NIKUA ISSUE NO. 10 OCTOBER 2020

INVEST IN YOUR TOUTOU SPORTS HEALTH PINK WARDROBE FNUNIKUA

Dr William May

Pinktober – Relevance to

t’s Pinktober month. A significant part of the family history cannot be changed. However, many activities related to Pinktober is directed towards of the other risk factors CAN be changed. Possible Iraising awareness about breast cancer. risk reduction strategies that should be encouraged The need to raise awareness about breast cancer are reducing alcohol intake, cessation of smoking, is particularly crucial in Fiji as most of our people achieving normal body weight, increasing physical present late. By the time they present, the disease is activity, healthy eating, choosing to breastfeed and already at an advanced stage. limiting exposure to radiation and hormonal therapy This progressive disease is both challenging and if possible. more expensive to treat. The advanced disease Below are some statistics that were published requires extensive operations and more extended in the recent issue of the Fiji Medical Journal. hospital stays. Complications and recurrences are The article by Dr Jale Temo, a local consultant cent of diagnosed cases were below twenty years. anticipated if the diagnosis is made at a late stage. pathologist, highlighted the confirmed breast cancer If there is anything this article intends to do, it is to cases from the breast specimens collected in Fiji try and change your attitude. from 2009 to 2014. Table 2 Source: Fiji Medical Journal Vol 24 No 3 August Many patients present late for various reasons, 2020 apart from not knowing that treatment options are Year Breast specimens Breast cancer Discovering a lump in the breast is a scary available. As breast cancer is initially painless, 2009 327 117 experience. Most of these lumps are not cancers, people do not consider it to be serious. Geographical 2010 351 132 however, all of them need to be assessed by a health location and costs involved may deter some women care professional so that a proper diagnosis can be from visiting a health care facility. The use of 2011 352 110 made. traditional is often sought first before a 2012 350 133 If the diagnosis is cancer, then the stage of the disease is determined before treatment is started. visit to a health care profession. 2013 415 171 There is a considerable difference between the Through the Pinktober awareness activities 2014 450 177 results of early and late cancer treatment. that Fiji National University (FNU) and other Total 2244 840 Ninety-eight per cent (98%) of stage 1 breast organisations are conducting, we hope to spread the cancer patients will survive for five years or more. message that breast cancer is curable and that the If the diagnosis is made when the disease is at stage Table 1 Source: Fiji Medical Journal Vol 24 No 3 August treatment is much simpler if the diagnosis is made 4 (which is very common in Fiji), about twenty-five 2020 early. per cent (25%) of these patients will survive for five years or more. We aim to increase health-seeking behaviour Thirty-seven per cent (37%) of breast specimens The one-year overall mortality for breast cancer among the population and reduce the barriers, both taken in Fiji between 2009 and 2014 was confirmed patients at CWMH for the period 1999-2003 was physical and mental, that prevent women (and men) to be cancer. Although breast cancer is predominant about sixty per cent (60%). from approaching health care professionals. In 2018, the overall one-year mortality had in females, 2.4% of the total breast cancer patients Evidence shows that about one in eight women significantly decreased to twenty (20%) per cent. over the six years studied above in Fiji were males. will develop breast cancer over the course of their The approach to diagnosis, management and Table 2 below shows that more than eighty- lifetime. comprehensive care of patients in the Ministry of five per cent (85%) of breast cancer patients were Some of the risk factors like age, genetics and Health facilities in Fiji has remarkably changed the between the ages of 39 to 69 years. Less than one per continued on Page 3 FNUNIKUA

and weaker was immensely distressing,” the teary- eyed Nurse mentioned. Both, McGoon’s mother and sister lost their battle against cancer, in a year, which she describes as the most painful moment of her life that left her devastated for years. “My mother and sister were the strongest women I knew, and losing them unexpectedly, capsized my life. I miss them every day.”

Oncology Unit Bottling up her grief, McGoon then joined the Oncology/Palliative Care Nursing team at CWMH in 2005, to provide compassionate care to cancer patients who have little hope of meaningful recovery. “Now, when I see any breast cancer patient, it reminds me of my sister. I remember the surgery she went through and the unbearable pain that she had to suffer. She had chemotherapy treatment abroad, and it motivates me to understand my patients better, to make them as comfortable as possible and to help alleviate their pain,” she said. McGoon spends most of her time visiting cancer patients at home. Her role includes monitoring patients, pain management, administering medication and providing patients with personal care. According to the specialised Palliative Care Nurse, an average of at least two new cancer cases, mainly breast cancer are referred to the Oncology Department each week. “I see the cases at home through the continuous taff Nurse Maraia McGoon is a familiar elder sister, who also happened to be in the medical support provided by the Fiji Cancer Society. I have face for cancer patients needing palliative field. This was enough for me to make that important travelled between -Nausori, Navua even to care at the Colonial War Memorial decision concerning my career,” said McGoon. places as far as Tailevu and Naitasiri to ensure that S my patients receive the best medical support.” Hospital’s (CWMH) Oncology Department in Suva. The FNU Alumna graduated with a Diploma in Her humbleness and soft smile is a beacon of hope Nursing in 1996 and worked at the CWM and “Following the death of my mother and sister, I for many end-stage cancer patients. Their stories hospitals, Levuka Health Centre and Batiki Nursing did not know what life had in store for me. However, are heartbreaking, one which McGoon can relate Station in Lomaiviti. I feel blessed to have touched the lives of the many to herself, having walked through similar pain after “My family was excited to see me achieve my goals patients I have looked after.” losing her immediate family members to cancer. even though I wanted to be a school teacher like my “My mother had colorectal cancer, and my elder mother, and indeed, becoming a nurse was a dream Advice sister was diagnosed with breast cancer. I lost both of come true,” she shared. While there’s no magic pill to eradicate cancer, them in a year,” an emotional MccGoon mentioned. Aspiring to continue her education, McGoon there are many cancer survivor stories which McGoon juggled work and studies as she graduated with a shares with her patients to encourage them to fight the Tertiary Life and Career Postgraduate Certificate in Leadership in 2006 and battle. McGoon (pictured above) hails from Vagadaci Postgraduate Diploma in Nurse Practitioner in 2019 “I always encourage my patients never to give up, village in Levuka with maternal ties to Nakobo, from FNU. and I urge everyone who knows someone suffering Cakaudrove. Inspired by her elder sister Sereima from Cancer, to keep motivating them for a new lease McGoon, a former Lab Technician who worked at Cancer-stricken of life,” she mentioned. Labasa Hospital, McGoon enrolled at the Fiji School Nine years into her career as a Staff Nurse, “My mother and sister’s journey with cancer of Nursing (FSN) in 1994. FSN is now part of FNU’s McGoon’s mother got diagnosed with colorectal has taught me to experience everything that I can, College of Medicine, Nursing and Health Sciences cancer. She was still coming to come to terms with always to forgive and most importantly, to never take (CMNHS). this when the news broke that her elder sister had anything for granted.” McGoon is a proud mother “I was always fascinated with the work done by the lumps in her breasts. of two children aged 22 and 11 years and the foster health care professionals, and I used to look upon my “To watch my mother and my sister grow weaker mother to her late sister’s 20-year-old twin daughters.

continued from Page 2 outcome in the past fifteen plus years. health as the foundation of an individual’s well-being that 50 million people suffer from epilepsy and 24 The message is clear – our attitude needs to and functioning. million from Alzheimer and other dementias. change. Reduce your risk of getting breast cancer, as However, it is unfortunate that we often do not According to the World Health Organization highlighted above. appreciate its value until it is lost. For example, (WHO), about 877,000 people die by suicide every Report to a health care professional immediately having experienced a bout of depression, nursing a year. if you discover any abnormality in the breast. When child with special intellectual needs or caring for a In the first 8 months of 2020, there have been the diagnosis is confirmed, get appropriate medical parent with dementia. 72 deaths by suicide in Fiji, as reported by the Fiji treatment without delay. We take mental health for granted and through a Police Force. We are losing young productive As Winston Churchill said, “attitude is a little thing lack of knowledge and appreciation treat our mental people to suicide which is preventable but complex that makes a big difference”. health like an indulgence we can do without instead of a phenomenon. It is a public health concern which as a vital basic necessity! requires a comprehensive, multidisciplinary and No Health without Mental Health Mental, neurological and behavioural disorders are integrated approach that includes not only the common to all countries and cause immense suffering. Government and the health sector but NGOs, CSOs, It is also worthwhile to mention another health People with these disorders are often subjected to communities and individuals. campaign that ran parallel with FNU’s Pinktober social isolation, poor quality of life and increased Mental Health is everybody’s business!! We must activities during the first half of October – mental mortality. These disorders are the cause of staggering invest in our mental health and wellbeing. health awareness. economic and social costs. We need to work together to take ownership of Mental health is vital to our existence. It affects our Hundreds of millions of people worldwide are our mental health and make the best use of limited behaviour, thinking, emotions and relationships. The affected by mental, behavioural, neurological and resources and expertise. World Health Organization (WHO) defines mental substance use disorders. For example, estimates made Having good mental health increases our morale, health as “a state of well-being in which an individual by WHO in 2002 showed that 154 million people productivity, resiliency and self-esteem leading to realizes his or her own abilities, can cope with the globally suffer from depression and 25 million people prosperous communities and nations. normal stresses of life, can work productively and is from schizophrenia, 91 million people are affected able to make a contribution to his or her community”. by alcohol-use disorders and 15 million by drug-use Dr William May This definition emphasises the importance of mental disorders. A recently published WHO report shows Acting Vice-Chancellor FNUNIKUA

in psychiatry in the final year of the programme starting from next year. For the Postgraduate Diploma in Mental Health students, this is one year of full-time training as psychiatry academic registrar – students are trained about holistic assessment and management of cases, with varying depth and extensiveness in accordance with the design of the courses.” “In terms of management, it includes both pharmacological and non-pharmacological interventions that range from counselling to brief psychotherapy, supportive psychotherapy, interpersonal therapy, insight-oriented psychotherapy and family therapy to cognitive behaviour therapy. “The range of topics related to CMNHS Head of the Discipline – Psychiatry, Dr Balram Pandit mental health issues across the said its students needed to know the issue so that they could various age groups and gender are better address and provide care to people coping with mental covered within the scope of these health issues. courses.” “At the College, mental health is a priority and as such, Dr Pandit highlighted that the psychiatry happens to be an integral major block in its flagship institution’s medical and nursing MBBS (Bachelor of Medicine and Bachelor of Surgery) graduates then work throughout the programme,” Dr Pandit said. country, and in many parts of the “There are elements of mental health in most of our region, at various levels. programmes at CMNHS, and we also have specific courses like “In terms of accessibility to the Postgraduate Diploma in Mental Health and Postgraduate mental health care, this means Diploma in Mental Health Nursing.” the services trickle down to the ackling mental health needs a multi- “These courses focus on recognition of signs and symptoms, community level through primary pronged approach and having well-trained comprehensive assessment, planning and executing management health care systems (which links people to deal with the issue is critical. strategies. The level of training varies according to the level of T the larger health facilities to The Fiji National University’s (FNU), College the course (Bachelor, Postgraduate Diploma or Masters) and primary health centres and village of Medicine, Nursing and Health Sciences’ trade (Medicine or Nursing).” health workers)” he said. (CMNHS), prioritises mental health and Dr Pandit said during the implementation of these programmes, “As highlighted, it’s not only incorporates it into its various courses, so medical medical and nursing students needed to undertake adequately counselling but various other and nursing students are equipped to deal with supervised clinic-based training. Consequently, they are prepared forms of non-pharmacological mental health issues when needed. for service delivery at the time of graduation. interventions plus biological “During the training period – for example, for MBBS students interventions such as this is seven weeks of separate psychiatry block training in year and electroconvulsive therapy that four plus a proposed one-week attachment are also available for managing mental health issues locally.”

FNU’s mental health campaign Your Say

n the weeks between World Suicide Prevention Day on September 10 and World Mental Health Day on October 10, Fiji National University I(FNU) organised various activities and wellness screenings to engage staff and students to foster wellbeing. These activities were organised in partnership with the Ministry of Health and Medical Services, FNU Student Association (FNUSA) and the Office of the Registrar’s Counselling Unit.

• Moving Mondays Staff and students were introduced to Deskercise, ( Desk Exercises). These were simple yet effective exercises that could be done at any time of the day at your desks. It does not require any special equipment or gear and helps us to move more to maintain our health.

• Talk time Tuesdays We spend the most time with our This was to encourage people to reach out and connect to others. Talk time thoughts. If our thoughts aren’t healthy, Tuesdays were organised for FNU staff to talk about work-related stress. that is projected in our performance. Videos on Mental Health was circulated to all staff and students. There is a saying that goes “your thoughts become your words and • Wellness Wednesdays your words become your actions,” so Regular health checks and lunchtime physical activities such as Walks, Zumba everything starts from the mind. It is and Bhangra were organised. statistically proven that our mental health affects our physical health as • Thankful Thursdays well, hence, it should be prioritised because our mental health is just as Staff and students were encouraged to reflect ect on what they were grateful important as our physical health. for. Experiencing gratitude, thankfulness and appreciation tend to foster positive feelings, which contributes to one’s overall sense of wellbeing. A Laura Hannah Rounds Positivity Tree was set up in all FNU Libraries, where the staff and students Student could share a positive thought. FNUNIKUA

Dialogue about

reast cancer is the most common treatment can be provided. Many patients cancer in women affecting on an still prefer to undergo alternative treatment BREAST CANCER Baverage = 40/100,000 women. methods such as herbal medicine and Despite the developments in health religious advice. Other patients would refuse services, breast cancer survival is still meagre surgery as they have fears surrounding ‘going in low and middle-income countries with at under a knife’. imperative least 40 % and 60% respectively, compared Breast Cancer is usually not a subject that to an 80% survival rate in high-income people discuss openly at home – it is mostly countries. done behind closed doors and less in public. It’s Pinktober: Breast Cancer Awareness By celebrating Pinktober and talking about Month again and this year the theme ‘Early it more openly is a step forward to create Detection, Early Presentation and Early awareness so that more women could come Treatment’ really hits home. and get the much-needed treatment. We Most literature has attributed the differences have launched the Pinktober celebrations in survival rates due to the lack of screening earlier this month and hope to create more services and in most parts, late presentation. awareness in the hope that our message Latest data from Colonial War Memorial reaches to everyone across the country. Hospital (CWMH) from January 2019 to The surgical team at CWMH have launched August 2020 shows that there have been 187 a Pinktober sports day for the doctors and diagnosed cases of breast cancer, and only a their families to commemorate breast cancer third of patients have agreed for treatment. awareness, and we hope to make this a yearly Majority affected [72%] are 40-70 years event. It is our objective to take breast cancer old. Therefore, the age bracket for women awareness beyond the hospital – to our is usually forties and beyond. However, this families and communities and at the same cancer can affect anyone as shown by our time, promote the importance of health and latest data, the youngest patient being 20 wellness. years of age. Breast Cancer is curable in the early stages While breast cancer affects women, our so if you know someone with a painless data has shown that 2% of cases are men – so breast lump or changes in breast appearance, it doesn’t discriminate against gender. do encourage them to present to the nearest The two main issues that are faced at health facility for a referral to the surgical CWMH with regards to breast cancer is department. related to late presentation and the low We take time to remember those who are treatment rates. The common reasons for 2/3 gone, those still fighting and those who we of patients refusing treatment is usually a are yet to help fight against breast cancer. lack of awareness and insight on the disease and the services that are available to help Dr Sajneel Prasad Dr Sajneel Prasad (right) during a surgery. them. So patients do not present themselves Surgical Registrar until the late stages when little to no curative CWMH

Toutou sports pink wardrobe

oung Kalaveti Mokosiro cancer and to honour those that have Toutou loves to come lost the battle. Ydressed in black for The former Natabua High School lectures. But for the entire month of students said he wants to create October, he had dedicated to wearing awareness for breast cancer and to pink to help raise awareness for encourage women to be pro-active breast cancer. with their health. Toutou (pictured left) is studying “By wearing pink, I am not only Trade Diploma in Customs at showing my support by what I Fiji National University’s (FNU) wear, but I’m also trying to spread Namaka Campus and said witnessing understanding of what the colour his aunt (mum’s sister) endure breast pink stands for. Pink is the colour cancer in 2018 was “scary” and for breast cancer and a symbol of “life-changing”. empowerment and hope,” he said. Tears flooded his eyes as he Toutou said his goal is to engage described how he felt helpless and and encourage men to wear pink. angry after hearing the cancer news. “By wearing pink, not only are However, he was supportive and we are raising awareness of breast loving by showing his aunt that she cancer, but we are committing to was not alone in her struggle. actively supporting the health and “I was supportive of my aunt. wellness of women in our lives. However, I was angry because she According to Toutou, he is was relying on herbal medicine and honouring his aunt by wearing pink, by the time she took the doctor’s and he hopes to encourage people advise, it was too late.” who are currently battling breast “I urge women to take preventive cancer. measures such as routine check-ups “Creating awareness of breast and getting tested. Early diagnosis cancer is very personal, and if I can is critical in most case, and it is so share my experiences with anyone, because it simply saves life” he said. it will definitely help them deal with Soft-spoken Toutou said that he fear and anger,” he said. was attending classes in pink, a Toutou’s advise to other men is colour seen as “universal love of to be supportive of breast cancer oneself and other” to offer support to awareness campaigns and to provide those undergoing treatment for breast support to females they know. FNUNIKUA

aints, pastels, egg cartons, clay, In this way, a person canvas and rice: these may not can develop a deeper Psound like the traditional tools used understanding of the issues in the treatment of mental health. or core beliefs that may be But a recent research collaboration at contributing to their illness, Fiji National University (FNU) has found as well as strengths that could that art-making could offer a meaningful help their recovery. and affordable recovery tool for Fijian Art therapy can also people trying to find their way back from increase self-esteem, lessen mental illness. levels of stress and anxiety, In a low-resource setting such as Fiji, offer a sense of control, it’s important that we think creatively and and provide a safe outlet innovatively about ways to help people through which to express suffering or recovering from mental deep and difficult feelings disorders. – particularly for those who Art therapy aims to help people improve struggle to express emotions their mental health through creative through words alone. practice, and is based on the idea that These benefits, however, self-expression through art can unlock haven’t been widely explored emotions and help the healing process. in low and middle-income Crucially, it’s usually about the thoughts, settings. feelings and ideas that accompany the With this in mind, process, rather than the resulting artwork researchers at FNU joined itself. forces with La Trobe University in Australia, the Fiji Ministry of Health, St Vincent’s Mental Health Service, and the Fiji Alliance for Mental Health to explore the challenges, benefits, and potential of art as a mental health recovery tool in Fiji.

“The use of art in therapy can yield many benefits, but a key outcome is a sense of being able to understand oneself better”.

Others spoke of feeling a sense of connectedness to Meanwhile, by working closely with St. Vincent’s Tradition and innovation others and feelings of acceptance. Mental Health Pacific Fund, local stakeholders have The project began with a series of training workshops A facilitator of the art sessions herself described benefited from opportunities for training and capacity to prepare facilitators and build capacity in the use of how art-making ‘helped lighten the mood and allowed building. art therapy in mental health. Chosen facilitators then participants to self-express and become relaxed’. For the next phase, we hope to explore other art went on to run a year-long series of once or twice As a psychiatrist working in the Fiji mental health forms that are particularly well accepted in Fiji, such weekly workshops which engaged patients, their carers service, the outcomes of this project have been very as dance and music. and families, health professionals, and volunteers in exciting to me. Another interest is talanoa, a traditional Fijian regular art-making sessions. It has shown that the use of art is an acceptable, concept of storytelling, which allows the open exchange The workshops sought to establish a neutral and non- appealing and affordable medium – one that is enabling of ideas and experiences for the collective good. judgmental environment in which participants were and engaging to users, and can have beneficial and This idea of ‘storytelling for a purpose’ has found guided to express themselves. meaningful outcomes when used as a recovery tool. particular resonance in recent years through the We provided a variety of art forms that we hoped Talanoa Dialogue – launched at the United Nations would appeal, including acrylic and fabric paints, Working together Climate Change Conference in Fiji in 2017 – which pastels, calico, cardboard, rice, canvas and clay, as well Involving those affected by mental health issues in the used storytelling to create a process of inclusive and as local materials such as voivoi – the dried leaves of project’s development has been an essential element transparent dialogue around climate change. an indigenous plant traditionally used for mat weaving, of its success, stressing the importance of the adage Despite the overwhelmingly positive feedback for and masi – a fibrous cloth made from the inner bark of ‘nothing for them without them’. our project, it remains difficult to harness local support the mulberry tree. Universities, too, have played a vital role, providing for mental health activities due to the stigma sadly still The use of traditional art forms and materials has local evidence for what is known anecdotally. associated with mental illness. been a strong point of the project and highlights Fiji’s We have also been able to provide evidence and But in spite of the challenges, the project team is multicultural foundations. testimony of strategies that are beneficial and practical keen to forge ahead and work with local communities We adopted a strengths-based approach – where in our context, and that have only previously been to continue the momentum and enthusiasm, and to the focus is on a participant’s strengths and skills, reported on in the developed world. establish art-making as a recognised recovery tool in rather than their perceived weaknesses. A particularly Fiji. important element for us was incorporating community Partnerships and traditional values, and exploring cultural Similarly, longstanding partnerships both within and *This is a reproduced article written by Dr Odille understandings of art-making in Fiji. outside Fiji have been vital. The Fiji Ministry of Health Chang that was first published by The Association of The art-making sessions were well-received by and Medical Services has frequently collaborated with Commonwealth Universities (ACU). Dr Chang is the participants, who reported that the imaginative, creative FNU and the Fiji Alliance for Mental Health to raise Head of School Medical Sciences at FNU’s College of process boosted self-esteem, fulfilment and morale. the profile of mental health issues in the country. Medicine, Nursing and Health Sciences’ (CMNHS). FNUNIKUA

iji National University (FNU) remove my left breast.” treatment. “The other obstacle was academic Ruth Lal, clearly “I was in total shock as the initial that I was away from my husband and Fremembers the day her doctor biopsy stated that the lump was not kids for almost one and a half years, uttered the words “breast cancer” and cancerous, and no malignancy cells and I missed them during that time. confirmed her worst fears. were found. I almost fell off my I overcame this through prayer again According to Lal, at that precise chair when I was told to remove my and calling and talking to them daily.” moment, she felt like the world around left breast because the results say it’s Lal, who resides in Ba, said that her just came to a complete halt as cancerous.” there were several programmes death stared her in the face. She decided to undergo further and services offered to her with the “It seemed as though I was delivered diagnosis overseas and travelled to a treatment process. a death sentence. I had voices echoing hospital in Sydney, Australia. “Awareness programmes, health and in my mind that I would die and that “There I was advised I had to exercise club member, even beauty there was no chance of survival. I felt undergo surgery to remove my left workshops, how to take care of skins, helpless and powerless,” she said. breast. After the surgery, I went through nails and body during and after the However, with the overwhelming chemotherapy and radiation in 2015 to treatment. I was also given vouchers to support of her husband, children and 2016,” she said. Lal said finance was have a free body massage three times her church group, Lal conquered her the only significant obstacle she faced during treatment, diet club member fear and battled the stage three breast during treatment. (focusing on special diets during the cancer. “I spent almost AUS$75,000 in total treatment).” The 55-year-old said it was during for my treatment, and I only had half of This year is Lal’s sixth anniversary, a routine self-breast examination in it. God provided the other half through and she’s had no recurrence of cancer. 2014 that she discovered a lump on her kind-hearted people, families, friends, She travels to FNU Namaka Campus, left breast. former students, and church families in thrice weekly to take lectures. Lal, who is a lecturer in Management Fiji and abroad.” “God answered every prayer. My at FNU’s, College of Business, “My families in Australia supported chemotherapy and radiation were Hospitality and Tourism Studies me tremendously, and my husband, painless; I did not experience any “When reflecting on her journey, Lal (CBHTS), said her initial biopsy test who did a lot of fundraising in Fiji to significant pain or suffering or was at said one piece of quick advice she would stated that the lump was not cancerous. collect funds for my treatment. My any time bedridden. I did not struggle give all women was to perform breast “After three months, the hospital in two boys helped me through prayer physically at all.” self-examination regularly and not to Suva advised me to remove the lump, and fasting,” she said. “My advice to women who are be embarrassed if diagnosed with breast cancer . which was sent for testing. After three The soft-spoken Lal said that she is newly diagnosed is to keep your head ” weeks, I received the results, and the thankful to her brother and her sister- high as there is always a light at the doctor informed me that I need to in-law, for their support during her end.”

he health and wellbeing inspirational stories of the many feel that they may have a lump in their of students and staff are survivors that we get to hear of, people breast or for those who have noticed a Tfundamental to the overall also begin to realise that lives can be change in size and shape of their breast health of individuals. It is important to saved. We, therefore, need to keep or changes in the skin, nipples and promote these practices as it creates a telling people the importance of early areola of their breasts.” happier study and work environment. detection and not just early detection “For anyone who has noticed any Fiji National University’s (FNU) but seeking proper medical attention lumps or changes in their breast, we UniClinic plays a pivotal role, working from then on.” encourage them to visit the Clinic within the organisation to ensure Dr Waqa said people needed to heed for further consultation and medical students and staff receive health proper medical advice and care, as advice.” services whenever required. many opted for non-medical treatment “Students can walk in with their General Practitioner at FNU’s after detection. student ID and staff are encouraged to UniClinic, Dr Henry Waqa, said “More people need to heed the make an appointment with the clinic the clinic was at the forefront of the proper advice for the best outcomes for nurse.” University’s Pinktober campaign as their health and the wellbeing of their He said these services were offered they advocate for the early detection families,” he said. all-year-round and proper referrals and screenings of health issues such as “We have seen that many who were done after consultations. breast cancer. tend to present late seek traditional “We examine our students and “The Pinktober campaign which is medicine first. Even though there is a staff and ensure that everything is in October of every year is important place for traditional medicine, when it confidential. If needed, referrals are because we need to continue to be comes to lumps in the breast, proper made to either the specialist Breast reminded that there is a fight against medical advice and treatment should Clinic at the two main hospitals (CWM Breast Cancer, and if we all join be sought.” Hospital and Lautoka Hospital for staff “The most important message we together in this fight, the loss of loved At FNU, he added, students and staff in the West), the Oxfam clinic or to the would like to get across is that all ones can be dramatically reduced,” Dr were encouraged to visit the clinic for private hospitals for those covered by women can and should self-examine Waqa said. consultations and examinations. insurance. Dr Waqa also highlighted their breasts every month for lumps and breast changes . “Our health and wellbeing are very “The UniClinic is providing free the importance of self-examination ” important.” breast examinations for women who, and encouraged people to take charge “Over the month, through the after self-examination of their breasts, of their health.

very October organisations, programs, provide cancer screening were engaged to help deliver institutions, companies, and services to encourage early detection screening and awareness services in Epeople worldwide join hands to of cancer and reducing cancer risks places where no has reached out to. support the Breast Cancer Awareness through healthy lifestyle choices. . month. Participants dress up in Making a difference pink, organise morning tea’s, hold Breast Cancer Awareness month The Fiji Cancer Society has and fundraising initiatives and organise For October, FCS had planned and continues to provide the continuum forums for survivors to share inspiring delivered over 18 cancer educational of care to the newly diagnosed stories related to breast cancer. programmes which will continue patients via our home visitation or These activities all have one throughout the month. The Society patient support program. We provide common goal: to raise awareness has also provided about seven free much-needed assistance to the about the importance of breast breast and cervical cancer screenings patients once they are registered with cancer prevention measures like at various locations including FCS. Such assistance is not generally mammography screening. Most public screening. Through outreach offered to cancer patients at the of the charity efforts surrounding programmes, FCS successfully hospital or once they are discharged. Pinktober aim to partake in the reached over 5,000 people last Hence, we bridge that gap and work fight against breast cancer through month to raise awareness on early together with the Ministry of Health financial support and donations to detection and the services available. and Medical Services to continue cancer organisations. Throughout October, FCS had assisting by giving priority to the partnered with the Cancer Survivor’s needy patients first. Our services are Fiji Cancer Society Network who equally partakes in all for those cancer patients who are not Fiji Cancer Society is dedicated to cancer education programs. A similar able to afford to come to the clinic for “In Fiji, the Fiji Cancer Society assisting cancer patients and their initiative was also carried out with their check-up due to lack of bus/taxi/ (FCS) has been the leading organisation families, supporting survivors, the Western Support Group, who airfare, buy diapers and medications largely involved in advocacy awareness conducting cancer education conduct cancer awareness programs which are not listed under the free- and patient support for over two programmes and providing free throughout the western division. government medicine scheme. decades . cancer screening Fiji-wide. FSC Various programmes were also ” engages, educates and motivates organised in the Western Division Darisha Datt | Program Manager communities through awareness whereby the respective zone nurses Fiji Cancer Society FNUNIKUA MY FNU

he journey for patients diagnosed with cancer is both mentally and physically exhausting. The on-going treatment and anxious moments hoping for some Tgood news takes a toll on patients and their families. Children who are diagnosed with cancer are treated at the Paediatric Oncology Unit at the Colonial War Memorial Hospital (CWMH) in Suva. This is a special unit that looks after children with cancer. As you walk into the specialised unit, you will quickly realise that it is different from the rest of the wards. Each room in the unit has cartoon-themed paintings and has a television, fridge, air conditioning and private bathrooms. These are designed to keep the children in a joyful environment and to make their stay as comfortable as possible. “The Oncology Units are always very different. While we provide the treatment and care for patients, we also try to provide support to their families. Seeing children suffer saddens me always so I can only imagine what their families must be going through,” said Vashilta Nair. Nair is a registered nurse by profession who had served in the Paediatric Oncology Unit for almost three years until July 2020. She further added that paediatric oncology covers every type of cancer and no cancer behaves precisely like the other. Sharing a typical day at work in the unit, she said that it usually involved a huge array of treatment protocols on the clinical side but adding that a human touch to it all was quintessential. “Besides the treatment protocols, equipment prepping for chemotherapy, organising the monthly chemo calendars, my work involved ensuring that the patients were given the best care possible. Because they are children, we needed to pay extra attention to them. Some of them are alone and needed cheering up. It is our job to ensure the patients are kept happy.” The proud FNU alumna is very passionate about serving the paediatric oncology patients and hopes to be transferred back into that unit.

Early Life and Education As a little girl, Nair would watch the nurses in their blue and white uniforms in awe. She had great admiration for nurses and respected that work that they did in helping save people’s lives. “I believe that nurses play a huge role in health care. Their role focuses on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Because of this, I was very passionate about nursing and hoped that one day I too would be a nurse,” she shared. Nair was born and raised in Suva. Her father is an Operations Manager at a shipping company while her mother is a homemaker. After serving there for seven months, she was transferred to Paediatric Oncology Youngest of three sisters, Nair completed her primary education at Nehru Unit. Memorial Primary School and her secondary education at Mahatma Gandhi After serving in this unit for almost three years, she was transferred to Neonatal Memorial High School. ICU in July 2020. This is where she currently serves. Nair embarked on her journey to serving people in 2013 when she enrolled in the “In this unit, we provide critical care to premature and sick newborns. We also Bachelor of Nursing programme at the Fiji National University’s (FNU) College of offer support to the parents and prepare them for the neonates’ care at home when Medicine, Nursing and Health Sciences’ (CMNHS) after completing high school. discharged as well as administer medications, monitor vital signs and provide vital “I was nervous and excited at the same time. I had waited a long time for this, nutrients to newborns. and I knew I had to work very hard to achieve my goal. The three-year journey was going to be no easy feat.” Words of Wisdom She completed her programme and graduated in December 2015, making her Her advice to those intending to take up placements at the Oncology unit, one of the pioneers of the Bachelor of Nursing programme at FNU. “nurses touch people’s lives in many ways.” “They usually spend more time with the Oncology patient than the patient’s Nair’s Nursing Career physician or any other professional caregiver and can develop a very intimate Nair started her internship in April 2016 at CWMH. During the one-year bond with their patients.” internship, she rotated in all wards; medical, surgical, obstetrics and paediatrics. “Patients and families will remember their nurses for the care they provide In April 2017, she became a Registered Nurse at the Paediatric Intensive Care Unit during a challenging time of the patients’ life.” (PICU). “You must ensure that you provide the best care possible and make the patients’ “In PICU, we had kids who needed critical care and life support because they as well as their families’ journeys through this difficult phase as easy as possible.” were acutely ill or injured.”

The Fiji National University’s Nikua is a monthly newsletter which aims to promote the University’s activities to the wider community. This newsletter is produced by the University Marketing and Communications team. Published in partnership with For views or comments please email [email protected] or contact 3394000.

Publisher: Fiji National University | Editor: Ranbeer Singh | Design & Layout: Tomasi Korovou | Division Head: Director Marketing and Communications Jenies Mudiliar Writers: Kalpana Kaajal, Shireen Lata, Charlene Lanyon, Saleshni Chaudhary, Sharon Chand | Contributors: Dr William May, Dr Odille Chang, Dr Sajneel Prasad, Darisha Datt

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