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06 March 2021
Dr. Claude Posala.

IN 2019 a 22-year-old Solomon Islander diagnosed with type 2 diabetes presented to the eye clinic with eye complications of diabetes called neovascularization retinopathy, a severe form of diabetic retinopathy. Her family was able to send her to Australia at that time for the urgent treatment of the blinding eye condition in a desperate bid to save whatever sight she was left with. 

A 30-year-old bank worker presented to the eye clinic complaining of blurry vision at times that made his work difficult. 

Diabetic retinopathy was diagnosed and he was shocked to learn that not only does he have diabetes, he also has microvascular complications already in his eyes. Most possibly his kidneys, heart, and brain are undergoing the same complication of diabetes.

Every two days the emergency department at the National Referral Hospital (NRH) saw a stroke or a heart attack emergency case, revealed Dr. Trina Sale the head of accidents and emergency at NRH in early 2020. 

Every day the emergency department sees cases of non-communicable diseases (NCDs) patients coming in with urgent health issues and emergency complications.

Every day the surgical department at NRH does between 5 to 10 debridement for diabetic foot sepsis and other diabetic-related infections. Debridement is the procedure by which diabetic sores get cleaned from dead tissue in an attempt to allow healing to take place. The surgical team does 4 major limb amputations each week according to Dr. Scot Siota a senior surgeon at NRH back in early 2020. Examples of major limb amputations are below the knee and above-knee amputations. 

Surgical inpatient stays for NCDs have a minimum of 20 days to a maximum of 100 plus days. A costly operational burden to NRH administration and operational budget. 

The internal medicine department also sees NCD admissions having hospital stays from 14 days to more than 100 days as well according to sister in charge Florida Pratt. This was back in early 2020. The statistics can be higher now. 

NCD admissions take up almost half of the total proportion of admitted patients at the NRH medical ward. A huge burden indeed.

Twenty years ago, this current state would have been unimaginable. People would have scoffed at this current situation if someone predicted it as such. It’s a hard reality for 2020/2021 and beyond in the Solomon Islands that most people do not realize.

Data from the 2015 Solomon Islands Steps Survey for diabetes showed that on average each Solomon Islander is only physically active 3 hours a day. It is also startling that at this current day and age only around 30% of all Solomon Islanders ever get a random sugar test done according to the same 2015 study. This does raise a lot of hard questions. Other findings in the same study revealed gross loopholes within our society that provide fertile ground for NCDs.

It is time that Solomon Islands government put in place actions and practices to ease the burden of NCDs. Perhaps we have trapped our economy into sole reliance on taxes from imported refined and processed foods and beverages rather than create a booming local agriculture sector? Why are imports of processed food so difficult to curb, avoid or reduce? Because it is addictive and it is a fast source of revenue through taxes and surcharges. 

Perhaps we should invest more in the food industry, tourism and other sectors which can be a win for health and a win for the economy as well.

When the local revenue footprint is on import tax of processed food and beverages and other non-sustainable industries such as logging, it's only time until we have a crippled workforce due to NCDs and a handicapped economy relying on this crippled workforce. Yes, a vicious cycle that has a downward economic and developmental direction.

Much aid money and government money has been allocated and spent on NCD infrastructures and activities and yet we have only seen relatively little in regards to the money spent. This is because it's all about sustainability and maintaining a healthy NCD approach, rather than a one-off solution and event. 

Currently, the government's focus is on COVID-19 and PG2023. NCDs should be placed on par with those two current government priorities. Nothing more and nothing less. We have the amazing 5,000 public servants housing project projected on Mamara. NCD infrastructure improvements and expansion would cater to more than 5,000 people with NCDs. We need to set our priorities for the future. 

A much more sustainable effort is to collectively get our acts together and start from the basic, little by little until we have breathing space to enforce more tangible actions. Right now we are literally drowning in an NCD crisis, whether we like it or not.  

Prevention is the cure, however, true prevention can only happen once a conducive healthy environment is provided. Without such directions from the government of the day, expect worse statistics within the next 5 years. 

Life can be a gamble indeed, and in the Solomon Islands, we may be placing our last and final bets that will create the future for our generations. Let’s place those bets wisely and let us not gamble away the rights of our children.

By Dr. Claude Posala





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