The tragic boating accident on New Year’s Day in the Solomon Islands in which 14 people from the Gizo area lost their lives has left many mourning loved ones and touched the hearts of the people across the nation.
It has truly been a very sad start to this New Year and I wrote about the loss at sea of the women and children who were in the boat when stormy waters took their lives in tragic circumstances.
An equally tragic situation in which 60 children from the village of Nagau Village in West Wainoni, in the Makira Ulawa Province reportedly lost their lives due to the isolated location of the village and the great handicaps to getting medical help brought less attention.
Allen Waitara first told the story about 18 months ago and his article was relayed nationally by the SIBC.
I picked up on the serious report and covered Allen’s disturbing news in a letter I wrote to the local media and posted on Linkedin on 2 January this year.
In the Linkedin article I illustrated the physical difficulties villagers had to overcome in accessing medical care by navigating the swift and deep waters of the Warihito River to get to the nearest health clinics some 15 klm away from their homes.
I realise the difficulties posed to the Solomon Islands MHMS and the government in getting health services to remote regions, but am mindful, and I am sure so is the government, that health care for all its citizens is a fundamental human right.
I am mindful, too that the challenges of geographic spread, low population density, limited infrastructure and the higher costs of delivering rural and remote health care affect access to health care but thought such considerations had been covered and would be resolved when the SIG announced in 2017 a bold new plan to get health services closer to home, and I quote from a piece I read at the time released by the WHO.
All that is about to change.
A bold new plan developed by the Ministry of Health and Medical Services, with support from WHO, sets out the Pacific nation's roadmap towards universal health coverage and the Sustainable Development Goals. The plan defines what services are to be offered at each of the 4 levels of the health system, from small rural health clinics offering basic primary care to area health clinics with simple surgical services, provincial hospitals, and the National Referral Hospital.
Developing the plan has involved not only the Ministry of Health, but also the Public Services Ministry, which deals with labour issues, as well as the Ministry of Infrastructure Development.
"WHO is excited to be part of this whole new reform agenda that the health ministry has embarked on which could be a game changer," said Dr Sevil Huseynova, the WHO Representative to the Solomon Islands.
No coordination
Almost half of all health expenditure in the Solomon Islands comes from donors. But much of that funding has targeted specific diseases, rather than strengthening the country’s health system and improving overall services. In addition, well-meaning local politicians and churches have built hospitals with little or no coordination with the Ministry of Health, and then seek the ministry’s support to run them.
The result: Fragmented services, and health gains that haven’t matched the levels of investment.
"With all the increased investments in the recent past, there have not been proportionately significant health gains," says Dr Tenneth Dalipanda, the Solomon Islands' Permanent Secretary for Ministry of Health and Medical Services. "For the last so many years measles immunization coverage has hovered around 75%, and we’ve never been able to get past the 85% mark despite increased investments. That’s what convinced us that something must be done differently."
The plan, called the Role Delineation Policy, also maps out the human resources, infrastructure, and equipment that will be needed at every level.
"The health ministry is undergoing reforms which will enable us to implement the new policy," Dr Tenneth said. "The provinces need to take control of delivering health services while the central ministry will deal with policy, resourcing, and governance."
More doctors
Under the plan, 9 provincial hospitals and 34 area health centres will be upgraded, while 202 nurse aid posts will either be closed or upgraded to become rural health centres to ensure resources are used most efficiently to provide health services at strategic locations.
The plan also includes staffing area health centres – previously run by nurses – with doctors, ensuring that the health services people need are available closer to where they live.
To meet that demand, almost 100 medical graduates are being trained in Cuba, about half of whom have already returned to the Solomon Islands.
The plan will be begin implementation after it is finalized in June this year. But some changes are already happening. Infrastructure upgrades have begun, and lists of equipment and the human resources needed have been drawn up.
Of course, all of that will cost money.
A grant from the Republic of Korea to improve infrastructure in one province will help to determine how much investment will be needed to implement the full plan across the archipelago.
Triple burden
The Solomon Islands faces a "triple burden" of disease: communicable diseases such as dengue, combined with increasing rates of non-communicable diseases and the effects of climate change, which cause frequent floods and droughts.
If successful, the plan may become a blueprint for some of the Solomon Islands' Pacific neighbours, says Dr Greg Jilini, an Under-Secretary to the Ministry of Health who leads the taskforce that drew up the plan.
"There are other countries interested to see what we are doing, like Vanuatu who have very similar problems," he said. "They’re very interested to take the same path."
WHO is helping other countries and regions learn from the Solomon Islands' example. A website launched last year on "integrated people-centred care" provides resources and real-life examples of people-centred health service reform.
End of quote.
Comment.
My understanding is that nothing has changed in 2022 from what it was some 18 months to 2 years ago.
Villagers at Nagua village still face the same difficult and often dangerous conditions to get access to medical care and I truly hope no more innocent children have died due to the circumstances of the remoteness of their home and the so called Delineation Plan failed to deliver.
With more reports of CDF money being made available for tangible developments, I respectfully pose the question to the MP for the Makira-Ulawa Province and to the Government’s Rural Development Authority, why has a road not yet been build to facilitate better access to health services for the community of Nagua village having lost so many of their children in getting their basic rights to health services over the years?
Yours sincerely
Frank Short
