Playing Politics with Typhoid
Map Health centres. Click to enlarge.The area affected is inland of Sigatoka.
The Fiji Ministry of Health has declared a state of public emergency in Navosa following two deaths, 20 confirmed cases and reports of over a 100 suspected cases of typhoid, a disease spread by bacteria that is usually transmitted through eating contaminated food or drinks prepared by someone who is sick. People over two years of age are being vaccinated to prevent the spread of the disease and public gatherings have been cancelled.
The Ministry advises visitors to villages and settlements to exercise caution with local water supplies and recommends tourists carry their own drinking water on such excursions. Tourists should avoid taking part in kava drinking ceremonies in rural areas unless tour operators can provide assurances that Fiji Ministry of Health guidelines are being observed. The public is urged to wash their hands with soap before taking food and after visiting the toilet. Australia is providing 60,000 vaccines and syringes. Notices have also been sent to hotel owners in the coastal areas to take precautions as the disease is infectious and could spread to other parts of the country.
No new travel advisory have been posted on DFAT or MFAT websites. Fiji remains "high risk" for Australians and "some risk" for New Zealanders --but for political reasons. The only MFAT health advisory on typhoid was posted last year when tourists were advised not to drink unboiled water when visiting rural villages. This, of course, could mean that the websites have not yet been updated.
Having a Field Day*
The outbreak is serious but the level of risk to tourists is surely overstated by Michael Field under a Stuff heading "Tourists warned of typhoid in Fiji." The warning he referred to came from Fiji health authorities who, as noted above, advised tourists to "exercise caution... on such excursions." The advice was specific to excursions (to villages) up the Sigatoka River. It was not a nation-wide warning.
Field goes on to write: "A public health emergency has been declared in Fiji after an outbreak of typhoid in the major tourist belt region of the country."
The health emergency is limited to Navosa. The area affected is definitely not part of the Fiji's "major tourist belt." The outbreak is in Navosa, centred on Keiyasi, some 50km inland from tourist hotels on the Coral Coast. It is accessible by an ungravelled road alongside the Sigatoka River. The relatively few tourists who visit the area do so on organized "village tours." Fiji's major tourist area is not the Coral Coast. The Nadi-Mamanuca area attracts over one-half of Fiji's tourists; the Coral Coast about a quarter. The nearest part of the Coral Coast (where no typhoid cases have been reported!) is a further 50km away from Nadi. Field blurs these localities and distances.
Further, Field writes: "The Fiji Times reported the outbreak was substantial but Health Ministry spokesman Iliesa Tora was refusing to divulge statistics of those infected." What more does Field want? He knows there have been two deaths, 20 confirmed and about a 100 suspected cases. Does he also want to know their ages and sex? No one is trying to hide the statistics, as Field infers. The figures have been reported in the mainstream media and the public is being kept up to date with developments. The latest figure is 263 suspected cases with 28 cases confirmed.
The problem has been caused by upstream villagers using the river as a toilet, and downstream villagers using the same water for drinking and cooking. Health spokesman Iliesa Tora (mentioned by Field for "refusing to divulge statistics") said "health teams had in the past educated villagers on the effects of unhygienic practices but this seemed to have been largely ignored."
Field goes on: "The US Centre for Disease Control (CDC) says typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi"? All health authorities in tropical countries know about typhoid. Why does Field cite the US; why highlight that it is life-threatening? Relatively few people die of typhoid; vaccinations are available; infection can be avoided by taking normal sanitary precautions, and no tourist to Fiji has ever been known to die of typhoid, and I doubt more than a handful have ever been infected.
In contrast to Field's report, the US Gant Daily reported Ana Tudrau-Tamani (AHN News) from Suva. "Two people are confirmed dead in Fiji as a result of a typhoid outbreak in Navosa, one of Fiji’s fourteen provinces, forcing the Health ministry to declare a state of Public Health Emergency in the province." She is not quite right. Navosa is not yet an independent province from Nadroga but she did know it is not part of of Fiji's "major tourist belt" and The Sydney Morning Herald, reporting a new
infection figure of 263, called Navosa as "an isolated province on the main island of Viti Levu."
It is hard to believe that a slip of the pen caused our veteran Pacific journalist to get his geography so wrong.
* Definition field day: An opportunity for unrestrained activity.
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