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New Insights into Oceania’s Health Challenges

Oceania's Health ChallengesRecent genetic studies of Pacific Islanders are revealing new insights into Oceania’s health challenges. In turn, these insights may drive sustainable solutions that improve community health and save lives.

Convenience-food diets, obesity, lack of resources and the health challenges that result from these conditions are escalating in many island nations in the Pacific. Worse, the resulting non-communicable diseases (NCDs) are leading to an increase in preventable deaths. Activists from many nations are working to better protect many Pacific Island populations from Oceania’s health challenges.

Oceania

Oceania is a group of countries and territories that share a border with the Pacific Ocean. These 14 countries and territories are diverse culturally, economically, geographically and demographically. Oceania includes the large and wealthy countries of Australia and New Zealand and smaller and less affluent countries including Figi, Tonga and Palau.

Vulnerability

Indigenous people in Oceania are more genetically prone to gut issues and certain NCDs that evolved during colonization. While traditionally, Oceania diets were low-energy-density, the introduction of processed foods and more modern snacks brought obesity and linking issues. Before colonization, there was little to no obesity in the Pacific Islands. According to a 2019 study published in Frontiers in Immunology, “During the period of nutritional transition, the people came to consume energy-dense foods imported from Australia and New Zealand.”

The study reports that certain health conditions disproportionately affect specific indigenous populations including the Polynesians in Hawaii, the Maoris in New Zealand, and the Aboriginal and Torres Straits Islanders in Australia compared to non-indigenous people in the same places.  Mortality rates, NCDs and fertility decline are all issues that disproportionately affect these populations. Studying Pacific Islanders’ health data more closely, as this study did, may lead to sustainable solutions.

Environmental factors such as urbanization, sanitation and pathogen exposure also have the potential to increase disease susceptibility. Genetic vulnerability in the form of microbiome genetic mutations and immune function justifies population-specific medical studies and consideration in regards to nutrition. Accessibility and food insecurity have also driven people to foods that are low in nutrition.

Solutions

There are several specific solutions to combat the sharp rise in NCDs in the Pacific Islands. One strategy is better health monitoring. Current medical data surrounding nutrition is almost nonexistent and therefore Pacific Islander nutrition lacks proper evaluation. Increasing data and enhancing research in this area can better inform people about their eating habits.

The George Institute for Global Health, Fiji National University, Sydney University and Deakin University have created the Global Alliance for Chronic Diseases project. This effort hopes to collect data on preventable deaths and possible food policy initiatives for the future. The researchers already found that decreasing salt intake by one gram a day for a year would prevent heart attacks and strokes and save 131 lives a year.

A second strategy is creating a sustainable interest and consumer demand for fresh and healthy foods.  Since COVID-19, Fiji’s Ministry of Agriculture has distributed seeds for people to grow their own food at home. Additional countries could benefit from a program like this as well.

Other strategies include projects and policies that focus on building a stronger market for healthy foods. Finally, the study suggests applying a gender lens to improve Oceania’s health challenges.  While more women are joining the workforce, they continue to play the primary role in caring for and feeding their families.  They do not have the time to prepare complicated meals so they are turning to convenience foods.

World Bank Showcases Oceania Women Leaders

The 2019 genetic study, others like it and the projects mentioned above are setting a trend of focus on the nutritional health of Pacific Islanders. Sustainable change and progress are occurring throughout Oceania. This progress prompted the World Bank to showcase some inspiring women who are starting to implement solutions to Oceania’s health challenges. In Samoa, Lenara Tupa’i-Fui is the assistant CEO of Health Information Technology and Communications at the Somoa Ministry of Health. She is helping lead the Samoan eHealth system that will better track medical records and provide accessible health monitoring and data. As program director of the Partnership of Human Development in Timor-Leste, Armandian Gusmão Amaral advocates for better health care, especially for women and children. She also focuses on mentoring women to pursue careers in the medical profession.

Looking Ahead

Advocating for better data tracking and health communication, increasing the understanding of and demand for healthy foods and applying a gender lens to improving eating habits are all steps that are helping the vulnerable in Oceania take action on their health.

– Karen Krosky
Photo: Flickr

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The Correlation between Poverty and Obesity in Nauru

The Correlation between Poverty and Obesity in NauruObesity may be the farthest topic from anyone’s mind when it comes to poverty, but it has greater relevance in today’s society than expected. The small island country of Nauru is home to little more than 10,000 people; however, the prevalence of obesity in Nauru and obesity-related diseases in that population is one of the most severe in the world. Globally, trends in malnutrition and obesity tightly interlace. While the resulting health issues may differ in their effect, the source is the same: a lack of accessibility. The civilians of Nauru are experiencing a significant lack of access to affordable but healthy food. Consuming highly processed food and not having enough space to grow crops has caused Nauruans to deviate from their traditional diets of seafood and vegetables, leaving the island in the grip of a dangerous obesity epidemic.

However, there are several related factors that also contribute to the health crisis Nauruans face today. While the island originally imported food from Australia and New Zealand, it has now spread farther to the west, such as China and Malaysia. The difference in language is a barrier that prevents the proper interpretation of food labels and consequently presents a hazard in maintaining food safety. Additionally, phosphate mines largely comprise the island, leaving the already small country with even fewer viable means to grow and sustain crops. As a result, the only option for the civilians of Nauru to gain their meals is to rely on cheap Western imports.

Poverty’s Role in Obesity

While Nauru may suffer from similar economic disadvantages as low-and-middle-income countries, its primary challenge is that the most accessible food is extremely detrimental to civilians’ health. Inexpensive, imported food from Western culture is now featured in Nauruan diets, often consisting of instant noodles, white rice and soda. Even worse, the existence of mutton flaps has been pinpointed by health experts as one of the main causes of obesity in the Pacific Islands because of its regular consumption by citizens, but it is still eaten on a regular basis in Nauru.

From a young age, the education system teaches children in Nauru about healthy eating and balanced diets; yet obesity is still a rampant problem. Amy McLennan, an Oxford University anthropologist who spent 11 months in Nauru, noted that “there’s a lot of desire to achieve better health, [but] at the moment, there’s a lack of tools and resources and the environment to do that.” The problem of obesity is an endless cycle that Nauru’s collapsed economy and years of unhealthy practices make difficult to erase.

Health Complications from Nauru’s Obesity Crisis

By assimilating the negative aspects of the Western diet and neglecting proper exercise, an overwhelming majority of Nauruans have seen a decline in their health. The World Health Organization denotes that 75% of all deaths on the Pacific archipelago are the result of diabetes, cardiovascular disease and hypertension. Notably, all of the aforementioned conditions are related to a spike in obesity and high blood pressure. A BMI, or a Body Mass Index, is a range that measures body fat in proportion to height and weight. With Nauru’s average BMI falling around 34, it is above the BMI for an average obese person of 30 which highlights the need to turn around these troubling statistics.

Diabetes, however, is the most prominent of these obesity-risen conditions on the island, a situation that has gotten significantly worse according to Eva, a diabetes care manager in Nauru. Eva asserted in an interview, “I have seen so many funerals for such a small island. So many people are dying at an early age because of diabetes.” The combined effect of unhealthy meals and the absence of exercise has exacerbated the number of diabetes cases on the island.

Awareness about Obesity in Nauru and Solutions

Raising awareness about the obesity epidemic that the Pacific islands have struggled with for many years is important for increasing the well-being of Nauruans’ lives and creating a more stable environment. Although there is a lack of viable land to yield more crops and fresh food, increasing fitness in Nauru will aid in reducing the chances of cardiovascular disease and cases of type 2 diabetes. At a societal level, implementing healthy practices can instill beneficial practices into individuals’ lifestyles in the long run. The food industry also has a significant role in international obesity rates. Addressing these issues and stopping companies that import fatty and greasy foods to developing countries, such as Nauru, is a step toward initiating crucial change.

– Esha Kelkar
Photo: Flickr

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Taiwan Provides Aid to Pacific Nations

 Taiwan Provides Aid
Taiwan provides aid to Pacific nations amid Taiwan and China’s strife over diplomatic ties with nations like Tuvalu, Vanuatu and Fiji. These Pacific nations either align with the Taiwanese-backed Western coalition or the Chinese coalition.

Background

Nations in the Pacific Ocean typically have low GDPs, limited resources and populations below 1 million. As a result, these Pacific nations receive substantial foreign aid every year. Most of this aid comes from Australia. Australia donates to these nations to preserve trade routes and ensure stability and good geopolitics in the region. Taiwan, however, is coming to these developing countries for a different reason. It is battling China for diplomatic ties with these nations.

Taiwan’s foreign aid to this region, while helping the local populace, attempts to gain diplomatic ties from these small Pacific nations that have equal voting power as large forces like China in international organizations like the U.N. The Pacific nations can then vote in favor of resolutions that benefit Taiwan.

China’s Involvement

However, China threatens to upend this mutually beneficial relationship. China has begun its courting process with the Pacific nations to weaken Taiwan diplomatically. China’s Belt and Road Initiative and its infamous debt trap diplomacy are attempting to make a foray into these Pacific nations.

China’s ability to provide much more funding than Taiwan and its strategic scheme to trap developing nations that cannot repay China into debt has caused some of these Pacific nations to flip allegiances. Samoa, Papua New Guinea, Fiji and Tonga are just some of the countries that renounced Taiwanese recognition in favor of the CCP. This partly occurred by China pouring money into significant investments. Even though China clearly has spent much more than Taiwan in philanthropic efforts to Pacific nations, these Chinese funds aim to be more flashy than useful.

Taiwan’s Involvement

Taiwan, on the other hand, provides small but practical aid. Taiwan can still levy ties with these Pacific nations despite the influx of money from the CCP. Taiwanese donations in the region opt for more personable diplomacy. Despite not matching the wealth of China, Taiwan’s local funding that directly impacts citizens is favorable with the people of these Pacific nations.

The Taiwanese plan to directly provide aid to the local people on local projects seems to be working. Palau, the Marshall Islands, Kiribati, Tuvalu, the Solomon Islands and Nauru officially recognize Taiwan rather than China. The U.S., a Taiwanese ally, has recently built a military base in Palau. With the effectiveness of Taiwanese philanthropic aid to fund local projects in Pacific nations, China’s geopolitical goals in the region are in jeopardy.

However, independent non-governmental organizations have not forgotten about the inhabitants of these Pacific nations when the focus has been chiefly on geopolitics. The Pacific Island Association for Non-governmental Organizations (PIANGO) focuses on 22 Pacific nations. It has provided services such as protecting the environment, helping to support trade, supporting democracy and developing society and young people in Pacific nations. Projects like EDF9 Non-State Actors Project in Tuvalu provided funding for education, water and environmental projects. Non-governmental organizations can offer the same aid to Pacific nations as foreign governments do. Weaning off of foreign government aid and supporting non-governmental organizations can help maintain the sovereignty of the people of these Pacific nations. The positive impacts of non-governmental organizations can conclusively support the people of these Pacific nations, consequently protecting these Pacific nations from the unstable geopolitical situation in the region.

– Justin Chan
Photo: Flickr

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New Zealand’s Foreign Aid in the Pacific Islands

New Zealand's Foreign Aid
A small country can have a big impact beyond its borders when it knows what it is doing. While the United State’s foreign aid receives significant attention, some pay considerably less attention to the efforts of nations in uniquely beneficial positions to help, such as New Zealand. Here is some information about New Zealand’s foreign aid.

Unique Location

New Zealand is far from its nearest big neighbors. This relatively small island of about 100,000 square miles and just under 5 million people brought the world the film adaptations of “The Lord of the Rings,” the comic musical duo Flight of the Conchords and what some call the best Sauvignon Blanc wines in the world. Despite a rich cultural impact, New Zealand also has a history of others overlooking it. On a world map or globe, New Zealand should show up to the right and slightly downwind of Australia. Instead, it almost looks like it went the way of the fabled Atlantis, swallowed up by the ocean, vanishing mysteriously without a trace, ready for adventurous archaeologists to make endless documentaries trying and failing to find it.

This modern mapmaking tendency to treat New Zealand like it went the way of the Dodo ended up turning into a tourism campaign that ran the tagline of “Getting New Zealand on the Map.” This happenstance showcases the humor and humility that Kiwis, the nickname for New Zealand citizens after the namesake unique bird, are known for. But while the country is breathtaking in its own right, perhaps its gifted application of focused foreign aid is what will really put New Zealand on the map in years to come.

New Zealand’s Foreign Aid and the Pacific Islands

While remote, New Zealand is not isolated in the sense of its outreach focus and capabilities. The country’s Prime Minister Jacinda Arden has received praise for her empathetic approach to leadership which seems to extend to the foreign policy that her administration enacts. While New Zealand provides aid across many regions including Africa, Latin America, the Middle East and Asia, a particular focus goes to its closest neighbors in the Pacific Islands region. This includes countries known as small island developing States (SIDS) like Fiji, Papua New Guinea and Samoa to name a few.

While undeniably beautiful, many of these islands are extremely remote making it challenging to provide them with a steady flow of viable trade and resources. The situation has worsened in part because the islands have also been among those that tend to experience significant natural disasters and environmental challenges. The UN reported that a fourth of all Pacific Islanders live below what it considers the basic needs poverty line.

This is where New Zealand comes in. As a nation that consistently ranks as having a high quality of life, it is working to provide aid to its fellow islanders. New Zealand is also arguably better equipped to understand the challenges facing island dwellers than larger landlocked nations governments.

The New Zealand Ministry of Foreign Affairs and Trade (MFAT)

According to the New Zealand Ministry of Foreign Affairs and Trade (MFAT) website, its policy acts on the notion that stability in the region surrounding a homeland is crucial for the success and stability of the homeland as well. This type of foreign aid does not intend to be a charity endeavor, but rather an investment that has shown great promise in minimizing and even sidestepping unnecessary conflicts entirely. To that effect, roughly 60% of New Zealand’s Official Development Assistance funds go toward “…shared community interest in the prosperity and stability of the [Pacific] region.” The dollar amount of this contribution is around $1.331 billion and helps the collective efforts of more than 30 government agencies throughout the Pacific region.

MFAT sets criteria and monitors the implementation plans of the countries that receive these funds. The overarching aim of these allocations and efforts is to foster infrastructure and trade development. Like many nations that have significant foreign aid programs, the result is potentially mutually beneficial as new markets emerge in tandem with stable governments and societies. To understand the success of its programs as objectively as possible, MFAT has stated that it uses external evaluators. Such a strategy is one of increased accountability without crossing the line into overbearing and overregulated. MFAT also focuses on humanitarian outreach and disaster relief, again with a specified focus on the Pacific Islands region. It acts as a support rather than a domineering neighbor.

Uniquely Focused Scholarships

New Zealand offers a clever array of scholarships with different beneficial outcomes in mind. Of particular interest are the short-term training scholarships for pacific citizens which provide comprehensive skills training as well as valuable job experience. For those struggling in the Pacific Islands, an opportunity like this can provide them with a relatively quick and practical way to change their lives. An English Language Training for Officials Scholarship is also available to government officials from qualifying African and Asian nations. From workers making a livable wage to those governing entire countries, these educational focuses do well to showcase the different angles in which New Zealand is hoping to foster more stable communities near and far from home.

A Useful Blueprint

New Zealand’s efforts provide a wonderful blueprint that other small, but economically strong nations worldwide could apply. While a greater challenge, the largest developed countries could utilize its strategy in foreign aid practices. If New Zealand’s foreign aid practices show the world anything, it is that insurmountable problems seem more manageable when empathetic eyes view them.

– Jack Leggett III
Photo: Flickr

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Hunger and Malnutrition in New Caledonia

malnutrition in new caledonia
New Caledonia is a French territory off the east coast of Australia. Like many Pacific Island nations, its main food staples include fish, fruit and coconut. While food insecurity is not a prevalent issue in the territory as a whole, food deserts are certainly. Rising food prices drive the poorest citizens — most often, those of the Kanak community (New Caledonia’s indigenous Melanesian population) — to scrounge for their needed caloric intake. Cheap food products sacrifice nutrition for convenience and the prevalence of these food deserts in New Caledonia has prevented the entire population from enjoying the sustenance the island has to offer. These are the factors that are contributing to the problem of malnutrition in New Caledonia.

Growth in Both Prosperity and Food Prices?

Growth stunting and hunger levels are generally low in New Caledonia. However, as food prices rise, it becomes difficult for rural and tribal communities (which have been most affected by the country’s spike in poverty rates) to maintain healthy diets. These increases follow the nation’s growth in prosperity — derived from its lucrative nickel industry and payments from mainland France.

Malnutrition in New Caledonia arises from economic and geographical limitations. Despite how the territory seems to flourish, wealth is unequally distributed. This, in turn, leads to a significant portion of the population struggling with rising food prices. When markets lack competition, sellers can raise the price of goods without the risk of a competitor undercutting them. On top of wealth and wage disparities, the poorest populations in the country cannot afford nutritional food.

A Victim of Geography

Like most islands, New Caledonia operates under the constraints of its remoteness, which involves limited space and a smaller, local market. Food prices are about 33% higher in New Caledonia, with inflation having risen in the territory at a faster rate than it did in France. Those above the poverty line in New Caledonia spend only about a quarter of their income on food. Yet, for the 17% living below it — they might spend more than half of their income on food. In New Caledonia, 85% of adults eat fish at least once a week. Of the total amount fished, 92% is used for subsistence, which leaves the remaining 8% for the market.

While New Caledonia has several great agricultural staples, the reliance on agriculture has been decreasing due to a reduction in available land (as well as the increase of non-agricultural jobs). The distribution of available agricultural land parallels the disparity in wealth distribution and food security concerning the Kanak community and the rest of New Caledonia’s population. The predominantly European-settled Southern Province holds about 22% of New Caledonia’s limited farmland. Meanwhile, the native Kanak Northern Province holds only about 14%.

During 2004–2006, the prevalence of undernourishment in the population was at 9.6%. This rate decreased in the next decade, dropping to 8.2% during 2017–2019. For comparison, the rate of undernourishment in the U.S., one of the wealthiest nations in the world, is less than 2.5%.

Closing the Gaps

While hunger is not an issue for all of its citizens, malnutrition in New Caledonia tends to plague those who receive less of the territory’s wealth as compared with others. As food prices rise, many of those who do not receive proper nutrition fall into the lower-income bracket and thus, below the poverty line. Also, this unfortunately tends to include members of the Kanak community. This wealth disparity (and subsequent nutrition disparity) is exacerbated by lower rates of education and job training within the Kanak communities. This of course results in lower rates of employment among the Kanak. By first bridging the education and employment gap, closures on the wealth and nutritional gaps can then follow.

– Catherine Lin
Photo: Flickr

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Environmental Challenges in the Pacific Islands

Climate Change in the Pacific Islands
The Pacific Islands are a geographical region that the many small islands scattered across Southeast Asia characterize. It contains 15 countries such as Fiji, Kiribati, Marshall Islands, Solomon Islands, Micronesia and more. As such, it is an extremely ecologically diverse area, home to many unique species of plants and animals. However, environmental challenges in the Pacific Islands pose a serious threat to the region, as natural disasters are prevalent. These ongoing natural disasters have destroyed much of the development in the area, leading to the Pacific Island’s long-standing struggle with economic growth as it lags behind its neighboring regions and countries.

Approximately one in four Pacific Islanders live below the poverty line, some of the highest rates of poverty in the world. These pressures have resulted in many people starting local projects to benefit their communities, which end up leading the world in how to adapt to environmental difficulties.

How Natural Disasters Exacerbate Poverty

As environmental challenges in the Pacific Islands continue to worsen, natural disasters have become increasingly common and dangerous. As an island region with some areas just 10 feet above sea level, the Pacific Islands is especially susceptible to the effects of these disasters. Estimates have determined that the region has lost a total of $3.2 billion since the 1950s due to natural disasters alone. As the area must allocate money towards repairing damaged structures and maintaining critical services, less can go to social programs to lift people out of poverty.

Major events like floods, droughts, tropical cyclones and tsunamis plague the region, reversing years of developmental projects like houses, hospitals, schools and more in just a few days. Long-term effects like inconsistent rainfall patterns, rising sea levels and seawater contamination have caused widespread food insecurity, water shortages and forced migration away from flooded or damaged areas. Many of these issues hit those already in poverty the hardest. Impoverished islanders lack the resources necessary for resilience in the face of such natural disasters, perpetuating a cycle of poverty.

Innovations to Deal with Natural Disasters

Native peoples have come up with creative strategies to combat the threat of environmental challenges in the Pacific Islands at the community level. They are driving the world’s innovations to adapt to natural disasters by combining their knowledge of the native flora and fauna with high-tech science to protect their homes and livelihoods. These innovations have taken many forms, ranging from new data models to resilience-building aimed at future-proofing local economies and resources.

Most notably, communities have begun focusing on ecosystem-based adaptation (EbA) in the Pacific Islands. This form of adaptation builds on the idea that healthy ecosystems are naturally resilient to the impacts of natural disasters. It prioritizes strengthening, restoring and sustainably managing damaged ecosystems.

Many areas have begun allocating resources towards the restoration of habitats resilient to natural disasters, such as mangrove and seagrass biomes. Studies that researchers conducted in Lami Town, Fiji have demonstrated that this method is both cheaper and more effective than man-made alternatives, especially for long-term development. As a result, the UN promotes EbA as the top method for adapting to the effects of natural disasters in the Pacific Islands.

Communities across the Pacific Islands have initiated projects to grow native plants along coastlines for their disaster-resistant properties and implemented laws to protect the many nearby marine ecosystems. They have also begun experimenting with drought-resistant crops. These projects have shown to positively affect local ecosystems, as well as benefiting the people’s sense of culture and identity while strengthening local governments and reducing reliance on outside forces.

Some areas struggling with water scarcity have rehabilitated their traditional water wells by adding a vegetation buffer to prevent sediments and pollution from falling into the well. Landowners are also agreeing to share wells during drought season, a concept that people developed and piloted in Oneisomw, Micronesia.

Work Remains

The Pacific islands have also made huge steps in climate-smart development, using the best science available to them to identify and prevent the devastating effects of natural disasters. The Catastrophe Risk Information System (PacRIS) acts as a huge database on where disasters have hit historically, as well as the damage they instigated. This project has grown to focus on urban development, strengthening building codes and making predictions about future disasters and their severity.

Although the Pacific Islands has made great strides in addressing the many effects of natural disasters and environmental conditions to prevent poverty and destruction in their communities, the region still requires imminent international support. The Pacific Islands account for a negligible amount of carbon emissions causing many of these issues. Yet the effects of environmental challenges in the Pacific islands are some of the most catastrophic, while major countries refuse to take action to reduce emissions and provide aid. Despite the large obstacles the Pacific Islands face, there is still hope that the area will be able to maintain its way of life and a reasonable amount of stability with the right tools and resources.

– Elizabeth Lee
Photo: Flickr

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Health Care on Air Delivers Healthcare in the Pacific

Healthcare in the Pacific
The COVID-19 crisis has cemented itself as a problem that all countries in the world must face. Complicating matters is the fact that circumstances surrounding COVID-19 are quite dynamic — changing by the day. As such, experts release new information and studies about the new coronavirus, constantly. Therefore, healthcare workers need to stay informed. For small, proximal nations in the Pacific, this is especially important. Healthcare in the Pacific faces a unique set of challenges. As Fiji’s Hon. Minister for Health and Medical Services, Dr. Ifereimi Waqainabete, says, “The global spread of COVID-19 to countries and territories indicates that ‘a risk somewhere is a risk anywhere’ and as a global village, the increasing incidence of the disease in some countries around the world is a threat to the entire Pacific.”

The Challenge

In many Pacific nations, it is challenging to ensure that all healthcare workers remain updated. “The majority of nurses and midwives in the Pacific are located in remote rural areas and outer islands, which means they often miss out on regular trainings and updates,” says UNICEF Pacific Representative, Sheldon Yett. These remote workers service more than 2 million people in the Pacific.

The Solution

To address this problem regarding healthcare in the Pacific, governments of nations therein have recently collaborated with UNICEF, the U.S., New Zealand and Japan to launch a new program called Health Care on Air. This is the first regional training program of the sort. The United States Agency for International Development (USAID) has invested $1.85 million in this program.

Health Care on Air consists of 33 half-hour-long episodes to be broadcasted on the radio and other communication channels. While standard communication platforms like TV and online training are available in the Pacific — they do not reach all workers. Importantly, radio is the only form of media that reaches every corner of the Pacific. These episodes will teach healthcare workers skills and give them the necessary knowledge to deliver effective services, during the pandemic. In addition to the training sessions, participants will be able to ask questions and share information through UNICEF’s RapidPro platform. Notably, the platform works with free SMS and other smartphone messaging apps.

Project Scope

The project is especially concerned with reducing human-to-human transmission and limiting secondary impacts of COVID-19. Secondary impacts, i.e. the additional burden and expense on healthcare systems caused by COVID-19. Efforts to limit these secondary impacts focus on preparing healthcare centers to quickly adapt to new knowledge and specializations. The focus on reducing transmission and increasing adaptability is key for Pacific Island countries. This is because they cannot handle large-scale infections in the same way that larger, developed countries do.

The first episode aired on July 10, 2020, in Fiji. The program will eventually show in 14 additional countries in the Pacific — including the Cook Islands, Samoa, Federated States of Micronesia, Palau, Tuvalu, Niue, Vanuatu, Solomon Islands, Kiribati, Nauru, Tonga, Republic of Marshall Islands and Tokelau. Notably, more than 5,000 healthcare providers will benefit from this program.

Applying Lessons Learned

In the future, the lessons learned from the Health Care on Air program will be integrated into national nursing accreditation programs as well. While the COVID-19 pandemic is a major world crisis, it is the hope that these new and innovative communication systems will continue to serve communities in the Pacific for years to come.

– Antoinette Fang
Photo: U.S. Indo-Pacific Command

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The Success of Indigenous Healthcare in New Zealand

Indigenous Healthcare in New Zealand
New Zealand has a large population of indigenous people. According to New Zealand’s 2013 Census, 15% of the population are Māori (indigenous New Zealanders), and 7% of the population are Pacific Islanders. Of the five million people who live in New Zealand, 894,546 people identify as Māori or as a Pacific Islander.

New Zealand is recognized around the world for its efforts toward indigenous relations. New Zealand first established a treaty with the Māori people in 1840, to which, over time, all indigenous and Pacific Islander communities have agreed. The treaty outlines that all Māori and Pacific Islander people are to have equal rights and opportunities across New Zealand. It has also allowed New Zealand to provide extensive healthcare to all indigenous people across the country. However, there are persisting health discrepancies between indigenous and non-indigenous New Zealanders.

Indigenous Health Challenges in New Zealand

In 2012, New Zealand reported that across the country, indigenous children aged zero to 15 years old were considered to be in overall good health. The discrepancy in overall health between indigenous and non-indigenous people came to light in adulthood. For instance, Māori and Pacific Islanders have higher rates of diabetes and obesity when compared to non-indigenous New Zealanders, with 44% of Māori people reportedly suffering from obesity.

Another health challenge for indigenous people in New Zealand is the heightened rate of smoking. Māori adults are 2.7 times more likely to smoke than non-indigenous New Zealanders. Additionally, 24% of the Pacific Islander population in New Zealanders are smokers. This is two times higher than the national smoking rate of 12%. The Smoke-Free Organization of New Zealand also reports that adults who smoke are more likely to have poor mental health.

A 2018 health survey found that indigenous people are more likely to experience psychological distress and be diagnosed with a mental health disorder than non-indigenous citizens. It is estimated that around 50% of the Māori population will experience a mental health disorder throughout their lifetimes. Of this 50%, only half will seek professional attention concerning their mental condition. By comparison, non-indigenous people are 25% more likely to receive professional attention for mental disorders than indigenous New Zealanders.

Access to Indigenous Healthcare in New Zealand

There is currently a challenge when it comes to healthcare accessibility for indigenous people in New Zealand. The government reported that only 61% of indigenous patients had their primary healthcare needs fulfilled in 2012. This highlights a large portion of the indigenous population that does not have sufficient access to primary healthcare. For example, many indigenous New Zealanders encounter barriers when seeking after-hours healthcare. In 2012, of the indigenous adults who needed after-hours medical attention, 14% were deterred due to the cost of care.

Indigenous Healthcare Initiatives

Improving indigenous healthcare has been a major focus for the local government. The New Zealand government emphasizes the importance of having accessible Māori health providers. These healthcare providers were first established in 1991 with the aim of increasing the accessibility of healthcare to indigenous people. Māori healthcare providers ensure that patients receive quality primary care with a focus on cultural relations and communication between the government and the local indigenous community.

Another initiative being established to improve indigenous healthcare in New Zealand is the cultural safety education training provided to nurses and midwives. This training places emphasis on the fact that healthcare professionals play a role in a healthcare system with obstacles and barriers that inhibit people from accessing healthcare. The training also ensures that professionals consider the cultural, historical and political context of each patient when providing care.

 

Overall, indigenous healthcare in New Zealand is of a fairly high quality. Despite having some health discrepancies, the New Zealand government has promptly established initiatives to target and improve the health situation for Māori and Pacific Islander people. Countries such as Australia and Canada are currently modeling their own indigenous healthcare initiatives on New Zealand’s due to the success of indigenous healthcare in New Zealand.

– Laura Embry

Photo: Flickr

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How America Helped Cause Obesity in the Pacific Islands

Obesity in the Pacific Islands
Picture this: it’s trivia night, and one question confuses the teams: “What country has the highest rate of obesity in the world?” When the whiteboards come up, the answer “the United States,” floods the guessing pool. The real answer? Nauru, a tiny country in the Pacific Ocean with only 12,704 people. The next nine countries are also all Pacific Island nations – and the problem of obesity in the Pacific Islands is getting out of hand.

Obesity in the Pacific Islands is an epidemic. While Pacific Islanders used to live off traditional island diets – fresh fish and vegetables – the introduction of processed fast food set the countries on a dangerous path of malnutrition. According to the CIA World Factbook, obesity levels are above 45% in all 10 of the Pacific island nations, topping the world’s BMI index. In addition, “about 40 percent of the Pacific island region’s population of 9.7 million has been diagnosed with a noncommunicable disease, notably cardiovascular disease, diabetes and hypertension.” These obesity-related illnesses account for “three quarters of all deaths across the Pacific archipelago.”

How America Plays a Key Role in the Pacific Islands

While the United States ranks number 12 behind Kuwait, the Pacific Islands still dominate the world in obesity rates. However, guessing America to be the world’s most obese nation is not naive; world obesity rates have skyrocketed in recent years due to the mass exports of American diets and products. Worldwide free trade organizations are allowing America to export fast food, sugary sodas and foods rich in high fructose corn syrup to other countries which is causing a “globesity” epidemic.

According to the World Health Organization, “worldwide obesity has nearly tripled since 1975.” This is largely attributed to the invention of high fructose corn syrup, a cheap sweetener that makes foods last for long periods of time. U.S. soda and processed food companies quickly integrated the ingredient into a majority of their recipes due to the high trade costs of real sugar.

In another snowball effect, cheaper ingredients created cheaper products. Therefore, Americans began to buy more processed food, succumbing to a wicked combination of addictiveness and low price. Noticing the high profits from this processed food, the U.S. started to export it to developing countries via various worldwide trading organizations.

A Slippery Slope

As developing countries plagued by the various contributing factors of poverty (most notably major infectious diseases, population density, environmental poverty and lack of fertile agriculture), the Pacific Islands are vulnerable nations. Due to their isolation within Oceania and a lack of economic wealth and resources, these nations are often perfect targets for wealthy nations to sluff off unwanted, cheap and highly profitable products like processed foods.

International trading organizations are often seen as the key to climbing out of poverty in developing nations. Through worldwide trade, Pacific island nations can buy cheap food for their people who struggle so immensely from a lack of food and unsustainable agriculture. While this agreement sounded idyllic, in its unregulated form it has caused these countries to suffer from devastating obesity.

However, the Pacific island nations are now caught between a rock and a hard place with trade organizations. Due to their lack of power and money, they cannot request better food from more powerful countries, and they also cannot afford to pull out of these organizations due to the helpful non-food goods that the organizations give them.

Let’s take Samoa as an example. After WWII, the country’s obesity rates skyrocketed due to “turkey tail” meat sold to them by the United States. This backend of the turkey, after being outed in America for its “fat,” “cholesterol” and “far from nutritious” nature, was shunned by the U.S. and sold to Samoa.

In 2012, the University of Michigan published a report on the problem of obesity in the Pacific Islands.  After eating this fatty turkey for years, many Pacific island nations banned the product in their countries due to the rapid increase in obesity. However, “the bans [were] lifted in order for these nations to join the World Trade Organization.” Samoa is now the eighth most obese country in the world and serves as a perfect example of how poorer countries can sometimes be manipulated for economic growth in richer nations.

Helping Obesity

Combating obesity in the Pacific Islands also becomes difficult after its initial onset. Since healthy food is often not available at cheap prices, in-school nutrition campaigns often do no good when there is no healthy food being offered in the cafeteria. In addition, nutrition labels are often not written in English, the language most widely read and spoken in the Pacific Islands.

However, many Pacific island nations have implemented ways to decrease obesity. Nauru “introduced a 30 percent tax on imported sugar, confectionery, carbonated soft drinks, cordials, flavored milks, sugar-sweetened drink-mix beverages, and high-sugar foods” in 2007. Tonga also places higher taxes on sugary drinks and lowered “import duties” on fresh fish and food goods.

While malnutrition, obesity and diabetic health issues plague the Pacific Islands, taxes on unhealthy foods and potential obesity education programs are looking to aid the situation in Oceania. However, WHO states that “tackling such widespread health problems in the region will require changes in food imports and agricultural policy.” In addition, wealthy countries must aid in systemic change to limit their exports of unhealthy, processed foods in order to combat malnutrition for their trading partners.

– Grace Ganz
Photo: Wikipedia