A second chance?

J. Roughan

26 March 2009

Honiara    
 

RAMSI gave Solomon Islands a second chance to re-invent itself when the intervention force landed on our shores almost six years ago. Concerned neighboring states--Australia, New Zealand, Fiji, Vanuatu, etc.--refused to allow a young sister state to fail. These nations poured in resources, personnel and finance to rescue us, to give the Solomons time and opportunity to once more get on its feet. We were given a second chance!

 

Again last week the nation was once more blessed. Cuba, a medium sized island nation on the other side of the world, gifted us with 10 trained doctors with the promise of 40 more young doctors. During the next few years these young medics will be working among our people. And to top this generous gift, more than 65 of our own young citizens are already in medical training in Cuba. So within a span of 5 years, Solomon Islands will be boasting of having dozens and dozens of its own people trained as doctors.

 

The RAMSI experiment guaranteed our people breathing space, to get our act together, to peacefully review what went wrong with us as a nation and to assist us in re-building our shattered institutions. Cuba's 50 trained medical doctors gift travels the same road.

 

Our tiny population of 1/2 a million people are scattered over a million and a half kilometers of ocean and located on thousands of islands, both large and small. The 5,000+ village and hamlets sends an even clearer picture . . . our people do not like to heap up in one central place, no matter how well serviced. And this same condition will continue through much of this new century.

 

The 1976 Census, for instance, found that 12% of our people did heap up in Honiara, the provincial capitals and a few other places. However, it was predicted at the time that by the end of the 20th century more than 3 out of 10 of our people would have moved to a few cities and towns across the nation. After all many other nations were following this pattern exactly. Yet, our 1999 Census said something else. During a 33 year period--1976-1999--some of our people did travel to the country's city and towns but their number remained quite modest. Only 16% of people had begun to root in town while more than 8 out of 10 (84%) people stayed in their beloved villages in spite of not being particularly well served nor rarely recognized as the nation's true owners.

 

This state of affairs became most evident went medical attention was considered. We were told that the nation's few doctors could only be effectively used if they practiced their skills in a major referral hospital and provincial hospitals. There was truth to this statement. Doctors, to be effective, need back up equipment--x ray machines, scanners, etc.--and professional testing of blood to confirm their medical diagnosis. 

 

Although preventative medicine was always in the back of the minds of our medical people, it soon became evident that what was indeed practiced was curative medicine. Even with the creation of dozens and dozens of clinics, staffed by trained nurses, the Ministry of Health's accent from the very beginning has been to curing sick patients not to prevent sickness and keeping diseases away from people. There was too few medical staff available to effectively follow a preventative medical approach.  

 

So the medical department slipped into its present role of curing disease rather than preventing it in the first place. Is it possible for these 50 new Cuban doctors to begin to change this emphasis to respond to the medical needs of our people where they actually live rather than forcing thousands of them to expend large amounts of money, time and effort traveling to Honiara's centralized medical system?

 

RAMSI bought us time and resources for our leaders to re-think what we want for ourselves as a nation. For nearly 6 years now neighboring Pacific nations have held out supporting hands. Now from the other side of the earth, a small nation is offering us a similar hand up. The easiest thing for us to do is to do nothing. Let the 50 new doctors fill in slots in our centralized medical system. The exciting thing to do, however, would be to use these new medical personnel to re-vamp our medical system by posting and backing them professionally to the rural areas. CNURA, to be true to its name, could truly accent its claim,  Rural Advancement.