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.
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.
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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.
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.
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.
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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. |
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.
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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.
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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.
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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
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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]
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