"We are the ones who will have to make the change": Cuban health cooperation and the integration of Cuban medical graduates into practice in the Pacific.

BACKGROUND: This paper responds to Asante et al. (in Hum Resour Health, 2014), providing an updated picture of the impacts of Cuban medical training in the Pacific region based on research carried out in 2019-2021, which focused on the experiences of Pacific Island doctors trained in Cuba and their integration into practice in their home countries. METHODS: The research focussed on two case studies-Solomon Islands and Kiribati. Study methods for this research included multi-sited ethnographic methods and semi-structured interviews as well as qualitative analysis of policy documents, reports, and media sources. RESULTS: The Cuban health assistance programme has had a significant impact on the medical workforce in the Pacific region increasing the number of doctors employed by Pacific Ministries of Health between 2012 and 2019. Qualitatively, there have been some notable improvements in the medical workforce and health delivery over this period. However, the integration of the Cuban-trained doctors into practise has been challenging, with criticisms of their clinical, procedural and communication skills, and the need for the rapid development of bridging and internship training programmes (ITPs) which were inadequately planned for at the outset of the programme. CONCLUSIONS: The Cuban programme in the Pacific is an important model of development assistance for health in the region. While Cuba's offer of scholarships was the trigger for a range of positive outcomes, the success of the programme has relied on input from a range of actors including support from other governments and institutions, and much hard work by the graduates themselves, often in the face of considerable criticism. Key impacts of the programme to date include the raw increase in the number of doctors and the development of the ITPs and career pathways for the graduates, although this has also led to the reorientation of Cuban graduates from preventative to curative health. There is considerable potential for these graduates to contribute to improved health outcomes across the region, particularly if their primary and preventative health care skills are utilised.

The China Alternative. Changing Regional Order in the Pacific Islands

The presence of China poses a challenge to the dominance of Western powers and their allies, who have set the agenda in the Pacific since the end of the Second World War. [...]today, the region has been characterised by (post-)colonial power structures. In her opening remarks, Dame Meg Taylor clearly states that the Pacific Island states regard the presence of China in the region as a positive development because it gives PIF countries access to markets, technology, financing and infrastructure. The Boe Declaration of the PIF meeting in 2018, which states that "climate change remains the single greatest threat to the livelihoods, security and wellbeing of the peoples of the Pacific" (ix) - is the principal element of efforts by Pacific Island state leaders to implement the "Blue Pacific" concept and stands in stark contrast to the environmental and security policy of PIF member country Australia as well as that of the previous Trump administration. In Australia alone, economic damage caused each year by Beijing's punitive actions in response to bans on Huawei equipment (Australia excludes the Chinese company from the country's 5G roll-out) and COVID-19 demands (Canberra's call for an independent investigation into the origins of the virus) runs into the billions annually.

Climate change and Pacific food systems: decision-making for transformational change - proof-of-concept - final report

Many studies have been conducted on Pacific food crops and fisheries, their vulnerability to climate change, and resilience-building strategies. However, there is a lack of decision-making tools that integrate this information and enable stakeholders to anticipate rapid climate change and uncertainty, and to adapt and transform food systems accordingly. To meet this challenge, in 2019-2020 the Australian Centre for International Agriculture Research (ACIAR) and New Zealand's (NZ) Ministry for Primary Industries (MPI) funded a proof-of-concept Small Research Activity (SRA). The SRA sought to develop innovative participatory decision-making tools that can map transformational options at a regional level to allow exploration and planning for future food systems. These aimed to integrate up-to-date climate projections with scientific and local knowledge of food systems, as well as determine how existing adaptation pathways planning methods could be modified for application in a food systems context, which has not been done to date. The SRA established a Steering Committee to guide the process, and a Science Committee of Australian and NZ food system researchers to design and test a conceptual approach. A case study was selected in Malaita Province, the Solomon Islands, following discussions with the Ministry of Agriculture and Livestock, and the Australian and NZ High Commissions in Honiara. Central and West Kwara'ae Constituencies and Langalanga Ward, which surround the provincial capital of Auki, formed the case study area. While the primary purpose of the SRA was to develop pathways planning methods suitable for a food systems context, the use of a case study helped to ground this in a practical context and test the attractiveness of these approaches with key decision-makers and stakeholders in one or more Pacific Island Countries. In September 2019 - March 2020 the science team collated available downscaled climate projections, sea level rise, cyclone risk and population projection data for the case study, plus an inventory of food and commodities produced in the area. The impact of a 'business as usual' scenario of climate change and population growth was modelled using the Assets Drivers Wellbeing Interaction Matrix (ADWIM), looking forward to both 2030 and 2050. A conceptual approach to planning with these drivers and their impacts in mind was designed based on the 'adaptation pathways' method, which plans for an uncertain future by identifying impacts and assessing and sequencing response options and actions over time. A two day adaptation pathways workshop to provide key decision-makers with an initial introduction to the approach was to be held in Auki in March 2020. With the onset of the COVID-19 pandemic, there were multiple delays and a fully re-designed workshop was finally conducted in November 2020 with remote participation by the science team, and facilitation by local experts. The workshop process was co-designed with the facilitators, and participants were invited from local farmer groups, the Auki Market Vendors Association, women and youth groups, NGOs and provincial and national government departments. The climate and population projection information, pest and disease, alternative production methods and ADWIM modelling results were presented as part of a decision-into-practice learning cycle. Participants described the current food system, assessed drivers of change, their impacts in 2030 and 2050, agreed an aspirational vision for the food system in 2050, and then began to formulate adaptation pathways to reach the vision by re-designing the food system. Instead of focusing on production alone, the pathways approach addressed many aspects of the food system, including resource conservation, marketing, consumption, waste management, education, land disputes and governance.

How do community responses from global south contribute to climate justice and resilience debate?

Torres, Pedro Henrique Campello;Jacobi, Pedro Roberto. Towards a just climate change resilience: Developing resilient, anticipatory and inclusive community response. Palgrave Studies in Climate Resilient Societies. Palgrave Macmillan, 2021Alternate : “Towards a just climate change resilience: Developing resilient, anticipatory and inclusive community response” fills an important gap in literature about climate justice and community responses by focusing its lenses in the global south. Designedly, the chapters cover the issue in all the continents where territories and their populations are located in the global south: Brazil and Uruguay (South America), Bangladesh (Asia), Mozambique (Africa) and Solomon Islands (Oceania). The biggest lesson learned from the cases is that strengthening the role of communities and multi-stakeholder coalitions is essential to reduce the injustices and inequalities inherent in anthropogenic climate change, in the face of deforestation, water contamination, declining catches, political instabilities and other economic impacts.Alternate : “Towards a just climate change resilience: Developing resilient, anticipatory and inclusive community response” preenche uma lacuna importante na literatura sobre justiça climática e respostas da comunidade, concentrando suas lentes no sul global. De maneira planejada, os capítulos cobrem o tema em todos os continentes onde os territórios e suas populações estão localizados no sul global: Brasil e Uruguai (América do Sul), Bangladesh (Ásia), Moçambique (África) e Ilhas Salomão (Oceania). A maior lição aprendida com os casos é que fortalecer o papel das comunidades e coalizões de múltiplas partes interessadas é essencial para reduzir as injustiças e desigualdades inerentes às mudanças climáticas antropogênicas, diante do desmatamento, contaminação da água, diminuição da pesca, instabilidades políticas e outros impactos econômicos.Alternate : “Towards a just climate change resilience: Developing resilient, anticipatory and inclusive community response” llena un vacío importante en la literatura sobre la justicia climática y las respuestas comunitarias al enfocar sus lentes en el sur global. Diseñados, los capítulos cubren el tema en todos los continentes donde los territorios y sus poblaciones se encuentran en el sur global: Brasil y Uruguay (América del Sur), Bangladesh (Asia), Mozambique (África) e Islas Salomón (Oceanía). La mayor lección aprendida de los casos es que fortalecer el papel de las comunidades y las coaliciones de múltiples partes interesadas es esencial para reducir las injusticias y desigualdades inherentes al cambio climático antropogénico, frente a la deforestación, la contaminación del agua, la disminución de las capturas, la inestabilidad política y otros impactos económicos.

COVID-19 and Online Learning Experiences of Solomon Islands Students at the University of the South Pacific

This study aims to investigate the experiences of Solomon Islands students during the shift to online, remote teaching during the coronavirus (COVID-19) pandemic. It utilises the "tokstori" to collect data from 16 Solomon Islands students of the University of the South Pacific's (USP) Suva and Honiara campuses. It is framed and analysed data using Khan's eight dimensions of gauging successful e-learning experiences. Prior to COVID-19, many of the courses at the USP were offered in blended mode, which encompasses both online and face-to-face delivery. However, with a sudden move to fully online offerings, and the associated fears resulting from the unknowns of COVID-19, this was disruptive and traumatic for many students. However, analysis identified several key factors aiding student success including many Solomon Islands students being able to eventually cope with the disruption and displayed independence and resilience. It is also found that Solomon Island students got to experience new applications and tools such as, for example, having to be in Zoom or having to sit an online exam. This study has potential to inform higher education institutes (HEIs) in the Pacific Islands and beyond, and the need to carefully navigate the practical realities of the islands in the interaction between digital technologies, instructors and students to facilitate online learning post-pandemic.