HIS EXCELLENCY RATU EPELI NAILATIKAU
CF, LVO, OBE (Mil), OStJ, CSM, MSD
President of the Republic of Fiji
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ADDRESS AT THE FIJI OBSTETRICS & GYNAECOLOGY SOCIETY INAUGURAL SCIENTIFIC CONFERENCE

Novotel Hotel Saturday, 10th August, 2013
NADI 9.00a.m.
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• Professor Ian Rouse, Dean of the College of Medicine, Nursing, and Health Sciences
• Dr Ken Clark, Chairman of the Asia Pacific Committee and former President of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists
• Dr Alec Ekeroma, President of the Pacific Society for Reproductive Health
• Associate Professor Dr Swaran Naidu, President of the Fiji Obstetrics and Gynaecology Society

Good morning, ni sa bula vinaka, salaam alaykum, namaste

It is indeed a great pleasure for me to be here with you all at your first scientific meeting.

I remember well that pleasant evening in June last year, when i launched the Fiji O & G Society at the Tanoa Waterfront Hotel in the presence of many of your international colleagues.

I recall that your birth was witnessed by the Presidents of the Royal Australian and NZ College of Obstetrician & Gynaecologist, the Asia Pacific Federation of O&Gs, The O&G Societies of India, Sri Lankan, Japan, South Korea, Taiwan, Philippines and Malaysia who were all present to support the birth.

I was heartened by the moral support you received on that occasion from your international colleagues as I am heartened by the support you are receiving today.

Fiji may be a small developing country, however, when it comes to the health of women and children every individual counts no matter where they may live or what their standing is.

Your Society was formed to ensure that your members are at the forefront of your specialty both in knowledge and practice. I know that in recognition of this the Fiji National University, the United Nations Fund for Population Activities, and the Ministry of Health, through the Fiji Health Sector Support Program, are supporting this conference.

Women are vital to nation building. None of us would be here today if it was not for our mothers. The future mothers of our country are the young girls and women who are attending our schools and tertiary institutions. Their reproductive health is of great importance.

I am saddened to note that unplanned pregnancies remain a challenge in Fiji. The contraceptive uptake rate has declined to about 30% when we should be aiming for at least double that rate. The teenage pregnancy rate is unacceptable at 10% of all pregnancies.

An unplanned pregnancy places a burden on the individual who finds herself pregnant, it compromises her individual development, as well as her social and economic aspirations. If she is a schoolgirl her education is disrupted and schooling is often terminated. For many girls and their families the pregnancy brings shame.

For an older woman an unplanned pregnancy can interfere with her employment aspirations thus disempowering her and her family economically.

Unplanned pregnancies are high-risk pregnancies. Some may seek unsafe abortion, and take the risk of serious complications and even death. Others book late and are poor attendees for antenatal clinic and care.

The physical, emotional and economic burdens of unplanned pregnancy are great, and I am glad that you have family planning as a priority.

A pregnancy should be a celebration for a woman and her family and not a burden. So you must advocate pregnancies by choice, and provide women and girls of our nation with the necessary knowledge, skills and attitudes so that they will use contraception as and when required.

You have, no doubt, heard about my visits to schools advocating, for safe sex, and the prevention of HIV/AIDS and other sexually transmitted infections. (STIS) because the figures for HIV/AIDS and STIS in certain countries in Oceania are still on the rise but particularly so for Fiji where the HIV epidemic is still in the exponential growth phase and is not showing any signs of leveling off.

This is a situation that is of great concern which must be continually addressed, advocated for and reversed.

The international community, in defining reproductive health recognized that all individuals should be able to enjoy their full sexual potential without the risks of an unplanned pregnancy or an STI, which has its own serious consequences of pelvic inflammatory disease, ectopic pregnancies, infertility, and cervical cancer.

It is essential that safe sex practices, be promoted by education and empowerment.

Your President Associate Professor Naidu is engaged in a project designed to empower rural women and girls about contraception, safe sex and cancer screening.

In her project, which is funded by the European Union, she is collaborating with the western branch of the Fiji Cancer Society.

I am aware that cervical cancer screening, is a challenge in this country, and I commend your Vice President, Dr James Fong for exploring new approaches to this problem.
In this work of screening by visual inspection with acetic acid (VIA), he has been assisted by the University of NSW, the Family Planning Association of NSW and the Fiji Health Sector Support Programme.

Cervical cancer is a preventable disease, yet Fiji is reported to have one of the highest rates in the Pacific and women with this condition present late when cure is not possible. Many women die young with this disease leaving behind a young family.

I am also concerned, about the current non communicable diseases crisis in our country. Cardiovascular disease and diabetes are the 2 most common causes of premature death.

Our Minister for Health Dr Neil Sharma has recently said that only 15% of the population will live to beyond 60 years of age.

Many of the risk factors for NCDs are common to reproductive health.

These risk factors are smoking, poor nutrition, alcohol abuse, and the lack of physical activity. The NCDs do not occur overnight. They take a long time to develop, and there is increasing evidence that a woman's health pre-pregnancy, during pregnancy and, immediately after pregnancy has health consequences not only for herself but also for her fetus and child. Obesity, diabetes and hypertension cause major complications in pregnancy for the woman and her fetus. The condition of the baby at birth can have lifelong consequences for the individual.

So I am pleased that the new development agenda post 2015, in its target has the following priorities:

1. End preventable infant and under 5 deaths
2. Decrease the maternal mortality
3. Ensure universal sexual and reproductive health rights.
4. Reduce the burden of disease due to HIV/AIDS, tuberculosis, malaria and neglected tropical diseases, and priority NCDS.

Ladies and gentlemen, in summary I am pleased to note that your deliberations at your conference will address several of these priority areas.

I am very pleased that you have included your midwifery colleagues in your deliberations. This partnership is extremely important. A competent work force and team work is essential in meeting our health challenges.

Your society is dedicated to improving the reproductive health of women and adolescent girls.

To do this, you must provide professional leadership, and ensure that your members are at the forefront of activities in this area.
I highly commend your efforts and I wish you a successful conference.

Thank you, vinaka vakalevu, bahoot dhanyavaad.