Fiji

Fiji is an island nation in the Pacific Ocean, west of Tonga and south of Tuvalu. The nation is comprised of 322 islands (106 of them inhabited) and 522 islets. Almost 90 percent of the population lives on the two main islands of Viti Levu and Vanua Levu. A popular tourist destination for nearly 500,000 people a year, Fijians have seen cycles of economic stagnation and political turmoil over the past 30 years. The nation has endured four military coups in the past 20 years, the latest in 2006. The population is 906,000, making it the most populous of the South Pacific's island nations. However, the annual rate of growth is just 1.4 percent, due to a low birth rate and increased emigration.

Many of those who leave the island are Indo-Fijians, descendents of Indian workers brought in by the British during a century of colonization. Once Fiji won independence in 1970, native Melanesians began to pass exclusionary laws against those of Indian heritage. Today, many Indo-Fijians suffer from racial discrimination and unequal access to public services, including education. Despite an overall literacy rate of 93 percent, a 1996 survey showed that only 14 percent of Indo-Fijian woman and 8 percent of men had received formal education.

Life expectancy rates have risen sharply since the 1960s, now standing at around 67 for males and 72 for females. Infant and child mortality has fallen to relatively low levels, with 16 infant deaths per 1,000 and 18 deaths per 1,000 for children aged 1–5. Mothers receive adequate prenatal care, and maternal mortality is rare.

While a variety of communicable diseases have been brought under control since the 1960s, problems do remain. The figures are not complete, but the World Health Organization estimates that at least 25 percent of Fijians live below the poverty line. Clean water and sanitation is spotty in some areas. Most child deaths are caused by acute respiratory diseases, meningitis, parasitic diseases, and anemia.

Noncommunicable, chronic lifestyle diseases such as diabetes and hypertension are also beginning to put an increasing burden on the health of Fijians. Like their island neighbors, Fijians have moved toward a more sedentary lifestyle and adopted a more westernized diet, leading to a rise in obesity levels. Smoking is also common. A 2002 survey indicated that the adult prevalence rate for diabetes was 12 percent, and the prevalence rate for hypertension was 19 percent. A third of all deaths in Fijians aged 40–59 were attributable to circulatory diseases.

Unlike most of the Pacific Islands, Fiji has a human immunodeficiency virus (HIV)-positive population, with 219 reported cases as of December 2006. Because HIV testing in Fiji is voluntary, the virus could be much more widespread; the Ministry of Health estimates that up to 4,000 Fijians could be undiagnosed. Other sexually [Page 665]transmitted diseases have also spiked up. Fiji contributes less of its Gross Domestic Product to total health expenditures than any Pacific nation, around 3 percent annually or $104 per capita. Little money has been allocated to hospital infrastructure or drug procurement. There are 24 general hospitals and 74 primary care centers to serve the population; the Ministry of Health counted 339 doctors, 1,682 nurses, and 1,435 other healthcare staff in 2003.

...