Posted by : Posted on : 11-Nov-2019

Solomon Islands: Women and girls rights in the context of medical services, screening and treatment.

It was reported today, Monday, that the Prime Minister, the Hon. Manasseh Sogavare, believes the national Government can learn from the Waka Mere model in improving gender equality in leadership roles in the country’s public service.

The PM was guest speaker at a business breakfast event to celebrate the successful completion and launch of the Waka Mere Commitment to Action report which shows 6,585 employees from fifteen companies in the private sector are now benefiting from more equal, supportive and respectful workplaces.

The PM went on to say, “We need more companies to take up the challenge to make their workplaces safer, more equitable, more supportive, and more productive. My government also needs to take up this challenge.”

I agree entirely with the Prime Minister’s remarks about women’s rights in the work places, but I would like to see more government effort in dealing with women’s health issues in view of the still, reported, lack of cervical and breast screening programmes.

The subject is a sensitive one for many women and girls in the Solomon Islands due to cultural and traditional norms and often a reason why so few women seek to get screening even when there are now, as I understand the situation, some private medical doctors undertaking such services. Another reason I believe is due to costs, although said to be relatively low, I am told that many women have so little means to pay for private examinations.

I picked up the same concerns the other day when I read that a local fisherman had suggested more people turn to eating fish in their daily meals to avoid obesity and the onset of diabetes and other non-communicable diseases (NCD.s). Many responding to the fisherman’s advice by saying they did not have the money to eat fish and had to resort to eating cheaper foods containing less healthy protein and too much fat or sugar content.

I don’t have an update of the prevailing health risks to women and girls in the Solomon Islands but believe that cancer of the genitor-urinary organs, skin cancer, breast and malignancies predominate in females.

Last month, Australia’s Minister for Foreign Affairs and Minister for Women, Senator the Hon Marise Payne, announced that Australia will support the Young Women’s Christian Association (YWCA) of Solomon Islands to continue its important work empowering at-risk girls. Australia’s support will be funded through its Pacific Girl investment.

Minister Payne made the announcement during a visit to the YWCA’s Honiara hostel on Wednesday.

The Pacific Girl program works to encourage girls to develop expanded peer networks to help them feel less isolated, more confident, to learn from each other and to work together to take collective action to advance their interests. It also supports girls with practical training opportunities to gain alternative income generation skills and opportunities; and connects them to essential health and law and justice services.

Minister Payne said adolescent girls in Solomon Islands face many of the same challenges as girls in Australia and other parts of the world.

Through the Pacific Girl program, young Solomon Islands girls will be connected with mentors to help develop their skills and build their support networks, she said.

I believe much more is needed than what Senator Payne offered the YWCA.

In 2016, I recall having read that theFamily Planning in NSW was partnering with the Solomon Islands Ministry of Health and Medical Services (MHMS) to provide new cervical and breast screening services for women over 25 years old

At that time it was claimed the Family Planning NSW and the MHMS aimed to screen 2,000 women for cervical cancer during the two-year pilot project.

The World Health Organization (WHO) recommended the use of VIA in low resource settings, such as in the Solomon Islands as it does not require a laboratory for processing specimens. In addition, the results of screening are available immediately, and women with suitable pre-cancerous lesions can be treated on site using cryotherapy.

The aim of the project was to determine the feasibility of a single visit approach in the Solomon Islands. If the evaluation found the project to be successful, a national program would be implemented with the aim of decreasing cervical cancer deaths in women of the Solomon Islands.

The Family Planning NSW was seeking funds to purchase equipment which would enable the expansion of the project. Funds would be used to purchase essential equipment such as cryotherapy guns, cryotherapy tips, sterilisers and carbon dioxide gas (the refrigerant used to treat pre-cancerous lesions).

In April 2016, it was claimed, twelve doctors, midwives and nurses completed the first Solomon Islands training on cervical screening using a single visit approach. During the five day course, participants learned how to conduct cervical screening (VIA and Pap tests), cryotherapy of the cervix, counselling on cervical cancer prevention and community education. Course content was developed for the local context and delivered by nurse educators from Family Planning NSW with funding from the Australian Government.

Since the training in April 2016, more than 200 women are said to have been screened at three pilot sites in Honiara and Guadalcanal province. Women with positive results were either treated in local clinics using cryotherapy or referred to the National Referral Hospital for follow up, where the lead obstetrician and gynaecologist is supportive of this project.

Are local clinics providing quality services to large numbers of women? I pose the question now three years since the NSW Family Planning Association project and given the fact that many clinics are not adequately provisioned and some patient care deemed to be inadequate.

I also raise the issue whether cervical screening tests did locally need referral offshore for processing. If so, what measures are now in place for alternative cervical screening and treatment?

Given all the complexity of issues in respect of women and girl’s rights to medical screening for cervical cancer and breast screening, including the very important factor of costs outside the hospital services once more fully covered by the NRH, but now more commonly referred to the HCC health clinics, what can be done by the SIG to encourage, support and ensure a much better health system for local women and girls?

I have in mind a Solomon Islands centred Family Planning Association being a leading provider of reproductive and sexual health services. Such services giving expert advice on contraception, pregnancy, sexually transmissible infections (STIs), menstruation, menopause, common gynaecological and vaginal problems, cervical screening, breast screening and awareness.

It is vitally important to know that most cases of cervical cancer and breast cancer can be prevented through cervical screening and treatment of pre-cancerous lesions.

 Yours sincerely

Frank Short

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