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Some diseases preventable, others not

By Giff Johnson MAJURO, Marshall Islands (Marianas Business Journal, Aug. 16) – Statistics from regular health screenings in the Marshall Islands confirm why the Pacific Islands Health Officers Association issued an emergency declaration in May, saying an epidemic of non-communicable diseases - diabetes, heart disease, strokes and cancer - is killing off people at an alarming rate because of what people in the islands are eating.

A recent health workshop that brought 75 men together from many of Majuro’s churches produced astounding statistics, according to the Ministry of Health: 75 percent had blood sugar levels that were borderline diabetic or diabetic, while 90 percent were overweight or obese. "Marshallese people are killing themselves with their forks and don’t realize the danger," said Denis Yates, director of the Wellness Center at Majuro Hospital that specializes in diet and exercise to control diabetes.

But while most of these non-communicable diseases are reversible with lifestyle changes and health interventions, most of the leading communicable diseases are preventable too. But they are showing up in equally astounding numbers.

The Ministry of Health’s goal is to reduce Hansen’s disease - leprosy - to just two cases per 10,000 people, or 12 cases nationwide. But the discovery of 33 new cases in this nation of 54,000 earlier this year on just three of the 24 main inhabited islands demonstrates the challenge of getting a grip on this preventable illness. The World Health Organization reported recently that leprosy continues to be a significant problem in the Marshalls, Federated States of Micronesia and Kiribati - all of which have small populations on far-flung islands, making delivery of health services a challenge.

Then there’s tuberculosis. At the end of 2009, the U.S. Center for Disease Control was called in by the Ministry of Health to help it get a grip on an outbreak of drug resistant TB. Ten cases of drug resistant TB were identified. But in the aftermath, as the Marshall Islands and U.S. government quickly approved US$1.4 million in additional funding to assist with eradicating the problem, health officials couldn’t get supplies and medications to Ebeye, the country’s second main urban area. Although Ebeye health officials screened more than 1,200 students and adults earlier in the year in response to the drug resistant TB situation and found 171 - 14 percent - positive on initial skin test screens, their prevention program was hampered because they couldn’t get enough test supplies and medicines from the Ministry headquarters on Majuro.

So serious was the TB drug and supply shortage on Ebeye that Ministry of Health TB program officials on Ebeye complained to the Ministry’s headquarters to "make sure that supplies are sent to Ebeye on a regular basis." The TB program coordinator on Ebeye was blunt, "We faced shortage of anti-TB drugs like PZA (Pyrazinamide, one of the routinely used drugs to treat TB). We received some PZA from Majuro, but it cannot cover our regular patients."

Health administration officials declined to comment on this situation.

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