Introduction by Croakey: Local solutions to public health issues are showcased in this month’s edition of the Pacific Islands focus column.
Isabelle Zhu-Maguire, PhD candidate at the Coral Bell School of Asia and Pacific Affairs, Department of International Relations within the Australian National University, reports on new research highlighting the important role of traditional healers and community-led approaches to better health outcomes.
Zhu-Maguire also provides an update on worrying HIV and dengue-fever outbreaks, and the ongoing impacts of USAID cuts, as well as news of a promising oral health screening program.
The quotable?
Dentists are inspired to enhance prevention, education, and treatment access, empowering PNG’s diverse communities to reduce oral cancer’s impact through local solutions and global partnerships.”
Isabelle Zhu-Maguire writes:
I want to start this month’s column with an interesting story that highlights the power of narratives when it comes to understandings of Australia and the Pacific relationship.
I have a fond memory of my dad telling my sister and I a story about the swimming stroke ‘freestyle’. As an avid swimmer himself, my dad would tell us with great authority about how the original nomenclature of the ‘freestyle’ race was that swimmers were free to choose any stroke they wanted.
Yet, one fateful race, a young Australian kicked his feet and paddled his arms one at a time and won so substantially with a stroke, from then on called the ‘Australian Crawl’, that it became the standard stroke when someone swims ‘freestyle’.
This week, thanks to an ABC article, I learnt that this stroke was actually popularised by a man called Alick Wickman with Solomon Islands and Australian heritage. He had spent his childhood in the Solomons and learnt this stroke from his peers while swimming in the ocean.
It is fascinating to learn how this important, trans-Pacific heritage has been removed from many of the narratives around this stroke which is commonly understood as an Australian export.
Australia’s connections with the Pacific Islands are long and rich. Whilst I personally believe the ‘family’ lexicon used by the Australian Government is often over-done or tokenistic, it is true that Australian history is interwoven with the Pacific’s and that legacy, including the good, the bad, and even the terrible, should be valued and better understood.
In this month’s Pacific Island focus, I cover some of the public health news from across the region, discuss environmental news including the ‘Pacific win’ at the International Court of Justice, and highlight Indigenous news from the region.
Dengue fever concerns
Dengue continues to impact the health and wellbeing of people in the Pacific Islands, particularly in Samoa and Nauru.
The World Health Organization’s Pacific technical support director, Dr Mark Jacobs, told ABC Pacific that 12,040 cases of dengue across the Pacific region had been laboratory confirmed but the actual number was likely closer to 18,000 cases.
“That’s the biggest number that we’ve had certainly in the last 10 years,” he said. Jacobs said that changing weather patterns due to climate change are likely to blame for this surge.
In early July, the American Samoa Department of Health reported three imported cases of dengue. Only five days later, six community cases were reported and an outbreak was declared. A third child has tragically died of dengue, while 2,200 cases have been reported in Samoa since January.
The Samoan Ministry of Health has reiterated public messaging to remove stagnant water sources, which are breeding sites for mosquitos.
In Nauru, the Health Department has confirmed 222 cases of dengue, the majority being children under the age of 10, including two child deaths related to dengue fever.
Health promotion
A new study published in July by several researchers from Massey University found that Taulasea, Samoan traditional healers, play an important role in public health in Aotearoa-New Zealand.
In particular, Taulasea were helping to improve the diets of their community members, encouraging people to return to simpler, customary diets that avoided processed foods.
In the Cook Islands, the Health Ministry has recommended increasing taxes on sugary drinks and alcohol, as well as restricting marketing for these beverages.
This sugar tax is aimed at decreasing the cases of non-communicable diseases, which currently impact over half of the population of the Cook Islands.
This recommendation comes a month after Aotearoa-New Zealand cut aid to the Cook Islands over ongoing geopolitical disputes.
USAID cuts
In reference to aid cuts, the impacts of Trump’s massive culling of USAID is still being felt.
The ABC highlighted that a massive water and sanitation project in Timor-Leste’s capital, Dili, has been made uncertain as its primary funding source was from the US. Timor-Leste is one of 16 countries facing this uncertainty.
In the East Sepik province of Papua New Guinea, Governor Allan Bird has taken aim at what he called the “corrupt, incompetent national government” and made a deal with pharmaceutical company City Pharmacy Limited, to provide medicines to East Sepik residents for free.
Bird said this will improve access to medication for residents who usually get medicine from one of two East Sepik hospitals now able to get access at pharmacies.
According to RNZ, the provincial government is making what appears to be an initial payment of PGK 500,000 (about US $118,000) from the Provincial Services Improvement Program to City Pharmacy Limited. Bird said there is three million PGK in the budget for the deal. He also said the pharmaceutical company is local, “honest and transparent”.
Guam too has attempted to improve its healthcare systems, raising US $1 billion from international donors. This money, supported by the Micronesian Islands Forum, will go towards building a new hospital in the Easter Guam village Mangilao. The Forum agreed that this will help facilitate making Guam a ‘medical hub’ for the Micronesian region.
Finally, leaders at the Pacific Regional and National Security Conference in Suva, Fiji, have agreed to strengthen collaboration on health-related issues.
This pledge on cooperation will likely have a specific focus on combatting the drug-driven spread of HIV in Fiji, which has the potential of putting the wider region at risk given Fiji’s role as a hub for the region.
The inflow of illicit drugs into the Pacific continues to be an ongoing issue of concern, with a large seizure of cocaine off the coast of New Caledonia and a trafficking arrest in Port Moresby last month.
Preventing oral cancer in PNG
In more health news, it is my privilege this month to highlight research being done by Dr Nerida Bunn, Dr Mahmood Siddiqi, Dr Gilbert Kamae (UPNG), Dr Marylyn Asing (Port Moresby General Hospital), Professor Leonard Crocombe (La Trobe University, UPNG) and Dr Silvana Bettiol (UTas) on Betel Nut chewing and oral cancer.
The authors shared this statement with me:
In Papua New Guinea (PNG), betel quid (buai) chewed with lime and betel plant parts drives the world’s highest oral cancer rates. It’s addictive, carcinogenic and, combined with tobacco and alcohol, fuels a public health crisis.
With only one or two dental officers per province, limited diagnostics, and low survival rates, PNG’s healthcare struggles. Linguistic diversity (839 languages) and rural populations (85%) hinder preventive interventions.
A PNG-Australian team is tackling this through oral cancer screening workshops across PNG’s four regions over three years.
The first, in Goroka (September 2024), was overseen by Professor Michael McCullough from the University of Melbourne. It trained PNG Highlands dentists in early detection.
Dr Elizabeth Sari from La Trobe University highlighted research that showed unripe areca nuts and betel stems are highly carcinogenic, suggesting ripe nuts and leaves as safer options. Reducing betel nut or tobacco use could lower risks.
These workshops prioritise primary and secondary prevention (altering behaviour) over treatment, due to difficulties in managing advanced cases.
Community-driven education, like Dr Rose Andrew Kelwaip’s No Betel Nut Chewing Days, shows promise. A bottom-up approach engages communities to co-design culturally sensitive solutions, respecting traditions. This work supports key SDG targets SDG 3 (Target 3.4), SDG 10, (Target 10.2).
Local champions, including Dr Gilbert Kamae (PNG Dental Association President), Dr Mahmood Siddiqi, and Dr Nerida Bunn, all from the University of PNG, are driving change through corporate partnerships, improved diagnostics, and public health research (SDG 17: Target 17.16).
A bottom-up approach educating communities and encouraging local solutions is key, given PNG’s diverse village challenges.
Early detection saves lives.
The next workshop in Port Moresby is coming up 25 August, 2025. Dentists are inspired to enhance prevention, education, and treatment access, empowering PNG’s diverse communities to reduce oral cancer’s impact through local solutions and global partnerships.
A tale of two climate court cases
I want to take some time to talk about two extremely important climate court cases that happened last month.
In early July, we got the disappointing news that an Australian Federal Court case, brought against the Australian Government by two Torres Strait Elders, had failed.
The Guardian reported that, “in respect of negligence law, it found the Federal Government did not owe Torres Strait Islanders a duty of care to protect them from global heating”.
This caused widespread condemnation both from Australians and Pacific Islanders. Pacific Islands Students Fighting Climate Change (PISFCC) for instance said that they were “heartbroken”.
This devastating news was somewhat eclipsed by the news that the PISFCC’s students’ case to the International Court of Justice (ICJ) was successful.
The court ruled unanimously that wealthy countries, under international law, should be held legally responsible for their emissions and that “the protection of the environment is a precondition for the enjoyment of human rights”.
This win comes after six years of campaigning, mostly by students and backed by Vanuatu.
I highly recommend reading the ICJ’s advisory opinion. It reads like a truth-telling document, outlining so clearly the impacts of climate change, who the culprits of said changes are and how they should be held accountable for facilitating global heating.
It is a wonderful departure from the vague language and misinformation that I have become accustomed to in many of the court decisions about climate change.
(You can also read more on these cases in previous articles at Croakey; see here and here.)
Celebrating Indigenous culture and independence
A historic ‘Alingano Maisu voyage’ from Palau to Taiwan concluded this July.
The 58-day expedition, led by Grandmaster Navigator Sesario Sewralur, had a crew of 11, mostly Micronesian and East Asian members, and only one woman. The first-of-its-kind voyage retraced ancient sea routes and taught the crew traditional navigation skills.
Research by archaeologist Robert Skelly from the Indigenous Studies Centre at Monash University has uncovered that women in PNG have historically played a much more significant role in knowledge sharing than what was thought.
Through tracing patterns and materials of pottery, archaeologists uncovered that women must have travelled between villages, sharing traditional knowledge on such things as pottery, tattoos and likely other cultural customs.
Two Pacific nations also celebrated the anniversaries of their independence this month.
The Cook Islands celebrated 60 years of self-governance with hundreds of people travelling from the outer islands to Rarotonga. The Government of the Cook Islands had allocated $4.1 million to support nation-wide celebrations.
Vanuatu marked 45 years since gaining independence from British and French colonial rule.
Anna Naupa, a ni-Vanuatu PhD candidate at the School of Culture, History and Language at the Australian National University, marked the occasion by highlighting that in these 45 years, only seven women have been elected MPs in Vanuatu and thus more needs to be done to reclaim and advance women’s leadership in the nation.
Other interesting reading
- ICE deportation action lands Marshallese, Micronesians in Guantanamo (RNZ Pacific)
- Taking matters into our own hands: aid dependency in the Pacific (Development Policy Centre)
- Fiji’s PM Sitiveni Rabuka says China’s military bases are ‘not welcome’ in the Pacific (ABC Pacific)
- Nauru could earn millions after backing US deep sea mining pathway (RNZ Pacific)
- Aotearoa’s AI strategy risks leaving Pasifika behind, expert warns (RNZ Pacific).
About the author
Isabelle Zhu-Maguire is a PhD candidate at the Coral Bell School of Asia and Pacific Affairs, Department of International Relations within the Australian National University. Her thesis investigates the ways in which Australia listens and responds to the climate advocacy of Pacific Island Nations.
She has conducted extensive research into the experiences of women in Afghanistan and their perspectives and realities living through conflict, oppression, and climate change.
Isabelle has also been advocate for greater youth inclusion within the United Nations Framework Convention on Climate Change.
Croakey thanks and acknowledges Isabelle Zhu-Maguire for providing this column as a probono service to our readers.
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