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7 Facts About Healthcare in Tokelau

healthcare in tokelauThe dependent territory of New Zealand, Tokelau, lies in the Pacific Ocean. It consists of three atolls, or islands made up of coral: Atafu, Nukunonu and Fakaofo. Tokelau has the world’s smallest economy, with an annual GDP per capita of $6,275 and a population of only 1,500 people. A lack of human resources and considerable financial constraints severely limit the Department of Health in Tokelau in addressing the population’s healthcare needs. Here are seven facts about healthcare in Tokelau.

7 Facts About Healthcare in Tokelau

  1. Population health: Tokelau’s central health issues are non-communicable diseases (NCDs), especially cerebrovascular and cardiovascular diseases. From 2007 to 2010, cardiovascular diseases in Tokelau had a mortality rate of 17%. Aside from viruses, other principal causes of death in Tokelau include old age, neoplasms (unusual growth of body tissue) and accidental death, often the result of trauma. Because of minimal amounts of physical activity, about 75% of Tokelauns are obese, and close to 50% of Tokelauans smoke daily.
  2. Hospital access: Each of the three atolls has one hospital. Every hospital has some medical and diagnostic equipment available for use, along with 12 beds. However, the hospitals lack some basic technology, like x-ray machines.
  3. Lack of healthcare workers: As of October 2012, there were only 37 healthcare workers across all three atolls. Each hospital has one medical officer, four to five nurses, four to five nurses’ aides and a porter. Healthcare in Tokelau suffers from a lack of doctors and specialized professionals in particular.
  4. Lack of secondary and tertiary care: While the three hospitals can provide some level of care for their patients, they cannot afford specialized employees and more intensive treatment. NCDs, the primary healthcare needs faced by Tokelauans, require intensive care. Currently, patients requiring such services go offshore to either Samoa or, in more critical cases, New Zealand.
  5. Funding: A combination of grant money from New Zealand, local revenue and international aid funds healthcare in Tokelau. However, the budget for healthcare is insufficient. Tokelau relies on aid from international organizations because it still lacks the means to invest in healthcare infrastructure on a large scale.
  6. Lack of transportation: Healthcare in Tokelau also lacks an inter-atoll transportation system. This creates a decentralized hospital system, with three separate hospitals. Climate change and natural disasters further strain healthcare in Tokelau.
  7. High life expectancy: Despite its unique challenges, Tokelau has worked to improve its healthcare system. Tokelauans have a reasonably high life expectancy rate compared to other countries in the Pacific region. In addition, Tokelau does not have high maternal or infant mortality rates.

Tokelau Health Strategic Plan 2016-2020

In August 2016, Tokelau launched a new initiative to better its healthcare infrastructure, called the Tokelau Health Strategic Plan. This plan has three parts: short-term goals in 2016 to 2018, intermediate goals from 2018 to 2020, and long-term goals for 2020 and beyond. Furthermore, Tokelau’s healthcare plan has created four key ideas to help guide the country’s healthcare initiatives. These ideas are developing healthcare infrastructure, improving general public health, improving governance of healthcare services and creating better clinical services for the island’s population.

The most important aspect of the plan is the construction of a National Referral Hospital in Nukunonu, the largest of the three atolls. With the creation of the new National Referral Hospital, Tokelau would be able to alleviate the issues caused by its decentralized healthcare system.

The World Health Organization (WHO) has been working in conjunction with the Tokelau government to see this plan through. WHO outlined these priorities to oversee the advancement of Tokelau’s healthcare:

  1. Monitor the healthcare situation in Tokelau and develop strategies that would work in tandem with Tokelau’s healthcare strategies.
  2. Monitor NCDs, improve treatment regulations and care for patients and increase access to medication.
  3. Develop healthcare infrastructure to minimize tobacco use in Tokelau and implement strategies to strengthen immunization.

Tokelau faces many challenges ahead as it looks to improve its healthcare system. The majority of these challenges come from a lack of economic means and a decentralized healthcare system. However, with international aid and the healthcare plan, the government can work to improve healthcare for all of its citizens’ benefit.

– Anushka Somani
Photo: Flickr

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Top 10 Facts About Living Conditions in Tokelau

Top 10 Facts About Living Conditions in Tokelau
Tokelau, a country between Hawaii and New Zealand, consists of three coral atolls and is home to a population of approximately 1,500 inhabitants. Here are the top 10 facts about living conditions in Tokelau.

Top 10 Facts About Living Conditions in Tokelau

  1. Tokelau’s culture, maintained through civil unification and tradition, emphasizes language, arts, song and dance. There exists a strong sense of social unity in terms of care and protection among Tokelau’s people.
  2. The coral atolls which make up this Oceanian nation are a mere one to five meters above the sea level. As such, the global rise in seawater levels is a significant threat to the preservation of Tokelauan lands. As a part of the Tokelau Emergency Plan, the country has tasked villages with the construction and upkeep of seawalls to protect from flooding.
  3. Emigration to New Zealand, where Tokelauans can travel without restriction, has been largely common among the population since 1962. Additional communities of Tokelauans exist in Samoa and Australia.
  4. Poor soil quality on the atolls largely restricts the expansion of Tokelau’s agricultural economy. Tokelau successfully cultivates only a handful of tropical crops, including bananas and coconut. Since 2011, the Food and Agriculture Organization of the United Nations (FAO) has assisted Tokelau on how to plan efficient land use to improve agriculture practices.
  5. The main source of animal protein in the atolls comes from fisheries located in the reefs and deep ocean. Additionally, the fisheries account for the majority of Tokelau’s annual income.
  6. The long-term health of the Tokelauan people has decreased over generations thus prompting the implementation of public health programs. This worsening health is due to an increase in noncommunicable diseases, particularly obesity. Despite this, the life expectancy in Tokelau, 69.1 years, is of the highest among small pacific locations.
  7. For international and inter-atoll travel, the people of Tokelau are limited to sea travel by the government ship, Mataliki. The ship travels to Tokelau every two weeks unless cases of medical or environmental emergencies disrupt the schedule. In the event that something disrupts the ship’s schedule, travelers must remain at their current locations until transit resumes.
  8. The 400 students living in Tokelau study in one of three schools, one on each atoll. The schools offer education from early childhood to year 13 with emphasis on Tokelau language, English, math, social sciences and science.
  9. Tokelau natives depend on solar panels for almost all electrical needs. In 2013, Tokelau became the first nation to go 100 percent solar. A reduced number of diesel generators remain as a contingency plan, though.
  10. Tokelauans do not currently have an established cell phone network available for use but landline installation is possible among households. Additionally, in 2017, Tokelau introduced a 4G broadband internet network to improve communication efforts. Education, health, commerce and transportation services have also been able to utilize the network for further efficiency.

As a result of Tokelau’s diminutive size and remoteness, the people of Tokelau live in accordingly interdependent communities. Extreme tropical weather and the effects of rising sea levels present challenges to life in the atolls. As a result, Tokelau has implemented plans for sustainability and preventative measures for emergencies to combat these issues. Recent advances in public services facilitate efforts to modernize the nation. As demonstrated by the top 10 facts about living conditions in Tokelau, the country and its people plan only to prosper.

– Bhavya Girotra
Photo: Wikipedia Commons

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8 Facts About Education in Tokelau

8 Facts About Education in Tokelau
Over the past half-century, the island of Tokelau has struggled with sustainable education due to its remote location. However, in recent years, its educational system has experienced tremendous growth and the government is overseeing its continued improvement. Listed below are 8 facts about education in Tokelau and their implications.

8 Facts About Education in Tokelau

  1. The island is divided into three atolls. According to the 2016 census, Tokelau has a total population of 1,499 people, which is fairly evenly distributed amongst the three atolls. There is one school in each atoll for a total of three schools on the island. Each encompasses primary, secondary and post-secondary levels of education from ECE to year 13. The total student population across the three schools is just over 400.

  2. The official language of study is Tokelaun but students must also learn English as a foreign language. From year three, schools introduce English into the curriculum for 20 percent of the school time; at year four, schools increase English to 30 percent of the time; year five to 40 percent; and year six to 50 percent. From year six to year 11, the curriculum consists of the preparation, teaching and assessment of students at 50 percent English and 50 percent Tokelauan. Around 45 percent of Tokelauns aged 15 years or over reported having good or very good English reading skills, whereas only nine percent of Tokelauans aged 75 or above reported this, indicating an increase in bilingualism among residents through the years.

  3. The village councils or the Taupalegas run the schools. In 2010, the average student-teacher ratio was about 17 to one. The Education Department oversees the development of schools, training of teachers and scheduling of the annual National Scholarship Examination. The examination decides which students are eligible for the Tokelau Scholarship Scheme. The government developed this program to grant scholarships to the top 10 performing students so they could pursue higher education abroad. The scholarships require the recipients to return to Tokelau upon completion of their studies abroad so that they may apply their skills toward the country’s development.

  4. Up until 2008, schools did not offer senior secondary education Tokelau. Students who wished to pursue education beyond year 11 had to study abroad. A primary goal of the Education Department was to implement year 12 and year 13 learning programs on the island. Tokelau achieved this in 2008 through the Senior Secondary Education Programme which established year 12 in each school and then year 13 in each school in 2009. This has resulted in an increasing number of students eligible and with the necessary prerequisites to access undergraduate tertiary studies.

  5. According to UNESCO, the educational system faces many challenges due to the island’s isolated nature, rendering transport and telecommunication services unreliable. Consequently, there has been poor school leadership and a shortage of qualified/certified teaching staff. A majority of the teaching staff are women with family responsibilities and the expense and inconvenience of travel make attending off-atoll training services difficult.

  6. From 2000 to 2010, the government of Tokelau has worked with the Volunteer Service Abroad Program (VSA) to combat challenges of the educational system. VSA sent 26 New Zealand volunteers undertaking 28 assignments. Volunteers on each atoll trained and recruited volunteer teachers for specifically requested subjects that local teachers lacked the teaching qualifications and experience to provide. There was strong evidence that suggested that the government built and strengthened the capacity of the schools. However, a number of factors including the structure and governance of the Tokelau Education system, uncertain leadership and unmotivated staff inhibited this.

  7. In 2011, the Department of Education implemented reforms to address the issue of poorly qualified personnel, implementing regular Principal Professional Development to improve school leadership and on-atoll pre-service teacher DFL training courses for the teaching staff. The Government currently funds up to four pre-service teacher trainees for each village enrolled through a DFL University of the South Pacific undergraduate program. Tokelau aims to have 80 percent of all primary school teachers with relevant qualifications. Effective school leadership through good management and governance structures and processes has also improved student achievement.

  8. In 2011, males were more likely to have completed secondary school than females, but in 2016, this gender gap had decreased from five percent down to less than two percent. One can attribute the decrease in gender disparity to the growing role of the women’s committee referred to in Tokelau as the Fatupaepae. The Fatupaepae is one of the three in community-based organizations (CBOs) that contribute to the well being of the community.

These 8 facts about education in Tokelau illustrate its tremendous progress in the past half-century. Education in Tokelau continues to progress, particularly as the Department of Education combats the island’s challenges of accessibility. These 8 facts about education in Tokelau show that the country is working to ensure that the educational needs of its residents are being fulfilled.

– Bradley Hu
Photo: Flickr

Causes of Poverty in Tokelau

Causes of Poverty in Tokelau

Despite being predominantly known as a lower-middle-income nation, Tokelau still has higher incomes than any other Polynesian country. However, the causes of poverty in Tokelau have impacted the standard of life on the island. These causes include extreme isolation, limited natural resources, depopulation and the island’s proneness to natural disasters.

Tokelau is a Polynesian state composed of three atolls: Atafu, Nukunonu, and Fakaofo, located about halfway between Hawaii and New Zealand in the Central Pacific Ocean. Tokelau is known to be politically associated with New Zealand. What this means is that Tokelau heavily depends on New Zealand to receive aid and remittances. According to Oxfam International, the island constitutes the smallest economy of any country in the world. This extreme isolation from the rest of the world is one of the causes of poverty in Tokelau.

Oxfam International showed that Tokelau has only one ship visiting three times a month and no air transportations. This leads to a cutback of resources entering the country, which restricts economic development and restrains the population to subsistence-based agriculture. The island’s main food sources are fish and coconut. Other cultivated food crops include bananas, breadfruit, pandanus and papaya. The island is subsidized with imported goods such as rice, flour and sugar. Without New Zealand’s assistance, this isolation and lack of natural resources would make the island almost unable to be self-sufficient.

Depopulation is also one of the causes of poverty in Tokelau. Because of its size, the islands have a restricted human development capacity and suffer from heavy emigration.

The third factor causing poverty in Tokelau is its vulnerability to damage from natural disasters. Climate change is a major issue across the island that threatens human existence and environmental preservation. Due to the island’s small landmass surrounded by ocean, rising sea levels constitute a threat to inhabitants. However, policies have been put in place to address this, such as making Tokelau the first country to derive 100% of its energy needs on renewables.

Despite Tokelau’s subsistence lifestyle and fragile environment, the island’s inhabitants maintain social cohesion and a strong communal culture that keeps the economy stable.

– Sarah Soutoul

Photo: Flickr