Someone in the Solomon Islands once wrote and said words to the effect, “At some point in our lives we will all end up at the National Referral Hospital.”
Over the years I have come to realise how prophetic those words were, given the NRH is the sole referral hospital in a country with a population now exceeding 710 million people, and a country where the birth rate remains one of the highest in the world.
The NRH is constantly under pressure to deal with levels of NCD illnesses and diseases, which include heart disease, stroke, diabetes, liver and bodily organ failure, cancer and the list is endless.
The doctors, nurses and ancillary support staff constantly work under extreme pressure and are handicapped by material and equipment shortages needed for a hospital required to deal with the influx of patients needing both critical long term care, as well as coping with birth deliveries and general health care.
The Prime Minister recently predicted that the NRH would not be able to cope with those needing hospitalization if Covid-19 and particularly the Omnicom variant of the virus gained a foothold in the country.
Anyone knowing the demands already on the NRH knows what the Prime Minister said to be true.
I am often quoted as having concerned myself about the rehabilitation needs of those hundreds of patients of the NRH, current ones and those in the past, that have had a leg or foot amputated as a consequence of contracting diabetes due to their life style habits, diet, or separately because of accidents or even heredity causes.
My concern is all the more because a gifted modular building to the NRH in September 2000 cannot be completed as the NRH does not have the funds to finish the fitting out of the building as a replacement rehabilitation workshop for the manufacture of artificial limbs.
The NRH despite its major importance to health care and health provisioning does not yet have its own independent budget and it is my belief and I understand a common concern by many Solomon Islanders, that it should be independently funded and properly resourced and equipped.
The vitally important cancer unit at the hospital remains, to my understanding, without a functioning mammogram machine to ensure women can be tested for early signs of breast cancer, one of the top causes of premature death of women in the country.
With the help from its many diplomatic ties and aided by agencies such as the WHO, the UN, UNDP, the ADB and the WB, I concern myself that the NRH detection work to prevent breast cancer is not yet supported with the vitally important equipment needed.
I could continue writing about the NRH’s needs, but I will end this letter by mentioning two other health topics that concern me deeply – one relating to cervical cancer and the other to rheumatic heart diseases and especially affecting young children.
Both cervical cancer and rheumatic heart disease are prevalent in the Solomons and rated highly as causes of death.
Apart from breast cancer, another threat to the futures of SI women is cervical cancer and is the fourth most frequent cancer in women.
However, cervical cancer screening is limited, I understand, but subject to correction, and only about 4% of women have received a Pap test and low laboratory capacity means that the tests must be sent overseas for analysis. Options for treatment and management of cervical cancer are similarly slim.
Some 4 or 5 years ago, with support from WHO, UNICEF and Gavi, the Vaccine Alliance, PATH, the Australian Cervical Cancer Foundation and Rotary International, focused on prevention of cervical cancer using the Human Papillomavirus (HPV) vaccine to protect girls aged 9-14 years old against the disease.
The pilot scheme was rolled out in two provinces and the partners were able to vaccinate 72% of girls in the target age group in Honiara, while 91% of girls in Isabel Province were vaccinated.
Part of the success was due to the strong links with the communities. The team from the Ministry of Health and Medical Services, WHO, and UNICEF worked closely with provincial health workers, school teachers and community leaders to share information about the HPV vaccine for young women.
Preparations were then put in place to roll out the HPV vaccine across the rest of the country in 2019.
I pose the simple questions did that happen in 2019 and what is the current situation?
The HPV vaccine does not eliminate the need for continuing screening and better treatment of cervical cancer in Solomon Islands, but prior to 2019 it was viewed as a significant step towards protecting women.
Since the recent sad and premature passing of young Linta Mabo from rheumatic heart disease complications, just as she was being readied for transfer offshore for surgery that could have given her a second chance at life. I have been made aware of the extent of rheumatic heart disease affecting a good number of young children as patients at the NRH, including one 11 year old boy.
The parents of that child are desperate to get their son to a hospital in Australia or New Zealand where it might be possibly to get surgery to aid his recovery from his rheumatic heart condition.
The same child is not alone with rheumatic heart disease at the NRH
Prior to COVID 19 , the diagnostic and confirmatory studies on patients, young and old were done by visiting paediatrics cardiologist .This was the practice until COVID 19 halted the program.
ROMAC supported the costs of overseas referrals for children less than 15 years but is temporarily halted; as a consequence many parents seek sponsorship for their children with rheumatic heart disease, just as the parents did for the late Linta.
In practically all instances, it’s challenge both for the referring doctors at the NRH to make informed decisions without definitive assessment to qualify or disqualify a patient with rheumatic heat disease to be referred offshore for surgery that could possibly extend those patients chances of making a recovery.
When the ROMAC project was in place, sponsors would meet all the costs for travel and accommodation apart from the surgical costs.
Surgery offshore for the treatment of rheumatic heart disease is known to be very expensive and surgery likely to be about 50,000 Australian dollars.
I have touched on just a few of my concerns for the NRH and the needs of its patients and my hope is that the NRH will both see its financial needs recognised, its equipment requirements supplied, and a restoration of the 10 bed hospitalization arrangement with St Vincent’s hospital in Sydney, and a re-start of the ROMAC programme once Covid concerns for travel are eased.
Yours sincerely
Frank Short
