Commentary |
| From Joseph Camillo (24 June 2010) Response to “Rotuma islanders refuse to change diet and lifestyle” I have a problem with this statement from FBCL and the Doc in Rotuma: From Ragfuata Kamoe Ralifo (25 June 2010) Well, the heading of this article potrays such a strong and negative
opinion on our people. From Henry Enasio (27 June 2010) Surely the learned doctor wouldn't have made the comments without any
hard evidence to qualify his statement. It'll be very naive of him to
do so without any raw data to base this allegation on; he needs
published statistics for support. Otherwise he's going to be inundated
with all sorts of responses and innuendos. Unless of course the FBC Reporter
had conjectured this to exaggerate and put a sensational spin on the
comment to mesmerise the community and justify to his peers the essence
of his trip and the hospitality Rotuma afforded him. From Alan Howard (27 June 2010) The data that I am familiar with suggests that Dr. Nadakuitavuki is quite correct about the transition from communicable to non-communicable diseases (NCD) on Rotuma, but he is badly mistaken to blame the traditional diet. Indeed, the traditional diet, described by Henry Enasio (above) was extremely healthy. That diet, along with plenty of exercise required by the traditional lifestyle, resulted in a people described by early European visitors as healthy and well-built. Diseases introduced by the Europeans (measles, influenza, whooping cough, etc.) were the main causes of death following European intrusion until the introduction of antibiotics in the 1950s. The transition to non-communicable diseases can largely be attributed to the adoption of a non-traditional diet high in fat, salt, sugar, preservatives and other additives to processed foods, in conjunction with a decline in vigourous exercise (walking to and spending long hours in the bush vs. using motorised transportation & sitting around drinking kava, etc.). This transition to so-called "modern diseases" has occurred all over the world, and quite notably in the Pacific Islands. That a rise in obesity, diabetes, hypertension and their resultant medical conditions has occurred in Rotuma was documented in 1996 in a survey by Dr. Temo Kilioni (see his report, which I have uploaded). Note the high rates of obesity in the report. Early European visitors to Rotuma described the people as "well built," "well proportioned," "who could have served as sculptor's models," with no mention of obesity. Even when I was on Rotuma in 1960, obesity was a rarity. Indeed, one could make a much better case for Rotumans to regain their healthy status by returning to the traditional diet and lifestyle. In my opinion, it is the loss of that lifestyle that is the the main threat to the health of Rotumans on the island today. I must conclude by saying that I, too, found Dr. Nadakuitavuki's language, as reported by Mr. Coka, offensive and ill-considered. Having read the related article and the correspondence that followed, I felt that at least one of the medical personnel should comment on this issue. I do agree with Dr Nadakuitavuki’s comments that Non-communicable diseases (NCD) are prevalent in Rotuma. This problem is not isolated to the island as similar trends have been noted in other Pacific countries as well. In fact, NCD is now a major public health problem among the Pacific Islands and amongst Westernized Countries including Australia. We don’t need any further studies in Rotuma to tell us about a problem that is common knowledge to us. What we actually need is to accept the current observation studies and start implementing strategies to counter this epidemic disease. I am sure that Dr Nadakuitavuki’s comments have been taken out of context. In addition, I do not see any reason why Rotuma’s medical officer’s comments need to be screened by non medical personnel especially as it relates directly to health issues on the island. We need to start implementing intervention and preventative strategies by involving relevant stakeholders on the island and the ministry of health to counter this epidemic. One must understand that change in behaviour takes time and unless we accept that we do have a problem than health promotion strategies and interventions that follows will be non-futile. As for the Mortuary issue, I believe this should be taken back to the Council of chiefs meeting in Rotuma so that the people are consulted on this issue, as this seems to be a recurring request and interest. I do understand Dr Nadakuitavuki’s views on this but I believe it is best for the people of Rotuma to make this decision, as it will basically affect them. As a final note I would like to thank the Subdivisional medical officer
Rotuma for his good work on the island and I am sure that the people
of Rotuma, like my parents are so thankful for his tireless contribution Dr Enasio Aisake Morris |