Jul 05, 2020 Last Updated 11:48 AM, Jul 5, 2020

The Pacific’s response to the COVID-19 outbreak is likely to lead to increased scrutiny of health budgets and investments in our region.

However first there are the very pressing questions of how to scale up response in individual countries and territories, best leverage regional expertise and cooperation, maintain public health messaging that is relevant to Pacific communities, and prepare for second and subsequent waves of infection.

When Islands Business first interviewed Sunia Soakai, the Deputy Director, Public Health Division, at the Pacific Community, only five countries had COVID-19 testing capabilities: Fiji, French Polynesia, New Caledonia, Guam and Papua New Guinea. Since then other Pacific locations have come online. Palau has begun random testing with equipment donated by Taiwan. American Samoa is doing limited local testing, while still sending samples to Hawaii. The Northern Marianas has taken delivery of kits from a South Korean manufacturer, and its government aims to test every resident.

The most efficient way of facilitating local testing in our region, says Soakai, is to use custom-made cartridges in machines already in place for TB testing. The joint Incident Management Team of which SPC is a member (see p13) has placed orders for the cartridges and the consumables that go with them.

“No firm date has been set by the manufacturer [for delivery]” Soakai says, “but given that the Pacific is a region that has limited capacity, WHO and UNICEF have provided their support and the manufacturer has agreed to provide priority for the Pacific.”

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The deadly measles outbreak currently spreading through the Pacific is exacting a great human, and likely significant economic cost. At least 60 children and one adult in Samoa have died from measles or its complications according to the National Emergency Coordination Centre.

A State of Emergency was declared in Samoa on November 15.

The outbreak traces its origins to New Zealand. Samoa has closed all schools as well as its only university. Graduation ceremonies were cancelled and preschools, day care centres and outpatient clinics at hospitals have been closed.

In declaring the State of Emergency, Acting Prime Minister Faimalotoa Kika Stowers-Ah Kau announced that measles, mumps and rubella (MMR) vaccines are now mandatory and that children

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Talking about a revolution

The secrets of combatting noncommunicable diseases in our countries can be found in our Pacific Islands food cultures says Kiwi chef Robert Oliver on the eve of his new show, the Pacific Island Food Revolution.

Oliver has long been an advocate for traditional Pacific foods. His earlier tv series and cookbook explored how tourism and hotel menus could become “the business plan of a nation”, more truly reflecting Pacific diversity and values.

Now Oliver and his fellow Pacific Food Warriors have health in their sights through the new reality television series.

“We have four countries, Fiji, Tonga, Vanuatu and Samoa, and in each country we do two episodes. We begin with three teams in each country and throughout the episodes there is one team left…We’ve made our challenges address particular issues. So there is one in Fiji called greens because Fiji has these insanely high rates of anaemia, but you walk into Suva market and there are greens everywhere. In Samoa there is one called ‘colour of the rainbow’ which is around putting many colours on your plate, because colours indicate nutrients and we had the Fa’afafine community, because they’ve done work with the Ministry of Health in Samoa, to help socialise that awareness. And in Tonga there was one around Royal food, because there was a tradition of Royal food that was high status, so we created that to give Tongan food the same status that Royal food implies. My co-host in Tonga was her Royal Highness [Princess Royal Salote Mafile’o Pilolevu Tuita] so she really helped with that.”

Oliver says in the modern Pacific, many people opt to farm and fish, and then sell their expensive crabs, healthy fresh fish and farm produce in order to buy cheap tinned-fish and other processed food in the supermarket.

“We live in paradise and do not need foreign intervention to help us change, but rather can adopt the Pacific food culture to fight NCDs,” he says. 

He says people eat junk food because it is convenient and cheap. “The cup of soup noodles is almost a benchmark for convenience and cost. They’re super cheap, they’re super easy but fundamentally, if you live on them you die. It just comes down to that…but you have to understand the real cost and one of the challenges of what we do is how do you say that without scaring people and putting people off.”

UNICEF Representative for Pacific Island Countries, Sheldon Yett, agrees. “People go to the lowest common denominator, salty noodles are cheap, they are available, they are heavily marketed, and people get addicted. Salt and sugar are addictive, that’s a tremendous challenge we have. We have to change habits, we have to change behaviour, that is not something that is done overnight. It’s done with constant reassessment and reinforcement and by those who influence people’s lives every day and that’s something we’re trying to do here.”

UNICEF is involved in the Pacific Island Food Revolution program through the “First 1000 days” challenge, and UNICEF Ambassador and Tongan Olympian, Pita Taufatofua co-hosts that episode. Yett says while NCDs are a huge and growing problem in the Pacific, so is stunting.

“A third of the population in the Pacific has a problem with stunting, that’s huge. That means that they are too short for their height. That’s because of nutrition and the interplay with their environment, it’s not because of their genes. So we are working to ensure that first of all, governments understand this, and that polices are in place. It’s really the first thousand days of a child’s life that are so important and that interventions have to be made, because after that, it’s irreversible. We are working to ensure that exclusive breast feeding is in place for the first six months, that pregnant mothers get access to good nutrition, [and] that babies have access to good nutrition and that does not include Coca Cola or juice.”

“We really need to engage people, we need to find a way to get some basic information to the communities, to individuals, to mothers to fathers, people in kitchens and we thought this avenue [the Pacific Island Food Revolution] is the perfect way of doing it,” Yett says. “Unlike other areas where stunting and malnutrition is a problem, there is no shortage of protein here, you are surrounded by it, and we want to make sure that people
go back to their roots and harness the proteins, the vitamins and the nutrients that are surrounding them and we want to do it in a way that cuts through, an entertaining way and also an informative and scientifically correct way, and we thought this is the perfect linkage.”

Apart from the reality television series (which Oliver describes as “like My Kitchen Rules but more warm-heated and filled with Pacific heritage and humour), the Pacific Island Food Revolution will also use the power of radio and social media to turn a mirror on the Pacific and show that eating fresh, local indigenous foods is the answer to good health.

“We do not want the show to be end of the story, it is the just the beginning,” Oliver says. “Behavioural change takes around eight years…We’ve been quite realistic, we’re not looking to have a dent in the health numbers for the first couple of years, it’s just ‘have we got people engaged and have we developed something that people want to be a part of?’ ”

  • For the full interview with Robert Oliver visit www.islandsbusiness.


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LATE detection and late presentation contribute to the high number of women who die from cervical cancer in the Pacific each year.

The HPV Information Centre reports that an estimated 1,268 Pacific Island women died from cervical cancer last year. The rate of diagnosis and death is highest in Melanesia, followed by Polynesia and Micronesia.

“The fact that it is curable and yet still able to claim a lot of lives in Fiji, across the region and all around the world is really saddening,” said Pacific Society of Reproductive Health President, Dr Pushpa Nusair.

In Fiji, cervical cancer is the third main cause of mortality in women; the leading cause of cancer death among reproductive women; and the leading cause of mortality in all cancer types.

“The biggest problem that we have in Fiji and in all the Pacific is that women tend to present us in the very latest stages where we cannot do very much for them,” said Dr Nusair.

She said by that time, medical officers can only offer patients palliative care. 

Prevention and treatment of cervical cancer has been a stated priority of the Pacific Islands Forum for several years. Forum Secretary-General Dame Meg Taylor has called it development issue, “albeit largely perceived as a women’s reproductive health issue.”

The World Health Organisation recommends vaccination against the cervical-cancer causing human papillomavirus (HPV) should be included in national immunisation programs, initially targeting girls 9-14 years of age, before extending to 9-18 years.

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AT least 747 new cases of people living with the Human Immunodeficiency Virus (HIV) have been diagnosed in Fiji since February last year. Jokapeci Tuberi, Regional Coordinator for HIV Stigma Index of the Fiji Network of People Living with HIV (FJN+1) says the number is expected to increase once the updated record is release from the Fiji Ministry of Health.

“With more aggressive public awareness and prevention campaigns, more people are coming out to have their status known to the public,” Tuberi said. From the month of January to October 2016, Fiji has a total of 43 newly-diagnosed HIV positive cases.

That is an average of more than four cases per month. There was also an increase in the number of new HIV infections, particularly among those between the ages of 19 and 29.

An overview report of People Living with HIV Stigma Index Study in seven countries in the Pacific indicated that Kiribati has 28 cases of people living with HIV, Samoa has 11, Federated States of Micronesia 9, Marshall Islands 8, Vanuatu 6, Palau 5 and Tonga 2. Tuberi said HIV cases in Kiribati was high because of the number of foreign fishing vessels that call on the island.

The report also found that people living with HIV in the Pacific Islands are experiencing high levels of stigma and discrimination, resulting in social exclusion and hindering access to basic social services including health care.

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