Friday, May 30, 2014

Lockington's Everyday Fiji ... Life Goes On

Hospital Services

We were at the Lautoka hospital and I saw a young man sitting by himself in the GOPD. He looked like he was in pain so I asked him what was wrong. He said he was just feeling weak.

I asked him where he was from and he said Nadi. When I said that he should have gone to the Nadi hospital he said, "If I go there I will be seen in the afternoon, I was here at 630 am and its now just after 8 o'clock and I'm about to be seen. If I go to Nadi hospital I will be seen in the afternoon."

I was taken aback by these remarks  and asked a few more people and they were also from Nadi. Wow.

Please could a survey be done to determine how true this is. Is service at the Nadi hospital really slow? And why.

Invitation

Good on you Paradise Beverages for the $18 million major capital investment. It's got an apt name in Project Bula Vou .. new life.

As reported the company provides Fiji with $1m a week in economic value. Vinaka, that's much needed money. More people will be employed and families will benefit.

Once again vinaka Paradise Beverages, can you send some samples to Mulomulo for this professional to taste?


Allen Lockington is a self-employed customs agent and business consultant who has regular articles published in Fiji. I thank Allen for permission to reprint some of them in this political blog. They remind us that life goes on, whatever the political situation. And it's good to know that.

Political Round Up for the End of May

There is a lot to report this week.

  Earlier we had independent candidate Roshika Deo protesting about the cancellation of a scholarship for one of her supporters; Mick Beddoes provided insights into the PM's "real" character; all opposition parties jumped onto the "disgraceful" conditions revealed by Biman Prasad after his visit to Nadi hospital; some parallels were drawn between the Thai and Fiji coups, and the new Fiji-Times Tebbutt Research poll showed the PM and Fiji First had the support of about two-thirds of those questioned — but nearly one-fifth had either not make their minds up or refused to answer.

More recent news sees an unusual statement from the FLP, a predictable one from SODELPA; a difference of opinion between chiefs; a chorus of objections by Opposition parties about Fiji First's registration; a plea from Mahendra Chaudhry that he's being got at; news from SODELPA and the NFP on levying their candidates to fund their election campaigns, support for Roshika's student from PDP's Felix Anthony, a possible loss of $22 million to the sugar industry in which Anthony is probably implicated; and a mixed ABC report on support for Bainimarama and Fiji First. The best rumour for the week is that two prominent lawyers are fleeing the sinking ship.

For weekend reading I'd recommend two thoughtfully provocative items, the first from Satendra Nandan on The enigma of being Indian; the second on Thai coups in which the author argues they are influenced by US policy in SE Asia.

Here are the main items published in the second half of the week:

YOU ARE ILL-ADVISED  TO FEED THOSE WHO BITE YOU. If items for this weekend's meeting in Lautoka are any indication, the Fiji Labour Party seems likely to contest the elections on unemployment and the inadequacies of the present government, normal practices for opposition parties; the high cost of living, a perennial of Labour parties world-wide, and, at first glance, the surprising praise for the Great Council of Chiefs and the statement that it would probably restore the GCC in the unlikely event it forms the next government.

In its quest for Taukei votes —surely the only reason to mention the GCC— the FLP seems to have forgotten the role the GGC played in the two coups, in 1987 and 2000, that removed two elected FLP-led governments from power, replacing them on both occasions with parties that it supported: the SVT after the first coup and the SDL after the second. The GCC even made the instigator of the 1987 coup, Sitiveni Rabuka, a life member!

The GCC has been a major (arguably the) major power broker in Fiji politics since Independence. With the collapse of Alliance and the victory of the Bavadra-led FLP, they supported the 1987 coup, the SVT Government and the 1990 Constitution that made Fiji a Christian state and embedded Taukei (read GCC) paramountcy.

The SVT lost support due to its accommodation with the predominantly Indo-Fijian NFP, an accommodation which led to the slightly more democratic 1987 constitution.

Cross-voting in the 1989 election resulted in Chaudhry's FLP forming government, but this lasted barely a year before the 2000 frontsman George Speight mounted the 2000 Coup, again supported by prominent members of the GCC. Witness the number of chiefs, including Ro Teimumu Kepa,  who arrived at the Parliament compound where George Speight held FLP and other government MPs hostage.

This is the institution FLP potential candidate Vjas Deo Sharma. is now applauding and referring to as:
"a much beloved institution in our country [that was] unceremoniously wiped off the books … The chiefly system of the iTaukei had endeared for generations, right through from the Deed of Cession until it's removal by decree.We value the chiefs' contribution in guiding Fiji and in particular the bulwark it provides for unforeseen social disintegration," 

But he confuses "chiefs" with the Great Council of Chiefs. One can respect the chiefly system ands individual chiefs but be opposed to the GCC interfering in national politics. And one can support a GCC whose role is limited to Taukei affairs. 

Vyas also seems to have missed the fact that many Taukei, including many chiefs, now have serious reservations about the interference of the GCC in politics. Advisers to Government on Taukei title successions, land issues, culture and custom, yes; but political interference, no.

REFORMING CHIEFS. The Roko Tui Ba has urged chiefs at this week's Ba Provincial Council meeting to re-visit title processes and chiefly roles and responsibilities at all levels, from the mataqali and tokatoka to the yavusa and vanua, so that all Taukei will be motivated by their example to "move forward."

A CHORUS OF OBJECTIONS. The Fiji Elections Office says it has received six objections from political parties complaining about procedures relating to the registration of the proposed FijiFirst party. FF applied for registration on May 5 and the process normally takes about 28 days. Time is nearly up before a decision will be made to uphold or reject the objections. UFDF's Mick Beddoes has also lodged a police complaint, saying Bainimarama was canvassing before his party was registered.

SODELPA leader and paramount chief Ro Teimumu Kepa continues to visit provinces asking permission to launch the party campaign.

She was apparently not campaigning when she told the Serua Provincial Council this week that, if elected, SODELPA will -
restore the Great Council of chiefs, remove the reference to Fiji being a secular state and bring God back into the Constitution, return all native land to the Native Land Trust Board that previously took 25% of rental money for administration (the Government has now removed this); restore Taukei-directed scholarships; and — continue the Government policy of providing free education from kindergarten up.
The Tui Serua supports SODELPA but says his people are free to choose the party they support.

DECREE TAILOR-MADE FOR CHAUDHRY. FLP leader Mahendra Chaudhry says he will defy the Elections Decree regulation that prevent a person standing for elections who has been convicted of a crime within the past eight years that is subject to imprisonment for 12 months or more. He says he'll stand in the elections: "This decree has been design to keep me out. Everyone can see that."

SODELPA RAISING MONEY. SODELPA will help finance its election campaign with a $3000 refundable levy from those who have applied to be candidates.Applicants that are not be nominated will have their levy refunded. Ro Teimumu reports the levies are coming in very slowly. The party will contest all 50 seats in the election.

NFP LEADER Dr Biman Prasad says the party is still to decide how much to levy candidates and whether it will contest all 50 seats. Much will depend on fundraising. In a further media release on policy the party says that if elected it will review the salaries of doctors, nurses and health workers and implement a new salary structure within six months of being in government. 

Recent polls show the NFP has between 1% and 5% support among those polled. At best, it is likely to be a junior partner of the government elected. To implement any of its policies, it should be thinking hard on which party is most likely to win the elections. Biman also said “fear still remains in Fiji’s societies today and this is preventing people from coming out of their comfort zones to campaign for the September election.”

NFP SAY COMMERCE COMMISSION POLITICAL. NFP General Secretary Kamal Iyer has accused Commerce Commission Chairman Mahendra Reddy of being political for correcting what he said were misleading statements made by opposition parties on the cost of living. 

But if the facts are wrong, one would have though it Reddy's job to correct them. Iyer needs to show Reddy has got his facts wrong before accusing him of being political. 
 
PFP SUPPORTS ROSHIKA'S PLEA. PDP leader Felix Anthony has called the cancelation of a Deo supporter's scholarship an "outright ... denial of political freedom and rights to students who wish to participate in the political process of the country. This Government has denied a large section of our community from actively participating in the political process including Unions, NGO’s and public servants. This is plain denial of fundamental rights and must be condemned."

He continued: "Where is the sense in this policy? Our young people must be encouraged to participate in the political life of our country. The PDP has a policy and rule that 20% of all its office bearers must be youth. It will also have youth candidates in its election line up." He called on the Chairman of the Tertiary Scholarship Board to explain why the scholarship has been cancelled and said the scholarship must be reinstated. He also called for more media freedom.

PDP ANTHONY IMPLICATED IN SUGAR LOSSES. The International Trade Union Confederation is lobbying stakeholders to stop a $22 million grant to the Fiji sugar industry, and Felix Anthony and the FTUC are at least indirectly implicated. Read  The Fiji Times article.

EU ASSISTANCE NOT CONDITIONAL ON GCC. The restoration of European Union assistance to Fiji does not hinge on the return or not of the Great Council of Chiefs (GCC), but rather a credible election and the return of Fiji to democracy, according to Deputy Head of the EU Delegation for the Pacific Johnny Engell-Hansen. Read the FijiLive report.  

VOTER EDUCATION. Electoral Commission chairman Chen Bunn Young has been stresing the importance of voter education for some time now and is on record as saying he would welcome contributions from NGOs. The response from NGOs that must submit their educational material to the Elections Office for approval, has been slow and only one unnamed NGO has applied to the Elections Office for registration so far.   Read more.

 JUDGES NOT LEAVING. A rumour circulating the anti-Government blogs at present is that Chief Justice Anthony Gates and High Court judge Paul Madigan are jumping ship, presumably because they fear the election outcome. Such unfounded rumours are not new and when found wrong, they are never retracted. . I assume their purpose is to create uncertainty and cheer their followers.
 
FINALLY, THIS FROM ABC. From Suva, ABC's Liam Fox reports "support growing for Frank Bainimarama's Fiji First party ahead of election" —and some opposition.  Listen to him here.

Thursday, May 29, 2014

Health Fact File

Dr Neil Sharma,. Minister of Health

Given the attention given by the Opposition parties to the state of health services in Fiji, it is necessary to publish this file from the Ministry of Health

      HEALTH FACT FILE


HEALTHCARE SPENDS OVER $1BN
GOVERNMENT has spent over one billion dollars in improving health services for Fijians in the last seven years as it moves towards developing a modern healthcare system.

Its major reforms have been backed by funding through increased budgetary allocation for the last three years.

These major investments in health infrastructure will support Government’s efforts to decentralize, and improve accessibility to health services around the country.

Government spent close to $160m in 2012, a further to $170m in 2013, and boosted spending to $222.5m in 2014.

The cornerstones of these reforms are the decentralisation of services to rural and semi urban centres which ultimately offer a cost effective serve to all Fijians.

Reforming pharmaceutical services, upgrading medical equipment and facilities as well better pay for medical professionals to deliver the best effective services have been some of the measures to improve Fiji’s healthcare system.

Prime Minister Rear Admiral Voreqe Bainimarama had also announced further reforms in the health sector to boost primary health care to Fijians.
This is in line with the Constitution guaranteeing adequate health care to all citizens and the extension of the Sigatoka hospital underpins the efforts of the Government to exploit all avenues towards this end.


2014 projects
·        Upgrade of hospitals and health centres continue to be major focus for Government. $4.9 million for the extension and refurbishment of the CWM hospital operating theatre
·        A further $3.0 million allocated for the extension of the CWM maternity unit. This will cater for the increasing number of births at CWM hospital.
·        Funding of $0.6 million has been provided for the construction of a low risk maternity unit in Makoi and $0.25 million for the new Naulu health centre.
·        The Valelevu and Keiyasi health centres will be renovated with a provision of $1.0 million.

·        A further $2.0 million will be provided for the construction of a new hospital in Nausori. The construction and upgrading of these health facilities should help cater for the increasing population within the Suva to Nausori corridor.

·        Furthermore, $7.3 million is provided for the construction of the new Ba hospital and $5.9 million for the upgrading of the Lautoka Hospital’s emergency department.

·        A further allocation of $1.0 million is provided for the extension of the Sigatoka hospital.

·        Other major capital works planned for 2014 include a new nursing station in Nagatagata and health centres in Lagi, Cuvu and Waivaka. A sum of $1.9 million is allocated for these projects.

Construction of Health Centre/Hospitals/Quarters:
·        2009: Labasa hospital extension $7million, 47 beds for the men’s surgical ward, a library and a laboratory.

·        2013: New Nasea Health Centre in the hub of Labasa Town, services include general outpatient department for minor surgeries, pharmacy services and a wellness centre. Benefit  the people of Labasa and the Macuata subdivision

·        2013: Standard Quarters Cikobia Nursing Station (Macuata Province) $192,207 cost

·        2014: New nursing station in Waivaka, Namosi to boost the outreach of medical services and facilities to the public
·        2012: Vatukarasa Nursing Station: interior of Tailevu and Naitasiri now have access to a good health facility. The new nursing station caters for five villages and a few settlements that are located close to Vatukarasa Village, including Navalau and Coloi villages (500 ppl) , cost $400,000

·        2013: Raviravi Nursing Station: people of Yanuca Island and the villagers of Raviravi, Lalati and Rukua, to serve more than 1000 people in the surrounding maritime areas.

·        2013: Korovisilou Health Centre- Construction of nursing Quarters (Serua Province) cost $325,000

·        2013: Dobuilevu Nursing Station in Ra. More than $1million spent on the project.

·        Work on new Nagatagata Health Centre began in 2014. Villagers of Nagatagata travelled more than 15 kilometers on foot to visit a doctor in Nadarivatu.  

·        On-going - New Navua hospital / US$3.5million, which will cover both the relocation and construction of related facilities, benefit 5400 ppl.

·          2013: Tonia Nursing Station in Tailevu/ $211,913 construction of  grade 6 quarters

·          2013: Nayavu Nursing Station Upgrading Project/ $270,000 construction of a duplex grade 6 staff quarter at the Nayavu nursing station (Tailevu Province) Population of 107

·          2013: Construction of Kamikamica Park Hub Centre in Lautoka for diabetic patients 25,000 ppl benefit


·        2014: Nalotawa Nursing Station, benefitted 500 and 700 people living in the following villages: Yaloku, Nanuku, Nalotawa, Tukuraki, Rara, Navilawa, Tabataba, and Nearby Settlement of Cirisobu, Nalotawa District School.

·        2012: Construction on Vunisea Hospital quarters at a cost of $464,000.

·        2012: Batiki Nursing Station refurbishment of clinic and construction of new Quarters $190.000

·        2013: New Accident & Emergency opened at Rakiraki Hospital at a cost of $170,000 benefiting 30,000 people.

·        2013: Makoi health centre mortuary benefit 53,000 people.

·        2010: Bureta health centre construction of clinic in Levuka cater 2403 people in Bureta village and 767 in Moturiki nursing area, 21 villages, 20 settlements and 5 schools also to benefit.

·        2010: Mualevu nursing station quarter in Lau benefitted 1, 200 people of Vanubalavu

·        2012: New dental clinic in Raiwaqa to cater for over 30,000 people living in the Raiwaqa, Raiwai, Vatuwaqa and Laucala Bay area. cost of over $198,000

New Ambulances
·        Replacement of ambulances in Labasa, Rakiraki, Korovou, and a new ambulance at Vunidawa Hospital at a cost of $425,217. These ambulances were more than 10 years old.

New Equipment

·        Installation of MRI machine at CWM Hospital for advanced medical diagnosis completed in 2011 / $3.35m

·        Construction of Cyto-toxic Suite at CWM Hospital for chemotherapy commenced in 2010 and completed in 2011/ $768,926

·        The removal, installation and commissioning of the two industrial lifts at the Lautoka Hospital started in 2012 and completed in 2013 / $988,175.52 for two lifts

·        The supply, installation and commissioning of an incinerator (Medivac model) at Lautoka Hospital.

·        In 2014, renovation of 10 operating theatres at CWM hospital benefits 300,000 population of central division.

·        Equipments such as ventilators, anaesthetic machines, cardiac monitors, treadmills and echocardiograms installed at three base hospitals

·        In 2009, MOH established cardiac catheterization lab worth $1.8m at CWM facilitating first angioplasty in the country.

·        In 2011, install CT scanners at Lautoka and Labasa hospitals

·        In 2010, a $2.4m to outfit all 19 sub-divisional hospitals with ultrasound equipment and x-ray machines.

·        In 2011, Magnetic resonance Imaging (MRI) services at CWM

·        Mokani mortuary and Tukavesi mortuary construction

·        Pacific Eye Institute opened in 2011

·        In 2011, new accident and emergency department at Savusavu hospital
Decentralisation
·        Since 2011, six health centres in the central division now have extended opening hours for Lami, Samabula, Valelevu, Raiwaqa, Nuffield in Tamavua and Makoi health centers. This is in line with the decentralisation of Health services to better service Fijians living outside the central areas.
Primary Health Care
·        In 2007 to 2011, outreach clinic by CWM to sub-divisional hospitals in Savusavu, Taveuni, Naitasiri, Koro and Kadavu Islands. Navua hospital also provided free medical services to villages in Namosi in 2011.
·        CWM outreach program in 2011 free medical services to people of Koro and Kadavu. 3, 094 people of Koro and 10, 996 people of Kadavu benefit.
·        Outreach /school health program including rheumatic heart disease conduct screenings and awareness program in the maritime zone
·        A total of 10,000 children benefitted from this project. And more that 10,000 adults were seen.
·        The Ministry of Health, in partnership with UNICEF and the Ministry of Education rolled out the National Micronutrient Supplementation Program in primary schools around the country in 2010
·        De-worming children and providing them with Iron tablets and Vitamin A tablets to supplement their growth/program targets to reach 52,000 students in the Central Division, 47,000 in the Western Division, 24,000 in the Northern Division and 8,000 in the Eastern Division.
·        NCD prevention program (Bula 5-30 campaign) launched in 2008 to encourage consumption of 5 servings of fruits and vegetables and 30 mins physical activity
·        National Oral Health Week in all divisions after endorsements of National Oral Health Strategic Plan 2007-2011.
·        Procurement of two oral cancer detection machines in 2009.
·        Promotion of school canteen based guidelines
·        Revitalization of village/community health worker scheme.
·        Finance of nine vaccine at a cost of $1.2m annually.
·        These are rotavirus and pneumococcal vaccine for children under 5 years and HPV vaccine for 12-14 year old girls.
·        Community mental health outreach clinics in all divisions with new stress management wards at CWM, Lautoka and Labasa hospital in 2011 providing treatment and medication.
·        In 2011, Jaipur Artificial Limb camp at Tamavua hospital provided free artificial limbs to 300 patients. This service is available to all people with disabilities.
 
·        New education resource centre opened at CWM hospital hospital’s children’s ward in 2011


MDG Achievements:
·        Fiji is on track to achieve two of the three health-related MDGs by 2015 – on Maternal mortality, Infant mortality and child mortality.

Laws/Policies:
·        In 2011, Cabinet approved HIV/AIDS decree
·        Fiji Essential Medicines Formulary
·        Fiji HIV TB Surveillance Policy
·        Influenza A H1N1 2009 Clinical Practice Guideline
·        National Clinical Products Management Policy
·        UNGASS – National Composite Policy Index (NCPI) 2007
·        Health Information Policy
·        Reproductive Health Policy and Strategy 2010
·        2008 Food and Nutrition Policy
·        Breastfeeding Policy
·        National Food and Nutrition Policy for Schools 2009
·        The Fiji Plan of Action for Nutrition 2010-2014
·        Expanded Programme on Immunisation Policy 2010
·        Fiji PMTCT HIV Policy
·        Rheumatic Heart Disease strategy (under development)
·        Child Welfare Decree 2010
·        Tobacco Control Decree

Human Resource Development
·        Cabinet approved creation of 56 posts for doctors in 2011 and FNU introduced degree course in public health nursing

·        In 2010, nurses increase to 170 annually for the next 3 years to meet 510 vacancies. 

·        Nursing training 40 by TISI Sangam nursing school and 40 by FNU.

·        In 2011, 109 nurses with 60 additional graduates

·        Total Nurses   from 1500 to  2400  with an estimate of 3500  in the next  three years.
Rural nurses are  now provided  free accommodation, and  public  utilities.


·        76 new doctors to be recruited in 2014

SODELPA Secretary Difficult to Follow

It's not just me. If you read the article, you'll see FijiVillage journalists were also scratching their heads. See link.  

Pio Tabaiwalu blamed the media after Fijivillage questioned him on why SODELPA is raising issues about the health sector now with just over three months to go for elections. 

He said they had released statements earlier that were not covered. Fijivillage denies receiving any of them, and wonders why the former SDL (now SODELPA) party that was in Government from 2001 to 2006 should only now say hospitals are in a disgraceful condition. 

Tabaiwalu blamed Government for bragging about taking Fiji into the internet era but failing to invest in basic data systems to give faster and more efficient hospital service.

He does not, however,  want what he called a caretaker government to do anything about the disgraceful hospitals so close to the the elections, and claimed that  Government's recently announced major medical reforms —some are continuations from the 2014 Budget— are vote buying.

And when questioned on SODELPA's health policy, he said they'd need to do a comprehensive study first and then decide on the areas of concern.

So, where does this leave us?
  • SDL/SODELPA take no responsibility for the hospital conditions. They only became disgraceful after Bainimarama came to power.
  • SODELPA has made a number of statements on health but the media has not published them.
  • SODELPA has a health policy but it needs to study what is needed before saying what it is.
  • SODELPA does not want the Bainimarama Government to do anything about the disgraceful conditions for any three months because it could influence voters.


WHAT IS THE BAINIMARAMA GOVERNMENT HEALTH RECORD?

To put the record right, this is a summary of Ministry of Health work since 2007 reported by FijiVillage.  See link.
  • Government has spent over one billion dollars on health in the past seven years. 
  • The country now has MRI machines, CT scanners, cardiac labs and a new chemotherapy suite. Ten operating theatres have been renovateat CWM Hospital in Suva.
  • Savusavu has a new Accident and Emergency Department. 
  • All 19 sub-divisional hospitals have been equipped with ultrasound equipment and x-ray machines. Six health centres in the Greater Suva have extended their opening hours. 
  • Labasa Hospital has a new extension and Nasea a new health centre, and nursing stations and quarters have been improved in different parts of the country.

Further, it is expected that :
  • the number of doctors will increase by about 400 by 2016, 
  • and nursing posts by 1,510 new posts by 2018.



I found it difficult to follow Pio's line of argument. He may have been better to say what the SDL did for the country's  health during the nine years in which it was the government. I do not have the figures but I doubt it would come anywhere close up to what has been done in the last eight years.