March 2023 – Médecins Sans Frontières/Doctors Without Borders (MSF) is providing paediatric support on Kiribati as the remote Central Pacific nation finds itself without any specialist paediatricians.
Facing one of the highest mortality rates in children under five globally, Kiribati’s Ministry of Health and Medical Services, approached MSF at the end of last year with an urgent request for temporary paediatric support. This was to allow the country time to recruit a consultant paediatrician after its last remaining paediatrician left.
Under the arrangement an Australian-trained paediatrician, Dr Joanne Clarke, has been working at the national referral hospital, Tungaru Central Hospital, since arriving in Kiribati’s capital, Tarawa, in mid-January.
The support comes as the country faces increasing cases of severe acute malnutrition among children.
Dr Clarke who has previously been on assignment for MSF in South Sudan and Afghanistan, said it was hard to escape the stark connection between the increasing impact of the climate crisis on Kiribati and the declining health of the country’s children.
“The encroachment of the sea on Tarawa in particular means that even in the capital people are living in increasingly overcrowded and unsanitary conditions.
“The high salination of the water means people can’t grow fresh vegetables or easily access clean water, and in turn the poor diet contributes to a high rates of diabetes, coexisting with increasing rates of malnutrition, especially in children.”
Dr Clarke said due to the low water table and ground level wells, recent heavy rains had led to an outbreak of paediatric diarrhoea that was putting some malnourished children at extreme risk.
“Children with malnutrition are so vulnerable that an episode of diarrhoea is enough to tip them over to the point where they need hospital care.”
MSF’s medical humanitarian assistance in Kiribati was formalised in October last year. MSF is supporting maternal and neonatal health on the main island of Tarawa, as well as on the remote Southern Gilbert Islands.
With the country covering an immense geographical area – mostly ocean – access to healthcare is often difficult. Kiribati has one of the lowest rates of access to primary care making pregnant women and children particularly vulnerable.
The country’s remoteness has also proven a barrier for i-Kiribati doctors wanting to access postgraduate training and upgrading to specialised areas such as paediatrics which can only be accessed at great expense offshore.