Brand-new bicycles, shiny red motorbikes, a car and clinics to address the health needs of their villages – these are all part of the new-look grassroots health system that received blessing of both the church and the government yesterday morning.
Secretary of Health Dr Aumea Josephine Herman sat down with representatives of five Rarotonga puna to sign local-level cooperation agreements – and to assign them responsibility for their community’s health.
It comes as an Asian Development Bank report reveals that, despite concerns about its health system, Cook Islands is probably more ready for Covid-19 than any other Pacific Island nation.
Per head of population, Cook Islands has twice the number of nurses and midwives of other western Pacific nations, and is second only to Palau for the number of doctors.
It boasts 170 hospital beds which is only half what it would need in the case of local Covid-19 transmission – but that is still far, far better than any other island nation in the Pacific.
“The containment measures have prevented the spread of the virus from reaching the Cook Islands,” the report says.
But there’s a major downside: “The fallout of the lockdown has been a complete shutdown of the hospitality sector estimated at 1,556 jobs, or 20.9 per cent of the working population.”
Cook Islands is still vulnerable, if there is a domestic outbreak of the coronavirus – but the Asian Development Bank report indicates that risk is outweighed by the risk of keeping the border closed.
“The economic rationale is clear: each month of no visitors arriving into the Cook Islands costs the economy about 3 percentage points in lost GDP and causes significant economic and social damage.”
And to maintain Cook Islands’ enviable numbers of doctors and nurses and hospital beds costs money – that means opening the borders to paying tourists.
That revenue will also help the health system address the less palatable statistics, like the second highest adult and child obesity rates.
The vision for Te Marae Ora is for all people living in the Cook Islands to live healthier lives and achieve their aspirations – and Dr Herman said the signing of the puna cooperation agreements was a step towards that.
“It’s a privilege for Te Marae Ora to be in a position where we can have this formal relationship with our people, with our communities.”
It was one of the few positives that had come out of the pandemic: moving the country’s primary health care services from the town to the districts.
Dr Tupou Faireka Jr, the Director of Primary Care services, said: “This is a landmark occasion as we are one of the first in Pacific.”
He had seen the initiative trialed in Fiji but with little success. “This is the combination of the community and the healthcare system working together for the betterment of the people.”
“It’s good to have the community involved so they may look after themselves as well, It has already been shown that when people visit the clinics in the punas, it is also a gathering place for the elderly to have chats with others – it’s good to hear their laughter.”
Dr Faireka noted that modernisation has changed the cultural family structure, and that money is now running the lives of many people, “with the younger generation moving overseas, our elderly are left behind, they need help.”
“So, this will also help strengthen the bond between the elderly and the rest of the community, looking after our elderly is our way of life; our community will become stronger.”
Dr May appreciates the movement of taking health care services closer to the people,
“Primary Care health is very important to prevent long-term diseases such as Non Communicable Diseases, we hope that this initiative will be well used by the community.
Director of dental health services Danny Areai announced that the establishment of oral health care in the communities had always been a dream.
“We had envisioned to take the primary dental care services into the community… thanks to Covid, things happened very quickly.”
“The principle has already proven to work, the beauty is we are taking the services closer to the people and that it is combined with the other Health care services, so we have a united front.”
Areai is positive that people will be pleased and happy at the convenience of the centers and hopes that people do use these services.
This is the first time dental services will be offered on such a large scale, and the department would like for people to be mindful of what the services are, “this is a major undertaking on the history of dental services.”
“Our goal is to get the tooth decay rate down.”
Visit the clinics for basic dental treatments such as aches, cleaning, examinations and tooth extractions, major reconstruction procedures will be done at the main dental clinic in Tupapa.
The arrangement is for three years is effective today August 1st 2020, the documentation was signed between each representative from the five districts of Nikao-Panama, Rose Kairua for Tepuka Community Health Clinic Incorporated; Matavera, Taakapi Tutakiao Kora for Matavera District Committee Inc; Ngatangiia, Ina Tararo for Ngatangiia Community Health Services Inc; Titikaveka, Ali Macquarie for Titikaveka Community Medical Services Inc. and Tupapa, Teokotai Robert for Tupapa Maraerenga Maternal Child Health Clinic Inc.
It is expected the other five districts will sign their arrangement in the near future.