Hydro-meteorological Disaster Preparedness and Public Health Response in Fiji: Facilitators and Barriers

Abstract

Background: Small Island Developing States in the Pacific and other regions are among the most vulnerable to the impacts of climate change due to geographic, demographic and socioeconomic factors. Studying preparedness and response to hydro-meteorological hazards can facilitate climate change adaptation. In February 2016, Fiji was hit by the category 5 tropical cyclone Winston, which resulted in 44 deaths. TC Winston adversely impacted Fiji’s health systems, damaging eighty-eight healthcare facilities, about forty percent of the healthcare facilities in the country. Objective: The general objective of this study was to identify facilitators and barriers to improving hydro-meteorological disaster preparedness and public health response after extreme weather events in Fiji. Methods: This qualitative study used in-depth semi-structured interviews with purposively selected key informants (n=15) and a focus group consultation (n=3). The interviews and focus group were divided into two sections:1) reflection on TC Winston and perceptions about current hydro-meteorological disaster preparedness in Fiji, and 2) climate change perceptions. All interview/focus group were audio- recorded and manually transcribed. Thematic analysis was conducted using Dedoose. Results: A total of 18 participants participated in the study [UN organizations n=5; NGOs n=4; national nursing association n=4; affected village n=3; Ministry of Education n=1; and national university n=1]. Six key emerging themes relating to organizational issues were identified: coordination, supply chain management, human resources, community involvement, policy and legislation. Prominent themes relating to individual/community impacts were psychosocial health and occupational health. When interviewed, ten informants of Fijian nationality agreed that climate change was occurring in Fiji and that it could affect human health. Conclusion: Effectively managing disaster risk and advance adaptation to climate change in Small Island Developing States such as Fiji should include top-down and bottom-up approaches. Recommendations based on this retrospective qualitative study were: 1. To strengthen health systems and existing structures; 2. To strengthen cluster coordination and Public Private Partnership; and 3. To involve communities in disaster risk reduction.