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Choosing Health

Professor Ian Rouse
Sunday, November 18, 2012

TODAY is a symbolic and significant day for the College of Medicine, Nursing and Health Sciences as we forge a special partnership with The Fiji Times. Three iconic institutions (The Fiji Times, the Fiji School of Medicine and the Fiji School of Nursing) that have served Fiji and the Pacific for between 120 and 150 years are sharing information we hope will improve all Fijians' health.

Over the coming months health professionals will, through this column, share up-to-date information about issues of interest to the community and individuals. Information which will be well researched and related to health matters of great significance here in Fiji.

There will be articles about filariasis, the proper use of medications, a low salt diet and how to make sense of health information. You are encouraged to participate with questions and comments directed to the experts at

The theme of today's introductory article is "choosing health" challenging all in Fiji and across the vast "Blue Continent" to commit to choosing health for themselves, their families, communities and country.

In restating this challenge, I join a very distinguished group of advocates here in Fiji. In 2012 we have seen strong statements for choosing health by the President Ratu Epeli Nailatikau, the Prime Minister Commodore Vorege Bainimarama and Health Minister Dr Neil Sharma. I can't recall such a strong commitment to change from so many senior public figures in any other country. To understand why we have to support such a strong commitment I would like to briefly reflect on the past, the present and the future.

The past

The Suva Medical School was formed in 1885 in response to the devastating measles outbreaks of 1875 and the fear of smallpox and cholera among indentured laborers aboard the first ship from India. A few years later the Fiji School of Nursing was formed by a close friend of Florence Nightingale - the mother of modern nursing.

Medical, nursing and health training, thinking and scholarship have been in the Pacific for a very long time and thousands have achieved their dreams by graduating in one of the noble health professions from an iconic and world class institution.

Over the past 100-plus years the schools have grown in numbers, in programs offered and in the countries from which we receive students. Over that time health challenges have changed. Many infectious diseases have been eliminated and many others are now better controlled. Some remain. The past has many stories of caring and compassionate health professionals, of significant challenges that were tackled and overcome and of dreams for a healthier future.

The present

Despite the gains in healthcare, we face new challenges of ill-health right across Fiji. Challenges that see far too many men and women, mothers and fathers dying while in their 20s and 30s, before their parents and before their grandchildren have been born.

As in other parts of the world, the last few decades have seen a significant transition in Fiji to an increasing burden of what we call non-communicable diseases (NCDs) - like heart disease, cancer, diabetes, respiratory illness and poor mental health.

The recent excellent publication from the Health Ministry's Health Information Unit starkly illustrates the challenges we now face.

* In the third quarter of 2012 a staggering total of 175,053 patients visits were made through the General Outpatients Departments.

* In the past three months there were 37,800 official notifications of infectious diseases - with viral illnesses/infections accounting for 35 per cent of these, acute respiratory Illness another 34 per cent and diarrhoea another 12 per cent.

* There were 2726 admissions to hospital in the third quarter - with diseases of the circulatory system, diseases of the respiratory system, certain infectious and parasitic diseases and injury poisoning and other external causes being the Big Four reasons for hospital admissions.

* There were a total of 1399 deaths reported in the most recent quarter of 2012. The major causes of death included: diseases of circulatory system (34 per cent), endocrine, nutritional and metabolic disease (23 per cent) and neoplasms (9 per cent). In simple terms heart attacks, strokes, diabetes and cancers were the cause of two thirds of all deaths in Fiji.

The unfortunate reality is that we face the burden of trying to conquer some old foes; dengue, typhoid, leptospirosis and tuberculosis, while we also work out what can be done about these new NCDs that result in so many people dying while still young.

The future

I like to think of us all working together for a better future where people live longer, healthier lives. Where we may eventually die from old age or from a NCD when we are 70 or 80, not when we are 20 or 30.

Choosing health is a personal challenge for all in Fiji, young or old, male or female from every race, culture and religion.

No health department in the world can solve all health challenges with the available resources. We all have to do our part committing ourselves, families, villages and communities to "choose health".

We can "choose health" by making some key lifestyle changes such as quitting smoking, improving our diets, reducing alcohol intake and exercising more. We have all heard about Bula 5-30 or SNAP for health or 10,000 steps a day … but without a personal commitment to "choose health" we won't get there.

We can also "choose health" by making the effort to have a regular health check-up.

If you are older than 40 go to your doctor or local nurse for some health screening and to have a routine check-up. This will probably include your height and weight, blood pressure, blood sugar, blood fats and family history. Nothing too painful. But it could save your life.

If you do have an illness like high blood pressure or diabetes or any of a number of common chronic illnesses you will have to personally "choose health". Get advice on how to control the illness and improve your health. And please take good care of yourself - maybe with diet and exercise and the routine taking of your medicines.

As a college we have committed to make a difference among our staff, students and our community. As a country we have seen outstanding support from the leaders and a strong commitment from the media. Now it's up to all of you, the readers to "choose health".

I hope we succeed, we have to. The health of everyone in this Pacific Paradise may well be in our hands.

* Professor Ian Rouse is the dean of the College of Medicine, Nursing and Health Sciences.

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