An unhealthy issue

Vani Catanasiga, Fiji Times, July 24, 2005

While Fiji boasts one of the most affordable, if not free, health services in the world, it is a system riddled with inadequacies.

From doctor shortage, nurses' external migration to lack of equipment, the story is the same everywhere.

This is a problem that Fiji Nurses Association president, Simione Racolo attributes to the different political parties that come into government.

"We have political parties coming in and messing up the system. They want political mileage, they say, 'we will provide free medical care or we will scrap the costs for sleeping in hospital for one night and free medicine for all'," Mr Racolo said.

"In the end who suffers? The patients because when doctors are frustrated, they leave, when nurses are fed up, they leave because with no equipment the service is not delivered properly."

"People here have the handout mentality because of the kind of policies that the Government puts in place."

"The problem with people is the handout mentality- it is a legacy from the colonial rulers who instead of allowing us to come and work for survival brought people from another land to come and do that for us."

"That mentality has affected us ever since, everything we want to get on a silver platter. People come here expecting everything free."

"The patients that I see, after I give them their prescriptions, the very next question would be, can I get it from this pharmacy? That's because they don't have to pay a single thing. And these are people who work."

"The least they can do is pay for the dressing but even the dressing is free but every now and then, we have a shortage."

"They don't understand that our cut in the budget pie is getting smaller and smaller. Even panadol is out of stock here at Valelevu."

"Before people used to pay for such services, you know like 50 cents for dressing and even 50c if you sleep over in hospital."

"At least the Labour government scrapped only the GOPD fee but now the SDL government has about scrapped everything else. Now we can't even deliver services properly because of the lack of everything."

"There was a job evaluation draft report that promised a lot for nurses. But the Government did not deliver those promises and most salary increases were for the disciplined forces."

"Anyway, this failure by the Government has prompted nurses to search for greener pastures. The exodus is picking up again."

"Nurses are leaving for Australia, New Zealand and the United Arab Emirates because they get better offers and excellent working conditions."

"In New Zealand, it takes only six weeks to register as a nurse. Nurses are being recruited to go to Australia. These nurses are overworked and underpaid."

"For the same job, they get twice the money in New Zealand and Australia and in the UAE, four times as much."

"The other thing is that conditions are much better than here. Here, at certain hospitals, one nurse has to look after 28 people in a ward. It really depends on the ward that a nurse is assigned to. But overseas, the ratio of nurse to patient is so much less."

"Equipment is another problem. Say for example, in this health centre, I am the only one who has a scope, which you need to examine ears and eyes."

"Imagine working without all the equipment you need, it is frustrating. Sometimes, nurses see up to 200 patients day in, day out."

"But under these conditions, it's hard not to get frustrated. Even the most good natured person can boil over some times, add to the fact that some patients are so demanding and expect so much."

"That's what I tell people when they complain of nurses' bad attitudes."

"The only solution is the user pay system because right now about 65 per cent of the health pie goes to salary alone. The rest is expected to go towards the functioning of the health system for the year."

He said that the user pay system did not mean exorbitant fees but just enough to sustain costs for better delivery of service.

"One other thing we need to be careful about is the kind of donations that we receive from overseas countries. Sometimes the machines that are donated are the ones which these countries have no use for or are rubbish there."

"When it breaks down, where do we search for spare parts? In the country where we bought it from. That's their way of recovering the costs."

"Most donations to the third world countries are donation of old equipment, it is never new."

While the association has often spoken out against health chief executive officers in the past, Mr Racolo, however, believes that current chief executive officer, Dr Lepani Waqatakirewa has the ability to change the system.

"Dr Lepani has the ability to change the current health system because he is a health professional and not just an administrator. But all he needs is finance."

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