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Meeting with the Staff and Students of the Fiji College of Medicine, Nursing and Health Sciences on Non- Communicable Diseases.

July 28, 2016       Fiji School of Nursing Auditorium, Suva.

  • The Minister for Health and Medical Services Honourable Jone Usamate;

  • The Acting Permanent Secretary, Dr Josefa Koroivueta;

  • The Chancellor of the Fiji National University, Mr. Ikbal Jannif;

  • The Dean of the College of Medicine, Nursing and Health Sciences, Dr. William May;

  • The staff and students of the College of Medicine, Nursing and Health Sciences;

  • Dr. Isimeli Tukana, National Advisor on Non-Communicable Diseases and Head of the National Wellness Center;

  • Distinguished Guests;

  • Ladies and gentlemen.

Ni sa Bula Vinaka, Namaste, As-salamu Alaykum, Noa’ia ‘e Mauri, and A very Good Morning to you all.

I am so glad and deeply honoured to be here with you this morning. 

This will be my third meeting with the key stakeholders within Fiji’s health sector. I have had the pleasure of meeting with the Minister, Honourable Jone Usamate, and the senior executives of the Ministry on Thursday last week. I also met with the Management and staff of the Colonial War Memorial Hospital on Tuesday. I have enjoyed my meetings so far and I hope that my message will be received in good faith by everyone within Fiji’s health sector, including our trainee doctors and nurses who are here with us this morning. 

I had asked for these meetings firstly to thank the Honourable Minister for inviting me to be Fiji’s champion and lead advocate in the national campaign to eliminate Non-Communicable Diseases (NCDs) in the country. 

In accepting this honorary role, I also wanted to appeal to all the stakeholders in the health sector for us to work together to achieve our collective goal of eliminating NCDs. Many of you would be aware of Fiji’s status concerning NCDs. 

The Honourable Minister has been reminding our beloved nation that NCDs contribute to about 80 percent of deaths below the age of 70 Years. This is confirmed by the World Health Organisation, which reports that Fiji has the second highest rate of NCD-related deaths in the Pacific. Essentially, this means that Fijians are dying young, and the main causes are NCDs.  And, as if that is not enough, we now hear that Fiji is ranked as the second highest Nation in the world with deaths caused by diabetes. 

A few weeks ago, I attended a foot-care symposium organised by the Fiji Diabetes Association in conjunction with the Ministry and the World Diabetes Association. I learnt that diabetes is Fiji’s top killer within the long list of NCDs. I also learnt that more Fijians are losing two lower limbs per day due to amputations because of diabetes.

A report on Fiji’s health status for the past 30 years shows an increasing trend in diabetes, high blood pressure and obesity. 

At the recent NCD-Summit in Tonga, the World Bank estimated that the economic burden of NCDs in Fiji – if business as usual continues - would be U.S. 213.58 Million Dollars by 2030. This is equivalent to approximately $444 Million Fijian Dollars. This burden is projected to increase to U.S. 342.37 Million Dollars or over $712 Million Fijian Dollars by 2040. If the 2030 projection were to be put in the context of our national budget for this year, the economic burden of NCDs would be over 12 percent.  In short, Fiji could be spending over 12 percent of our national budget just to treat NCDs!

The World Bank further noted that the biggest driver of lost output/outcome is the potential loss of labour due to early deaths from NCDs. It says that the potential loss of effective labour force by 2040 in Fiji will be 16.4%. Heart Diseases will contribute to 60% of this burden; Diabetes 24%; Cancers 8% and Lung Diseases 7%.

Ladies and gentlemen, this trend will inevitably and sadly reduce productivity and economic growth.

Both the World Health Organisation and the United Nations Development Programme are currently doing a more comprehensive research and evaluation on how NCDs are affecting social and economic developments in Fiji and as the lead advocate in our work against the prevalence of NCDs, I am dreading to know the final outcome of such work because as more Fijians become victims to NCD related ailments, the resultant social and economic burdens on families and our Health and Medical Services increase too.

All these statistics are alarming. We will all agree that Fiji’s status on NCDs is extremely unfavourable. They not only project a very poor image of our Nation, but they, importantly, reflect a trend of very bad decision-making on the part of Fijians. 

Some might say that these circumstances are by-products of development especially in developing countries as they try to improve their social and economic status. However, we cannot and must not accept this because even as a developing country, we are a progressive Nation that is beginning to take leadership positions within the international society of States, and we are also placing significant emphasis on educating our people to be responsible and productive citizens, by changing mindsets and more importantly, making the right choices.

This is reflected in Government’s budgetary allocation where education has consistently received the highest budget within the social services sector. I concur and endorse the Government initiative that the national effort and strategy to combat the increase and prevalence of NCD in our beloved country is to focus on our young generation – the youths and the children – by educating and convincing them to change lifestyle in making the right choices.

Ladies and gentlemen, as a Soldier I believe in keeping fit and leading a healthy lifestyle so please allow me to digress a bit.  A large component of a soldier’s training and actual work is focused on maintaining peace and stability at home and if need be, in war-torn countries. 

Soldiers learn to conduct security assessments, among other things. They learn to detect threats and potential threat situations and deal decisively with them. 

Dealing decisively with threats and potential threats includes not beating around the bush, but addressing the core issues. We should all realize that NCDs are a threat to our Nation. NCDs are not a perceived threat. They are real.  In fact, I see NCDs as a scourge to our Nation. They are a threat to all our people irrespective of their age or ethnicity. 

They are a threat to our potential and capability to progress and prosper socially and economically. They are a threat to our children and the future of our Nation.  NCDs are a real and present threat that we must deal with decisively. I am aware that the Honourable Minister for Health and the Assistant Minister are doing all that they can by educating the public, considering facilitative legislations, and re-positioning the entire health sector to deal with NCDs among the other national health concerns.

I am also aware that the staffs of the Ministry are trying their best to help the Honourable Ministers and especially to render their technical expertise and interventions in the clinical management of NCDs and their resultant complications. I have acknowledged and thanked them for their commitment and tireless efforts. However, I also acknowledged that our health statistics strongly suggest that Fiji needs to do more to control and eliminate NCDs, and to avoid the increasing economic burden. 

This is the key reason I have asked to meet with the stakeholders in the health sector in my capacity as President and Head of State and in my additional capacity as Fiji’s Champion in the fight against NCDs. I want to reconfirm my support for you so that we can decisively deal with NCDs, together as a united team. Our end-state and desired outcome must be to have a healthy, productive, prosperous, sustainable and happy Nation. To achieve this, our quest must be to eliminate NCDs and to promote wellness. 

We need to properly identify the root causes of NCDs.  I appreciate the advice from our National Advisor on NCDs, Dr. Isimeli Tukana that NCDs are caused by Smoking, Nutrition (or the lack of it), Alcohol and Physical Inactivity. The acronym is SNAP.  Having identified the root causes, we must make haste in identifying all the opportunities, which I suppose will be multi-faceted in nature.  We need to educate our people, we need to consider various forms of legislation that will help our Nation’s cause, and importantly, we need to “walk the talk”. 

I want to help especially with the walking the talk aspect. And I believe that it is very important that we start right here, not only with all of you in the health sector, but also with the staff and members of the Office of the President.  

For your information, my staff and I are not only walking the talk, but ‘running the talk’ literally because I have instituted a revised diet and physical training regime within the household to assist us in maintaining a healthy lifestyle, thus avoid becoming victims of NCDs. I appeal to you for us to lead by example.  I cannot imagine encouraging the public to make the right dietary choices and exercise daily if I do not do these myself.  Similarly, our people will not heed our advice if the medical personnel and all those who work in the health sector, and the leadership of this country, do not eat healthy meals and exercise daily. Let us look first at our own status. Are we healthy?   Are we physically fit?  Are we mentally, spiritually and intellectually sound in mind and body to lead and be role models for our people?  Or do we still prefer to be complacent and continue to lead a sedentary lifestyle as senior officials and administrators which in my humble opinion, is at variance to Government’s vision of a healthy and prosperous Fiji?

Ladies, gentlemen and students, I wish to recommend a few pointers for your consideration. These emanated from discussions I have had with Dr. Tukana:

We should all quit smoking and declare all our work and study places Tobacco Free;

We should not allow unhealthy foods and drinks to be served, eaten nor sold in all Ministry of Health and Medical Services facilities including all facilities of the College of Medicine, Nursing and Health Sciences;

We should be responsible in our drinking of alcohol and kava;

We should exercise daily and promote physical activity in our workplaces and within the College; and last but not the least,

We should make every effort to reduce obesity.

I appeal especially to you the students. I know that as budding health professionals, you can add to the list on how Fiji could and should deal with NCDs as a threat to our Nation.  I look forward to hearing from you on the proposed approaches and strategies so that I could help promote them in my engagements with our communities.

The reality of the present situation is that we have identified this problem and must accept the fact that we have a significant amount of work to do, and the work starts right here with all of us, right now. Let us please lead by example. I thank you again for this opportunity to be with you. 

May Almighty God continue to bless you all and bless our beloved nation, Fiji.

Vinaka Vakalevu, Dhanyavaad, Fai’eksia and Thank you all.