of Tonga

‘Barefoot doctors’ of Tonga

The stereotype of the robust Pacific Islander, frolicking through an outdoor life of bucolic healthiness, needs a lot of revising. The truth is that the South Pacific isn’t a particularly healthy place in which to live.

A newborn baby faces a much more chancy prospect of surviving here than in many parts of Asia. The infant mortal ity rate, as low as 10 or 11 per 1000 live births in places such as Hongkong or Singapore, soars to 87 in Kiribati and 105 in Papua New Guinea.

The survivors can expect a foreshortened life span. Citizens of Kiribati, PNG and Solomon Islands, for instance, live an

average of less than 54 years.

Such cruel statistics are an eloquent plea for improved health care. But for poor, iso lated island societies, the usual prescription more doctors and expensive facilities is clearly the wrong one.

Tonga, one of the smallest and least endowed Pacific countries, spends only one tenth as much money on health care as does wealthy Japan. Yet it is successfully raising its stan dard of health using a basic, community-level approach.

One who appreciates the im provement is a young mother of three named Sarah Manisela.

Her village, known as Houma, a cluster of weathered wooden houses and huts roofed with brown coconut fronds, never had medical facilities. When ever her first two children needed medical attention, she had to transport them across the island to the capital Nukualofa a 16-kilometre (10-mile) trip that involved either three bus rides or a plodding trek by horse-drawn cart.

Caring for her third child has become much simpler. Today she has brought the baby to a little health centre right in the village. Here the child is routinely checked every month.

She says the baby is healthier, and so is the rest of her family.

The health centre is a small, cement-block building, as gleamingly white as a freshly starched nurse’s uniform. The waiting room is nearly filled by a dozen or so village women, most of them with children.

Mrs Manisela’s baby is being examined by health officer Ofa Teu, a solidly-built young man with soft eyes set in a wide Polynesian face, stethoscope dangling over his white smock.

Mr Teu is what is sometimes romantically referred to as a “barefoot doctor”, trained locally in basic medical care by the World Health Organisation of the United Nations, and then dispatched into the doctorless countryside.

He has run the centre since it opened two years ago, spen ding mornings here and afternoons making home visits.

Assisted by a nurse, he sees an average of more than 20 pa tients a day at the clinic 40 to 50 on Mondays.

Two days a week, he con ducts “baby clinics” for mothers in surrounding villages. He also holds training sessions for women on caring for diarrhoea and acute illness; makes home sanitation inspections; and visits primary schools.

Since coming here, Mr Teu says he has observed a marked improvement in the health of the 4000 villagers whom the centre serves. Long-term illness has decreased as ailments are treated more promptly. Diar rhoea, once common, has be come rare as sanitary condi tions improve.

The health centre one of four in Tonga financed by a loan from the Asian Deve lopment Bank also is helping lighten the load on the hospital in the capital. While the number of Tongans receiving medical consultations has doubled with the coming of the health centres, the number of hospital patients has dropped by several thousand each year.

Perhaps the South Pacific can, one day, become a little

more of a “paradise”.

Peter

Stuart.