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Letters To The Editor, 11th, November, 2016

Letters To The Editor, 11th, November, 2016
Letter To The Editor
November 11
11:00 2016

Take mental health seriously

M  Parameshvara Deva ,

Professor of Psychiatry University Tunku Abdul Rahman, Malaysia

I read with sadness the incident at St Giles Hospital recently in Fiji Sun 9/11/16 in which a nurse was attacked by a mentally ill patient.

I worked in 2011 and 2012 in mental health to develop the postgraduate programme in psychiatry for the Fiji National University’s School of Medicine and helped the Ministry of Health open the three Stress Management wards at the Colonial War Memorial Hospital, Lautoka and Labasa by training its staff in acute care in community based general hospitals.

However the problems in St Giles and the care of the mentally ill had been big issues whose answer lies in the eventual  closing down of mental hospitals as has become the practice world-wide.

The proposal by MOH Fiji to open stress management wards met with opposition from many quarters  but eventually succeeded because it was decreed under the then Mental Health Decree.

For over 128 years the medical community and the public in Fiji had gotten used to the mentally ill being housed in an out of sight and out of mind institution that was “between the Prison the Graveyard and the largest rubbish dump” (quote by former superintendent of St Giles Dr Shish Narayan) and neglected. And often were the brave staff who worked in St Giles.

Unfortunately the many problems of St Giles took over 12 decades to be noticed by the Ministry of Health which with great difficulty embarked on a reform of the system that started with a new decree.

The concept of St Giles as a dump for the mentally ill was associated with 19th century concepts of custodial “care” when no truly effective medicines were available, that has long been superceded by effective and available medicines that have made mental institutions redundant.

However the administrative and regulatory laws had kept the institution with all its faults going – something that allows the sad events that you reported possible.

A plan to separate acutely ill patients from less difficult ones was funded and started in 2011 by MOH Fiji, but still remains incomplete.

Furthermore the need for good and up to date training for staff, including detection of potential for violence in new patients, and more importantly the effective doses of available  medicines by doctors and nursing procedures for handling difficult patients needs to be done at regular intervals to minimise serious events from occurring.

It is important for psychiatry to be taken seriously and not as an afterthought in health care if we are to see less of the incidents that occurred.

I learnt recently that the one year diploma in psychiatry at FNU has no trainees this year thus reducing the available manpower for optimum care for the mentally challenged in Fiji. Indeed some of those trained doctors in mental health in Fiji have sought work overseas and career structure for mental health appear less than attractive.

 

Counselling for Child Abuse

Joan McGoon,

Nadi

As child abuse statistics raise alarm (73 per cent classified as Violence under United Nations definition), a bigger light shines or exposes rather, the misdeeds and acts of adults involved. Fights occur from unresolved issues between parents, adults and children.

It would be advisable to for all of the adults involved in these ‘reported’ cases (children included) to undergo counselling. That is, counselling in terms of dialogue.

Both parties need to thrash out their issues in front of a mediator or counsellor. A third party should be the mediator who can act maturely and remain neutral while handling the exchange.

Counselling doesn’t have to be a negative initiative but a positive one for all those involved. Use a ‘talking stick’ if necessary. ‘Talking Stick’ defined as whoever holds the stick, talks while the other listens.

It takes responsible and mature adults to thrash issues out peaceably and come up with good strategies and solutions moving forward in relationships and actions.

Culture has an important part to play as well. Dialogue may be culturally taboo, however, as the alarming statistics show, there is no longer an excuse. The stakes are too high.

The lives of our current and future generation depend on peaceful dialogues.

 

100 years of Girmitiya

Josaia Bulavakarua,

Nalawa, Ra

First of all, I would like to commend the Fijian Government for organising the Girmitiya celebrations around Fiji.

The Girmitiya has done a lot for this country and they are one of the driving factors that has shaped Fiji in social, political and economical development.

For us in the rural areas we are fortunate that we lived with our Girmitiya brothers and they have introduce many innovative ideas to us which has changed our perception about farming and business.

Because of them, local towns such as Rakiraki was built which allows rural people to enjoy the luxury of towns. I can say that Ra Province is fortunate to have our Girmitiya.

I warmly congratulate all the Girmitiyas for this 100 years of celebration.

 

Labasa River

Sukha Singh,

Labasa

Could the people working at the Ministry of Environment just take a boat ride down the Labasa river and see for themselves how fast the river bank is eroding and do something about it now.

I would also like to know what are the actual job descriptions of the Ministry of Environment; and the Ministry of Sports.

Feedback:  jyotip@fijisun.com.fj

 

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