Shelley Thompson and colleague Ravinesh Chetty visit a rural village.
Beyond the image of beachside recreation and fresh-caught fish, Fiji is facing an epidemic of lifestyle-related diseases. Australian volunteers Shelley Thompson and Brigid Buick are working with the Fijian Ministry of Health to put fresh food and exercise back on the menu.
Fresh fruit, vegetables, root crops and seafood were once staple foods for Fijians. Today, a range of lifestyle factors have changed the way people live and eat - resulting in serious health problems. Non-communicable diseases such as diabetes, cancers and heart disease are now the leading cause of disability and death in the country.
Ravinesh Chetty, National Non-Communicable Disease Project Officer for the Fijian Ministry of Health, says that poverty, urban migration and the effects of natural disasters have all led to a significant increase in the consumption of imported foods.
"People now eat more processed foods high in salt, sugar and fats rather than eating local vegetables or produce," Ravinesh says. "If you ask them to have a balanced meal or healthy meal they say 'We can only afford these things'. Poverty levels and the recent effects of the flood play a major role in what they decide to eat."
It is this pre-packaged diet - coupled with an increasingly sedentary lifestyle - that the Ministry of Health is trying to change. Seeking expertise in lifestyle-based health promotion, the Ministry approached AusAID in Fiji, which led to the arrival of volunteers Shelley Thompson and Brigid Buick through the Australian Volunteers for International Development program. Shelley and Brigid are supporting the Ministry of Health to promote healthy eating and exercise habits in Suva and Lautoka.
A major focus for the Ministry of Health is the 'Wellness Approach' and Brigid has been working with Ravinesh to develop an internal communication plan aimed at promoting wellness.
"The Wellness Approach provides an opportunity for health professionals and health services to include health promotion and disease prevention as part of their regular activities, as opposed to being solely focused on disease and acute care," Brigid says.
"The Ministry is proud of this approach and motivated; they also recognise that it poses very real challenges as the focus is on behaviour change from the Ministry itself down to the community."
An example of the Wellness Approach in action is the SNAP program (Smoking, Nutrition, Alcohol, Physical activity). The program includes workshops to engage the community on these topics. Shelley and Brigid will be involved in these workshops in the coming months.
Shelley is also supporting Ministry of Health activities for an upcoming Fijian agricultural show. Planned events include SNAP consultations, free screening for diabetes, live cooking demonstrations, aerobics sessions and a walk-a-thon.
Brigid recently assisted Ministry of Health nurses with screening activities, which involve assessing people's body mass index, checking blood pressure and blood sugar levels. In one case a woman was referred to doctors because she was hypertensive. Further tests revealed she was in the beginning of renal failure.
"That certainly made me realise how serious the job here is … it was a really good motivator," Brigid says.
The approach taken by the Ministry of Health in managing non-communicable diseases has greatly impressed the Australian volunteers.
"From a clinical management point of view it's about reducing risk factors and prevention," Shelley says. "Keeping the healthy, healthy is quite an innovative approach."
"With diseases like diabetes, it's easy to feel like the problem is overwhelming because a lot of it is about behaviour change and it's hard to get people moving, to get people eating better," Brigid adds. "But what has impressed me so much is the determination, the real passion that I've seen in the workplace."
For Ravinesh and his colleagues, having volunteers with expertise in health promotion on board is a real boost to their human resources.
"They're doing tremendous work and it's something that is going to help at a national level as well. There's only two of us working on this program at the national level and for us to implement everything is not possible," Ravinesh says.
It's a two-way street: working with the Ministry has given the volunteers invaluable experience in relationship building and leadership. As Shelley explains: "Wherever I go after this I think I will have a more mature approach and more experiences to draw upon."
Photo: Sue Yantses/Australian Red Cross