1 December 2018
The key to strengthening governance of Non-communicable Diseases in the Solomon Islands.
Last week in Honiara, the Prime Minister, the Hon. Rick Hou, spoke at the round table meeting with the Ministry of Health and Medical Services and the World Health Organisation (WHO).
The PM outlined the fact that the Pacific Islands countries have the highest prevalence of ‘tobacco use’ than the global average of 23 percent.
In the Solomon Islands, Prime Minister Hou said the average prevalence of tobacco use was almost double the global average of about 44 percent.
The PM went on to say how the Pacific had been described as the epicenter of the global diabetes epidemic and the world’s capital of NCDs.
Referring to Non-communicable diseases (NCDs) the Prime Minister said it was “better late than never to tackle the problem” posed by NCDs.
Given that statistic show that 70 percent of all deaths in the Solomon Islands are attributed to NCD related illnesses such as diabetes, heart disease, cancer, stroke and chronic respiratory diseases, to give just a few examples, it is indeed a very sad irony that it is only now that the “penny seems to have dropped” to do something about tackling the killer disease that has cost so many lives already.
It is also, to my mind, a double irony because it is well documented that in July 2014, Pacific Health Ministers and Economic Ministers approved the Pacific NCD road map, to guide each country’s efforts to reverse the trend of the NCD epidemic in the region.
Sadly, however, 7 years after the declaration of the NCD crisis, and four years after the call to develop national NCD road maps to combat the NCD epidemic, very few countries have heeded the call.
In the Solomons what might now change to make things happen?
One has to comment, despite the excellent set of policy options contained in the NCD road map report, the fact remains that the MHMS is constrained by their lack of resources, including physical infrastructure, health workforce and sustainable financing.
Where health budgets are severely limited, as is the case in the Solomon Islands, the government may be forced to choose between treating people who are sick, and seeking to reduce the future burden of NCDs and associated expenditures.
Quoting an extract from a World Bank report in 2014, one reads:
“It is not surprising that the political imperative to direct limited resources towards those who are currently sick often wins out. For this reason, there is a strong case for governments to seek to expand their revenue base at the same time as they scale up their budget for NCD control, particularly by increasing taxes on those products that most contribute to NCDs, including tobacco, alcohol, and unhealthy foods and sugar‐sweetened beverages.”
“Despite this, raising taxes may be politically challenging for governments: ‘the [political] pain in raising taxes is now, [whereas] the public health gain is later”
One might say here that for all the reasons, the challenge Solomon Islands face it is not the lack of knowledge about the policies that could make a difference, but implementation: translating knowledge into actions at the country level.
Whether seeking to raise taxes, or to implement other regulatory responses the government would likely face resistance from tobacco, alcohol and processed food industries and potentially from other countries, including development partners.
What I see is required today is the political leadership and politicians who will become ‘issue champions, ‘ in pursuing a policy of strengthening health systems, re-focusing on primary care and getting greater regional and international cooperation to be sustained by accountable monitoring systems to measure progress.
Although urgent action on NCDs makes good economic sense for the Solomon Islands government the challenge of NCDs is more than just about responding to rising health expenditures, or the impoverishing impact of out‐of‐pocket payments on families.
The real key is the absolute obligation of the government to take action on NCDs which is enshrined in the right to health, a universal human right.
“All countries have ratified at least one international treaty that imposes obligations on government regarding the right to health.” (WHO 2014)
30 November 2018
Solomon Islands: Exciting news about the discovery of what is believed to be the biggest crystal natural Moisssanite
The Solomon Star newspaper reported today, Friday, that a team from the Technical Institution of Malaita (TIM) had discovered what is believed to be the biggest crystal natural Moissanite ever found on Malaita.
The world’s biggest crystal natural Moissanite ever recorded was 4.14 mm discovered in north-eastern Israel along the Kishon River in 2012.
However, the crystal neural Moissanite that was uncovered in East Kwara’ae was measured at 15 mm with the biggest one measured about 20 mm. This sets a new local, regional and world record.
Quoting the Solomon Star “This discovery breaks the world record on the size of the biggest Moissanite ever discovered.”
According to the Instructor and Head of Gemology at the Department of Technical Institute of Malaita, Henry Dao, Moissanite is one of the rarest mineral on the planet earth.
Mr, Dao told the Solomon Star in an exclusive interview after the discovery that synthetic Moissanite was created as a substitute for diamonds; however, the search for natural Moissanite is incredibly high.
“Moissanite is almost identical to diamond with a hardness of 9.25 on Moh’s scale and a diamond is 10,” Mr Dao told the Solomon Star.
The TIM is aiming at developing a gemstones cottage industry in the local province where the latest discovery of Moissanite could prove a bonus to the institution that is dedicated to gemstone development locally.
With the reported local discovery of Moissanite, I wish much success to TIM in continuing exploration for more of the valuable gemstones and ultimately see a flourishing cottage industry spring up to help the East Kwara’ae community generate some much needed income
30 November 2018
Solomon Islands: Deeply worrying news about continuing alleged shortages of resources at the National Referral Hospital (NRH)
In today’s edition of the Island Sun newspaper there is an article covering claims by a local civil society advocate, Ismael Nori, that he had discharged himself from the NRH saying (quote)
“It is no use being admitted to the NRH.”
He went on to claim that very sick patients were seeking medical help from the hard working but ill resourced doctors and nurses.
“People are dying at the NRH’s medical ward due to lack of resources.” Mr Nori alleged.
Mr Nori said he had made his comments in the light of the Parliamentary Entitlement Commission’s move to increase the terminal grant to 50 Members of Parliament.
(It was announced recently that retiring Members of Parliament would each receive S$400, 000 tax free)
“Our hospital needs more money. One reason why our hospital does not have the right equipment is because the government is not putting enough money in the hospital or medical budget,” Nori commented.
Earlier this week, the Chairman for Bills and Legislation Committee and Member for Parliament for Aoke/Langalanga, Mathew Wale, had also commented in the local media about the “crisis in our health sector.”
When contributing to the 2018 Supplementary Appropriation (No.2) Bill 2018 debate in the Parliament, Mr Wale was reported in the Solomon Star newspaper to have said (quote)
“We have a serious ongoing crisis in our health sector and there is no indication that the Government appreciates the gravity of the situation,” Mr Wale said.
The country’s health crisis has been widely talked about in the local media and in the social media over the past months.
The Solomon Islands Medical Association (SIMA) in July this year made the call that the shortage of medicines and consumables at the NRH has reached crisis point.
At that time, the Prime Minister, Rick Hou, and the health minister insisted there was no crisis in the health system, as doctors continued to battle with months-long drugs and supply shortages.
Mr Wale alleged medicine shortages are but one aspect of the mismanagement of the country’s healthcare system.
“There is lack of basic equipment, the work environment is a hazard to our health workers and the neglect of primary healthcare is increasing the pressure on health facilities and the budget.
“In the meantime, Non Communicable Diseases are on a very fast and dangerous rise,” Mr Wale said.
He further exclaimed that the role of delineation policy was taking too long to be costed.
“However the government must not wait for the costing to be available before allocating adequate funding to the needs in the healthcare system.
“Government can and must start funding some of the urgent and desperate needs,” Mr Wale exclaimed.”
Meanwhile, also commenting in the local media, the Permanent Secretary (PS) of the Ministry of Health and Medical Services, Dr Tenneth Dalipanda, cited the current situation facing drugs and medical supplies at the National Referral Hospital (NRH) and National Medical Store (NMS) had improved significantly.
Dr Dalipanda wrote (quote)
“Whilst there are still shortages of drugs and medical supplies being experienced the situation continues to improve,” he said.
“We have reached 91 percent availability of stocks of medicines and 76% availability of consumables at the NRH.
“The National Medical Store currently has 91% availability of medicines and 78% availability of consumables. As more stocks arrive, these figures will continue to improve,” he said.
Dr Dalipanda last week responded to comments in the press and social media about the lack of examination gloves that were available at the National Referral Hospital (NRH).
He said, “On the issue of examination glove availability at the National Referral Hospital (NRH), I want the public to know that yes, stocks of examination gloves did run out for a short period.
“Additional stocks of these gloves were ordered in July and were expected to be delivered in early October.
“They ended up not arriving until 8th of November and supplies were provided to the NRH next day.
“During the period that stocks were out of supply, sterile gloves were made available to the staff at the NRH for use in ensuring infection control throughout the period,” he said.
On the broader drugs and medical supplies issues, Doctor Dalipanda added that whilst there are still some items that are out of stocks, the situation has greatly improved and continues to improve.
“The Ministry’s major tender for drugs and medical supplies, the annual tender was finalised in October and orders for the items tendered have been placed.
“Interim order arrangements put in place earlier in the year to cover the gaps in supply coverage that we predicted to occur, have been arriving and will continue to arrive over the coming weeks and months,” Dr Dalipanda said.
He added by saying; “The Ministry has been working hard to rectify drug shortages and stock outs that have occurred during the year.”
“Both the World Health Organisation (WHO) and Australia’s Department of Foreign Affairs and Trade have provided technical assistance to the Ministry in support of rectifying the shortages that have been experienced and I’m grateful for this support,” Dr Dalipanda concluded.
(Source: Solomon Star newspaper)
During the Public Accounts Committee (PAC) hearing into the 2018 Supplementary Appropriation Bill at Parliament, the Member of Parliament (MP) for Shortland, Christopher Laore, questioning the MOHMS as to how much longer they would wait before capacity and compliance were satisfied at the NRH
At that time MP Laore said, “I feel that the NRH has been neglected for so long. If we think of after moving to the new National Hospital site before we make things progress then I believe the NRH will be run down continuously until it will be not conducive for sick patients.
“The question is how long will the health planners see to it and consider NRH as it is important it provides tertiary hospital services?”
“ Primary health care does not work in this country.”
Solomons health shortages costing lives – Wale
Quoting Radio New Zealand – 30 November 2018
“A Solomon Islands MP says the government's failure to address drug and equipment shortages in hospitals around the country is costing lives.
“The Solomon Star reported Matthew Wale called for the removal of the health minister over the issue during Wednesday's parliament sitting.
“Mr Wale said the health minister, Kaitu'u Tautai Angikimua, has failed to show any sense urgency in addressing what he described as a health crisis.
“He called on the prime minister Rick Hou to sack Dr Kaitu'u.
“At the height of the shortages in July the Solomon Islands Medical Association declared a crisis but this was downplayed by the government.
“It is understood part of the reason for recent drug shortages was a change in procurement processes at the ministry of health.
“However, the lack of medical equipment as basic as gloves, wound dressings and gauze is an ongoing issue.
“The working conditions for healthcare professionals is also a major concern with most departments understaffed.”
Copyright @ 2018, Radio New Zealand.
$1m mysterious payment
Quoting the Solomon Star newspaper – 30 November 2018
“THE one million ($1m) in shipping grant that was supposed to be received by Didao Development Cooperation remains a mystery and untraceable since documents related to the payment were missing from the Ministry of Finance.
“The payment was made between 2015 and 2016. Didao Development Cooperation never received the payment.
“According to the Auditor General’s report related to the Shipping Grant that appeared on the report all the documents about the $1million payment to the company were missing from the ministry’s data.
“The report prepared by Auditor General Peter Lockay was sent to this paper containing information about the shipping grants and its recipients for the year 2015 to 2016.
“It appeared that Didao Development Cooperation received $1million but no documents about the payments could be made available.
“Officials within the Ministry of Finance and Treasury (MoFT) only confirmed that the documents were missing and nothing can be traced from their records.
“A representative from Didao Development Cooperation denied the company receiving the million dollar payment.”
Copyright @ 2018, Solomon Star news.