It was by force of necessity that Te Marae Ora moved the country’s healthcare out of town and into village clinics – but locals have welcomed the change.
Secretary of Health Dr Josephine Herman says the puna model, with nurses based in 10 halls around Rarotonga, as well as in the outer islands, has been successful.
The feedback from our people is they’re really happy with seeing the doctors, the nurses, closer to home.
“And I must say, the best health system in the world is the one that gives the power and control to the people,” Dr Herman said.
“We’re hoping that Covid-19 had been the catalyst for us to reset our health system. We’ve talked about this for a number of years since I came in, and it’s happening now.”
She said they now want to make the new decentralised model more permanent – and that means finding new buildings for village clinics. “As you know some of these punas are sitting in halls, and those halls need to be returned to their communities.”
They intend to use that new local health provision model to take on the sleeping giant of health problems: dengue.
Dengue is a viral infection that causes a flu-like illness that sometimes develops into severe illness. It is carried by female Aedes Egyptii mosquitoes, that bite in the daytime. It starts with fever, headache, nausea, vomiting and pain behind the eyes – and can get rapidly worse.
Early detection and proper medical care can lower fatality rates to below one per cent. There have been 242 cases since the Cook Islands outbreak began in January last year but there have been no deaths.
Through Operation Namu, public servants and puna volunteers have worked systematically through the villages, getting rid of junk, cleaning up wet areas and trimming back grass and foliage. They collected at least 355 large bags of rubbish. Huge amounts of plastic, tins and bottles were sent to landfills, along with tyres, old appliances, syringes and car batteries.
Te Marae Ora staff have been grabbing every opportunity between rainstorms to spray the perimeters of schools and homes with pesticides – tactics successful in beating zika and chikungunya in 2015.
Dr Tereapii Uka has taken charge of the puna system and the response to Covid-19 locally, while Dr Herman is in New Zealand for the next two to four weeks. But she said she’d be in close contact with her team.