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WORKSHOP ON DISASTER RISK MANAGEMENT FOR HEALTH (DRM-H) IN THE PACIFIC ISLAND COUNTRIES AND AREAS

28/07/2014

Dr. Neil Sharma – Minister for Health – Fiji

On the Opening of the DRM-H Regional Workshop at Tanoa International Hotel, Nadi

Dr Liu Yunguo, Director, Division of Pacific Technical Support, WHO WPRO

MrManasaTagicakabau,   Director, Fiji National Disaster Management Office

Representatives of World Health Organization – Manila Office

Representatives of World Health Organization – Suva Office

Representatives of Various UN Organizations

Representatives of the Secretariat of Pacific Community (SPC) – SOPAC Division

Health DRM Representatives of Pacific Island Countries & Areas

Facilitators & Trainers

Representatives of the Media

Distinguished guests, ladies and gentleme

Good Morning!

It gives me great pleasure to provide some comments on behalf of the Government of Fiji and Ministry of Health – Fiji and to warmly welcome all the participants to this occasion of the Regional Disaster Risk Management for Health Workshop.

Setting the Scene:

According to the 2013 World Risk Report, the Western Pacific Region is notoriously known as the world’s disaster epicenter: 10 of the top 20 countries most exposed to natural hazards such as typhoons (cyclones), earthquakes, floods, and tsunamis reside in the Western Pacific. Furthermore, booming economies expose large geographical areas and dense populations to technological hazards such as air pollution, contamination of large crop productions with chemical hazard materials, structural collapse and transportation accidents.

There are more tropical typhoons forming in the tropical western regions of North Pacific Ocean than anywhere else in the world. More than 25 tropical storms develop each year, and about 18 become typhoons/cyclones. Sixteen of the 18 deadliest tropical typhoons/cyclones in history occurred in the Western Pacific Region. Over the past 100 years, seven out of the top 10 largest flood disasters in the world have occurred in the Western Pacific Region.

Ninety percent of recorded tsunamis have occurred in the Pacific Ocean, which is bordered by the so-called “Ring of Fire” comprised of major geological subduction zones, where 75% of the world’s active and dormant volcanoes are located. Great trans-Pacific tsunamis are typically caused by massive earthquakes located in these subduction zones and occur at mean intervals of once a decade. In a 100-year period from 1895 to 1995, there were 454 tsunamis recorded in the Pacific Ocean, the deadliest of which killed more 51 000 people.

Disaster Risk Management – Health:

In the last 20 years, disaster management has been largely reactive – taking actions during and after an event. Now a now proactive approach focusing on managing risks related to different hazards with specific activities for all the 4 phases of the Disaster Risk Management cycle (DRM), namely: prevention, preparedness, response to and recovery is being taken.

As you all know, in 2005, after the Indian Ocean Tsunami, the Hyogo Framework for Action (HFA) 2005 – 2015 was created to offer a set of actions to substantially reduce human and economic losses and build the resilience of nations and communities to disasters. Countries are now using a more comprehensive and long-term approach to identify hazards, assess vulnerabilities and prepare exposed communities for disasters before they occur.

As a new post-Hyogo (Post 2015) agenda for disaster risk reduction has begun to emerge, aiming to avoid new risk to emerge in addition to reducing existing ones, it is clear that the health sector must take a more active role in disaster risk reduction, with strong linkages to other sectors, and an emphasis on enhancing partnership among governments, communities and organizations.

In Fiji’s Disaster Context:

Fiji is geographically situated in one of the most natural disaster prone areas in the world. Some hazards occur as a consequence of tropical depressions and cyclones or as part of tropical weather condition that normally affects the region

There have been 36 recorded natural disasters in Fiji since 1980, with 221 fatalities and over $1 billion dollars’ worth of economic damage to Fiji’s economy. Natural disasters such as Cyclone Evan which battered Samoa and Fiji in 2012 – 2013 and the devastating earthquake and tsunami in Solomon Islands recently remind us again of the power of nature and the vulnerability the high levels of risk to Pacific nations of both climate change impacts and natural disasters.

The Health costs and implications to these disasters are often under estimated.

DRM – Ministry of Health – Fiji

At this junction, I would like to share Fiji’s Health Ministry’s approach to Disaster Management.

The guiding principles of Disaster Management for Health are defined in a Plan know as the Health Emergency & Disaster Management Action Plan (HEADMAP). This document was developed during the SARS and Avian Influenza events and has been periodically revised. The document attempts to encompass the four phases of disaster risk management and focuses four key components identified in the Regional Framework of Action for Disaster Risk Management for Health; namely Governance, Policy, Planning, and Coordination; Information and Knowledge Management; Health and related services and Resources:

A key focus of Fiji Ministry of Health has also been ensuring that our health facilities are safe during disasters. Periodic inspections of all health facilities are conducted. Planning of new facilities is carefully considered to avoid future hazards

Our Ministry has established a Unit within the Ministry which looks at after Disaster Risk Management – developing policies, guidelines and standard operating procedures for health staff.

The Health Ministry also works very closely with our National Disaster Management Office (NDMO) to align itself towards a collective vision of ensuring the populations at risk are well prepared and to reduce risks both to human life and to systems important to livelihood.

Conclusion Remarks

Ladies and gentlemen, in conclusion disaster preparedness is everyone’s business. The disaster whether natural or human-caused can sometimes be unavoidable but we can prepare ourselves to be ready if they happen and minimize the impact of the disaster to human being.

Disasters affect all works of life and it our duty to mitigate the effects of disasters.

In Pacific we are fortunate to have kind offers of international assistance in times of disasters and I would like to thank you those partners in assisting us at our time of need.

However, being prepared for the unexpected takes planning and this gathering is a landmark event as we prepare for the next World Conference on Disaster Risk Reduction in 2015 in Japan and stamp our (health) mark towards DRM for Health.

I am indeed grateful to WHO towards organizing this workshop and I wish you all a successful Workshop and I look forward to its outcomes.

Thank you for your attention!

Address at SMOKE FREE LAUNCH

09/05/2014

Healthy city is a global initiative that is currently been implemented by 1000 cities across the globe. It engages local governments in health development through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects.

The primary goal of the WHO Healthy Cities Network is to put health high on the social, economic and political agenda of city governments.

Health is the business of all sectors, and local governments are in a unique leadership position, with power to protect and promote their citizens’ health and well-being.

Suva was declared a healthy city in 2011, and since then have been partnering with all key stakeholders in implementing activities that sets itself as a platform for addressing NCD.

Tobacco smoke is the leading single cause of death globally and any decision for cessation will increase longevity and quality of life.

This declaration coincides with the Framework Convention on Tobacco Control (FCTC) meeting that will be convened in Nadi from Monday next week for all the Asian Pacific region and places Suva City high up on the recognition list among similar cities implementing the same around the globe.

The Tobacco Degree 2010 and the Tobacco Regulation 2012 sets the platform for further enhancing the tobacco free initiatives and provides the opportunity for the MOH to work closely with the Council on the same (Tobacco Free Program).

This is the first of a series of phases in the declaration process, declaring most places in the Suva CBD smoke free which includes (Terry Walk, Ivi Triangle, Handy Craft Centre, Market, Bus Stand, etc).

Consecutive phases will see further work around the construction of smoking booths as a requirement under the current tobacco legislation, and further progressing the initiative to see that Suva City becomes the first ever city in the region to be SMOKE FREE.

Fiji Society of Medical Imaging Technologists Council Annual Conference 2014

09/05/2014

Distinguished Participants

Good Morning

I am delighted to be with you all today.

Medical Imaging is an integral part of modern day healthcare delivery. This is more so in the Area of Maternal and Child Health in this day and age.

Fiji Has moved forward dramatically in this area in the last 5 years.  With improved quality of ultrasound technology, computerized axial tomography and more recently MRI,  Fiji is well equipped to meet the challenges of reducing maternal & Child morbidity and mortality as an international commitment to our MDG’s.

As the World plans ahead towards the Post 2015 Development agenda it is pragmatic to address this topic nationally and to review our gaps and challenges.  Strategies for the next 15 years in the Post 2015 Development Agenda are now needed collectively. Socio-Economic development is underpinned on a positive health and educational platform.

Health delivery cannot suffice on just efficient clinical skills alone any more.  Technological advances will assist in earlier diagnosis and likewise Clinical/Surgical intervention will optimize outcomes in the area of MCH.

Traditionally when Ultrasound was introduced in Fiji with the support of the Fiji Medical Association fund raising, the scepticism was keen to advise caution.  That was also a feature when CT Scans and more recently MRI was introduced by government.  Although the steady March on improved technological applications will need its checks and balances we must grow with the technology.

Fiji as the largest Pacific Small Island  Development States (PSIDS) has great potential for growth and development in “ Health Tourism”.  Not developing our health services is definitely not an option but a deterrent to progressing health care delivery.

The issues of Medical Imaging in Fiji currently is to train and retain our younger technologists and professionals in Imaging services. There is a greater need to address distribution and equity of manpower as we rationalize the workforce ie:  with new health facilities being established in the Divisions and subdivisions.  This is being undertaken at Ministry of Health.

A greater degree of specialization is in progress with Echocardiography, and the training of technologists in CT Angiography, CT using multi-slicing, MRI techniques and soon Radio-technology. All phases of these processes are in progress with the support of our External partners including the Sahyadri Hospital (Fiji) Group and College of Medicine, Nursing and Health Sciences.

Any government will need to see efficiency ingrained into service delivery.  We cannot see “Wet film”  “Chemical” outages and service disruptions.

The system of procurement, distribution and storage remains in your hemisphere.  We can address these simple issues at operational level and must stop the blame game with FPBS.  Work ethos, professionalism must be addressed at the business end of your AGM.

Also addressing the need for a Structured Continuing Professional Education Programme now is long overdue, under the 2009 Radiation Decree.

In Conclusion

I wish you well for 2014 and trust that your meeting today will add value to your professional life.

God Bless Fiji.

 HEALTH MINISTER’S ADDRESS AT USP CLEANUP LAUNCH AND CAMPAIGN

25/03/2014

The Vice Chancellor Professor Rajesh Chandra

Deputy Vice Chancellor Dr Esther Willams

USP staff and Students

And invited guests

Good afternoon to you all,

I must say that it is indeed encouraging to have the University of the South Pacific on board in this fight against dengue.

By now you all must be aware of the gravity of dengue in our Country. We have recorded a total of 11,356 suspected cases and 13 reported dengue deaths. These figures are alarming and have triggered great concerns.

The Health Ministry has continued to work effectively at addressing the dengue fever outbreak.  Our health facilities and staff have been strained through this dengue outbreak but remain undaunted in providing essential health services to the public.

Dengue is transmitted from person to person by the bite of an infected mosquito. We continue to remind the public that there is no cure or specific treatment for dengue fever. It is appropriate to say that “Prevention is better than cure”.  Hence the need to destroy dengue mosquito breeding places immediately.

For this reason it is necessary to engage in cleaning up our surroundings by getting rid of any receptacles that contains stagnant water. This includes discarding tryes and drums, apart from the coconut shells, cans, tins, white goods and so forth.

Over the past 2 weeks, the Health Ministry along with Public Service Commission has launched a National Cleanup Campaign to destroy mosquito breeding places. This campaign is ongoing and the Health Ministry remains appreciative of the support received from the Government, government ministry’s, stakeholders, partners and communities.

We have received successful reports of the cleanup from as far as Rotuma and Taveuni apart from the cleanups being conducted within our localities.

Your participation, the University of the South Pacific in this ongoing cleanup campaign shows your commitment and concern in effectively and actively participating in the fight against dengue.

We continue to allow dengue cases and deaths to increase because we allow and provide dengue mosquito’s a place to breed.

As a student or lecturer, falling sick with dengue is the last thing you would want to happen. Especially when there is a cost involved, time, resources, fall back from studies, which contribute to the overall performance as a student or lecturer, and ultimately to the University and at large our economy.

It is high time that we all take responsibility in destroying and removing dengue mosquito’s before another loved one falls victim to the dengue virus.

With these words I wish you all a successful and blessed day ahead.

Thank you

Commissioning of Colonial War Memorial Hospital Projects

25/03/2014

Dr. Neil Sharma – Minister for Health – Fiji

Medical Superintendent and Management of CWM Hospital

Senior Health Executives

Representatives of our Public Private Partnerships

Digicel and International Women’s Association

Invited Guests

Ladies and Gentleme

I am privileged to be with you this morning to officiate at the Commissioning of projects at CWM Hospital.  Health Systems Reform and Strengthening in the last five (5) years has taken on monumental leaps in Fiji.

We had a fragile system with all components in areas of Human Resource (HR), Technology, Infrastructure and pharmaceutical and medical consumables supplies in dire straits.  A multi prongs approach was utilized to short-medium term gains and improvements.

In the area of HRH

Basic recruitment was increased at both the nursing and medical schools.  Middle level training increased in areas of need.  Overseas experience for postgraduates increased as enhanced cooperation developed in areas of specialist surgery.

Longer term gains will accrue as the Post Graduate programs at Fiji National University’s College, Medicine and Health Science is modernized and adequately manpowered with stronger mentors, teachers and professors

Technology

upgrade in the last five (5) years has seen the introduction of mammogram, CAT, MRI, ultrasound and cardiac echo services being developed with Telemedicine links to overseas partners for 2^o opinions if needed.

The Cardiology services is almost complete but no quite seamless, with non-invasive cardiac assessment, angiography, stents, valvoplasty, pacemaker services and open cardiac surgery now undertaken at CWM and Lautoka.

Infrastructure

We note Governments injection of $30million into infrastructural upgrades in 2014 after a process of rationalizing space utilization.

The East Wing (CWM) is undergoing some very painful modifications.  Shortly the maternity units 1^st phase to develop 200 beds, additional delivery suites and operating theatres will be commissioned for 2014 – 2015.

Our focus is nationwide with nursing stations, health centers, subdivisional hospitals receiving a facelift after decades of in attention.

HRH/Technology and Pharmaceutical/Consumable supplies are being reviewed to optimization.

The Position on Pharmaceutical/Medical Consumables

This is a very complex issue with the global market changing, population movement in country, transportation in/out country of items and changing patterns of prescribing.

Our efficiency levels are must more robust, wastage markedly reduced and better procurement, storage and distribution in place.

Safe motherhood Initiatives

byDigicel (CSR) sees the internal renovations of the maternity unit with improved paintwork, sanitary facilities and equipment donations in progress.

We are very grateful to Digicel for this Corporate Social Responsibility whilst Ministry of Health painted the maternity externally in 2013.

The Top Kitchen at CWM

is no longer an Occupational Health and Safety risk with better facilities, a new head dietitian we expect better quality food for our patients and in house staff.

The principles of salt, sugar and oil consumption, based on NCD Best Buys is being promoted further.

Reform in health care have included changing the laws, establishing Policy, Plans and operational implementation.  The Health Policy, Planning, Budget Analysis Unit and the Wellness Unit stand out as two shining examples.

Innovation programs include:

•  The establishment the Prosthetic Unit for Diabetic and other Amputees.
•  The step down Stroke Unit at Tamavua
•  The Diabetic Hubs
•  The NCD Bus – for outreach
•  Revitalization of Community Health Worker Program

As the Country moves for Communicable Diseases focus to Non Communicable Disease we have been eclipsed by this dengue outbreak in 2014.

The messages remain clear that the dengue types outbreak is lethal but preventable if all of society takes responsibility.

The Media can very well play the 4^th pillar role of governance and encourage and support positive measures to combat stagnant water accumulation and the destruction of mosquito breeding, rather than create fear and a hype about the fatalities which are very sad events on a daily basis.  Ministry of Health offers regular media conferences and has no political agenda on this issue.

Today we have a mix of achievements to share and demonstrate at CWM Hospital through Public Private Partnership and Corporate Social Responsibility with Ministry of Health.

The liquid Cytology Analyzer raises our ability to screen up to 50,000 pap smears with our current staff level.  Cancer Screening becomes a lot more robust as a consequence.

Apart from the HPV vaccine introduce in 2011 with Support of the Government of Australia/Fiji and more recently the trials of V.I.A. and Cyrocautery this analysers will assist positively, hoping to address premature cancer disability and death.

The Urology Clinic with its modern lithotripter will now address kidney stones without the large incisions of the past and long hospital stays.  The unit will become the startup of a male health unit too.

The top of the range lithotripter and Uro-station have has trial runs and successfully treated patients from Fiji wide destinations in the last six (6) weeks.

Finally:  The Old Oxfam Family Planning Clinic has had an extreme makeover thanks to the Executive and Members of the International Womens Association.  The new IWA Wellness Centre will provide a Central Hub for areas of Womens Health incorporating Advocacy on Family Life, Sexual and Reproductive Health, Family Planning, Cancer Screening and Counselling Services.

Bubbly Mohan and Caroline Rouse stand out as women of diamond substance.  Bright, shining, unbreakable, both have been dug out of the depths of Sri Lanka and Australia to impact the lives of our Fijian women.

Ladies we are indebted to both of you and your executive committee.

They will tell you more of their plans for 2014.

Before I conclude – Many thanks to all our Nursing and Medical Staff for all the effort being put up with the excessive strain of this Dengue outbreak.  Sometimes society kills the messenger and does not heed the message.

We do need to up our “internal” and “external” communication skills in situations of grief, dying and death.

This year we must focus on better “human skills”Customers Focus and ownership of the new services and technology.

To the organizers and participants – Thank you and God Bless.