Climate change is known to affect Pacific Island nations in a variety of ways. One of them is by increasing the vulnerability of human health induced by various climate change impacts, which pose an additional burden to the already distressed health systems in the region. This paper explores the associations between climate change and human health on the one hand, and outlines some of the health care challenges posed by a changing climate on the other. In particular, it describes the links between climate variations and the emergence of climate-sensitive infectious diseases, such as the mosquito-borne diseases dengue, chikungunya, and Zika. The paper also presents a summary of the key findings of the research initiatives Climate Change and Prevalence Study of ZIKA Virus Diseases in Fiji and the findings from the World Mosquito Program as two examples of public health action in the Pacific region.

Background: Ascites, a condition characterized by fluid accumulation in the abdominal cavity, is a common complication of chronic liver disease and other serious health conditions. In resource-limited settings such as Fiji, managing ascites presents unique challenges. This study investigates the prevalence, associated risk factors, and current management approaches for ascites in the Western Sub-Divisional Hospitals of Fiji, focusing on population demographics and healthcare practices. Methods: This retrospective study analyzed patient records from January 2021 to December 2023 across five hospitals—Sigatoka, Nadi, Ba, Tavua and Rakiraki. Data on demographics, medical history, lifestyle factors and treatment practices were collected. The study adhered to ethical standards, with approval from the Fiji National Research. Results: Ascites primarily affected individuals over the age of 50, with a higher prevalence among men and individuals of Indian descent. Key risk factors included alcohol abuse, chronic liver disease, and metabolic syndrome. Management typically involved sodium restriction, diuretics and in limited cases, Transjugular Intrahepatic Portosystemic Shunt (TIPSS) due to accessibility constraints. Conclusions: The findings highlight a need for culturally responsive healthcare strategies, improved screening, and multidisciplinary treatment protocols to manage and prevent ascites effectively in this population. Enhanced public health initiatives and clinical guidelines could significantly impact patient outcomes in Fiji.

Background: Abscesses, localized collections of pus resulting from bacterial infections, pose significant challenges to patient care. They are categorized into internal and cutaneous abscesses, with internal abscesses being more severe and harder to diagnose. Limited data exists on the epidemiology and management of abscesses in Fiji, particularly in subdivisional hospitals. This study aims to investigate the prevalence, anatomical distribution, demographic trends, and etiological factors of abscesses in subdivisional hospitals in Fiji’s Western division. Additionally, it seeks to analyze management strategies and outcomes to inform improvements in clinical practice. Methods: A retrospective study was conducted from January 2020 to September 2022, analyzing patient data from four subdivisional hospitals-Rakiraki, Tavua, Nadi, and Sigatoka. The study utilized both qualitative and quantitative methods, with MBBS students collecting data under medical supervision. Statistical analyses were performed to assess demographic trends, anatomical sites, and microbiological findings. Results: A total of 1,160 abscess cases were recorded, with Sigatoka hospital reporting the highest number (588 cases). Pediatric patients (ages 0-20) were the most affected, with a male predominance. The most common anatomical sites included the scalp, abdomen, head and neck, limbs, and gluteal region. S. aureus was the predominant pathogen, followed by S. pyogenes and E. histolytica. Management strategies involved incision and drainage (I and D), antibiotic therapy, and wound care, with variations based on abscess location and severity. Conclusions: The study highlights a high prevalence of abscesses in pediatric and male populations in Fiji’s Western division. The identification of bacterial and parasitic pathogens underscores the need for targeted antibiotic and antiparasitic treatments. Findings emphasize the importance of public health interventions, improved hygiene practices, enhanced diagnostic capabilities, and antibiotic stewardship programs to optimize patient outcomes and reduce abscess-related morbidity in the region.

Background Surgical emergencies demand timely diagnosis and immediate intervention to prevent complications. In Fiji, sub-divisional hospitals like Sigatoka Subdivisional Hospital (SSH) are often the first point of care for trauma, abdominal emergencies, and other acute conditions. While SSH manages a high volume of these cases, its operating theatre functions at limited capacity, and the shortage of surgical specialists requires frequent referrals to tertiary hospitals such as Lautoka Hospital. These gaps contribute to delays in care and increase risks for patients requiring urgent procedures. Rationale Understanding the types of surgical emergencies presenting at SSH, how they are managed, and why they require referral is essential for strengthening emergency surgical care in resource-limited settings. Identifying system gaps can inform policy decisions, guide resource allocation, and support improvements in surgical readiness at the subdivisional hospital level. Objectives Determine the prevalence of surgical emergencies at SSH. Evaluate the management strategies used for these emergencies. Identify challenges associated with referrals to tertiary hospitals. Recommend improvements to strengthen emergency surgical care. Methodology Study Design Setting - A prospective observational descriptive study was conducted at SSH from June 19 to July 14, 2023. Data Collection Inclusion: All surgical emergencies presenting to the emergency department and inpatient wards were included.Exclusion: Elective procedures, follow-up cases, and non-surgical emergencies were included.Sources: Patient records, real-time clinical assessments, demographic logs. Data Analysis Descriptive statistics were used to categorize emergency types, management strategies, and referral outcomes. Results Deep lacerations due to trauma (40%) were the most frequently encountered surgical emergency, followed by urinary obstructions, fractures, abscess drainages, acute abdomen cases, skin and soft tissue infections, acute appendicitis, gastrointestinal bleeding, and respiratory issues. Abdominal emergencies accounted for the highest proportion of cases when categorized collectively. 99% of abdominal emergency cases required referral to Lautoka Hospital, highlighting a critical gap in surgical capacity at Sigatoka Hospital. Males accounted for 62% of cases, with the highest incidence of lacerations and fractures. Patients aged 0–15 years were most prone to fractures, while those over 50 years presented predominantly with abdominal and urinary emergencies. A total of 52 cases were recorded. Deep lacerations from trauma accounted for 40%. Other common presentations included urinary obstructions, fractures, acute abdominal cases, abscesses, and soft tissue infections. Males represented 62% of cases. Children aged 0 to 15 showed the highest fracture rates, while adults over 50 experienced more abdominal and urinary emergencies. ConclusionThis study highlights the heavy strain that trauma-related and abdominal surgical emergencies place on SSH. Without the necessary surgical facilities, the hospital must rely heavily on transferring patients to tertiary centres, which can lead to delays in life-saving care. To ensure better patient outcomes, reopening the hospital’s surgical theatre and bringing in skilled surgeons who can handle emergency cases on-site is crucial. Additionally, community awareness programmes are important to prevent trauma-related injuries while strengthening the hospital’s capacity to manage surgical emergencies more effectively. Future research should focus on collecting data over a more extended period and expanding the study to include multiple healthcare facilities, ensuring a more comprehensive understanding of emergency surgical care in Fiji. Keywords - Surgical emergency, trauma, deep laceration, abdominal pathology, fractures, emergency intervention, resource-limited settings. Corresponding Author: abhijitg@unifiji.ac.fj

Medical education has evolved significantly to incorporate active learning strategies, with problem-based learning (PBL) being widely adopted. This study compares the effectiveness of PBL and traditional lectures in enhancing knowledge retention, critical thinking, and student engagement among medical students. Conducted at the Umanand Prasad School of Medicine & Health Sciences (UPSMHS), University of Fiji (UniFiji), from 2019 to 2022, this study involved 500 medical students. Quantitative results showed that students in the PBL group scored on average 12% higher in critical thinking assessments and demonstrated 15% greater improvement in case-based performance tasks compared to the lecture group (p < 0.05). Survey results also indicated that 78% of PBL students reported higher engagement and satisfaction with the learning process. These findings suggest that PBL promotes deeper learning and skill acquisition, while traditional lectures efficiently deliver foundational knowledge. A hybrid model integrating both approaches could foster comprehensive medical education by combining knowledge transmission with critical skill development. Such a model has significant implications for curriculum design, suggesting a move toward curricular integration and educational reform that emphasizes self-directed learning and clinical reasoning from early training stages.

Bangungot and sudden unexplained nocturnal death syndrome (SUNDS) remain complex phenomena at the intersection of culture and medicine. This systematic review investigates their epidemiological prevalence, cultural interpretations and genetic foundations. We highlight the urgent need for culturally sensitive public health interventions by synthesizing Southeast Asia and Fiji's findings. Key findings indicate Brugada Syndrome, associated with genetic mutations such as SCN5A, as a primary medical explanation, while environmental and lifestyle factors further elevate risk. Integrating cultural narratives with scientific research can improve strategies to address and reduce sudden nocturnal deaths.