Fiji

FIJI Post-Disaster Needs Assessment
Losses to the Health Sector (F$6 million)
Total losses for the health sector were estimated to be approximately F$6.2 million (see Table 42). Losses incurred post-TC
Winston include psychosocial support and psychological first aid provided by development partners, NGOs and MoHMS
to affected population. Retired nurses were reengaged to assist medical teams that provided immediate medical care to
affected communities in the aftermath of TC Winston. Losses include: costs associated with additional outreach activities
conducted following Winston; and increased operational costs associated with such activities that were calculated as
increased expenditure by the health sector during the disaster emergency period. 80
Approximately F$3.6 million was used by MoHMS to purchase additional drugs and supplies and F$0.3 million for additional
service delivery costs. Approximately F$0.7 million was used by the Ministry from its own budget for operational expenses
related to TC Winston.
Table 42: Damage and Losses to the Health Sector by Division (F$ million)
Damage Losses Total Effects
Central 2.6 0.8 3.4
Western 2.1 1.2 3.3
Northern 0.4 0.3 0.7
Eastern 2.6 0.5 3.1
Headquarters – MoHMS 0.0 0.1 0.1
National level 0.0 3.4 3.4
Total 7.7 6.3 14.0
Source: Estimations by Assessment Team.
Social Impact of Damage and Losses
The disaster has affected economic and physical access to food. The extensive destruction of agricultural produce could
have serious repercussions for food security and nutrition in both the short and long term. Because some of the nutritional
impacts may not become evident until the harvest season begins, the government and development partners may be
prompted to end food rations prematurely. The assessment of fisheries indicates that fisheries resources may take more
than 10 years to recover. This could have serious consequences for nutrition, which is already suffering from the population’s
increased preference for cheaper but less nutritious foods, such as instant or tinned foods.
Malnutrition usually comes a few months after a disaster has occurred and sometimes even a year later. As families struggle
to meet competing basic needs on reduced incomes, some of their coping mechanisms may include reducing the amount
and nutritional quality of the food they eat. A focus on restoring homes and livelihoods without a focus on maintaining
proper nutritional levels could, therefore, come at the cost of the health of children and pregnant or lactating women. While
some households are actually reporting temporary increases in food intake because of food rations being distributed by
the government, NGOs and donor partners, households in remote areas (such as Yasawasa and Burewaki villages in the
Western and Eastern Divisions, respectively) are already facing food challenges. In Burewaki, women reported that they
are only eating twice a day because they lack sufficient food. Furthermore, MoHMS is already recording an increase in
malnutrition among children, including on Koro Island. 81 Sustained surveillance of nutrition status among children, pregnant
women and lactating mothers is essential. Food supplements (through programmes, such as the Expanded Food Voucher
Programme for pregnant women in rural areas) should be provided to pregnant and lactating women in the most affected
districts to reduce malnutrition and anaemia, while targeted nutrition programmes for children in areas already reporting
malnutrition cases should be increased and scaled up.
Teenage pregnancy is a growing sexual and reproductive health issue in Fiji. 82 Evidence from the 2012 floods suggests that
women and girls who lacked access to food were offering sex in exchange for food as a coping mechanism. Anecdotal
reports suggest that exchanges of this type are already happening in some parts of Fiji. 83 Reproductive health services and
outreach by the government and NGOs should, therefore, be strengthened to provide critical services, including maternal
health/family planning, assistance in responding to sexual violence, and adolescent sexual reproductive health services
and information.
80
The reported figures only represent services delivered through the public sector. No data are available for the impact of TC Winston on
health services through the private sector, as no requirements exist for private services to report to MoHMS.
81
Screening has identified 80 cases of moderate acute malnutrition: 33 in Koro, 17 in Taveuni and the rest in other affected areas. It has also
identified 28 cases of severe acute malnutrition: 7 in Koro and 9 from Taveuni. Thus, most of the cases detected so far were from Koro
and Taveuni.
82
ADB, “Fiji Country Gender Assessment,” 2015.
83
The inference is based on the Gender Based Violence Subcluster Advocacy Note, “Gender-Based Violence in the Aftermath of the Fiji
Tropical Cyclone Winston.”
70 Tropical Cyclone Winston, February 20, 2016