Report / Medical Department, Fiji.

  • Fiji. Medical Department.
Date:
[1969]
Catalogue details

Licence: Public Domain Mark

Credit: Report / Medical Department, Fiji. Source: Wellcome Collection.

    11/76 (page 3)
    26. The economy of Fiji is based mainly on agricul¬ ture, sugar being the predominant crop, but tourism and mining are also important sources of revenue. The total expenditure of Government has shown a steady increase over the years and, in 1969 it reach $34.42 million. Government expenditure on health services in the same year amounted to $3.15 million or 9T4 per cent. If the small revenue from medical services is taken into account and only nett expenditure is considered, the figure drops to $2.78 million and the proportion of Government wealth spent on health is seen to be only 8-07 per cent. The Fiji dollar is worth approximately the same as the Australian and New Zealand dollars, or $1.12 in United States currency and 9s. 7d. in sterling. 27. The population of Fiji on 31st December, 1969 was estimated to be 526,765 giving an overall density of 74-67 to the square mile (28-83 per square kilometre) but, as in all countries, the population density varies enormously, being over 6,000 to the square mile in Suva and less than six to the square mile over large parts of the centres of both main islands. Fiji has a multi-racial society and this results in an ethnic variety of some epidemiological significance. The two largest racial groups are the original inhabitants, the Fijians, and the descendants of indentured labourers who came from India about the turn of the Century. The Fijian component of the population numbers 219,893 (41-7 per cent) and the Indian one 262,947 (49-9 per cent). The remaining 43,925 consist of a number of different races as may be seen in Table XVIII. 28. It is against this background that the Medical Department must be studied and its activities judged. Ill—THE MEDICAL DEPARTMENT “Far better it is to dare mighty things, to win glorious triumphs, even though checkered by failure, than to rank with those poor spirits who neither enjoy much nor suffer much, because they live in the grey twilight that knows not victory nor defeat.” —Theodore Roosevelt. History 29. The Medical Department of the Government of Fiji has met with failures and defeats, with hurricanes, floods, earthquakes and disasters, with misplaced enthusiasm and sluggish apathy, with shortages of staff, funds and supplies, with frightful epidemics and chronic ailments and with dirt, poverty and ignorance m the course of its history. It has overcome them all. As this report attempts to show, Fiji is now one of the healthiest countries in the world. It is not yet Utopia but it is a country looking forward to the future, on the brink of independence, full of hope and confidence, healthy, strong, vigorous and with a population which enjoys the good things of life. For this successive generations of the Medical Department, both from overseas and from within Fiji, can take much of the credit. 30. In most Colonial territories the history of the hea'th services has undergone three stages of develop¬ ment. Western medicine was first introduced for the benefit of the European community and no concern was felt for the health of the original inhabitants, bflen, either because it was realised that surrounding ill health and lack of hygiene could affect the European community or because of the interest of the Medical staff, some attention began to be paid to the native population; but this was definitely allocated a lesser priority and the facilities were usually poor. It was only in the later stages of development that modern medical facilities were extended to the community at large and that the whole range of public health was spread throughout the country. 31. Fiji was an exception to this pattern. 32. The country was ceded to Great Britain in 1874 and the following year measles was introduced. This minor disease to Europeans struck the unprepared Fijian community with such deadliness that within months a third of the population had ceased to exist. Indeed it was only in recent times that the Fijian race really recovered from this appalling blow. The Medical Department was therefore established in Fiji shortly after Cession with this experience fresh in the minds of all and it commenced its work by tending for the “ natives ” as a matter of priority. 33. In the Century that has elapsed since then the Medical Department has grown steadily. Hospitals have been built and extended. Bush dispensaries set up and staffed by medical auxiliaries have given way to health centres with attendant doctors and nurses and the benefits of preventive medicine have percolated down to the smallest and most isolated communities. Organisation 34. The Medical Department is one of four within the portfolio of the Minister for Social Services who is charged with the formulation of medical and health services throughout Fiji, the Director of Medical Services being responsible to the Minister for its execution and for professional advice. The Director is in turn assisted at headquarters by a small staff of medical, paramedical and lay personnel. 35. To provide medical care for the people of Fiji there were in 1969, 217 doctors or one for every 2,427 persons, 38 dentists or one for every 13,862 persons and 715 nurses or one for every 736 persons. The vast majo ity of these were in Government employ and almost all of them were citizens of Fiji. The ratio of doctors and dentists to the population decreased during the year whereas that of nurses improved slightly. 36. For the purposes of medical administration the Colony is divided into four medical divisions which correspond to the general administrative divisions of the country; each is under the control of a Divisional Medical Officer. The main island of Viti Levu comprises the Central and Western Divisions, the second large island of Vanua Levu and its off-shore islands make up the Northern Division and all the remaining smaller islands compose the Eastern Division. Each of the three mainland Divisions is subdivided into four subdivisions, one of which is under the direct control of the Divisional Medical Officer and the others of Subdivisional Medical Officers. The geographical difficulties of the Eastern Division have delayed its subdivision but by 1969, Subdivisional teams had been established in Kadavu and in Lakeba to cover Southern Lau. Each Subdivision is divided into several Areas, each in charge of an Area Medical Officer who, in turn, has his Area divided into Nursing