Tuesday 4th October 2016
Increasing community based programs is one of the key strategies of the Ministry of Health and Medical Services to raise awareness on the reproductive health development. Minister, Hon. Rosy Akbar reiterates that it will be achieved through providing a comprehensive and integrated reproductive health services in communities.
“In providing an enabling environment, the Ministry of Health and Medical Services is committed towards improving the accessibility to reproductive health services. The International Conference on Population Development (ICPD) Plan of Action affirms that reproductive rights embrace certain human rights that includes the recognition of basic rights of individuals to have the information and means to access highest standard of Reproductive Health services. Fiji is one of the Pacific Island Country (PIC) signatories of the ICPD.
“The Reproductive Health Policy of Fiji explicitly supports the rights of all women and men to have access to curative and preventive reproductive health services. It also takes note of the rights of young people to have access to youth friendly services, access to reproductive health information that will help them make responsible choices and in particular prevent unplanned pregnancy, STIs/HIV.
“The role of Non-Government Organizations (NGO’s) in raising awareness at community level on Reproductive Health and Family Planning services is notable. And linking of the public sector with these organizations has significantly contributed towards improving access to services especially to those hard-to-reach vulnerable groups,” Minister Akbar said.
The Health Ministry will also capitalize on a collaborative platform to enable active participation of the communities in responding to the reproductive health issues.
“Increased awareness is the key to enable the communities to understand the impact of Family Planning on their future health, livelihood and wellbeing. Strengthening the health systems response to unmet needs in terms of specialized nurses in Family Planning through provisions of training, availability of information and guidelines on Family Planning also needs to be addressed.
“It also means increasing accessibility of counseling services at all levels of health system including the community level. And empowerment of community health workers and general awareness on booking for antenatal clinic and through the stages of prenatal and postnatal care are some of the ways the Ministry will enhance the community based programs for reproductive health services,” Minister Akbar added.
Reproductive health services in Fiji covers a wide area of health care, the main ones include:
- Safe Motherhood – encompasses maternal care and neonatal care
- Infant and child care • Adolescent health care
- Family Planning and Prevention of Abortion
- STI-HIV prevention and management, and Basic Infertility services
- Management of gynaecological morbidity – including reproductive tract cancers & infections.
Emergency care at CWM Hospital is provided by a highly skilled team of expert doctors and nurses. They include specialists in emergency medicine – doctors who have completed a four-year Master’s degree in Emergency Medicine at the Fiji National University.
The FNU Masters programme was developed under the guidance of Dr Anne Creaton, an emergency physician from Australia. It is now run by Dr Dennis Lee, who trained in Emergency Medicine in Papua New Guinea with support by visiting specialists from Australia, New Zealand, UK and USA. The first six doctors graduated from the FNU Masters programme in 2016.
Emergencies don’t just happen in our capital city however so the team at CWM Hospital also offers support, advice and training for staff in smaller health facilities around the country. The following case, which took place recently, is not unusual and illustrates how effective teamwork can be.
Josaia (not his real name) is 56 years old. At home one evening he experienced chest pain. The pain gradually eased but in the middle of the night it suddenly got worse again. He felt his heart racing and he was sweating heavily. He rushed to Nausori Health and was assessed by the Medical Officer on duty who found he was critically unwell with a dangerously high heart rate and abnormal heartbeat.
The Medical Officer immediately called the Emergency Department at CWM Hospital for advice and was told that Josaia required cardioversion, a procedure where electrical energy is applied to the heart to return its rhythm to normal. The staff at Nausori were not expert at the procedure but Dr Deepak Sharma, the emergency medicine specialist at CWM Hospital was able to guide them through what was required. The staff at Nausori then explained the procedure to the Josaia and his wife and Dr Sharma remained on the phone to provide continuous support while it was carried out.
The procedure was a success and Josaia’s condition stabilised while he was at Nausori Health Centre. Dr Sharma then sent one of the emergency team to bring the patient back to CWM Hospital by ambulance but when he arrived it became apparent that he was having a heart attack. He was treated with a special clot busting drug after which his condition stabilised and he was admitted to the coronary care unit.
Josaia remains well and was able to leave hospital after a couple of days. His experience is a good illustration of how our locally-trained emergency medicine specialists, their colleagues in CWM Hospital and doctors and nurses elsewhere in the system are working together and using their skills to save lives every day.
On 21 June 2017, the Ministry of Health and Medical Services (Ministry) alerted the public of four (4) deaths within the Neonatal Intensive Care Unit (NICU) at Suva’s Colonial War Memorial Hospital (CWMH). As of 11 July, a further two (2) deaths have occurred within the NICU.
The NICU is a specialist unit which provides intensive care to ill or premature infants born at CWMH, the national referral hospital of Fiji. Many of the infants who are cared for in this unit suffer significant pre-existing illnesses such as compromised immune systems.
The presence of the multidrug resistant bacteria, Acinetobacter baumannii, was detected by CWMH laboratory services in samples obtained from NICU patients. This bacterium is commonly found in hospital settings and hospital patients around the world. Whilst the bacterium poses very little risk to healthy people, it can be a significant health risk to those with compromised immune systems.
A similar outbreak of this bacterium occurred within the NICU at CWMH between December 2016 and March 2017.
The Ministry and WHO are working together closely with CWMH’s clinicians and Infection Prevention and Control team to respond to this current outbreak and ensure the safety of the hospital’s most vulnerable patients.
As part of the immediate response, CWMH has increased surveillance in the hospital to support early response to new cases of infection; enhanced screening and infection precautions of all new admissions to the hospital and the NICU; and intensified its infection prevention and control measures.
A specialist team has also been deployed by WHO to Fiji to work with CWMH to try and identify a source of the bacteria, in addition to reviewing current infection prevention and control practices within CWMH and, as a further preventive measure, also examine practices in Lautoka and Lambasa hospitals. Based upon their findings, this team will be providing recommendations for ensuring that the hospitals’ current processes are appropriate, and adequate systems are in place to ensure the delivery of quality clinical care and patient safety.
Whilst a common source of the bacteria has not been found, this is not unusual as sources are only identified in 50% of all outbreaks reported globally. As sustained elimination of multidrug resistant bacteria in hospitals is extremely difficult, enhanced prevention, surveillance and early intervention measures are critical to preventing the infection of individual patients and consequent outbreaks.
The Ministry and WHO will continue to provide updates to the public on this issue.