiotics, there's just no health workers present in the rural places."

Mr Mills said hospitals in the districts were also incredibly basic, with some not even having power or running water, with little or no medical supplies.

PNG's health minister, Michael Malabag, has been recently quoted as saying the country's system was in need of a complete overhaul and had been severely underfunded in previous budgets.

Not enough trained staff

Using mental health in the country as an example, he said that for a country of over 7 million people, there were only six trained specialists in mental health care.

But doctor shortages aren't unique to PNG, Fiji Medical Association president James Fong said skilled, senior physicians were leaving for better opportunities overseas, and junior doctors weren't being properly mentored.

"The main shortage remains at the very senior level, amongst the senior people, senior clinicians. People who have worked a long time and are mature within the system and [who have] the capacity to mentor and supervise the younger ones coming through, that's where most of the limitation is."

However, David Mills said governments, donor countries and NGOs were starting to pay adequate attention to the situation and he was hopeful that things were improving.