RISE IN FIJI MATERNAL DEATHS REFLECT DOCTOR SHORTAGE

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SUVA, Fiji (Fiji Times, Oct. 18) – Some of the deaths of mothers during childbirth over the past four years in Fiji were the result of possible misdiagnosis by medical personnel on duty.

Government consultant gynecologist and obstetrician James Fong said 12 women died last year from a number of birth complications.

Authorities said the figure could have been much lower if patients had come in for early diagnosis and if medical personnel were more skilled in dealing with such cases on an individual basis.

"That is a very significant figure for us and we are quite concerned with it at this stage," said Dr Fong yesterday. "It has been a concern for us for a long time but the biggest problem in terms of doing something about it is the accuracy of figures we have to work with. This is the situation given the level of socio-economic development and resources that are available for health authorities."

Dr Fong said any death during pregnancy, particularly in rural areas, should necessitate an urgent meeting by divisional medical heads and responsible health authorities to discuss efficiency and competency of personnel.

He said a handful of the mortality cases were the result of possible misdiagnosis.

The matter was set high on the agenda for the meeting of the recently established National Maternal Health Committee on October 27.

Dr Fong said public awareness on the issue was ongoing but needed to gain momentum.

Ministry of Health statistics show 51 women reported to have died during or immediately after childbirth over the last four years.

"Women have to start coming early for diagnosis for us to be able to do something before it gets worse," he said.

Nine women died from ectopic conditions, while seven died from heart complications and another seven from preclampsia, or high blood pressure related disorder.

This comes as the ministry noted there was only one doctor available for every 2,500 people in the country.

[PIR editor’s note: According to an article published by the United Kingdom’s The Guardian, the World Health Organization reports that the Cuban doctor-patient ratio is 1 doctor for every 170 patients, better than the U.S. average of 1 doctor per 188. According to the U.S. Center for National Statistics, the maternal mortality rate in the U.S. was 12.1 deaths per 100,000 live births in 2003. Irishhealth.com reported in 2001 that Ireland's ratio of doctors to population is 2.3 doctors per 1,000 people, whereas the European average stood at 3.5 per 1,000 people.]

The shortage of doctors has forced medical authorities to upskill nurses in an effort to fill the void. Local reproductive health organization Marie Stopes International Pacific is disturbed by the report.

[PIR editor’s note: According to their website, Marie Stopes International (MSI) was established in London in 1976 and grew out of the organization originally set up by Dr. Marie Stopes in 1921. Today, the MSI Global Partnership provides sexual and reproductive health information and services to 4.8 million people worldwide in 38 countries across Africa, Asia, Australia, Europe, Latin America and the Middle East.]

"Access to reproductive health services is crucial to the continuing development of Fiji. The rise in maternal mortality rate is indicative of the need for accelerated efforts to improve maternal health care services," said Carolyn Warren, a project officer with Marie Stopes International Pacific.

The reduction of maternal mortality is one of the major goals of several recent international conferences and has been included in the Millennium Development Goals.

Globally, every minute a woman dies from complications related to pregnancy, childbirth and the post-partum period. Most maternal deaths can be prevented by ensuring good quality maternal health services, including ante-natal and post-natal care, skilled care during childbirth, including emergency obstetric care.

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