In Fiji, low-lying coastal villages are beginning to retreat and relocate in response to coastal erosion, flooding and saltwater intrusion. Planned relocation is considered a last resort as a form of adaptation to the impacts of climatic and environmental change. The health impacts of planned relocation are poorly understood. This paper draws on data from multi-year research with residents of the iTaukei (Indigenous) Fijian village of Vunidogoloa. We used qualitative research methods to examine experiences of planned relocation, including residents’ accounts of their health and quality of life. In-depth interviews and group discussions were conducted with villagers living in a site of relocation, at four points in time (2015, 2016, 2019, and 2020). Twenty-seven people in Vunidogoloa, Fiji, participated in in-depth interviews, several on more than one occasion. Six group discussions with between eight to twelve participants were also conducted. Qualitative analytic software (NVivo) was used to analyse interview transcripts and identify themes. Villagers report both health benefits and challenges following planned relocation. Key facilitators for good health include movement away from some environmental risks to health, adequate drinking water and sanitation, food security including through farms and kitchen gardens, livelihood opportunities, improved access to schools and health services, and appropriate housing design. However, residents also refer to unanticipated risks to health including increased consumption of packaged goods and alcohol, disruptions to social structures and traditional values, and disrupted place attachment following movement away from a coastal site of belonging with consequences for mental wellbeing. Therefore, planned relocation has altered the social determinants of health in complex ways, bringing both health opportunities and risks. These results highlight the need for context-specific planning and adaptation programs that include meaningful involvement of community members in ongoing decision making, and call for an understanding of diverse social determinants of health that emerge and evolve in contexts of planned relocation.
Climate change has compounding effects on development, including direct and indirect impacts on food systems and human health. In the Pacific Islands region, the incidence of non-communicable diseases is among the highest in the world. Additionally, in policy documents, climate change features prominently among the issues most responsible for hindering development in the Pacific. Global discussions are now shifting towards a greater understanding and emphasis on the links between climate change, food systems, nutrition, health, and development. While these links are increasingly appreciated in research and practice, there is a need to understand which types of policy frameworks are best suited to address these issues in an integrated manner. This study was conducted by analyzing policy alignment and coherence in national level strategic planning instruments (policies, plans, and strategies) for two countries in the Pacific Islands region: Fiji and Vanuatu. Documents in the policy domains of development, agriculture, nutrition, health, and climate change were assessed to identify evidence of vertical (national to local), horizontal (between sectors), and integration across different thematic policy approaches (e.g. between economic development sustainable development approaches). By deconstructing the aims of different planning approaches and documents, and by mapping the relationships among them, it is possible to identify opportunities and gaps in the policy architecture that could be addressed in future planning cycles. The study identifies that policy alignment and coherence need to be explicitly addressed in the policy and planning design stage and included in monitoring and evaluation frameworks. The study also highlights the lag in the design and implementation of comprehensive food and nutrition security strategies in both countries and these lags can be linked to policy solutions for agriculture, health, and climate change. Key policy insights There is a need to explicitly consider policy alignment in the design stages of the policy cycle and set policy coherence as an explicit outcome to also be included in monitoring and evaluation frameworks. A lack of consideration of vertical, horizontal, and approach integration in planning and policy processes can lead to failures in the implementation of climate policy, thus delaying countries’ efforts towards achieving the Sustainable Development Goals (SDGs). Pacific Island countries have an opportunity to work towards use of policy frameworks that are able to provide comprehensive responses to the compounding effects of climate change on food systems, diets, health, and, more broadly, on development.
Disasters and climate-related risks displace millions of people each year. Planned relocation is one strategy used to address displacement and is increasingly being analyzed for the potential opportunities and challenges it creates for relocated people. However, little attention has been paid to the secondary impacts of planned relocations, and how they influence the risk, vulnerability and well-being of other groups, particularly people who live on the land that is selected for relocation sites, or in neighboring areas. This paper explores how current and potential future planned relocations in Fiji and the Philippines redistribute vulnerabilities to non-target communities who previously lived on, or alongside, relocation site land. The notion of cascading displacement is introduced to illustrate a serious consequence of planned relocations in which insecurity and displacement are re-created and perpetuated due to a failure to consider the needs of non-target groups who are directly disadvantaged by relocation processes. Insights from this paper may be used to inform future relocation policy and practice for more equitable and sustainable outcomes for all involved. This article is protected by copyright. All rights reserved.
BACKGROUND: Typhoid fever is endemic in some Pacific Island Countries including Fiji and Samoa yet genomic surveillance is not routine in such settings. Previous studies suggested imports of the global H58 clade of Salmonella enterica var Typhi (Salmonella Typhi) contribute to disease in these countries which, given the MDR potential of H58, does not auger well for treatment. The objective of the study was to define the genomic epidemiology of Salmonella Typhi in Fiji. METHODS: Genomic sequencing approaches were implemented to study the distribution of 255 Salmonella Typhi isolates from the Central Division of Fiji. We augmented epidemiological surveillance and Bayesian phylogenomic approaches with a multi-year typhoid case-control study to define geospatial patterns among typhoid cases. FINDINGS: Genomic analyses showed Salmonella Typhi from Fiji resolved into 2 non-H58 genotypes with isolates from the two dominant ethnic groups, the Indigenous (iTaukei) and non-iTaukei genetically indistinguishable. Low rates of international importation of clones was observed and overall, there were very low levels an antibiotic resistance within the endemic Fijian typhoid genotypes. Genomic epidemiological investigations were able to identify previously unlinked case clusters. Bayesian phylodynamic analyses suggested that genomic variation within the larger endemic Salmonella Typhi genotype expanded at discreet times, then contracted. INTERPRETATION: Cyclones and flooding drove ‘waves’ of typhoid outbreaks in Fiji which, through population aggregation, poor sanitation and water safety, and then mobility of the population, spread clones more widely. Minimal international importations of new typhoid clones suggest that targeted local intervention strategies may be useful in controlling endemic typhoid infection. These findings add to our understanding of typhoid transmission networks in an endemic island country with broad implications, particularly across Pacific Island Countries. FUNDING: This work was supported by the Coalition Against Typhoid through the Bill and Melinda Gates Foundation [grant number OPP1017518], the Victorian Government, the National Health and Medical Research Council Australia, the Australian Research Council, and the Fiji Ministry of Health and Medical Services.
This paper uses a holistic approach within a catchment scale, through the application of both climatic and non-climatic parameters, to analyze the impacts of river floods on the human security needs of rural riverine communities in the Waimanu Catchment situated in Nausori, Fiji. Consideration of both climatic and non-climatic factors is required since non-climatic factors could be controlled to build resilience against floods. The indicator-based flood vulnerability index methodology is applicable worldwide, but the indicators used in this study were specifically related to the Pacific Island context. In the context of fluvial flood vulnerability, effects of land management and climate change are not mutually exclusive of each other. Consequently, vulnerability assessments should consider the connection between people’s actions and ecosystems for the entire catchment area since upstream land use practices influence flood vulnerabilities downstream. In our research, a community-based flood vulnerability index system in conjunction with rainfall variability and land use assessments was used to quantitatively and qualitatively analyze the flood vulnerability, and it was found that increased rainfall, poor agricultural practices, gravel extraction, and improper waste management predominantly increased the exposure and sensitivity of midstream and downstream communities to river floods by modifying river morphology. Midstream communities in the Waimanu Catchment were most vulnerable to river floods due to their very low adaptive capacity in terms of poor ecosystem health and lack of natural resources to cope with the subsequent impacts of floods, being most sensitive to changes in land use and land cover.
