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Pacific Island nations develop new strategies to cope with diabetes

APJ P3 Marcus Bank - Diabetes - poster 425wide

Billboards like this in the Cook Islands are erected across the country to educate the people about the consequences of diabetes. Image: CI Ministry of Health

The number of people in the Asia-Pacific region suffering from diabetes is increasing every day, with now more than 138 million people estimated as having the disease. Asia-Pacific Journalism looks at how small countries such as the Cook Islands are developing new strategies.

Pacific Scoop:
Report – By Marcus Bank

Scooters and cars pass by it every day. Some don’t even notice it.

Others turn their head briefly to look at the billboard planted between palm trees on the main road leading in and out of the town of Avarua, capital of the Cook Islands.

The yellow and black hoarding shows the bottom of a foot. Four of the toes have a much darker colour then the rest.

APJlogo72_iconThe disease is called peripheral vascular disease and is one of the many side effects of diabetes.

The sign is just one of many put up by the Cook Islands Ministry of Health as part of a campaign seeking to make people aware of diabetes.

”Diabetes is a major concern in the Cook Islands,” says Karen Tairea, Nutritionist and NCD (Non-Communicable Diseases) Coordinator at the Cook Islands Ministry of Health said.

Along with the rest of the ministry, she is structuring new strategies trying to reduce the level of diabetes among Cook Islands people.

”The new strategies are encouraging people to be more active. We are gaining partnerships with schools and the local community to engage the people,” she says.

The new strategies also focus on promoting healthy food. A new documentary aired on TV, and more focus on health stories covered by the media is set to try and change the lifestyle of the Cook Islanders.

”Almost 10 percent of the people here have diabetes – and those are just the ones registered,” Tairea says.

The new strategy for Cook Islands is scheduled to launch next year.

Not isolated incident
The problems on Cook Islands are not an isolated incident. Throughout the Asia-Pacific region, countries are fighting the diabetes epidemic.

Seven out of the top ten countries of prevalence of diabetes are Pacific Island nations, a report published by the International Diabetes Federation (IDF) last year shows.

Timothy Cundy, professor of medicine at Auckland University, says the reason is partly urbanisation in the countries.

”It is a big problem in many countries. They become more westernised, especially when people move from the island countries to Australia and New Zealand,” he says.

”There are so many people affected and the numbers are increasing all the time.”

Dr Sunia Foliaki, who is both a medical doctor and holds a doctorate, at the Centre of Public Health Research at Massey University, he says the numbers are alarming.

“In Tonga, just under 40 percent of the adult women have diabetes. It is a big problem,” he says.

And the consequences can be life-threatening to those who have diabetes, says Dr Foliaki.

“Apart from the people dying prematurely, we have people who need limbs amputated. Diabetes doesn’t happen in isolation. When you have diabetes you have something else as well like cardiovascular diseases.”

Cola over water
There are many reasons why the problem has got this far, Dr Foliaki says.

“We have always said that diet and lack of physical exercise is one of them. But we need to look at the causes of the causes.”

He believes that the focus on health issues have been hijacked by subjects like economy and trading.

“The kinds of development we see are those towards designing cities for cars, not for walking or bicycling. Take Tonga for example. It is a perfect flat country and would be ideal for biking,” he says.

Alongside a lack of focus on exercising, the problem of unhealthy diets is also being neglected, believes Dr Foliaki.

“The people can afford a cola, but not water. They can afford the imported frozen chicken, but don’t have the money for petrol so they can go out and catch the local fish.”

Diabetes congress
In November, the eyes of the Asia-Pacific region will turn to Singapore.

The IDF is hosting its 10th congress on diabetes in the Western Pacific Region.

The three-day congress will discuss the epidemic of obesity and the rise of type-2 diabetes, and how to tackle this in the Asia Pacific region.

Even though congresses like these help keep the focus on the problem it is not enough, says Dr Foliaki.

“We can go to every workshop and commission but what is being said needs to transfer into action.”

Big NZ problem
The problem with diabetes is not only concerning those living in Pacific Islands such as Cook Islands, Nauru, Samoa and Tonga. The problem is also big among the around 350,000 Pacific Islanders living in New Zealand.

Kate Smallman, project manager and diabetes nurse specialist at the Diabetes Projects Trust, said that especially the type-2 diabetes numbers are increasing.

The reason can be divided into two categories, she says.

“It is both because of lifestyle but also because of genetics.”

According to the Ministry of Health’s latest statistics (December 2013), more than 28,000 Pacific people living in New Zealand are diagnosed with diabetes.

While genetics among Pacific people is a big part of the reason, Kate Smallman also points to culture as a factor.

“They are a group of people who like to reward with a lots of food. We need to support and educate what healthy eating is,” she says.

One of the ways the Diabetes Projects Trust tries to help the Pacific people is by educating those important to the community, such as priests and pastors, Smallman says.

“We help to get them to be the role models. We need them to come up with their own ideas rather than the ideas coming from someone like me.

“It’s not about changing their culture, but to support it within to make it more healthy,” Smallman says.

Marcus Bank is an Inclusive Journalism Initiative (IJI) programme student journalist from Denmark on exchange at AUT University and on the Asia-Pacific Journalism course.