Tonga

Named “The Friendly Islands” by Captain James Cook when he landed in the 1700s, Tonga is the Pacific Islands’ only monarchy and the only nation that never fully lost its indigenous control of the government. [Page 1671]The 500-mile long archipelago is located due west of Samoa and consists of 169 islands, 96 of which are inhabited. The total landmass is around 465 square miles, about four times the size of Washington, D.C.

The total population is about 115,000 with a growth rate of 2 percent annually. This is due mainly to a high birth rate, with 25.37 births per 1,000 people and a fertility rate of 3.8 children per woman. The death rate is 5.28 per 1,000 people. Population density is high at 157 people per square kilometers, with 70 percent of the population living on the largest island, Tongatapu. Thirty-three percent of Tongans live in urban areas.

Tonga has made great strides in combating poverty since the 1950s. Four percent of Tongans live in extreme poverty with under 7 percent unable to meet basic food needs. Tourism and agricultural exports are the nation's main sources of income; however, the economy is not robust, with an estimated 55 percent of the Gross Domestic Product coming in the form remittances from those working outside the islands.

The health profile of Tonga has improved greatly in the last 50 years. Life expectancy at birth is currently 70 years for males and 72 years for females. Tonga has the lowest rates of infant and child mortality in the Pacific region; maternal mortality is also very rare. Childhood immunization rates better in some areas than in industrialized countries.

Common infectious diseases have been largely eradicated. Dengue fever reemerged in 2003 but is believed to have little chance of becoming endemic. The government completed a program to eliminate lymphatic filariasis in 2005. The last indigenous case of leprosy was diagnosed in 1998. There were 12 cases of tuberculosis diagnosed in 2004. As on other Pacific Islands, the AIDS rate is low, with just 14 confirmed cases of HIV since 1990. The rate of other sexually transmitted diseases is not really known because of poor reporting.

Poor sanitation contributes to endemic levels of hepatitis B, and there are about 20 cases of typhoid fever diagnosed each year. In 2005, there was a widespread outbreak of watery diarrhea which killed six children.

The main health problem facing Tongans today is obesity. A 2004 study found that in the last 30 years, the average weight of a Tongan male has climbed from 172.1 pounds to 210.5 pounds, and the average female's weight grew from 162.8 pounds to 209 pounds. Sixty percent of the population is obese, and weight gain is now starting in adolescence. The causes are due primarily to the quantity and quality of food within the context of Tongan society. One study shows that the average Tongan male eats twice the amount of food as the average Australian man; feasting holds an important place in island culture. However, traditional foods have been supplanted by a westernized diet high in fat, sugar, and salt.

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