Easter Sunday in the Christian belief and tradition is associated with new birth and resurrection and yet here I am today writing, yet again, about dying rural clinics and the poor state of health care for 80 percent of the rural population without proper health clinics amidst a growing rural population in the Solomon Islands.
For many years already I have highlighted the decaying state of many of the health clinics and rural health centres constructed in the colonial era, broken down, termite infested, never renovated, resurrected or totally replaced.
Under the previous administration of Prime Minister Rick Hou there was a promise made at the start of his term in office to rebuild the rural health clinics and health centres but such an encouraging promise never materialized.
Today, the Island Sun newspaper reports on the present state of two of the rural clinics in Ulawa, in Makira Province, and graphically illustrates the situation with depressing images.
I will share the article with readers.
Quote,
Clinics on Ulawa Island in the Makira Ulawa province are in a bad state and can be closed down.
Two of the four Rural Health Clinics (RHC) on Ulawa, namely Haupala and Taheramo are too old and need urgent repairs as the roofs have leaked, walls damaged by termites and too small in relation to the islands’ increasing population.
John Matemotu from Kelimei village said, “That this is an issue for the North Ulawa ward which is the catchment area of Taheramo clinic, and if health authorities decide to close down Taheramo because of the current state of the building and no proper storage room for medical supplies.”
“Since 1993 when the clinic first opened its doors for service, there has never been any infrastructure upgrade or improvement done with our clinic. The clinic’s two room building is now too old and has been damaged by termites and it is small compared to today’s increasing population.
“The only development here was the failed Maternity building way back in 2012 funded by the Solomon Islands Rural Development Program (SIRDP)”, Mr. Matemotu said.
Mr. Matemotu added. “The big question is who is responsible for the development of clinics back in the rural areas?”
“Who is responsible for the upgrading of these infrastructures, the communities here or is it the Makira Ulawa provincial government or the National government?” he asked.”
“Responsible authorities should not turn a blind eye on these things as we are dealing with people’s lives and their rights to access better health facilities.” Mr. Matemotu said.
He added that people here are doing their part in keeping the clinic compound clean, doing repairs to thatched roof buildings. such as the admission house and others as they only need local materials which are free and available unlike hardware materials.
“The communities have played their part in doing maintenance work as these don’t require hardware materials but local materials which can be collect from the bush, but people are tired of doing maintenance and repairs to the thatched roof buildings such as the admission house, toilets and staff kitchens every year,” he further added.
Ishmael Maeohu of Mwajoa village also shared similar sentiments about Haupala clinic which is located in Ward three of the Makira Ulawa province and about ten kilometers east from Taheramo Clinic.
He said Haupala clinic too is facing the same problems and there is also no proper toilet for the staff and the sick patients.
“I can say here that Haupala’s clinic building conditions are far worse than that of Tahramo clinic. We don’t have any toilets here and both the nurse and the sick patients admitted here are using the seaside as toilets,” Mr. Maeohu confirmed.
“Imagine somebody who is very sick and has to walk for a few meters to the seaside if he or she wants to go to the toilet.” He adds. “It is very bad that the clinic lacks these very important facilities that they should have.”
End of quote,
On the occasion of World Health Day in 2015, World Vision highlighted the need for better access to quality health care particularly for the people in the remote communities of Solomon Islands on the islands far from Honiara.
The World Vision report, in part, read.
Quote.
The country’s 187 nurse aid posts and 102 rural health clinics chronically lack essential equipment and medicine to save mothers and children’s lives, says international humanitarian organisation World Vision.
“It’s important that when pregnant women, mothers and children seek medical assistance from aid posts and clinics, they are able to get the help they need,” says Janes Ginting, Country Director of World Vision Solomon Islands.
About 80% of the population of Solomon Islands live in the rural areas and rely on rural health services. Mothers die during childbirth at alarmingly high rates and many children do not live to see their fifth birthday. The maternal mortality rate in Solomon Islands is 100 deaths per 100,000, compared with 1 in 4,700 in wealthy countries.
World Vision is working with communities to establish Village Health Volunteers who can assist pregnant women as they prepare to give birth safely and also educate them about maternal and child health issues.
“The Village Health Volunteers are trained by World Vision to provide health advice to families and also to encourage pregnant women to do antenatal check-ups and prepare for delivery as well as taking good care of their babies when they are born,” says Everlyn Darcy, World Vision Solomon Islands Health Coordinator.
End of quote.
Without proper rural health clinics and health centres, where they are most needed with a vastly increased rural population in 2021, what became of the Village Health Volunteer scheme proposed by World Vision 6 years ago?
In 2016, I wrote the following article and published it on my international website www.solomonislandsinfocus.com as well as posting the piece on Linkedin.
Quote.
Looking at the Health Care Needs from a Rural Perspective
Thursday, 01 September 2016
Dear Editor
"If we do not lay out ourselves in the service of mankind whom should we serve?"
John Adams
Over 80 percent of the Solomon Islands communities live in rural areas where geographic isolation and dispersed populations make the provision of even basic goods and services logistically difficult and expensive.
The Australian Government’s Direct Aid Program aims to improve livelihoods in some of the most remote and disadvantaged areas and we should all be extremely thankful of such targeted, meaningful help.
It is widely known that most, if not all, of the country’s 344 rural health clinics, generally staffed by experienced nurses, are run down and many needing urgent repairs and renovations in order to function effectively to serve the health needs of great numbers of local people.
In April this year the SIBC conducted a field trip to Choiseul and, on reading a report of that visit, I commented that I found it rather odd that complaints over local conditions and alleged shortages of development aid in the rural communities were, seemingly, not being better monitored and communicated to the national level, even if immediate remedies could be easily accommodated.
In recent weeks, in letters to the local newspapers, I have attempted to highlight the plight of the Gwaunaoa Rural Health Clinic where doctors have said patients are being put at risk when operating without electricity and having to use torches and kerosene lamps to attend to women giving birth. At theTingoa Mini Hospital a critical shortage of water tanks has meant the hospital turning away patients. Meanwhile, at the Manuopo Health Clinic, the situation is reported to be so critical the place is unfit for habitation and health services are suffering, placing a large community of over 5000 at risk.
In keeping with what I said about the SIBC’s field trip, why is that the needs of the rural clinics often requires a community representative or an individual health worker to resort to writing to the media to highlight the plight of their rural health services? Who monitors such shortcomings and brings them to the governments notice?
We seldom hear from those dedicated nursing professionals who daily struggle to meet their patients medical requirements with little equipment, supplies and accommodated in run-down clinics. There are truly some real heroines out there, dedicated and committed to their calling.
I would like to, respectfully, pose the question what the Solomon Islands Government plans to do to improve the state of the country’s health clinics, and I am sure many in the rural communities seek the same answer?
Through its Direct Aid Program Australia has provided, in recent times, AUD $2.7 to the Solomon Island’s Government to improve health care outcomes for all Solomon Islanders, with 40 per cent earmarked for the provinces to support hospitals and rural care centres performing lifesaving primary health care.
Australia has proven to be the largest donor to the Solomon Islands’ health sector since 2003 with AUD$ 80 million (from 2012-2016) to support the Solomon Islands Government achieve its national health objectives, under the National Health Strategic Plan.
Most recently, Australia’s Senator Ferriavante-Wells said the Australian Government will provide up to $66 million over the next four years to support key strategic health priorities in Solomon Islands.
If it is not too imprudent to be asking, will any of the $66 million aid to the Solomon Islands go towards the early development of static clinical and medical services, as part of outreach activities to the rural communities covering the length and breadth of the Solomon Islands?
In giving medical aid to the Solomon Islands, Australia works closely, of course, with many other regional and international organisations, and partner governments to support Pacific Island Countries ( including the World Health Organization, UNICEF, UNFPA, the World Bank and the Secretariat of the Pacific Community) to improve health outcomes and all should all be thankful for such generous assistance.
One should not forget the help of New Zealand, Japan, the European Union, the Republic of China (on Taiwan) and helping charity organizations such as my partner, ‘Take My Hands’ (TMH), the Auckland based organization currently cooperating with the MOHMS and the NRH by way of a MOU to supply, annually, containers of medical equipment and supplies to the NRH, Provincial Hospitals and selective NGO’s, including the disabled and the Hearts of Hope charity.
The Honiara based National Referral Eye Hospital funded and built with New Zealand aid now provides excellent, free eye care to all Solomon Islanders and acts as a regional training hub for visiting eye care professionals.
While, today, I see the bigger picture in the Solomon Islands generally improving from the perspective of health care, I think of the many in the rural communities who are still deprived of basic health care facilities and my plea for help for them is the message I leave in this letter.
Yours sincerely
Frank Short
End of quote.
· What did become of the $66 million Australia pledged in 2016 for four years to support key health priorities? Clearly, the money was not devoted to the key health priority of rebuilding rural health facilities.
In 2011, the Japanese government built a new state of the art hospital in Gizo, Western province.
The Gizo hospital consisted of sixty beds, two operating theatres and now serves more than 100, 000 people in Western Province, Choiseul and part of Isabel.
The development happened after the tsunami in 2007 devastated the old hospital.
Just recently, according to an article in the Island Sun online newspaper, the Japanese Government is conducting internal discussions with relevant government ministries to upgrade the Kilu’ufi hospital in Malaita province.
The First Secretary to the Japanese Embassy, Asano Yoko confirmed this when she appeared before the Public Accounts Committee in Parliament.
She said a study team is expected to travel to Kilu’ufi to collect all information before the start of construction.
Kilu’ ufi hospital is the third largest hospital in Solomon Islands and located 4km North from Auki, the capital of Malaita Province.
Last week, the Solomon Star newspaper today reported how the Prime Minister had recently been briefed by the US Deputy Chief of Mission in Port Moresby, Bernard Link, during a courtesy call on the PM in Honiara.
Later the Prime Minister’s Press Secretariat issued the press release, I quote.
Updating PM Sogavare on the US’s development projects in the country, the US Deputy Chief of Mission outlined a number of development project initiatives for the Solomon Islands.
These included:
USAID’s $25 million (SBD$200m) Strengthening Competitiveness, Agriculture, Livelihoods and Environment (SCALE) Program, which will be the USG’s largest investment in the Solomon Islands. This is a national Project that will benefit Malaita and other provinces.
The primary objective of SCALE is to advance the Solomon Islands’ economic competitiveness and inclusiveness with specific emphasis on the development of the agribusiness sector and improved management of the forestry sector. It will seek to improve the enabling environment for increased trade and investment; promote the expansion and further development of the agribusiness sector; and improve governance. By advancing regulatory reform and improving the performance of the agriculture and forestry sectors, more employment will be generated; incomes are expected to rise and the quality of life of the citizens of Solomon Islands.
While one is very appreciative of the promised US SBD200 million aid package it is to me, at least, worrying and rather disappointing that none of that aid is likely to be directed to the rural health care concerns I have mentioned.
China, the Solomon Islands newest diplomatic partner, will be injecting nearly $8 billion in new investments towards the hosting of the Pacific Games inn Honiara in 2023, but none of that investment is likely to be used to restore health care facilities, including, as I understand it, the National Referral Hospital (NRH).
I wrote recently, quote.
The Solomon Islands Government is wished success in providing the vital infrastructure for the Games, with successfully holding the event and, hopefully, ensuring more facilities beneficial for the people after the Games conclude.
I have very much in mind social services and particularly the pressing needs of the health services, including major improvements needed for the National Referral Hospital (NRH).
It has been my experience in other countries where national sporting events have been staged that economic activity that flowed after the events was placed within the private sector and not into public funds.
End of quote
Indeed it is my hope that after the outcome of the Pacific Games (if not sooner) a collective of diplomatic partners will coordinate with the Solomon Islands government, with agencies such as the WHO, UNDP, World Vision, Oxfam, Save the Children and maybe the World Bank and the Asia Development Bank, to ensure the decayed rural health clinics and rural health centres are given new birth.
The regular reporting of the neglected rural health facilities and the plight of the people needing adequate and effective rural health care borders on a duty of care and a breach of fundamental human rights in terms of health needs and surely the Solomon Islands diplomatic partners are not unaware of the big picture and the difficulties faced by the Solomon Islands government in adequately fulfilling all its many obligations.
Yours sincerely
Frank Short
