Press Release

Cyclone Dengue

Written By: Website Administrator

31/03/2014

Authors: Dr Devina Nand and Dr Eric Rafai

Global

Approximately 40% of the world is at risk of Dengue (≈2.5 billion people). There are 50 – 100 million cases of Dengue every year. Almost 500 000 require hospitalization and 25 000 cases die annually.

Dengue fever has been reported in over 100 countries in Africa, the America’s, the Caribbean, Eastern Mediterranean, South East Asia and the Western Pacific regions.

Dengue fever outbreaks commonly occur in populated urban and residential areas of tropical nations. The disease is distributed along the distribution of the vector (agent that carries the disease). In this case, the vector is the mosquito (in particular the Aedesaegypti). The distribution remains 40˚North to 40˚South latitude.

Figure 1: Map of distribution of Dengue Cases Globally (source WHO Dengue training ppt)

The yellow areas are where there is known risk of transmission of Dengue Fever. The red dots denote areas such as Hawaii, Galapagos Islands, Sudan, Nepal, Bhutan and Madagascar where Dengue re-emerged in 2000-2006 after many years of being in remission.

Regional

The region has been experiencing Dengue outbreaks before the 1950’s in countries like American Samoa, Cook Islands, Fiji, French Polynesia, Guam, Kiribati, New Caledonia, PNG, Solomon Islands, Tonga, Tuvalu and Vanuatu. Resurgence in outbreaks was documented from the 1970’s.

Fiji is vulnerable to dengue fever outbreaks that occur at neighbouring Pacific Island countries. Our vulnerability is related to travel through our country and hub for trade in the Pacific. The same dengue 3 & Dengue virus serotype 3) outbreak in Fiji occurred in the Solomons, Vanuatu in 2012 and Kiribati early this year

French Polynesia, Queensland (Australia) and possibly Tonga are currently reporting DEN 3 outbreaks..

Figure 2: Map of distribution of endemic and non-endemic countries for Dengue in the Western Pacific Region. (source: WHO)

Figure 3: Map of distribution of outbreaks as at 10/03/14 in the Western Pacific Region. (source: http://www.spc.int/phs/PPHSN/)

The Republic of Fiji

Fiji declared an outbreak in December 2013 and commenced immediately on its outbreak response that is not limited to enhancing clinical management of cases, monitoring the disease in affected and unaffected areas, increasing public awareness, prevention strategies, targeting clinical interventions, mobilizing community groups, government and stakeholders. Currently there is over 15, 446 suspected cases of Dengue notified to the Ministry of Health. There have been 12 confirmed deaths.  About   10% of these cases in Fiji are hospitalized. The initial outbreak was centered in the Central division in December; it has peaked in the Western division with the Northern division showing an increase in numbers.

Other Diseases in Fiji may mimic to Dengue Fever

The symptoms of Dengue fever include fever with:

• Nausea or vomiting
• Muscle or joint pains
• Severe headache or pain behind the eyes (retro-orbital pain)
• Rash

The Warning signs include:

• Any bleeding (gums, nose, blood in stool, vomiting blood, vaginal bleeds, bruising or bleeding under the skin)
• Persistent vomiting
• Abdominal pain
• Restlessness or lethargy

However, it is important to understand that the symptoms and signs are similar to other infectious diseases in the region. These include:

• Leptospirosis ( endemic in Fiji)
• Typhoid fever (endemic in Fiji)
• Influenza ( seasonal in Fiji)
• Zika virus (New Caledonia, Cook Is., French Polynesia)
• Chikungunya virus (New Caledonia, PNG)
• Other viral illnesses such as West Nile virus.

Leptospirosis and Dengue fever can be fatal if the person remains untreated at home and comes to the hospital very late in the course of the disease

It is very important to consult a doctor if you are having any of the symptoms mentioned above so treatment can be received early and precautions taken to prevent others from falling sick.

It is also important to protect oneself and family from the bite of mosquitoes.

Conclusion

The Republic of Fiji is not alone in experiencing dengue outbreaks. Other countries in the Western Pacific Region are experiencing the same challenges including the more developed nations such as Queensland, Australia. Globally, the Americas, South East Asia and Africa continue to experience dengue outbreaks.

The only effective responses are to work together, every individual, community and institution to reduce the breeding of mosquitoes by destroying man-made containers that breed mosquitoes, protecting ourselves from getting bitten by mosquitoes, protecting people suffering from Dengue from being bitten by mosquitoes and transferring the disease, and educating everyone around us in the importance of consulting a doctor when someone falls sick.

References

1. Bhatt et al. (2013). The Global Distribution of Dengue. WHO database
2. http://www.spc.int/phs/PPHSN/
3. Singh N., Kiedrzynski T., Lepers C., Benyon E. S. (2005). Dengue in the Pacific –  an update of the current situation Retrieved from https://www.spc.int/phs/pphsn/Publications/PHDSurveillance/Surveillance-pages111-119.pdf.
4. World Health organization Dengue Training Slides

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.