PART 1: FIJI MEDICAL CARE - THE
CONTINUING STRUGGLE TO BRING WORLD CLASS TERTIARY HOSPITAL HEALTH CARE TO FIJI
Thakur
Ranjit Singh
A HISTORY
The concept and the initial idea for a tertiary specialty hospital for Fiji was formed in 1982
when three prominent people from Fiji went for their cardiac care to heart cardiovascular
physician/cardiologist, Dr Michael Sushil Chandra (originally from Yalalevu,
Ba) to Iowa, USA.
Dr Chandra visited Fiji in 1982 and met Dr.
Karam Singh, who was the President of the Fiji Medical Association at that time
and discussed with him the hospital concept. That developed into the now
pending PRIME HEALTH SOUTH PACIFIC (PHSP) project.
Here are the excellent intellectual sons of
Fiji, still having their hearts in Fiji, with their outstanding internationally-recognised
credentials:
 |
The image of how the brand-new tertiary hospital building would sit atop Lautoka Golf Course in Tavakubu, Lautoka, with modern state-of- the-art medical facilities and equipment. |
Diplomate of the American Board of Internal
Medicine, and also Subspecialty Board of Cardiovascular Diseases. Born in Ba, Fiji,
graduated with distinction from Fiji School of Medicine, trained in India and
USA, Internal Medicine at Creighton University School of Medicine, Omaha, Nebraska
and National Institute of Health (NIH) Fellowship in Cardiovascular Medicine at
the University of Iowa Hospitals and Clinics. 40 years of experience in
cardiovascular medicine in the USA, academics and clinical practice. Instrumental
in training many cardiovascular specialists in the USA. Pioneer and developed a
comprehensive cardiovascular program including CV Surgery de novo (from
scratch, initiator) in 1976 in a city of 90,000 population in Iowa. This has
become one of the largest and very successful programs in the State of Iowa.
Present focus to develop comprehensive tertiary health care in the South Pacific.
 |
Cardiologist DR MICHAEL SUSHIL CHANDRA of Iowa, USA |
Pathologist Dr Karam Singh
Born in Fiji, descendant of a retired First
World War Indian soldier. Graduated as the dux of Fiji School of Medicine in
1969. Post-graduate training at Otago University, New Zealand. First graduate
outside Australasia to obtain Fellowship of the Royal College of Pathologists
of Australasia. Extensive experience in Fiji, New Zealand and Australia.
Established the first private pathology laboratory in Fiji which was burnt in
arson attack during political instability in 1987. Moved to Australia in 1987.
Founder of Medical Laboratory Australia which employs over 500 staff today.
Always desired to establish a world class, high-tech, low-cost tertiary
healthcare for the people of the South Pacific.
 |
Pathologist, DR KARAM SINGH of Sydney, Australia. |
Here are two celebrated sons of Fiji, who have been relentlessly trying for the last 40 years for somebody to hear them out and share their vision of a comprehensive tertiary health care in Fiji - and still doing so.
When approached by Dr Chandra in 1982, Dr Karam was thrilled with the idea and very quickly was able to organize a steering committee of prominent people in Fiji to drive the project. Dr Chandra was able to convince the Sisters of Mercy Health Corporation of Farmington Hills, Michigan, USA to partner with them in this project. A feasibility study indicated such a facility was needed and viable.
The then Prime Minister of
Fiji, Ratu Sir Kamisese Mara blessed the project and offered to donate
10 acres of land adjacent to the National Stadium called Pony Park for the
Hospital site. (Now, reportedly, it has been given for children’s
heart hospital project.)
HOW COUPS KILLED THE PROJECT
The project was first killed by the coup of
1987.
However, when Rabuka government came
in, this project was revived in 1992. A Delaware corporation was formed in
1997, a 40-acre Crown land with 99-year lease in Tavakubu, Lautoka, adjacent to
Lautoka Golf course was identified, bought and the project commenced. But
Rabuka lost the election in 1999.
 |
Ba Hospital, built some 4 years and now started after many stalled dates. There are many unanswered questions. Is it leaking? Is it poorly designed, and hence seen unsuitable by the chosen ASPEN group to be used as a hospital? Has government come our with any explanation? The agreement with ASPEN was signed over 3 years ago? And it seems it is operation now. |
In the year 2000 Mahendra Chaudhry
became the Prime Minister of Fiji and he endorsed the project. Dr Chandra, with
the project manager from USA met Chaudhry in New York when he visited the
United Nations and he promised to have FNPF finance the project and be a
partner in it.
Lo and behold, another coup happened in May,
2000 and Mahendra Chaudhry was out and hence the project stopped
In early 2005, Mahendra Chaudhry approached Dr
Chandra to revive the hospital project. He indicated the desperate need in Fiji
for the tertiary specialty hospital in consultation with Dr Karam Singh. While
discussion was taking place, they were drawn to a recent Wall Street Journal
article, describing the Apollo Health Systems of India and how Dr. Pratap Reddy
had developed this powerful world-class low-cost tertiary healthcare system in
India and now recognized by the Americans.
Dr Reddy’s expertise, experience, dreams and
achievements were very similar to what Doctors Karam and Chandra had desired
for Fiji. They both possessed the expertise, courage and experience to develop
a similar system for Fiji. Both of them were highly trained and established
tertiary level physicians. Dr Karam had de novo (initiated and designed from
the beginning), developed the Medlabs of Australia which is now the largest private
pathology labs in that country whereas Dr Chandra had de novo (from scratch)
and developed a comprehensive cardiovascular system in Sioux, a large city in
Iowa, USA.
The plans were finalized to sign an agreement
with Apollo, whose Dr Reddy consented to support the Fiji project. Both Dr
Karam and Dr Chandra agreed to fold their projects in their respective
countries and shift to Fiji. The feasibility study showed that a tertiary
hospital in Fiji was needed and economically viable.
 |
The 40 acre land already acquired for the project, lying on top of Lautoka Gold Course, sitting at a very strategic location in Tavakubu, Lautoka ,with stunning and breath-taking unhindered sea view. |
Things started to move - land for the hospital was already acquired, and Mahendra Chaudhry got the blessings from PM Laisenia Qarase for the project. When two Doctors were in Delhi to sign to project, they received another bad news in 2006.
Lo and behold, another coup, Bainimarama coup
of 2006 again halted the project. No agreement was signed and it was the end of
the third attempt.
HOW THE PROJECT RECOMMENCED UNDER
BAINIMARAMA’S RULE – BUT KHAIYUM USED FNPF FUNDS TO BUY AEROPLANES INSTEAD
Mahendra Chaudhry, who was the Finance Minister
for a short while in the Military government, approached the doctors again to
restart the project. This was especially around 2007-2009 when FNPF started
thinking about health insurance plans for its members. Another feasibility
study cost the two doctors personal funds for Apollo Health System, and the
study again confirmed the need and viability of the facility.
However, FNPF backed out as reportedly the
funds destined for the Hospital were used to finance the new Airbus planes. The
Bainimarama Government, namely the surrogate PM, Aiyaz Sayed Khaiyum
told them there was no money for the project in Fiji and that they had to get
financing from abroad if they wanted to pursue further. Hence an international
finance consultant was hired who advised that this was very difficult because
Fiji did not have a democratic government but a military rule at that time.
Several business leaders and prominent people were
approached to participate in the project, but without any success. The doctors were
very disappointed because no one showed any interest citing that they had permanent
residency to Australia and New Zealand and could easily get medical treatment
in those countries.
Therefore, the project was dropped for the
umpteenth time.
KHAIYUM THE BIGGEST OBSTACLE IN PROGRESS
OF THE PROJECT
The two Doctors did not sit idle, and while in
Fiji in 2013 to teach at the Fiji School of Medicine at the request of the
Minister of Health, they had discussions with Solomon Island Provident Fund for
a shared facility in Fiji and Honiara. They proceeded with discussion with the
Solomon Islands National Provident Fund who became very interested to invest in
the proposed tertiary hospital in Fiji and also building a sister secondary
hospital in Honiara, Solomon Islands. Hence in 2015 they revisited discussion
with the Medanta Group, Apollo Group and the Narayana Group in India. They
chose Narayana which fizzled out once it became a public company and its new
owners were not keen.
They never gave up, and Vamed was
brought into the picture. Vamed is an Austrian company based in Vienna. It is
the world’s largest builder and manager of hospitals and other health care
facilities. It has built over 800 hospitals so far all over the world. Vamed is
a division of the medical behemoth Fresenius, the world’s largest producer of
kidney dialysis machines with the annual revenues of about 32 billion euros.
Vamed was ready to proceed with the project but got hindered by the announcement of the PPP (Private, Public Partnership) by the Fiji Government with Aspen Group to renovate and convert Lautoka Hospital to a tertiary health care facility. As we will show in later articles, this sounds unusual, as Aspen is not geared for PPP which is generally meant for Design/ Build facilities, while Aspen only specializes in outsourcing health and medical facilities in disasters.
 |
Fijian Attorney-General and Minister for Economy Hon. Aiyaz Sayed-Khaiyum and Aspen Medical Group CEO Bruce Armstrong at PPP contract signing in Suva on 17 January, 2019 to renovate and run Ba and Lautoka hospitals. We have just passed 3 years of the signing, and Ba hospital was lying idle for 3 years, and there was no activity at Lautoka Hospital. What process was used in granting contract, was it transparent? Do the Minister of Health and the Permanebt Secretary know about this? Is this an exclusive arrangement, meant to prevent Prime Health South Pacific bid? |
Agreed, Khaiyum may have Operation and Maintenance (O&M) arrangement to deter two intellectuals from entering Fiji with their project. O & M arrangement by Khaiyum with Aspen is like converting a one-engine piper propellor, used for island-hopping into an Airbus A 380 jet, flying to Los Angeles.
The whole PPP seems suspicious and will be raised in the coming
articles, with details of the chosen one, Aspen, delays with Ba Hospital and
why the project looks doomed and far from tertiary medical services, only
providing primary care like Mission Hospital in Ba. Watch the space for more
revelations on this.
DOES KHAIYUM HATE BRIGHT, EDUCATED INTELLECTUALS?
One word that best explains Fiji’s surrogate
PM, Khaiyum is Narcissistic - somebody who seems deeply engrossed in self-love,
self-importance, is egoistic and despises anybody else brighter than him.
His unceremonial deportation and treatment of
greatest Fiji Historian, Professor Brij Lal, the midnight deportation and
humiliation of regional Vice Chancellor, Professor Pal Ahluwalia, the unconstitutional dismissal of Solicitor
General Sharvada Sharma, sexual framing of a business executive whose treatment
by police and the prosecutions was rebuked by the magistrate, and bullying into
resigning of former Lands Minister, Ashneel Sudhakar, (coming in future articles) are just some of the many
misdemeanors of this person.
His continued mistreatment of the two of Fiji greatest international medical minds and extremely qualified doctors shows what Fiji is made to be deprived of and suffer under Fiji First which seems to be ignoring the health services, and tertiary medical teachings in Fiji.
It seems Bainimarama is in the dark, while
the prospective Prime Minister, Sitiveni Rabuka of Peoples Alliance Party seems
to have a vision of better medical facilities in Fiji. Rabuka would be more
accommodating once there is a change of government and vision for tertiary
medical services in Fiji -not the primary care outsourced with Aspen.
This move by Khaiyum is myopic and smells of improper advice, as two of the most qualified medical practitioners have been trying and struggling to help Fiji for the last four decades. They are still waiting the outcome of the PPP Project and support of the Government of Fiji.
On December 10, 2020 they had written to the Attorney General and Minister for
Economy, Civil Service and Communications for Licensing Approval. They are yet
to receive a response in spite of sending reminders.
The proposed tertiary hospital had received
approval from previous successive Fijian Governments, went through approval of four
Fiji Prime Ministers, and is now stuck with the fifth one, Khaiyum, the
surrogate PM. Despite this obstacle, the two medical warriors are continuing
with the struggle that began four decades ago. Because of their love for the
country of their birth, they have not given up hope.
TO BE CONTINUED:
PART 2: Why
the need for a tertiary specialty hospital for Fiji built from scratch, the
advantages and the benefits to Fiji.
PART 3: The
international - standard medical facilities for Fiji to be provided by 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]
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