Atlantis Is Not Just a Fever Dream: Existential Health Risks in the Pacific
The Pacific Region. How can you plan for the future, when you are facing existential risks to your home and livelihood? Part 1: COVID-19 and health risks.
The Pacific region is home to some of the world’s smallest and most vulnerable countries. Hundreds of small islands spread over a huge area are connected by flags and cultures but separated geographically. Often an afterthought on the global scene, the eleven tiny countries are among the most affected by the themes on the global agenda. Names such as Palau, Nauru, and Tuvalu are unlikely to ring a bell for anyone except geography buffs and climate scientists but combined, the Pacific Islands have a population of 2.3 million (roughly the same as Latvia), which are scattered across an area corresponding to 15% of our planet’s surface¹. The Pacific Island countries rank among the most at-risk countries in the world. In this article, I look into the public health risks that the Pacific region is facing, exacerbated by the current COVID-19 pandemic and what can be done to mitigate these risks.
COVID-19 and public health risks
Geographic remoteness and swift measures such as border closings and the quarantining of suspected disease carriers earlier in the year has largely served to prevent the spread of COVID-19 in the Pacific Region. The proactive intervention has left most of the countries largely unscathed by the disease itself, despite being among the most susceptible places to suffer from large outbreaks. Inadequate health systems and infrastructure, including few and dispersed core facilities and a limited amount of both qualified health personnel and hospital beds is a volatile recipe for potential disaster in the region.
A case in point is Samoa, a nation of nearly 200,000 people. Last autumn, the island nation went into lockdown and declared a state of emergency due to a measles outbreak that cost 83 lives. Most of them were young children, after a decrease in public trust in vaccines had led to a decline in children vaccinations. The country is also struggling to educate enough nurses and other qualified health personnel to carry out an extensive village outreach programme, which is an effort to circumvent the poor infrastructure for the scattered population. Nevertheless, the measles outbreak meant that public officials and international aid workers were better prepared when the COVID-19 crisis struck².
While the worst disease scenarios seem to have been avoided in Samoa, closing the borders for tourists has had major consequences for an economy heavily reliant on tourism. 12% of the population is employed in the tourism industry, and tourism makes up 30% of the country’s economy. This is accompanied by the International Monetary Fund’s (IMF) expectations of a 40% decrease in tourism in the Pacific Region this year. While the Samoan government has announced two large relief packages, it remains to be seen whether it will be enough to avoid a severe economic downturn³. Meanwhile, the World Bank and the World Health Organization (WHO) have been active in supporting with funds and equipment to improve the public health system⁴.
Samoa is one of the region’s largest countries. So, if they have problem building a solid public health system, imagine the concerns in smaller countries. Things can turn ugly very fast, if COVID-19 takes a hold in the Pacific Region. During the Spanish Flu of 1918, 90% of the Samoan population contracted the disease and nearly one in four died. On top of this, most of the Pacific islands are facing serious health problems, among them diabetes, vitamin and mineral deficiencies, as well as higher than global average level of obesity. The age-standardized prevalence of obesity among adults range between 22% for the Solomon Islands and 61% for Nauru (for comparison, in the US, the number is 37%)⁵.
Keeping Atlantis afloat for the foreseeable future
The COVID-19 threat is far from over. In the month of October, the first positive cases of COVID-19 in the Marshall Islands and the Solomon Islands were reported. While French Polynesia is outside the scope of the article as an overseas collectivity of France⁶, the territory has been suffering from high COVID-19 numbers and is projected to be among the worst-affected regions per capita by year’s end, a symbol of how challenging the pandemic can be.
To improve resilience in the region, change is sorely needed. Both in terms of new agricultural policies and food import structures to combat these far-reaching health problems. Better collaboration across countries and sectors is also imperative. Climate change and the proliferation of large-scale industrial fishing have left the Pacific Islands vulnerable in terms of food supply, while playing a role in transforming the regional diet from mostly local and traditional food to imported and more processed food. However, a difficult behavioral change needs to take place alongside an improvement in food supply for real change to manifest itself.
On top of regional collaboration and a strong community feeling, sustained development and mitigation of climate change will take international action and responsibility. Preventive health measures such as the ability to track nutrition and diseases in society can in the long-run serve to keep people outside of the sparsely located hospitals. The future of health in the region will depend on the ability to build better infrastructure, educate more health personnel, generate more awareness about nutrition, and improve the economic situation.
The effective employment of technological solutions such as telemedicine, health data tracking, and drones is necessary to overcome the large distances and poor health infrastructure. If internal resilience and collaboration is complemented by international support mechanisms and technology, then future health risks could be mitigated, keeping these paradisiacal Pacific Islands afloat.
The Pacific Island countries rank among the most at-risk countries in the world, with five of the region’s countries among the top 20 globally, according to the World Risk Index 2019. Among these are Vanuatu and Tonga (first and third on the list, respectively). In this article series, I will dive into three existential, compounded risks that pose a threat to the lives and homes of the region’s population.
— — — — — — — — — — — — — — — — — — — — — — — — — —
Sources:
¹ World Bank. 2020. The World Bank In Pacific Islands. https://bit.ly/2E0glCO
² The Guardian. 2019. ‘These babies should not have died’: How the measles outbreak took hold in Samoa. https://bit.ly/2RpHXEA
³ TV2. 2020. I det coronafrie paradis går livet videre — men manglen på turister er en alvorlig trussel. https://bit.ly/2RpH5zX
⁴ WHO. 2020. Strengthening Pacific Health Systems. https://bit.ly/3c1Y9FB
⁵ WHO. 2010. Pacific islanders pay heavy price for abandoning traditional diet. https://bit.ly/33wKxhO
⁶ Asia & The Pacific Policy Society. 2020. COVID-19 — the Pacific response: 30 September. https://bit.ly/3jYfYYr
