1. PRESENTATIONS MELBOURNE AUSTRALIA PRESENTER: L. MATAITINI.

2.  This exploratory study investigated the incidence of diabetic complications amongst the I- Taukei population (Indigenous) in Fiji.

3.  Data collected from the Diabetic Foot Clinic and also the Fiji MOH Health statistics.  Health statistics in the past decade reported by Fiji's MOH showed an alarming increase of NCD'S and more importantly the complications of Diabetes amongst the I Taukei population.

4.  Data gathered from the Diabetic Foot Clinic shows the high prevalence of diabetic complications amongst the I Taukei (Indigenous Fijians) population compared to other ethnic groups living in Fiji. This is clearly indicated in the figures shown in the table below:

5. ETHNICITY 2008200920102011 FIJIAN 480779302595 INDIAN 475805364814 OTHERS 8611440105 TOTAL 104116987041514 (Source: National Diabetic Center) Figure 1 Summary Bar Graph from 2008-2011 Diabetes Cases

6. SUMMARY OF DIABETIC CASES FROM 2008 – 2011 (Source: National Diabetic Center)

7. According to Dr.Parshu Ram, a survey was done by Dr Cassidy in 1964-1965 shows that:  SURVEY RESULT ON 1000 ADULT INDIANS AND 1000 ADULT FIJIANS (20 -40years ETHNIC GROUP Indians- 9.7% (97) Fijians -1.3% (13)

8. About 30 – 40 years ago there were less Fijians/I Taukei population suffering from Diabetes and NCDs. More Fijians live in the community (villages) and are encouraged to plant root crops/subsistence farming

9. The reason being that most of the I Taukei families plant and maintain specific numbers of taro, coconut and other crops for their source of economy and also to maintain healthy way of living. Due to the increasing rural to urban drift, more I Taukei are moving out from their villages and communities to seek employment and education in urban centers.

10. This has seen a change in lifestyle and diet, with the consumption of more processed food leading to diabetes. Figures provided demonstrate there was less Diabetes among the I Taukei community as it’s more prevalent in Indians at that time.

11. From my personal experience over the years, I have seen that more I Taukei are only seeking medical attention when their disease are into the late stages. This has also seen an increase in amputations

12. 20032004200520062010 Below Knee119118 110107 Above Knee3029302840 Toe7111911094143

13.  Denial and belief that it is a curse in the family.  Ignorance  Opted to use herbal medicine  Use of traditional and spiritual healers  Seek medical attention at a very late stage.

14.  Education on diabetes are done through the media outlets  Brochures are distributed to all health facilities around the nation.  Still patients are presenting themselves very late to the nearest health centers for treatment.  This is identified in the figures highlighted on the next slide.

15. Health Centre PopulationNo of cases% of cases per population Subdivision Suva 143421370.96 Raiwaqa305945121.67 Samabula159525223.27 Nuffield424158552.02 Valelevu473236421.36 Lami245623311.35 Makoi236795662.39 TOTALS 19886735651.79 Source- 2007 CMR reports – Health Information Unit MoH HQ

16.  The results of this study should assist in the development of health promotional guidelines for nurses and other primary health care providers in teaching the I Taukei population on the prevention of diabetes and its complications and also support the development of NCD policies for Fiji’s multiethnic population.

17. More research on the prevalence of Diabetic complication amongst the Itaukei POPULATION IN FIJI. Continuing Education. Traditional medicine.

18. VINAKA AND THANK YOU FOR YOUR ATTENTION….