The Honourable Minister for Health and Medical Services,
The Honourable Assistant Minister for Health,
Your Excellency, the Australian High Commissioner,
Distinguished Guests and especially the representatives of Community Health Workers throughout Fiji,
Ladies and Gentlemen,
Bula vinaka and a very good morning to you all.
With the general standard of health in Fiji still far from satisfactory, the role of community health workers has never been more important. So I’m delighted to join you this morning for the signing of a memorandum of understanding to revitalise our community health program and take it to another level.
This agreement between the Ministry of iTaukei Affairs and the Ministry of Health and Medical Services is designed to strengthen the Community Worker Health Program that began 38 years ago in 1978.
It is a partnership with the Australian Government through its Fiji Health Sector Support Program. So I want to begin by acknowledging that support and to ask Her Excellency the Australian High Commissioner to pass on our gratitude to her government and the Australian people.
Ladies and Gentlemen, this program is designed to improve the effectiveness of our community health workers and their efforts to raise health standards at the grass roots – in the hundreds of individual communities scattered throughout Fiji.
Community health workers are community-based volunteers who act as the first point of contact between ordinary Fijians and the Ministry of Health and Medical Services. The best of them are practical, sensible and accessible people with a genuine sense of caring for the wellbeing of their communities and the health needs of the people, from the very young to the very old.
They not only enable ordinary Fijians to access health services quickly and efficiently in times of need and to navigate the system. But they are also important health coaches – encouraging all members of the community to pursue healthy lifestyles and take care of themselves in a holistic way. Whether it is to eat better, exercise more, give up smoking or curb their consumption of alcohol or kava.
In a typical community, a health worker might encourage a mother to have her children immunized or give her advice on the best food to feed her baby. It might be to remind an elderly person to take their blood pressure medication or work with someone with diabetes to stabilize their condition with a better diet. And, of course, all community workers have a special responsibility towards pregnant mothers in our communities – to remind them of their appointments with a nurse or doctor, assist them and their families to prepare for the birth of their child and provide education on breastfeeding.
So, Ladies and Gentlemen, our community health workers are vital members of Fijian society. Pillars of our communities with a special understanding of the nature of those communities and the needs of our people. But unfortunately, we have found that they don’t always enjoy the support of those communities they deserve and that they need to make them more effective.
A report five years ago by the Ministry of Health funded by the Australian Government revealed that out of the 606 community health workers interviewed, 85 per cent said they had no support from their communities at all. And this was leading to a huge turnover of community health workers, as they left the system to pursue more satisfying roles in which they felt more valued and effective.
Ladies and Gentlemen, this is clearly not good enough if we are to deal effectively with the health challenges we face, and especially the alarmingly high incidence of Non-Communicable Diseases in Fiji. We have one of the highest rates of NCDs in the world – preventable diseases such as heart disease, hypertension and diabetes.
A study three years ago showed that a staggering 80 per cent of the premature deaths of iTaukei between the ages of 40 to 45 were due to NCDs. I repeat: these deaths are preventable. They needn’t happen at all. And it is vital that we make the battle against NCDs an important national priority.
Part of this means educating our people that a change of lifestyle can save lives. That eating less fatty food and more fresh vegetables and fish, not drinking as much kava or alcohol and walking rather than taking the bus, can make a huge difference to a person’s lifespan and general wellbeing.
We must also step up our effort to emphasise that prevention rather than cure is the best way to relieve the huge burden that NCDs are having on our health budgets and the system as a whole. The burden on our hospitals and health clinics caused by diseases that can be prevented must be lifted. And it is the responsibility of every Fijian to play their part in this effort.
Ladies and gentlemen, that is why this program of strengthening the community health worker system is so important. And not just in the battle against NCDs but by using these workers more effectively to educate our people about a range of health challenges, many of them also preventable.
Unfortunately here too, the iTaukei are especially vulnerable. Almost 60 per cent of all maternal deaths and 60 per cent of pregnancy-related deaths are among iTaukei women. There is also a higher incidence among the iTaukei of typhoid, dengue fever and other diseases. And malnutrition in children under five years of age is also higher than among other Fijians.
We must make more of an effort as a nation to confront this crisis. We must build a better bridge between our community health workers and the people who desperately need their services. They need to be engaged at a much better level. And I’m delighted to see a concerted effort being undertaken in this report to embrace a range of measures to turn this situation around.
They include more funding; better training; better standards of governance; more comprehensive community participation through village health committees; more clearly defined roles for our health workers; more clearly defined roles for the two ministries involved in this program; stronger links between the health system and provincial councils; and better supervision and monitoring of the program to ensure more effective outcomes.
Ladies and Gentlemen, I want to close by warmly thanking the community health workers who are present here today, representing more than 1,500 others across Fiji. I salute you all for your dedication to improving health outcomes for the Fijian people. You are already making a difference and with better support, I know you will be able to make much more of a difference. But that depends not only on providing you with better tools to do your job but strengthening your links with your communities.
So I also want to close by making this appeal to the Fijian people as a whole: seek out your community health workers. Engage with them. Tap into their wisdom and knowledge. Treat them as valued members of your community. As friends. Because they are there to help you. And they are a vital link to better health outcomes for every Fijian, and especially in rural and isolated communities.
To everyone who has been involved in this program, vinaka vakalevu on behalf of every Fijian. And I have great pleasure on behalf of the nation in wishing this program every success.
Vinaka vakalevu. Thank you.