Category Press Release

Suva, Fiji – An Emergency Medical Team (EMT) Country Preparedness Workshop began today at Pacific Harbour aimed in providing an opportunity for key country health and emergency service leaders to engage collectively and further strengthen national capacity to respond to disaster emergencies and outbreaks including events that require international Emergency teams.

The Ministry of Health and Medical Services with support from the World Health Organization is conducting an Emergency Medical Team (EMT) Country Preparedness Workshop. This is part of the commitment towards disaster preparedness, and experience in deploying national rapid response teams and accepting elements of the new global health emergency workforce (Emergency Medical Teams (EMTs), Global Outbreak Alert and Response Network (GOARN) The Government and Ministry of Health & Medical Services accepted a WHO proposal to run a GHEW workshop in late October 2016 to expand its capacity to respond and coordinate responses to emergencies in future.

The Fiji Ministry of Health and Medical Services (MoHMS) has created a technical working group (TWG) to manage the project and in particular the development of national EMTs and public health rapid response teams and improve the mechanisms for identifying needs, requesting and coordinating international assistance using the EMT coordination framework and access to expert groups such as GOARN. The Fiji EMT is known as FEMAT (Fiji Emergency Medical Assistance Team).

The workshop aims to help Fiji Islands national health response system better manage deployments for national clinical and public health teams to areas of need during outbreaks and disasters. It further is aimed to understand what the World Health Organization and partners support to national response efforts, how to activate and access teams and experts from international EMTs and GOARN. The workshop will be able to match country level risks and gaps with international EMT capacities as well help develop national response standard operating procedures (SOPs) at every stage of the response cycle to incorporate national and international EMT capacities.

The Deputy Secretary Public Health, Dr. Eric Rafai opening the workshop said that this training is aimed at bringing together a group of health professionals with supporting Ministries and partners to prepare for emergency health care specifically for disaster affected populations. He further reminded the participants that the Pacific was just a few days away from the next cyclone season and that this preparedness workshop was timely to revisit our collective effort for emergency medical responses to disaster and emergency scenarios.

Mr. Sean Casey, the Health Cluster Coordinator of WHO, Suva also spoke and pledged the support of the WHO Suva Office towards the EMT Pacific Initiative. He assured the participants WHO support in emergency preparedness and response capacity in the health sector.

The first day had participants from Ministry of Health & Medical Service, representatives from the Red Cross, National Disaster Management Office, Ministry of Foreign Affairs, Representatives from the RFMF, Navy, Police and National Fire Authority, a representative from Fiji National University, the representatives from Volunteer First Responder and UN agencies.

The workshop is facilitated by WHO EMT Secretariat Team from Geneva, WHO Manila Office and WHO Suva with guest’s speakers also from the Australian Medical Assistance Team (AusMAT) and the New Zealand Assistance Team (NZMAT) teams. The EMT Pacific initiative is supported through the World Health Organization through the Australian Department of Foreign Affairs support. The workshop ends on Thursday.

The Fiji Ministry of Health and Medical Services (MOHMS) has released a World Health Organization (WHO) report on the recent outbreak of Acinetobacter baumannii (A.baumannii) bacterium within the neonatal intensive care unit (NICU) at the Colonial War Memorial Hospital (CWMH), Suva.

Download Full Report here

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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.

During July, its first full month of operation, the Ministry of Health & Medical Services’ Customer Contact Centre handled almost 1,000 calls, emails and text messages from members of the public.
The main areas of concern raised by those who contacted the centre related to staff attitudes or perceived delays and long waits for attention, which together accounted for 23 per cent of the calls received. The next largest group of calls were those where the caller considered their treatment was ‘unsatisfactory’ (four per cent of the total).
Those figures have been noted by the Ministry and, while it is still too early to identify any real patterns or trends in the data, they provide a useful basis on which to monitor future performance. Where possible, additional information on callers’ actual waiting times and the reasons why they considered their treatment to be unsatisfactory will also be obtained. Such concerns may stem from inadequate explanations by staff or unrealistic expectations on the part of patients: both areas where better communication could help.
The Customer Contact Centre received compliments on services delivered in several facilities including Nadi, Navua and Wainibokasi Hospitals and Valelevu, Dreketi, Raiwaqa, Cuva, Natabua, Balevuto and Nasea Health Centres. There were also a significant number of calls (around one in four) which did not relate to health services or where the caller simply hung up without speaking. Those calls may be a result of people wanting to test out the new service or being unfamiliar with its operation. They will, hopefully, reduce over time.
By the end of the month all but a handful of the issues raised by callers had been satisfactorily resolved with the overall average time taken to deal with an issue and respond to the caller being less than 2½ days.
In a typical month more than 80,000 people attend the Ministry’s hospitals and health centres as inpatients or outpatients. The total number of complaints registered by the Customer Contact Centre in July was fewer than 350 which represents just 0.4 per cent or one in every 250 patients.

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.