The UNDP Human Development Index (HDI) rates Fiji as a medium developed country. A series of political coups since Fiji gained independence from the British in 1970 has resulted in poor economic growth, with an estimated 31% of people living below the poverty line (ref HSR, Fiji Bureau of Stats 2010). The overall standard of living is declining, especially in the rural areas (ref HSR). High rates of school drop-out, overseas migration of skilled professionals, rising prices of food imports and chronic underfunding of the health care system all affect the health and well-being of the Fijian nation.
Only 16% of the population lives longer than 50 years. This is in part due to the high rates of non-communicable diseases (NCD) such as diabetes and hypertension. Without adequate primary health care access and education, many cardiovascular risk factors are left unchecked. Alongside the NCD’s there are also high rates of communicable diseases. Skin and soft tissue infections, gastrointestinal and respiratory diseases are common causes of morbidity due to poor sanitation and hygiene often found in remote and rural villages. Outbreaks of typhoid, dengue fever, measles and leptospirosis are also a regular public health concern.
We have found that many Fijians avoid seeking medical help out of fear or mistrust of their health care system. Travel to the nearest town can also be a deterrent for many rural populations, both due to the cost involved as well as poor quality roads making access difficult in rainy season. We therefore work with the Fiji Ministry of Health to bring medical and dental care to the villages where it is most needed.
The most common needs we have encountered during our outreaches are:
• Health education
• Dental care
• Management of cardiovascular risk factors
• Mental health care
• Skin and soft tissue infections
• Eye care
Some statistics for Fiji:
Life expectancy: 69
Adult mortality rate (probability of dying between 15-60 years):
Male 242 (global 187), Female 146 (global 124)
Child mortality rate: 22 (global 48) = fairly good child health and maternal services, but still nowhere near achieving Millennium Development Goals
Adult health: neglected (2x to 3x compared with NZ/Aus)
Expenditure on health per capita: less than 150$, regional average >700$
80% of deaths due to NCD: high rates of high blood pressure (29%), diabetes (16%), obesity (31%), cancer
Squatter settlements now 200, over 100 000 people
Rural water supplies built during colonial period now deteriorating