This July, Tonga eliminated lymphatic filariasis. Lymphatic filariasis is a mosquito-borne illness that attacks the lymphatic system. The Tonga Ministry of Health used a combination of large-scale treatment to control transmission and disability prevention activities to eliminate lymphatic filariasis.

Lymphatic filariasis is caused by a parasitic infection when filarial parasites are transmitted to humans and can become infectious through the bite of a mosquito. Most lymphatic filariasis cases are asymptomatic. While there are no external signs of infection, the parasites can damage the lymphatic system, kidneys and immune system. Eventually, the disease can become chronic and cause tissue swelling and skin or tissue thickening. This affects the limbs and genitalia.

Chronic infections of lymphatic filariasis cause severe disfigurement, pain and disability. This can cause people to lose their jobs and income. In addition, the social stigma associated with the disfigurement can lead to depression and anxiety.

Lymphatic filariasis has been prevalent in Tonga since the 20th century, and it has taken decades of work to eliminate the disease. In the 1950s the prevalence rate of lymphatic filariasis in Tonga was close to 50 percent. The disease incidence steadily decreased in the 1970s and 1980s as the Ministry of Health administered mass drugs throughout the country. Doctors administered two doses of medicine annually to the at-risk population. This drug reduces the amount of parasite in the bloodstream of an infected person, which prevents the spread of the parasite by mosquitoes. For these drugs to be successful in eliminating a disease they must be administered to the same population every year or four to six years. These treatments reached a coverage ranging between 81 percent and 92 percent.

Tonga’s efforts were so successful due to the continuous and focused work of their Ministry of Health. In addition, there was strong financial support from other donors and partners who contributed drugs and educational resources. Tongan communities also played a significant role in the reduction of the disease; they were willing to take the drugs and work through different treatment programs for disabilities.

The incidence of lymphatic filariasis in Tonga is now less than one percent. Over the last five years, several independent experts analyzed the incidence of the disease through three transmission assessment surveys. Tonga must continue these surveys for the next five to ten years to ensure that the disease is not reintroduced.

Sarah Denning

Photo: Flickr

Poverty in TongaTonga is a group of islands east of Australia and north of New Zealand. Tonga has relatively high rates of education and a productive health care system, however, there is still poverty in Tonga.

As with many countries, the rural people of Tonga tend to be the poorest. Small farmers and fisherman are often the most burdened with poverty, as the contribution of labor is crucial for subsistence, so when there aren’t as many work opportunities the family suffers.

Tonga is made up of several islands, the outermost islands being the the most vulnerable. This vulnerability stems from high transportation costs, which make it difficult for farmers to transport their goods. This provides a larger financial burden and less marketing opportunities. Citizens of the outer islands also do not have access to as many health and social services as they should.

Poverty in Tonga stems from a lack of work opportunities. Work opportunities are limited because the degradation of land over the past couple of decades has made productive land for cultivation scare. Many poor people have emigrated to Australia and New Zealand in search of work opportunities. These outer islands contribute very little to the national economic growth of Tonga.

The economy is very dependent on remittances from overseas donors. In 2015, and estimated 33 percent of Tonga’s GDP was made up of remittances. This dependency has cost Tonga because those remittances have declined, making more citizens financial unsteady.

The number of people living on $1.90 a day was 61.48 percent in 2001, in 2009 it was at 1.09 percent. This shows an incredible amount of improvement orchestrated by the government of Tonga and contributions from the international community. Of course, there is still a wealth disparity throughout the islands based on geography, but poverty in Tonga has diminished significantly throughout the years.

Lucy Voegeli

Photo: Flickr

Poor water quality is a prevalent epidemic in the Polynesian islands of Tonga. Despite the fairly steady supply of water in the islands, sourced from rainwater catchment systems and groundwater, water quality in Tonga needs improvement to prevent potentially deadly waterborne illnesses. The inability to access appropriate sanitation, as well as the cultural absence of hygienic attitudes, led the Tongan government to intervene in community affairs.

A major contributor to poor water quality in Tonga is the lack of any statistical information about water distribution or a centralized sewage system. No data exchange systems have been enforced because much of the country’s water consumption is managed at a communal level, bearing little to no legislative authority. Although Tonga’s Ministry of Health attempted to keep the water supply free from wastewater contamination, the local community remains in control of wastewater due to the culture of the islands.

Another factor that inhibits water quality in Tonga is that the population has grown by 46,000 people in the last decade, according to the Pacific Community. The steady increase of population created greater pressure on how the water supply is managed and treated. It is now more important than ever for Tonga to ensure that the quality of water is acceptable.

Despite the absence of authority regarding water resources, the Tongan government recently enforced the Water Supply Plan. The World Health Organization defines this as “a risk assessment and risk management plan for water supplies that, when implemented, reduces or eliminates the water becoming contaminated by pathogens, chemical or through physical means.” Part of this plan includes educational programs which are also successful in raising cautionary awareness towards water quality and personal sanitation.

The road to improvement for Tongan water quality is optimistic. According to the Secretariat of the Pacific Community, external aid from the EU provided 1.1 million euros to address water security for the Kingdom of Tonga, which is used for innovative technology to make collecting and cleaning water more efficient and secure. However, establishing lasting improvement of the water quality in Tonga is ultimately dependent on members of the community who must comply with the governmental pleas to change.

Mary Hocker

Photo: Flickr

The Food and Agriculture Organization (FAO) of the U.N. partnered with Tonga 30 years ago to focus on improving its agricultural policies and practices. The director-general of the FAO commented on the state of hunger in Tonga, saying that although the country is not in a state of distress, it is striving to create a more sustainable agricultural industry.

The FAO, in conjunction with government officials in Tonga, created the Future Farmers of Tonga program, which strives to promote greater youth involvement in agriculture. This program aims to teach young people how to manage a farm and market their agricultural products to the public, especially those living in impoverished areas. The FAO also supports the government-led national Food Security Coordination Cluster, which focuses on creating disaster preparedness plans and crisis response programs for the country.

Tonga has faced a deficiency in its fishing industry over the last several years, according to FAO officials. Fishing plays an important role in Tongan culture but is hurt by the vulnerable marine ecosystems in the area. To combat this problem, the FAO has tried to restore milkfish to the area in order to provide a source of both food and income to the rural areas of the country. The focus is on developing technology, producing better management strategies and improving business marketing, which in turn will improve the conditions to prevent greater issues with hunger in Tonga.

The developments that have been made over the last 30 years have helped decrease the percentage of children who experience stunted growth. According to UNICEF data, as of 2012, less than one percent of children under the age of five are stunted. In Pacific countries as a whole, the rate is two percent. The FAO says that it is still working with Tonga to help the country meet its goals for improvement, which include policy planning, supply chain efficiency, and environment management.

Helen Barker

Photo: Flickr

Education in Tonga is free and compulsory between ages six and 14, and the literacy rate is approximately 99 percent. Roughly 80 percent of all primary schools and 90 percent of secondary schools are run by religious organizations.

Although there are some post-secondary agricultural, medical, nursing and teaching education programs, most young Tongan people pursue their studies overseas. As a result, many young Tongans live in New Zealand and Australia, while 22.5 percent of their peers residing in Tonga live below the poverty line.

Over the last decade Tonga’s Ministry of Education, Women Affairs and Culture has sought educational reform through the Tonga Education Support Program (TESP), which has been segmented into two phases. TESP I addresses three particular areas of improvement identified by the 2003 Tonga Education Sector Study:

  • Improvement of equitable access universal primary education in the first six years of schooling and quality of universal basic education for all children in Tonga.
  • Improvements to the access to and the quality of “post-basic” education and vocational training in hopes of increasing Tonga’s role in the global economy.
  • Improvements to the administration of education and training to facilitate the prior two goals. In particular, this goal calls for cooperation between both government-funded and nongovernment-funded education programs to serve the national interest of education development.

The Ministry also developed TESP II, an adapted form of the Tonga Education Lakalaka 1 Policy Framework, to improve student, teacher and institutional performance rates across all schools.
Australia has contributed AUD $6.5 million to this project, while New Zealand has cosponsored NZD $8.2 million.

Lack of comprehensive reporting has made it difficult to assess whether or not these education development programs have successfully achieved their goals, but from what has been reported, these programs show promise in improving education in Tonga. The Ministry also expects to achieve at least 99 percent access to and participation in formal education programs and 99 percent retention and completion in the coming years.

Casie Wilson

Photo: Flickr