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]

 

 

 

PART 1: FIJI MEDICAL CARE -THE CONTINUING STRUGGLE TO BRING WORLD CLASS TERTIARY HOSPITAL HEALTH TO FIJI

 

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.

Cardiologist Dr Michael Sushil Chandra:

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.

PART 4: Concluding part and why Fiji needs this, and a change in government.

[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]