Common Diseases in KiribatiKiribati is a small island country in the central Pacific. The people of Kiribati have a positive outlook on life, despite the fact that many factors such as a lack of sanitation, overcrowding, high unemployment and environmental threats have led to 22 percent of the population living without basic needs.

The Ministry of Health in Kiribati provides free hospital services and public health and nursing services on the island and tries to focus on disease prevention and education. Yet, the persistence of urban poverty, climate change and poor water quality have led to a nearly constant influx of disease on the island.

Diarrheal Disease
Diarrheal outbreaks are common diseases in Kiribati for a few reasons. One of the most prevalent sources of diarrhea is dirty water. One in 20 infants dies before their first birthday in Kiribati from drinking unclean water. Some other causes of diarrheal disease are poor food handling and public defecation due to overcrowding.

Malnutrition
There are three different types of malnutrition: wasting (low weight for height), stunting (low height for age) and underweight (low weight for age). The most common type of malnutrition in Kiribati is stunting. Malnutrition not only reduces quality of life but also contributes greatly to infant mortality, weak immune systems and mortality in general.

Dengue Fever and Chikungunya Virus
Two other common diseases in Kiribati are dengue fever and chikungunya, both of which are viruses transmitted through the Aedes aegypti and Aedes albopictus mosquitoes. In 2015, it was reported that more than 12,000 people have been infected with mosquito-borne illnesses.

Ciguatera Poisoning
Ciguatera poisoning comes from consuming reef fish that have been contaminated by ciguatoxins, or marine biotoxins that cause food intoxication. The toxins can cause a wide range of neurological, gastrointestinal and cardiovascular symptoms. According to research, the toxins mainly develop in shallow waters that contain seaweed, sediments and dead coral. Thus, it is possible that low sea levels and surface water temperatures are contributing to the poisoning.

Lifestyle Disease
Some of the most common diseases in Kiribati are those that stem from certain lifestyle habits or behaviors. Diseases of this kind include HIV and other sexually transmitted infections, cardiovascular disease, respiratory disease and diabetes. The prevalence of HIV and STIs are due to a lack of sexual education. Cardiovascular disease and diabetes are most often associated with physical inactivity and poor eating habits. Tobacco use also contributes to respiratory disease and cancers.

Kiribati is working with the World Health Organization (WHO) on a national development plan for the 2016-2019 period that includes operational plans for the Ministry of Health and Medical Services. Immediate goals include reducing the risk of non-communicable diseases, improving maternal and child health, preventing the spread of communicable diseases and strengthening health service delivery.

Awareness and prevention of communicable disease will be key to implementing this plan. With the intervention of WHO, Kiribati has made strides in providing cost-effective, quality health services and preventing disease.

Madeline Boeding

Photo: Flickr

Kiribati Refugees
Climate change will drive migration on a massive scale in the coming years. Estimates of people fleeing natural disasters range from 25 million to 1 billion. The small island nation of Kiribati in the Pacific will be extinct by 2100. The government is trying to help the Kiribati refugees migrate with dignity, but their legal status is still in limbo.

    1. Most of the land of the Kiribati islands is less than two meters above sea level. It is therefore very vulnerable to rising sea levels due to climate change. Its residents may have to be the first climate change refugees.
    2. In 1999, two islands disappeared underwater. The nation is made up of 33 small islands, whose land is being swallowed by the ocean at a rate of almost 4 millimeters a year. According to the U.N., the entire nation will be submerged by 2100.
    3. Even before this drastic event occurs, changes in weather patterns are likely to produce Kiribati refugees. Droughts are becoming more severe, whilst rainfall is increasing, causing flooding. The oceans are acidifying, disturbing the delicate balance of coral reefs, whose marine ecosystems are the source of many people’s livelihoods.
    4. Freshwater supply is also problematic, as saltwater from high ocean tides is polluting wells and prolonged droughts are pushing water supplies to their limits. Many residents of South Tarawa, the island housing half of the country’s 100,000 people, are now completely reliant on rainwater.

  1. In 2003, the Kiribati government cooperated with the World Bank in the $17.7million Kiribati Adaptation Program. They built coastal sea walls, planted mangroves on the shores, developed water-management plans and invested in rainwater harvesting infrastructure, to postpone the effects of the rising ocean. The project has managed to protect one of 710 miles of Kiribati’s coastline.
  2. The former president, Anote Tong, started the “Migration with Dignity” program to ensure the Kiribati refugees will move to other states with dignity. The government has increased the level of qualifications available to citizens to those of Australia and New Zealand so that they are employable.
  3. The former president also bought 6,000 acres of land in Fiji, an island nation more than 1,000 miles away. This will act as a refuge for any Kiribati residents who will need to relocate.
  4. A Kiribati citizen applied for asylum in New Zealand in 2011. Four years later he was rejected and deported back to his sinking homeland.
  5. The 1951 Refugee Convention defines refugees as those “fleeing persecution at home.” As such, the Kiribati refugees are not protected by international law. “The truth is no one agency in the system because no one could have imagined this situation 60 years ago,” said José Riera, a senior advisor to the U.N. High Commission for Refugees.
  6. The Paris Agreement signed this past April does little to help climate change refugees. It didn’t resolve the issue of their legal status or mandate their protection.

It is hopeful that with the help of the government and international aid, each refugee, resident and the overall island will be preserved.

Eliza Gkritsi

Photo: Flickr

Top Diseases in KiribatiKiribati is stricken with a hefty mix of diseases that are communicable and non-communicable. The top diseases in Kiribati resulting in death are circulatory, parasitic, nutritional and metabolic disorders. The leading causes of health complications are fungal, respiratory and diarrheal infections.

Life expectancy in Kiribati is the second lowest in the Pacific, with females at 69 years and males at 64 years. Factors contributing to Kiribati’s increased burden of disease are overcrowding, poor hygiene, inadequate sanitation, insufficient immunization coverage, as well as a lack of care and supplies for maternal/neonatal health.

Water-borne illnesses are among the top diseases in Kiribati. The primary infections being diarrhea, dysentery, conjunctivitis, rotavirus, giardia and fungal. These diseases are most threatening to children, causing 60 deaths per 1,000 live births in children under five.

The prevalence of water-borne illness plagues Kiribati mostly due to sanitation issues. Unfortunately, unsafe water is only part of the problem, improper food handling and the continued sale and consumption of expired foods only adds to the cycle of parasitic diseases.

Once a contagious disease has planted itself on the island, it becomes hard to contain because of the high density living arrangements of most communities. For example, Kiribati is one of only four countries in the world that still has leprosy, the number of contractions reaching 180 last year in 2015.

Tuberculosis (TB) is another top disease in Kiribati. TB remains rampant in Kiribati because it is easily spread and can remain dormant for long periods of time. However, disease begets disease. A burdened immune system makes it harder to prevent and treat other diseases. Not surprisingly, the magnitude of diabetes in Kiribati contributes largely to the continued occurrence of TB.

Lifestyle choices, or ignorance of health, feeds the expansion of diabetes, making it one of the top diseases in Kiribati. The majority of I-Kiribati fit into a profile at high risk for diabetes: high blood pressure, obesity, lack of exercise, poor nutrition and smoking. Already, 25% of the adult population is receiving treatment for diabetes or pre-diabetes, with numbers growing each year.

Smoking and diabetes are a deadly combination progressing towards a failing circulatory system, resulting in limb amputation and other disabilities. The rate of amputation in Kiribati is increasing at an alarming rate. In 2014, there were 136 amputations, nearly doubling that of the previous year.

Tobacco consumption is a risk factor for diabetes, but smoking also carries its own army of diseases such as respiratory infections, stroke, cancers and circulatory problems. Kiribati’s tobacco consumption is the highest in the South Pacific as 61.5% of its population smoke.

Like with combating most diseases, the key to success in ending the cycle of disease in Kiribati is awareness and prevention. The government of Kiribati, along with support from the World Health Organization have implemented plans to heighten the awareness of communicable and non-communicable diseases.

The goals for these programs are to reinforce good hygiene, improve water sanitation services, increase standard immunizations, educate citizens on the harmful effects of smoking, as well as informing them on the benefits of exercise and good nutrition. As awareness spreads and prevention occurs, there will be a decline in top diseases in Kiribati.

Amy Whitman

Photo: Flickr

International Aid for Small Island States - The Borgen Project
The International Panel on Climate Change, or IPCC estimates a one meter sea level rise if global temperatures increase by four degrees Celsius. This could happen by the year 2100 and would render the small island nations of Kiribati, Maldives, Marshall Islands and Tuvalu uninhabitable.

The dire situation of low-lying island states has prompted the World Bank Group to announce a Small Island States Resilience Initiative. The Initiative was prompted by the outspoken leaders of the island states who have asked the world for assistance.

“As some of the most threatened people and places on the planet, small island nations are stepping up their efforts to deal with climate change. This Initiative is designed to address the specific needs of small islands and make it easier, faster and simpler to access funding to deal with resilience and climate change,” explains Rachel Kyte, WBG vice president and Special Envoy for Climate Change.

The WBG will also increase its aid to the island states to $190 million from $145 million per year.

Small island developing states have realized that they do not have it within their capacity to prepare themselves for the impending rise in sea level. The increased aid from the World Bank will help preserve the diverse culture, ecosystems and indigenous knowledge that the SIDS hold.

The World Bank Group is not the only organization that recognizes the importance and need of the Small island developing states: many various organizations have donated to projects focused on climate and disaster resilience. However, instead of helping, this has served to overburden the government. Samoa has to manage 14 different projects, while the Solomon Islands is struggling under the load of 22.

“Our hope is that this Initiative will help pool donor resources available now, reduce transaction costs, allow for economies of scale across countries, and above all, lay the ground work for direct country access to global climate fund,” said Kyte.

— Julianne O’Connor

Sources: World Bank, The Guardian
Photo: WordPress

kiribati
One of the many effects of climate change concerns the rising of the world’s oceans. As both climate scientists and one country’s president realize, Kiribati, a low-lying nation in the Pacific Ocean, will likely become non-existent within the upcoming decades.

Kiribati is home to some 100,000 people. Located in the Pacific Ocean between Australia and Hawaii, it consists of 33 small islands and atolls scattered over an area the size of India.

On average, the nation loses 3.7 millimeters of land a year due to rising water. President Anote Tong said the country could be completely uninhabitable within less than 60 years.

In fact, the county has already purchased nearly 6,000 acres of land in Fiji to address economic and food security issues. The government said in a May press release that the land is “an investment by the government to explore options of commercial, industrial and agricultural undertakings.”

Since 1880, global sea levels have risen nearly 10 inches. By the end of the century, scientists believe the seas could rise nearly three feet.

One of the islands in the country is Tarawa, known by most of the world as a World War II battle site among the Japanese and Americans. Because so much of the population lives on top of the island’s main water lens, where fresh drinking water lies, it is difficult for the island’s inhabitants to find a place to defecate. Health officials estimate that nearly 60 percent of Tarawa residents defecate outdoors.

Since the nation may soon be completely submerged, the government has found it difficult to find any substantial investors. In fact, the U.S. does not have an ambassador for the country. Instead, the U.S. ambassador of Fiji also serves Kiribati, Nauru, Tonga and Tuvalu.

Moreover, for the Kiribati residents who may choose to evacuate the country in the coming years, the situation may become difficult.

In the past, New Zealand permitted 75 Kiribati citizens into the country each year so long as they met the necessary visa requirements. However, the country recently ruled against a Kiribati man who requested to become a refugee in the country on the grounds of climate change.

Yet, much of the country is increasingly skeptic of climate change due to religious purposes. In a census several years ago accounting for over 90,000 Kiribati citizens, only 23 stated they did not follow a religious practice.

In an interview conducted with Businessweek, Tong said the Western world has not focused enough attention on effects of rising oceans and climate change.

“Ecoterrorism is equal to terrorism,” he said. “This is a kind of terrorism that is more dangerous in one way, because it is treated as legitimate and acceptable. Maybe 10 years ago, they didn’t know what they were doing. But it’s not an excuse any longer.”

– Ethan Safran

Sources: Net Nebraska, Business Week, NPR, NY Times, Kiribati Climate Change
Photo: Net Nebraska