ABSTRACT
In 2020, there were reports of people with albinism being branded as 'Corona' and 'COVID-19', using individuals as scapegoats and further ostracizing them from communities. People with albinism are vulnerable to human rights' violations and suffer with skin and eye health. Albinism is increasingly recognized in the Pacific Region, particularly in the Polynesian community in Fiji, Samoa, Vanuatu and Tuvalu. A register has been created for Fijians with albinism, with the objective of understanding the scale and health needs of the population. In 2014, The Fiji Albinism Project was established through charity funding in partnership with the Fiji Ministry of Health. The aim is to improve the quality of life of people living with albinism in Fiji. Proformas are completed by Fijians with albinism and their details are collated into an Excel spreadsheet, including name, gender, date of birth, ethnicity, contact details, address, nearest health centre, school, date of entry and additional comments. The database currently holds the details of 172 people with albinism (aged 9 months-77 years), with 161 self-reporting as iTaukei. There are 88 females and 82 males registered (two do not have gender documented). Sixty-four participants are < 18 years of age. Basal and squamous cell carcinomas have been seen among adults, with one incidence of clinical Bowen disease in a child. Similar numbers of people attended the national skin clinic in 2020 vs. nonpandemic times. However, uptake of outreach clinics was reduced and fewer people with albinism are collecting free sunscreen. Owing to the COVID-19 pandemic, the first virtual International Albinism Awareness Day was held in 2020, with participants from Fiji. In 2020, a 5-year National Strategic Plan for Dermatology, Leprosy and Albinism was submitted and reviewed by the Minister of Health and Permanent Secretary of Health in Fiji. The plan includes proposals for continued free sunscreen and formalizing of referral pathways to Tamavua Twomey Hospital and The Pacific Eye Institute. This incorporation of albinism care within the Ministry of Health and Ministry of Education provides a model for other pacific islands and developing countries to follow.
ABSTRACT
The Pacific Dermatology Training Center began its life on February 8th 2019 when it was officially opened by the Hon Minister for Health in Fiji- Hon Ifereimi Waqainabete in Tamavua, Suva, Fiji. This marked a new beginning for Dermatology Services in Fiji-it now has a Training arm that will strengthen Dermatology Services in Fiji and the South Pacific. Following the opening, four young medical officers enrolled through Fiji National University to become the first cohort of the Postgraduate Diploma in Dermatology Programme. While the major disciplines (Internal Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology) have had their postgraduate programme to Masters Level for more than 20 years with the then Fiji School of Medicine, dermatology like many subspecialities was not included. The first dermatology trainees were from Kiribati, Samoa and two from Fiji. The 2019 academic year, although challenging, had four trainees successfully complete the programme through the FNU accredited and supervised programme. Three trainees enrolled in 2020-two Fijians and one from Papua New Guinea, The Covid19 pandemic caused the teaching and assessment to be converted to on-line, in conjunction with clinic participation and supervision. The Fijian trainees were diverted for Covid 19 response. Our PNG student returned home after the first semester, with online teaching and assessment continuing from Fiji and Australia, and the trainee passed the examinations in February 2021. The center continues to survive and three trainees enrolled in 2021 including two Fijian and one Solomon Islander doctors. 2022 will see commencement of the Masters In Medicine (Dermatology) programme and continuation of the Diploma, with 4 students already registering interest. Online teaching will be supplemented by local clinic supervision. The presentation therefore highlights this journey and the players involved behind the scene.