PART 4: FIJI MEDICAL CARE -WHAT A TERTIARY HOSPITAL WOULD DELIVER TO FIJI

 

PART 4: FIJI MEDICAL CARE – WHAT A TERTIARY HOSPITAL WOULD DELIVER TO FIJI

Thakur Ranjit Singh

Synopsis of Parts 1-3

Part 1

After 4 coups and approval by four Prime Ministers, the tertiary health project seems to be stuck now with Fiji First government which seems to frustrate this development by going into a PPP - a public, private partnership with an Australian company ASPEN, which is not suited to what is proposed by the two doctors. Agreements with them (Aspen) were signed over 3 years ago to run Ba and Lautoka hospitals, but little progress to date, except broken promises.

The whole series of articles suggest and plead to people of Fiji to change the government if they wish to see changes to the trend of dying people in our sick and run-down hospitals, and where a 40-year project is now hindered by the Fiji First Government.

Part 2

We defined levels of hospital services: primary, secondary and tertiary. We have primary and secondary services which are acutely run down, and despite claims from ASPEN, Lautoka Hospital cannot be redesigned to work as a tertiary facility where they can hardly afford toilet papers and basic needs, with buildings and facilities falling apart.

An advantage of the new tertiary institution is the synergy of support from a highly educated Fiji Indian Diaspora in medical services around the world, and their contacts with medical fraternity who could help in this project. In addition, retired Fijian Diaspora, Fiji people who left because of deficient health services may wish to come back. Hence this project brings great deal of economic, social, tourism, patriotic, agricultural and other associated benefits.

Both Bainimarama and Khaiyum would have been treated here in Fiji with top-class international medical care and facilities if this project was allowed to proceed when they took charge to clean Fiji up over 15 years ago.

SITIVENI RABUKA - The leader of Peoples Alliance Party (PAP), commanding the lead in polls in Fiji election is likely to be a mover and shaker in the next government. He is a supporter of the Tertiary institution, and like Mahendra Chaudhry, remains the other former PM of Fiji who has given their blessings to this development in Fiji and still support South Pacific Hospitals in Fiji. Therefore this project will proceed if he becomes the next Prime Minister of Fiji, or a key decision-maker in the next government.

FIJIANS NEED TO VOTE FOR A CHANGE IF THEY DESIRE TO HAVE THESE TERTIARY FACILITIES IN FIJI.

Part 3

Financial viability is through insurance coverage by FNPF, Civil servants, FSC for cane farmers, Land Owners via ILTB, Fiji care and all other institutions with medical coverage for their employees or members.

This facility would further enhance regional cooperation with treatment and training facilities for Pacific countries lacking tertiary hospitals.

Lautoka hospital which is now politically projected by Fiji First for tertiary facility is ill-equipped to do that with basic facilities and support missing. It could be a good recuperating and healing facility after a thorough renovation and cleansing. A secondary hospital, with Asbestos which cannot provide toilet papers and Panadol cannot be expected to be turned into a 24/7 heart by-pass facility overnight.

Now let’s see why and what a brand-new tertiary facility looks like, especially for those who think a rusty 737 (Lautoka Hospital) can be repainted and converted to a Jumbo 747. (Tertiary Hospital). No, we need a new one which delivers reliable facility. Please read why and what….

LAUTOKA HOSPITAL - A secondary hospital, with asbestos, and grossly run-down, lacking basis amenities like toilet paper, Panadol and pillows, is now used as an election gimmick by the Government to provide 24/7 heart bypass tertiary hospital. First it needs to be renovated to provide the services for which it was originally built than to be falsely, mischievously  and politically elevated to a higher level it cannot medically do. No surgeon worth his salt would wish to operate in this junk which lack of vision and underfunding has degenerated it into.

 

Current State of Fiji Healthcare

The South Pacific Islands region is one of the very few frontiers in the world where there is limited tertiary care facilities available to the citizens. This affects growth in many industries including tourism. The current hospital structure is struggling to provide services in accordance with the demand.

With underfunding and lack of successive visionary medical leaders in Fiji governments, hospital facilities are grossly rundown.

Fiji has a high rate of diabetes and hypertension with kidney damage. Basic services such as haemodialysis are not readily available. Current treatments for Cardiovascular, Neurological and Kidney diseases are not readily available in Fiji. Many people migrate because of lack of good health care. Currently patients travel abroad to India, New Zealand or Australia if they can overcome stringent Visa requirements.

The World Health Organisation (WHO) reports show that up to 82% of the population will succumb to NCD (Non-communicable diseases) in the region and hence tertiary health care services are critical to address this plague.

Non-communicable diseases are chronic health conditions that are not contagious to others. The main types of NCD are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes

 

A study by Asian Development Bank (ADB) identified that tertiary health care facility is very important for economic development of the region as well.

What will the proposed hospital provide:

·      A healing environment that incorporates advanced technology and full spectrum of advanced tertiary health care. The high site of the facility with exotic unhindered sea view is classed as a great healing balm.

 

·      A world-class specialty health care facility at affordable cost. No relocating cost overseas, no visa-issue, and cost-effective healing accommodation at a renovated Lautoka hospital, with specialist care facility next door.

 

The facility will also provide the development of postgraduate training programs for doctors, nurses and allied health professionals for Fiji and the entire South Pacific Region. This would enhance regional cooperation raptured by a myopic USP Vice Chancellor saga of the Fiji First Government.

 

Facilities in the proposed hospital

 

·      120 – 200 beds, with a provision to go up, depending on the demand.

 

·      Specialised Operating Theatres

 

·      Dialysis chairs/machines

 

·      Extensive Diagnostics capabilities

 

·      Very Comprehensive Medical Laboratories.

 

·      Pharmacy

 

·      Specialist doctors in various different areas of medicine.

 

Clinical Profile:

▪ Accident & Emergency ▪ Critical Care Medicine ▪ Day Surgery Unit ▪ Outpatient ▪ Diagnostics Centre ▪ Education Centre ▪ Neurology Unit ▪ Cardiology Unit ▪ Gynaecology Unit ▪ Orthopaedics Unit ▪ Nephrology Unit ▪ Oncology Unit ▪ Rehabilitation Unit

 

SOUTH PACIFIC HOSPITA, as proposed by Prime Health South Pacific would provide state of art facilities, as detailed in this article. This has been a dream in making for the last four decades, and can only become a reality in Fiji if there is a change of Government. The Fiji First Government is not giving approval for these facilities which Fiji acutely deserves.

State-of-the-Art Technology

▪ The latest MRI and CT scanners. MRI is magnetic resonance imaging. It determines the extent of injury, and whether the person needs surgery. CT scan is a computerized tomography (CT) scan which combines a series of X-ray images taken from different angles around your body. CT scan images provide more-detailed information than plain X-rays do.

▪ Dual head gamma camera ▪ Third generation operating rooms ▪ Referral laboratory ▪ Fully equipped ambulance

 

Key benefits

·      South Pacific Hospital (SPH) is to provide low cost, high-powered tertiary healthcare, to the people of Fiji and the South Pacific region.

 

·      Stimulate improvement in healthcare generally in other government and private hospitals around Fiji and the Pacific.

 

·      Boosts tourism potential and promote medical tourism to the region. As already stated, there is huge potential of this with huge tourism facilities in Fiji.

 

·      Stop the tremendous loss of foreign exchange from Fiji when patients seek expensive tertiary healthcare overseas. Furthermore, it can potentially earn significant foreign exchange once we develop world class health tourism.

 

·      Traditionally, Fiji has depended on Australia, New Zealand and India for its tertiary healthcare. This has added to the vulnerability of the nation as restrictions have been put on Fijian lives. This dependency will cease

 

Target markets

 

A.          Local Fijians ▪ Emergence of the Empowered Consumer ▪ Increasing Accessibility to Health Insurance. Insurance for FNPF members, Cane Farmers, Civil Servants, Teachers, Land Owners through ILTB and those already covered by specialist medical cover. No need to travel overseas, costs and visa issues.

 

B.          General Tourists - Tourism has seen a boom in entire South Pacific region. This will prevent exodus of such tourists needing medical attention to overseas. Medical tourism is a multi-billion income worldwide and Fiji can tap into this market as a low-cost centre in exotic tourist location with tourism infrastructure like Thailand.

 

C.           South Pacific Islanders -Aims to develop a HUB and Spoke Model, with hub being the advanced Tertiary care hospital in Fiji supported by Secondary care facilities in neighbouring countries, like Solomon Islands, Samoa, Tonga and others.

 

D.          Medical Tourists ▪ Better quality care ▪ Improved patient experience ▪ Excluded treatments ▪ Speciality treatments ▪ Shorter waiting periods.

 

E.           South Pacific Diaspora -There exists a large proportion of South Pacific Diaspora in Australia, New Zealand and West Coast of US and Canada that will travel to Fiji in order to access the affordable and quality healthcare facilities.

 

BA HOSPITAL - This white elephant has been sitting idle for some four years while Ba people have been dying in large numbers in a very deficient and run-down Ba Mission Hospital. Fiji First, to frustrate South Pacific Hospital project has gone into a partnership with Aspen three years ago but little has eventuated. The only way for people of Fiji to improve health services is to see a change of government with visionary leaders.

Strategic Partner -VAMED

·      VAMED is a global provider for hospitals and other facilities in the healthcare sector. 

·      The VAMED portfolio ranges from project development, planning and turnkey construction via maintenance, technical, commercial and infrastructure services to the total facility management of healthcare facilities.

·      With its range of services, VAMED covers all areas of healthcare, from prevention and wellness to acute care, rehabilitation and nursing.

·      VAMED is also the leading private provider of rehabilitation services and, in health tourism, with VAMED Vitality World, the largest operator of thermal spas and health resorts in Austria.

·      Unlike ASPEN, the choice of Fiji First which is an outsourcing operation, VAMED provided full support from the scratch to the end.

 

CWM HOSPITAL -this has been a pride of Fiji in its prime, but sadly, like Lautoka Hospital, it has been run down and so severely deteriorated that it stinks of human faeces (s***) as one goes to visit their loved ones. With a Tertiary health services proposed by South Pacific Hospital, it will help uplift the capabilities, capacities and speciality services provided by this secondary facility, which also lacks very basic amenities and facilities. Only a change of government and vision can change this sad state of affairs.

Discussion

 

Election Gimmick

 

Fiji First has gone in the election mode and started misleading people with information on medical services that defies logic and reality.

 

They claim to have 24/7 heart bypass facility at Lautoka Hospital, which is infested with asbestos materials, and can hardly provide toilet paper, Panadol and pillows for its patients. When and how it can be converted to a tertiary facility defies logic. It is an election gimmick.

 

Fiji government signed PPP (Public Private Partnership) with Aspen over three years ago and no movements are seen at either Lautoka or Ba hospitals to date.

 

Fiji First Government preventing this development

 

As already mentioned earlier, this project had been approved by four previous Prime Ministers stretching over 40 years but prevented due to various reasons, especially political instability. Two former PMs, Sitiveni Rabuka and Mahendra Chaudhry are still there, standing in the upcoming election, and they wholeheartedly support this project.

 

However, Fiji First Government is denying approval for this project, which VAMED would only commence, with approval from Fiji Government. One wonders who is so medically qualified and medically astute amongst Fiji First advisors to deny this facility to Fiji people, and under what rationale?

Aspen cannot provide the requirements as provided by VAMED partnership, and it has been utter failure in the last three years. In the meantime, common Vili and Ramu are dying in run down hospitals, while Fiji leaders are airlifted to Singapore and Australia for their medical treatment.

 

SITIVENI RABUKA - The leader of Peoples Alliance Party (PAP), commanding the lead in polls in Fiji election is likely to be a mover and shaker in the next government. He is a supporter of the Tertiary institution, and like Mahendra Chaudhry, remains the other former PM of Fiji who has given their blessings to this development in Fiji and still support South Pacific Hospitals in Fiji. Therefore this project will proceed if he becomes the next Prime Minister of Fiji, or a key decision-maker in the next government.

Choice for Fiji People

 

The only way Fiji will have the facility outlined above is to have visionary, thinking, accommodating, compassionate and visionary leaders, which it lacks now.

 

THE ONLY WAY THIS WILL BECOME A REALITY IS TO HAVE A CHANGE OF GOVERNMENT.

 

FIJI PUNDIT now rests his case. The ball now is in the court of the voters of Fiji.

[About the Author: Thakur Ranjit Singh is former Publisher of Fiji’s Daily Post newspaper. Thakur was fired and removed from positions by two diametrically opposed Prime Ministers: Chaudhry and Qarase for speaking the truth frankly, without fear or favour. This series of articles reflect this trait. He is a media commentator, a journalist and runs his blog, FIJI PUNDIT. Thakur is a Post Graduate in Journalism (with honours) from Auckland University of Technology, (AUT), NZ.

E-mail: thakurjifj@gmail.com]

 

 

 

PART 3: FIJI MEDICAL CARE -THE TERTIARY HOSPITAL - NEED FOR FIJI TO HAVE VISIONARY LEADERS FOR THIS PROJECT TO PROCEED

 

PART 3: FIJI MEDICAL CARE- TERTIARY HOSPITAL, SUPPORTED BY VISIONARY POLITICIANS PROMOTES DEVELOPMENT IN FIJI

Thakur Ranjit Singh

Synopsis of PART 2:

We defined levels of hospital services: primary, secondary and tertiary. We have primary and secondary services which are acutely run down, and despite claim from ASPEN, Lautoka Hospital cannot be redesigned to work as a tertiary facility where they can hardly afford toilet papers and basic needs, with buildings and facilities falling apart. Despite signing outsourcing agreement over 3 years ago, little progress has been made either in Lautoka or at a long time white elephant, Ba Hospital.

An advantage of the new tertiary institution is the synergy of support from a highly educated Fiji Indian Diaspora in medical services around the world, and their contacts with medical fraternity who could help in this project. In addition, retired Fijian Diaspora, all Fiji people who left Fiji because of deficient health services would come back. Hence this project brings great deal of economic, social, tourism, agricultural and other associated benefits.

Both Bainimarama and Khaiyum would have been treated here in Fiji with top-class international medical care and facilities if this project was allowed to proceed. We continue….

 

THE HOSPITAL PROJECT - SYNERGY OF ASSOCIATED DEVELOPMENTS ENHANCING WELLBEING OF ALL FIJIANS

 

Financial Viability

Fiji would reap multi-advantages from this very ambitious long-overdue project. Firstly, tourists coming to Fiji on medical insurance would be assured of international medical facilities when in Fiji, and would not have to be evacuated for any care. Their insurance would take care of that. 

Secondly, like Bangkok, Fiji could develop and expand into medical tourism hub of the Pacific, and tourists would be enticed to seek specialist international-standard treatment while enjoying our facilities and hospitality.

There was some talk previously of Japan wishing to relocate its expanding elderly rich people from winter of Japan to the warmth of a tropical Fiji. While escaping the cold Japanese winter, they would also have access to international-standard medical care which would be less than half hour from five-star hotel facilities of Fiji. This would be a good boost to tourism industry and the facilities where money has been blindly poured into only partly-used hotels, which could be gainfully utilised by giving approval for such a facility in Fiji.

It would cost a third the price of Fiji Airways A 350 Aircraft costing over US $300m. With an investment of US $100m, with a tertiary hospital, we could open the doors of Fiji to huge tourism-and other associated economic boom, which, as you will see later, even Rabuka can envision. But for that to eventuate, you need leaders and a government with a vision for Fiji and its people.

This is an artist's impression of how the tertiary hospital complex atop Lautoka Golf Course in Tavakubu would look like. It will have modern state-of-art medical, other facilities and  support services attached to it. More about this in the concluding Part 4.

Of course, these services will not be free and will not come cheap. There are many rich people who can afford the international costs of first-class medical treatments, and many people would not hesitate to pitch in to help their relatives get first-class treatment. Huge rich business community will be able to pay and have services in Fiji. 

The FNPF members could be covered by their insurance cover. The insurance now handled by Fiji Care and the likes would not have to seek overseas evacuation and have the services given here at home. For cane farmers, FSC, once properly structured and managed, could have a long-shelved saving and insurance scheme to cover the farmers, their families and the landowners. The cover for Members of Itaukei Mataqali (land owning units) would be covered by insurance scheme from Itaukei Land Trust Board (ILTB). 

For other people who fall from the hole, government could have a subsidized scheme for them, with partnership from public secondary hospital facilities like in Lautoka, but seeking specialist facilities from this hospital.

As the leader of People’s Alliance Party (PAP), Sitiveni Rabuka has mooted, Fiji needs to have a National Health Scheme, in association with FNPF, ILTB, FSC, Fiji Care and others who care. Funds from FNPF, FSC and land rent money from ILTB could divert part of members contribution as premium for the insurance scheme and medical services provided locally in Tavakubu, and recuperating at a well-renovated and properly equipped Lautoka Hospital.

 

Sitiveni Rabuka, the person many Fiji Indians still find hard to forgive, seems to be the only hope to rid Fiji of the extremely poor governance under the Fiji First Government. The only way the new tertiary facility can become reality is for Fijians to have a change of Government and have visionary leaders running the country. Rabuka in the past, and still supports such a medical development in Fiji.

Regionalism and tertiary education

Regionalism was given boots in the guts by Fiji First through shameful midnight deportation of the Vice Chancellor of USP, Pal Ahluwalia. USP is the largest and most successful example of regionalism which has been grossly adulterated by the blinkered vision of Fiji First Government. Pacific medical education, which was once a sign of regional cooperation with the Central Medical School in Tamavua could be revived into a thriving hub of medical education, with a tertiary facility in Lautoka.

With a change in government, and with visionary leaders, the tertiary hospital project could resume stalled talks with the National Provident Fund of Solomon Island, and its government, to have the main facilities in Lautoka, with feeder regional facilities in Honiara. Similar arrangement could be made with Apia, Nukualofa, Port Moresby and other Pacific countries lacking tertiary facilities.

Medical education throughout Fiji in other scattered institutions and Fiji School of Medicine would link with expertise and facilities to provide world-class exposure and medical education in Fiji. It would also be a springboard of promoting enhancement of medical education in the wider Pacific Forum countries. 

Fiji School of Medicine (FSM) had initially commenced as a regional cooperation teaching institution over half a century ago, but like this tertiary hospital project was also a victim of political instability in Fiji. This new facility could revive the half-a century old shattered dream of developing a regional training facility back in Fiji.

This facility and opportunity cannot be initiated, envisioned and provided by foreign-thinking overseas companies and their money-minded Sahebs, foreigners. We need our home-grown sons, like Doctors Karam Singh and Dr Michael Chandra who know what is best for Fiji, are passionate about their place of birth, still loyal to Fiji and wish to gift this facility to their country of birth, as it has been their long-term dream, running over 40 years and through approval of four Prime Ministers.

The underhand dealings of Fiji First government in general, and Khaiyum in particular to frustrate and block this project smells of improper motives and is more the reason why Fiji has to be rid of the curse of such blinkered leadership which has caused huge massacre in our run-down hospitals, which have been converted to morgues rather than houses of healing, with tens of thousands of untimely and preventable deaths.  

The abhorrence of Fiji First leadership to intellectuals after their treatment of Professor Brij Lal and Pal Ahluwalia indicates that Fiji needs to be urgently freed from obscenity of such blinkered leaders who are vindictive, blatantly nepotist, extremely ethnocentric (towards their belief), bereft of compassion and grossly lacking in vision. That is where the current political support is very encouraging from past two Prime Ministers who are still around to grant that vision a reality and  provide support to the project which they had backed while they were respective Prime Ministers - Sitiveni Rabuka and Mahendra Pal Chaudhry.

Pathologist DR KARAM SINGH, whose laboratory in Suva was burnt during political terrorism of 1987, and he relocated to Sydney and established a very successful Laboratory chain there. He has been trying for 40 years to establish  a tertiary medical facility in Fiji. Despite that , he is not vindictive, very forgiving, and wishes to gift Fiji a world-class tertiary medical facilities.

The continued Political Support from Sitiveni Rabuka

As stated earlier, this project had already been blessed by four Prime Minters going back four decades. They were Ratu Sir Kamisese Mara, Sitiveni Rabuka, Mahendra Chaudhry and Laisenia Qarase. Thankfully two are still around, and supporting the project. It seems it is only objected by the current surrogate Prime Minister of Fiji, Aiyaz Sayed-Khaiyum. 

What qualification and credentials has he got to grant contract to an outsourcing Australian ASPEN, who after signing the agreement over 3 years ago delayed their project, while our people keep on dying in run-down hospitals which cannot even provide Panadol’s or toilet papers. As I had questioned before, Khaiyum, has never been a respectable practising successful lawyer within his own profession, so therefore how can he be granted authority to decide on what medical facilities are needed and deserved by the people of Fiji?

The only light that we can see at the end of 40 year long tunnel is that Sitiveni Rabuka, the leader People’s Alliance Party (PAP), and who seems most likely to be the next PM of Fiji, has already given his full support to this project. In a self-explanatory letter to Dr Karam Singh, he said, among others:

 “The establishment of an internationally -accredited health facility in the country will not only provide better and cost-effective services, it will also be a “catalyst” to other sectors of our economy in generating investment and creating employment opportunities in other sectors, particularly in our growing tourism industry and its direct linkage to other sectors, such as agriculture.”

Rabuka further assured that PAP would work very closely with them in mobilising of the required local financial resources so that they could collectively realise the vision and dream of the establishment of an internationally recognised tertiary medial facility in Lautoka. Rabuka added that he and his party would provide full cooperation so that we all could realise this dream and initiative together.

Cardiologist DR MICHAEL SUSHIL CHANDRA is a world-renowned international medical professional, based in Iowa, USA. He with Dr Karam Singh has been relentlessly trying to bring this tertiary institution in Fiji and still have not given up after 40 years. They both plan to relocate to Fiji once the project gets green light from Fiji Government.

One wonders which part of the dream and advantage the Fiji First Government cannot understand, and why is one man single-handadly trying to stall this project which had been blessed by previous four Prime Ministers. The only hope for Fiji is to change the government to grant an opportunity to compassionate, engaging and visionary leaders to lead the nation out of the current doldrums and sad medical conditions.

Mahendra Chaudhry, who is leader of Fiji Labour Party is also coming strongly in the upcoming election, and like Rabuka, his initial support as the then Prime Minister decades ago still stands in support of this extremely beneficial, ambitious and long over-due project.

 

Lautoka Hospital

Lautoka Hospital has a massive multi-storey run-down infrastructure, degenerated so by underfunding of successive governments which had the eyes of leaders dazzled with five start golf-courses, international five-star hotels and shining Airbus and Boeing planes. By proper attention, priorities, renovations and equipping, this hospital (together with CWM and Labasa Hospitals) can come back to its past glory to provide free and subsidized health services to Fijian people.

However, it cannot be converted to provide an international type tertiary facility for Fiji which needs to be custom and purpose-built with all advanced medical facilities built-into the building to provide continuous, reliable and dependable services. Lautoka hospital is not good for that purpose. Yes, second-hand equipment donated by Australia and NZ can be used to equip this and other hospital to provide basic services. But they cannot be relied on to provide specialist tertiary services, and no surgeon worth his salt will wish to operate in an unreliable facility that may fall apart any moment. A tertiary hospital has to be built from scratch, as is required by this project.

Dr. Karam Singh's $150,000 Medical Laboratory of Fiji Limited complex was deliberately set alight by political thugs on 16 September, 1987. It was located at St. Forte Street near CWM Hospital. It was rated as the best medical laboratories in the Pacific, apart from those in Australia and NZ. It could do AIDS and other complex tests not available anywhere else in the region. Despite that, he is not vindictive and still wishes to help his country of birth get back more than what it lost in the 1987 arson. And this time, a changed, matured and repented Rabuka is with him, providing him all the support. 

To make Lautoka hospital into a world-class tertiary facility is like converting a piper (propeller-driven) aircraft into a Jumbo Jet 747, or picking up a rusty 737 from Arizona desert and painting it up and trying to convert it to a Dreamliner aircraft or A380. Hence the current run-down hospitals in Fiji need to be renovated to provide proper primary and secondary health care, for which they were initially built. 

Most are today converted to morgues as they have degenerated into because of lack of funding, vision of medical Ministry, pathetic services, overall poor governance due to political instability and blinkered vision-less leadership as Fiji currently has. As stated, they could be feeder hospitals for the specialist recuperation, but as erroneously suggested, cannot be reliably converted as tertiary facilities.

Fiji in the past, like foreign-based governance system, had been failed by the western concept of democracy, especially when we had blinkered, selfish and greedy leaders as happened in 1987. Hence, we need home-grown solution from Fiji people who appreciate and understand our problems. Therefore, Fiji no longer needs foreigners on holidays, recommending to provide band aid health services, but our Fiji born specialists who can understand and appreciate our systems, problems, are passionate about correcting our sick health system, and are nationalistic about medical development in the country.

That is where the Maestro Pathologist Dr Karam Singh and Internationally renowned Cardiologist Dr Michael Sushil Chandra come in. Dr Karam is not vindictive, but still has a heart for Fiji. His laboratory in 1987 was burnt by Taukei movement thugs, and he relocated to Australia and started and built reputable health services. He is very forgiving, and despite his mistreatment, has been trying relentlessly for 40 years with Cardiologist Dr Michael Sushil Chandra to give Fiji what Fiji really deserves from its children. It is the last gift which these retired Qaselevu (wise elders) or Bujurg (respected Senior citizens) wish to give to Fiji before they depart this world.

Hope the new government we will have before end of this year can fulfil that dream. Good Luck

 

PART 4: The international - standard medical facilities for Fiji to be provided by this Prime Health South Pacific (PHSP) project.

 

[About the Author: Thakur Ranjit Singh is former Publisher of Fiji’s Daily Post newspaper. Thakur was fired and removed from positions by two diametrically opposed Prime Ministers: Chaudhry and Qarase. This was for speaking the truth and being too frank and not mincing his words, as he is doing so here again. He is a media commentator, a journalist and runs his blog, FIJI PUNDIT. Thakur is a Post Graduate in Journalism (with honours) from Auckland University of Technology, (AUT), NZ.

E-mail: thakurjifj@gmail.com]

 

PART 2: FIJI MEDICAL CARE - PROJECT BLESSED BY PAST 4 PRIME MINISTERS NOW DERAILED BY FIJI FIRST GOVERNMENT

 

PART 2: FIJI MEDICAL CARE- PROJECT BLESSED BY PAST 4 PRIME MINISTERS NOW DERAILED BY FIJI FIRST GOVERNMENT.

Thakur Ranjit Singh

Synopsis of PART 1

You already read: After 4 coups and approval of 4 Prime Ministers, the tertiary health project seems to be stuck with one person in Fiji – Aiyaz Sayed-Khaiyum, who seems to have gone into a PPP - a public, private partnership with an Australian company ASPEN, which is not suited to what is proposed by the two doctors. 

Agreements with them (Aspen) were signed over 3 years ago to run Ba and Lautoka hospitals, but for some mysterious reasons, they started very late. It appears this was a unilateral reason without wider expert consultation, just with an objective to keep this tertiary project out of Fiji, and showcase before the election.

Khaiyum, for somebody who has never been a respectable practising successful lawyer within his own profession cannot be granted authority to decide on what medical facilities are needed and deserved by people of Fiji.

The whole series of articles suggest and plead to people of Fiji to change the government if they wish to see changes to the trend of dying people in our sick and run-down hospitals, and where a 40-year project in hindered by just one person in Fiji - Khaiyum. Fiji’s Attorney General, who is its surrogate Prime Minister, has little and scant knowledge, pride and understanding of his own profession, let alone about world-class tertiary hospital facility for a Third World Fiji, with collapsed primary and secondary health services.

The tertiary hospital project that commenced in 1982 was  blessed by 4 former Fiji PMs: first blessed by Ratu Sir Kamisese Mara, then Sitiveni Rabuka, then Mahendra Chaudhry and finally by Laisenia Qarase. But now it is derailed by the surrogate PM of Fiji, Aiyaz Sayed-Khaiyum.

PART 2- the urgency and need for such a facility in Fiji- and the benefits

To get an appreciation of what Fiji needs, we will educate on the different levels of health care. This is for the benefit of the non-medical community (especially for an ignorant Khaiyum) so that there is very clear understanding of the differences. Basically, there are three levels of health care: 

1. Primary Health Care, 2. Secondary Health Care and 3. Tertiary Health Care.

 1)  PRIMARY HEALTH CARE.

 

Primary health care consists of care given to patients in the private GP offices, outpatient clinics and dispensaries and small community or rural hospitals staffed by general practitioners. An example in Fiji would be Savusavu, Navua, Tavua or the former Ba Mission Hospital, now Ba Aspen hospital staffed by general practitioners, nurses and medical assistants.

 

Analogy - a piper sigle-engined propellor airplane, good for local island-hopping only.

 2)  SECONDARY HEALTH CARE CENTERS.

 

These are regional hospitals with facilities for x-ray, labs etc. and have full time staff of specialists in general surgery, internal medicine, pediatrics, obstetrics and gynecology.

Examples of these in Fiji are the CWM Hospital, Lautoka Hospital and the Labasa Hospital. These centers get referrals from the primary care centers and are capable of handling general surgical procedures, internal medicine diagnosis and treatment and pediatrics and ob-gyn cases.

These centers would then refer complicated cases requiring super specialized diagnosis and treatment to tertiary institutions like presently being done in Fiji for cardiac, neurological and cancer cases to India, Australia and New Zealand.

 

Analogy-A Boeing 737 or Airbus a-320, suitable for domestic services only.

 

Lautoka Hospital is a secondary hospital, badly run down, hardly able to provide toilet papers, Panadol, clean sheets etc, is expected to commence heart surgery by Khaiyum-chosen medical outsourcing company, ASPEN. Agreement was signed over three years ago, but no show till strategically -timed just before the election. Such delipidated hospital cannot be renovated as a tertiary facility with second-hand equipment. No medical specialist worth his salt would wish to work in an ill-designed and ill-equipped neglected hospital, masquerading as a tertiary hospital.

   3) TERTIARY HEALTH CARE INSTITUTIONS.

 

These facilities are the most advanced and have full time specialists and subspecialists in all facets of medicine and surgery disciplines to offer comprehensive tertiary care to the patients. These centers have the full capabilities of handling cardiac, neurological, cancer, orthopedics, trauma and all the other subspecialty cases in medicine and surgical disciplines.

There is no tertiary hospital in Fiji and the surrounding South Pacific Island countries at this time. Examples of tertiary hospitals would be Auckland Public Hospital, Auckland Mercy Hospital, St. Vincent, St George Hospitals in Sydney, and Batra and the Apollo Hospital in India,. among others, where most of the Fiji people are going for this level of care. There are certain International Standards required of these hospitals in building designs and the complement of subspecialty physicians by different Accreditation Agencies for approval and recognition as world class facilities.

 

Analogy - a Boeing Jumbo 747, a Dreamliner, or an Airbus A 350 or A380 for going around the world, and world-class.

 

In order to provide world class tertiary care in Fiji, one virtually has to design and build a facility with all these capabilities; otherwise, it would be very difficult to recruit the specialist doctors and the staff which are in big demand worldwide. To upgrade and convert one of the existing secondary facilities to tertiary level would be a mountainous task and may not be feasible to accommodate the latest technologies.

As analogy has been given of converting a piper plane to a 737, or to a Jumbo plane. Therefore, Lautoka Hospital is not seen suitable to convert to a tertiary hospital, as its original design and purpose lacked the requirement of such sophisticated facilities.

 

Therefore, Fiji’s questionable deal with an outsourcing group from Australia, ASPEN, and their claim for a tertiary facility at Lautoka Hospital is highly debatable when placed under microscope of those who have decades of experience in such facilities. I have already written about the charade of a heart bypass in Lautoka hospital as an election gimmick

Suva Private Hospital remains a primary-care hospital

Before I proceed any further, I wish to clarify a misconception people have of Suva Private Hospital. It was started by some GPs and hence remains a primary - care hospital. It is not a secondary like CWM Hospital, as it locums the specialists from there on a part-time basis. Having few medical machines run by specialist outsourced from other facilities do not make them into a Secondary. Just because it charges more, is well kept, very clean, provides personalised services by mostly same doctors, GPs and specialists in secondary hospital or in private facilities, they do not become into a secondary facility.

This is the concept of custom and purpose designed and built tertiary hospital complex in Tavakubu, Lautoka, Fiji. It has been 40 years in planning with approval from 4 Prime Ministers but stuck now with the Fiji First Government. Te only chance of it going ahead is a change in government.

A Tertiary Hospital with perfect synergy and collaboration with Medical, economic and tourism development in Fiji.

The hospital project is very ambitious and long overdue - some forty years since initiated in 1982. There is a 40-acre land sitting atop Lautoka Golf Club in Tavakubu, Lautoka, ready for the project. This site is only 5 minutes from Lautoka Hospital, which could be renovated as a secondary service hospital, and can become a feeder hospital for Prime Health South Pacific (PHSP) to be a suitable site to support low-cost recuperation facility with abundance of beds. 

This would be for common citizens of Fiji, and others, who could have specialised treatment at the tertiary hospital and then transferred to Lautoka Hospital to recuperate at a reduced cost, but still have access to specialists from the nearby PHSP facility to provide necessary after-care consultation. With an in-house ambulance service, there would be no strain on this scarce public services.

Advantages from the Fiji Indian Diaspora

Fiji Indians who have migrated worldwide, mostly to Australia, NZ, Canada and USA have produced multitude of doctors and medical health specialists excelling around the world. Many are well-connected with their other colleagues in USA, Canada, Australia and New Zealand, who are prepared to help if Fiji has proper access to specialist facilities as proposed by Doctor Karam Singh and Doctor Chandra. They also have contacts with so many doctors who are more than happy to help, provided Fiji has world-class facilities, welcoming compassionate leaders and good democratic governance. 

No accredited medical practitioner would like to work in a run-down Lautoka Hospital with band-aid repairs and second-hand equipment which became obsolete in advanced countries. Fiji needs to be supported to stand on its feet and not be a dumping ground for used equipment, as it is a matter of life and death, and not merely used as a dump for laptops and computers to be used by accounts clerks.

Patients waiting at Tavua Health Centre in Tavua, Fiji. Most health services in Fiji are badly run-down , unable to afford  Panadol, toilet paper and basic facilities with acute underfunding and poor management by the medical services in Fiji, where many people are dying. All this while our leaders who neglect such hospitals get first -class treatment overseas.

Fiji Indians in the diaspora have multitudes of second and third-generation Fiji Indian doctors and other medical health specialists with their umbilical cord already linked to their motherland, or that of their parents. Many would be able to shift back, or even come for holidays, while providing services in the tourism hub of Nadi-Lautoka. These people, with links in Fiji have a soft-spot for Fiji and would be willing to provide health services if Fiji has facilities which can provide respect and validity to their international training.

Fiji has so many retired doctor sons and daughters, who would be more than willing to help as they visit Fiji regularly, if the country has a reputable respected compassionate government and a well-managed tertiary medical and health facilities, and of course visionary leaders and good governance. Many of these medical specialists see Fiji as an exotic holiday location, and they could be urged to come on work and balance with their holiday visits with free accommodation build on the site with magnificent sea views of Yasawas, and they would be happy to share their expertise.

Many in Fiji Indian Diaspora living worldwide, including me, have left Fiji to live longer in developed countries with better medical facilities, because of poor medical services in Fiji. If I was in Fiji, I would have died a decade ago. And if many of our dead relatives were in developed countries, they would still be alive today, including my parents, elder brother and many friends and relatives in Ba, and throughout Fiji. Like me, many people we meet in developed countries would tell they also would have died long time ago if they were in Fiji with myopic leaders and equally sick hospitals. 

With advanced tertiary facilities proposed by these two doctors, those who left Fiji would be prompted to return to help in economic development, and in other ways. Many of us still have farms and homes in Fiji and retired people would feel comfortable spending winter months in Fiji with a tertiary world-class medical facilities, covered by insurance, and many with ability to pay.

Newly built Ba Hospital which is supposed to have replaced the Ba Mission Hospital. Outsourcing and management agreement was signed with ASPEN over 3 years ago, but this white elephant remained so for some 3 years, and just commenced recently.

The present-run down facilities by successive governments is the reason for massive brain drain of qualified people as well as qualified doctors who cannot fly jet planes in piper propellor aircrafts, because of collapsing medical facilities.

One major problem of poor health services is misplaced priority by blinkered leaders to pour money on international golf -courses, aeroplanes and five star -hotels, ignoring health services. And these selfish unworthy and heartless leaders then fly overseas for their first-class medical treatment to Singapore or Australia, while our poor Ram Singh and Viliame die in faeces-stinking medical services in Fiji.

The case in question is recent overseas treatment for Khaiyum and Bainimarama. If the 40-year request had been made into a reality today, both Khaiyum and Bai could have been treated by world-class doctors, with world class facilities, services and care in Tavakubu, Lautoka. The FNPF funds commandeered by Khaiyum to buy Airbus planes cannot give lives - tertiary hospital can.

The only way Fiji can have these facilities is to change the government, and have more visionary, caring and compassionate leaders to lead Fiji.

A TIME TO VOTE FIJI FIRST OUT

Ba Methodist Mission Hospital where yours truly (Thakur) was born nearly seven decades ago. It has been providing magnificent services to the people of Ba over that time, with some Government support. Lack of vision and support by government has turned it into a morgue and a dying house, while the replacement Ba Hospital remains a white elephant for over 3 years. And Fiji First government is stopping a new tertiary institution in Lautoka. The only way to change the dying hospital services in Fiji is to change the Fiji First government.

TO BE CONTINUED:

PART 3: The tertiary hospital: Financial viability, regionalism, political support and why Lautoka Hospital is unsuitable for tertiary project.

PART 4: The international - standard medical facilities for Fiji to be provided by Prime Health South Pacific (PHSP) project, and why Fiji needs it.

 

[About the Author: Thakur Ranjit Singh is former Publisher of Fiji’s Daily Post newspaper. Thakur was fired and removed from positions by two diametrically opposed Prime Ministers: Chaudhry and Qarase. This was for speaking the truth and being too frank and not mincing his words, as he is doing so here again. He is a media commentator, a journalist and runs his blog, FIJI PUNDIT. Thakur is a Post Graduate in Journalism (with honours) from Auckland University of Technology, (AUT), NZ.

E-mail: thakurjifj@gmail.com]