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Nurses at Fiji's Colonial War Memorial Hospital (CWM). Credit: Fijian Government website

Fiji’s Health Services in Crisis As Nurses Migrate

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Nurses at Fiji's Colonial War Memorial Hospital (CWM). Credit: Fijian Government website

By Pauliasi Mateboto

SUVA, Fiji, 13 June 2023 (IDN) — Fiji’s ailing medical industry has seen another massive blow as over 800 nurses have reportedly left for greener pastures so far this year, either to the local private sector or migrated overseas, mainly to neighbouring Australia and New Zealand.

Along with the ageing medical infrastructure,  neglected by past Fijian governments, low salaries and the quality of support from the Ministry of Health during the height of the COVID-19 pandemic have all contributed to the sorry state of the health sector here.

According to orthopedic surgeon Dr Eddie McCaig, nurses are leaving in droves, with over 800—a quarter of the workforce—migrating overseas in the past year alone.  (P06)  CHINESE | JAPANESE

Dr McCaig said that healthcare workers opted to exit because of several factors. Still, their primary concerns were poor compensation and working conditions, a challenging political environment, and seeking better opportunities for their children.

“Last year (2022), we lost 807 nurses, which equates to 26.7 per cent of 3056 nurses,” he revealed, noting the standard of patient care provided by healthcare professionals had also declined because of socio-economic issues.

“We do not have the resources to provide all the care that is promoted by providers and desired and demanded by the public,” he said.

Divisional medical officer (DMO) Central Fiji, Tevita Qoriniasi said the Nausori Health Centre had 37 vacant positions in the nursing department. He added the current staff were tired, and counselling sessions with Medical Services Pacific (MSP) were engaged for the team.

“Of the total 61 staff that resigned in the last three months, 16 were from Nausori (outskirts of capital Suva),”  Qoriniasi said. “As far as staffing is concerned, we have 138 established positions with 39 vacancies, 37 of which are in the nursing department”.

“On average, about 2500 patients are seen at our GOPD (general outpatient department) per week. This number excludes those that are seen at our SOPD (Specialist Outpatient Department) clinic and maternity unit,” he added.

Qoriniasi said staff are working extra hours and that specific departments have closed. “The current staff have to work extra hours to ensure duties are covered, and shift hours have been extended to 12 hours to enable some breathing space,” he complained.

Qoriniasi also pointed out that some regular services like IMCI (Integrated Management of Childhood Illness) had to be closed, and (this) has contributed to longer waiting times.

Qoriniasi said management and the Ministry of Health have the plan to mitigate the current shortage of staff issue without elaborating on it.

Australian and New Zealand healthcare sectors have aggressively recruited trained and experienced Fijian nursing staff in the last few years. Some Pacific Island nurses taking up aged care jobs in Australia must be more qualified. Experts here are concerned about the “brain drain” leaving critical gaps in the region’s healthcare systems.

Fiji Nursing Association President Dr Alisi Vudiniabola confirmed to IDN that many of the country’s “very experienced and well qualified” nurses that have left to work in jobs overseas in aged care are over-qualified for it. “Some of them are midwives, some advanced clinical nurses, some are managers in primary healthcare centres,” she said. “It’s a big loss for Fiji when we lose such qualified nurses.”

No data is available on the total number of Fijian nurses now working overseas. Still, Dr Vudiniabola estimates most have left for Australia, New Zealand, the Middle East and the United States during the past six months.

Despite mounting pressure on the health system, she said the Fiji government kept tight-lipped about the figures. “They just keep all the information to themselves; we are not seeing the numbers that are leaving, but we know that nurses are leaving almost every day,” she said.

Dr Vudiniabola hoped that at least Pacific nurses would have opportunities to increase their skills. “I’m just hoping that … Australia looks at pathways for professional development and does not just leave them being an aged care worker,” she added.

During the pandemic, most of the COVID-19-related deaths in Australia were in aged care nursing homes, and critics there said that a contributing factor was a lack of adequately trained staff in the sector.

While the Australian and New Zealand High Commissions were not to be reached for comments on the issue, Australian Broadcasting Corporation reported in November last year that the Australian government refuted claims that the Pacific Australia Labour Mobility (PALM) scheme is causing the nursing shortage in Fiji.

The PALM scheme allows eligible Australian businesses to hire workers from 9 Pacific islands and Timor-Leste when more local workers are needed. They can recruit workers for seasonal jobs for up to 9 months or longer-term roles for between one and four years in unskilled, low-skilled and semi-skilled positions.

The Australian government’s website says it allows “employers access to a pool of reliable, productive workers (while) it also allows Pacific and Timor-Leste workers to take up jobs in Australia, develop their skills and send income home”.

In the Federal Government budget presented to parliament in Canberra on 9 May, the Australian government has committed to expanding further the scheme, which currently provides jobs to more than 37,700 Pacific and Timor-Leste workers. 

When the scheme was first introduced the then Minister for International Development and the Pacific Pat Conroy said only a “small proportion” of Pacific workers training to work in aged care were qualified nurses.

“Australia wants to contribute to the economic development of our region. We do not want to deprive the Pacific of its health workforce,” he said, claiming that the PALM scheme had been a “win-win” for Australia and the region.

“It’s making a significant contribution to economic development in our region, through workers sending their Australian earnings home, and at the same time helping with worker shortages in Australia,” added Conroy.

Speaking anonymously, a Fijian nurse who has been in the industry for over 30 years and plans to move to New Zealand by the end of the year said the decision to move has not been easy. Still, she has decided to journey across the Pacific Ocean for better opportunities for her and her family.

“The working condition for us (medical workers) in Fiji over the last few years has been ignored (thus), so many of us have taken the difficult decision to look for greener pastures,” she added.

“Most of us nurses have to start with caregiving when we first move, then study further for a chance to join the medical industry there; it is an extra battle we don’t mind fighting,” she added, referring to what is in store for Fijian nurses migrating to New Zealand. 

She said many of her colleagues that have migrated overseas had blended well with the lifestyle there and have been providing for their families back in Fiji, which is a bonus.

Meanwhile, as Fiji’s new coalition government seeks to address numerous issues affecting its economy, reducing the mass migration of nurses is undoubtedly a top priority.

At a media briefing, Permanent Secretary for Health, Dr James Fong, told journalists that the Ministry has met with nursing stakeholders such as the Nursing Association to discuss plausible solutions. He says a working group involving all related government ministries and nursing stakeholders will formulate proposals for submission to appropriate budget forums over the next week.

Dr Fong says that whatever they do, they must maintain all parties’ aspirations. The Permanent Secretary hinted that the Ministry will be able to sort something out for the nurses in the upcoming 2023-2024 national budget later this month. [IDN-InDepthNews]

Photo: Nurses at Fiji’s Colonial War Memorial Hospital (CWM). Credit: Fijian Government website





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