Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694841679136.pdf (Nauru)
MINISTER OF HEALTH PARLIAMENTARY STATEMENT 20th DECEMBER 2011 Mr Speaker and Members, I wish to present some of activities and services undertaken by the Ministry of Health during 2011 as well highlighting major activities planned for 2012.

Governance The Ministry is headed by the Secretary for Health and consists of 5 Departments, Medical, Nursing, Public Health, Administration and Planning and Finance, each are headed by a Director.
The Ministry of Health Strategic Plan, 2010-2015 and Annual Operational Plans, 2011-2012 have been completed.

The Health Implementation Strategy for the Pacific Partnership Programme with the Australian government has also been completed and is now awaiting clearance by the Australian government.

Staffing The Ministry has a staff establishment of 240 of which 36 are expatriate, a further 10 staff are employed under donor projects.
There are 22 vacancies in the local and 4 in the expatriate establishments.

These vacancies are attributed to resignations, dismissals, reserved for returning scholars and non renewal of contracts.

The Ministry has initiated recruitment of all these vacancies to ensure a full strength workforce.

Administration I acknowledge the Director of Administration and her team’s efforts in providing efficient and effective support services across the departments.
Republic of Nauru Hospital I thank and acknowledge the Director Medical Services and Director of Nursing and their staff for coordinating all visiting specialist teams in additional to ensuring outpatient and inpatient services are available 24/7.

The Nauru population benefitted during the year with visits from a cardiac, gastroenterology, ophthalmology and mental health teams.

The Taiwan Mobile Team visited twice as well as donating much wanted drugs and supplies.
Naoero Public Health Centre Hon Valdon Dowiyogo, Minister of Health Parliamentary Statement 20th December 2011 1 The Naoero Public Health team successfully implemented a whole of population STI/HIV Presumptive Treatment campaign and we would anticipate a reduction in the incidence of cases, however we must not become complacent and continue to implement robust public awareness and education campaigns.
As we are all aware Non Communicable Diseases are contributing to the early mortality and morbidity of our people.

I recognise the efforts undertaken by the Director Public Health and his team to address the 4 NCD key risk factors; alcohol abuse, tobacco use, poor diet and lack of physical activity.

Despite all good interventions it is the individual that must make the decision to change his or her behavior.
Thus we have the collective responsibility to be the agents of change in encouraging fellow Nauruans to make that life style decision, as political leaders this is my challenge for us.

Staff Training As we are all aware national capacity across both the public and private sector is an ongoing challenge for Nauru and the Ministry of Health is no exception.

A snapshot of the workforce indicates there are 8 doctors in employment of which 2 are Nauruan.
All qualified clinical support staff (laboratory, pharmacy, x-ray, physiotherapy, nutrition) are expatriates.

All practicing midwives are also expatriates with 2 nationals completing their supervised practice.

The Ministry has a total of 29 Nauruan nationals pursuing health studies, 20 abroad and 9 Health Trainees pursing bridging courses at USP campus, Nauru.
Of the 20 aboard there are 9 studying medicine in Cuba and 2 in Fiji, 1 dentistry, 1 physiotherapy, 4 nursing, 1 public health, 1 radiology and 1 dietician.

The Ministry for the first time in 2010 was able to fill its 4 ARDS scholarships and repeated in this in 2011.

I am pleased to further advise 4 candidates have again been shortlisted for ARDS scholarships in 2012 and we are awaiting second semester results to enable AusAID to complete its assessment of all regional applications.
The Ministry was delighted to employ 2 nationals who graduated following completing nursing studies from the Fiji National University, School of Nursing, they are Ms. Jamie Seymour and Ms. Vivian Notte.

Two staff are currently pursuing midwifery training at the Fiji National University School of Nursing and expected to return in March 2012.
Leadership Group To complement the staff training programme and to acknowledge promising staff currently employed, the Secretary of Health in consultations with Directors have identified staff who are potential leaders across the Ministry’s 5 departments.

Participation in the leadership group is entirely voluntary and each staff is required to confirm their interest and willingness to be involved.

For staff agreeing to participate, career development plans have been developed.
Hon Valdon Dowiyogo, Minister of Health Parliamentary Statement 20th December 2011 2 The group has completed their classroom component of the USP Certificate IV Leadership and Management adapted for health and are now undertaking their workplace projects.

I recognise this is a step in the right direction in the development of Nauruan nationals to take a lead role in managing the Ministry’s various sections and lessen our dependency on expatriates.
Cuban Medical Brigade The Cuban Medical Brigade completed their 2 year term this month and departed Nauru on 14 December.

The brigade members assimilated exceptionally well both professionally and socially and the people of Nauru have benefitted from their service and contribution.

Unfortunately the replacement team was unable to arrive prior to the outgoing team’s departure and we anticipate the new team arriving in quarter 1 2012.
Arrangements have been implemented to cover obstetrics, internal medicine and paediatrics until the new brigade arrives.

Visiting Medical Specialists The AusAID funded Pacific Island Projects managed by the Royal Australian College of Surgeons continued to provide much need specialist medical services to the people of Nauru.

A renal visited in April and gastroenterology team visited in August.

Due to flight changes the renal was unable to visit in October and a visit is now confirmed for January 2012.
Taiwan Mobile Medical Team The people of Nauru continue to benefit from the bi annual visit of the Taiwan Medical team with visits in May and November respectively.

Both teams donated much need pharmaceuticals and medical supplies and we look forward to receiving further visits in the future.
Reverse Osmosis Unit The Reverse Osmosis Unit donated by the Department of Immigration and Australian Citizenship (DIAC) continues to operate and complements rain water captured at Naoero Public Health Centre and the Republic of Nauru Hospital and deliveries from Nauru Utilities Corporation.

The unit is serviced by a local technician.


Oxygen Plant The 2nd oxygen plant was commissioned in early November and Nauru is probably the only Pacific country that has the luxury of a back up plant which is used alternately ensuring extended life.

Both plants have contracted technicians who visit periodically to undertake service and repair.
Hyperbaric Chamber The New Zealand government has provided funding for the refurbishment of the chamber and invitation for bids were initiated, bid evaluation completed and the successful bidder has Hon Valdon Dowiyogo, Minister of Health Parliamentary Statement 20th December 2011 3 initiated preliminary work.

It is anticipated the refurbishment will be completed early in quarter 2 2012.
Dialysis Services This service continues to be available to Nauruans and the Technician regularly visited to undertake routine service and repair of the units, the most recent visit in November whereby 10 of the 12 units are operational.

Pharmaceuticals Given drugs and medical consumables is the second largest budget item following salaries the Ministry has afforded special attention to ensuring expenditure for drugs and medical consumables are controlled.
The Ministry has introduced an Essential Drugs List (EDL) to guide its procurement of drugs.

An Essential Medical Consumables List (EMCL) has also been developed and introduced to guide procurement.

The National Medicine Policy has been completed and is now with the office of the Parliamentary Counsel for review prior to preparation of a Cabinet submission for consideration and decision.
Pending Cabinet’s decision it is anticipated appropriate legislation will be drafted and subsequently processed to Parliament for deliberations.

Public Health Act The Public Health Bill is been finalised by the office of the Parliamentary Counsel and anticipate its tabling before Parliament for deliberations.
This is an important piece of legislation to bring Nauru up to regional and international standards and provide the public and staff clear accountabilities in which to perform their public health responsibilities.

Food Safety Regulations On the advice of the Parliamentary Counsel the draft food regulations prepared by the WHO consultant requires reviewing to ensure unique contextual issues are taken into account.
A series of internal and public consultations are planned whereby the regulations would be discussed and where appropriate be amended to reflect Nauru’s realities.

Outsource Security I am happy to advise security services at the Republic of Nauru Hospital and Naoero Public Health Centre have been outsourced since October 2010 and the contractor has provided excellent service to date.
Infrastructure I was pleased to participate in the rededication of the Maternity ward and anticipate patients and staff will appreciate the efforts undertaken to improve this critical service.

Hon Valdon Dowiyogo, Minister of Health Parliamentary Statement 20th December 2011 4 The Administration building was extended and refurbished and Administration and Nursing management staff are able to perform their responsibilities in a more conducive office environment.
District Health Promotion Centres The Scope of Works developed for the standardised District Health Promotion Centres has been completed and bidding documents were released.

The bid evaluations have been completed and the successful bidder has been informed.

Commencement of construction awaits landowner agreement.

Districts that have responded to efforts of the District Health Care Workers request for land are, Boe, Anibare, Nibok and Meneng.
2012 Activities In addition to implementing existing and routine activities across all the departments, I wish to highlight the following activities planned for 2012.

The Master Planning exercise for the Nauru Multipurpose Health Facility will commence in January 2012 and the Master Plan will be available in May.

It is anticipated detail design will take place from June 2012 to March 2013 and from April to December 2013 donors will be sought.
From January to June 2014 construction bids would be undertaken and by December 2014 we anticipate construction would commence.

The incidence of Rheumatic Heart Disease in Nauru is high and if this trend is not arrested the burden on the health care system will only increase with patients requiring expensive cardiac services later in life.
Thus I am pleased Nauru is one of 5 Pacific countries participating in the AusAID funded project entitled Reducing Rheumatic Fever and Controlling Rheumatic Heart Disease in Pacific Nations.

Primary activities planned for Nauru is to strengthen the Rheumatic Heart Disease register, developing a National Rheumatic Fever strategic plan, conduct surveillance and screening and training of health care professionals.
The Government of Nauru requested UNFPA to support the implementation of a national survey on Violence Against Women and health is one of 3 line agency’s considered as focal point for the survey.

Whichever agency is finally assigned this role I have pledged the Ministry of Health’s full support with this undertaking.

The current dialysis machines are ageing and require replacement.
Through the Partnership Programme funding has been provided to purchase replacement units and these will be delivered in quarter 1 2012.

Medical referrals to India have proven to be successful in terms of patient outcomes and cost, as such the Ministry will continue to refer patients to India.

An assessment of potential referral hospitals in the Philippines was undertaken in October and early in 2012 a pilot referral to the Philippines will be made.
Acknowledgement of Development Partners Hon Valdon Dowiyogo, Minister of Health Parliamentary Statement 20th December 2011 5 The Ministry of Health recognises the significant contribution the Government of Australia provides through the Pacific Partnership for Development which covers a range of essential activities and services which include, Staff Training, Specialist Medical Visits, Repair and Maintenance Medical Equipment, Equipment Purchase Drugs and Consumables Hospital Building Repairs, Health Information Consultant, Pathology Preventive Health Programme, School Feeding Programme and the Master Plan exercise.
I further wish to acknowledge the support provided by Republic of China (Taiwan) for the continued support to the Nauru health sector.

This relationship has further been strengthened with the signing a couple weeks ago of the Memorandum of Understanding for a permanent medical team to be stationed in Nauru.

I understand the team leader is an Obstetrician who will arrive in March 2011.
Concluding Remarks It would be remiss of me not to acknowledge the work and leadership of the previous Minister of Health, Hon Mathew Batsiua, M.P.

in progressing Nauru’s health sector.

Mr. Speaker I trust the above provides a snapshot of the work pursued by the Ministry of Health’s during 2011.
I wish to acknowledge the leadership provided by the Secretary for Health, Mr. Sunia Soakai, and support of his Directors, Dr. ‘Alani Tangitau, Dr Setareki Vatucawaqa, Ms. Gano Mwareow, Ms. Marissa Cook, the Health Educator, Ms, Min Lene, the Health Services Adviser Dr. Lepani Waqatakirewa who have collectively encouraged and supported their staff to produce the results I have tabled above.
I thank all the staff in the Ministry for their loyalty, dedication and support who have all contributed to the accomplishments and achievements reported.

I wish each of these staff a joyous and safe festive season and prosperous 2012 both on a personal and professional basis.

Thank you Mr Speaker.

**************End of Statement***************** Hon Valdon Dowiyogo, Minister of Health Parliamentary Statement 20th December 2011 6