In the Solomon Islands' capital of Honiara, there's a wry joke about its main hospital. The colloquial pidgin expression "numba wan" translates as "the best", while Central Hospital's local name is Number Nine.
Rust and water stains creep across the network of covered walkways and lattice brickwork, while disused equipment stands incongruously outside wards in the tropical sun. In the gynaecology ward, a handwritten sign marks the ultrasound scanning room, supported by a New Zealand-registered charity, the Pacific Society for Reproductive Health (PSRH).
A relic of the US-led Pacific campaign of the 1940s, Number Nine is the largest hospital in the country. Today, signs of a more benign occupation are everywhere; dozens of aid agencies cluster on Honiara's streets, from Oxfam to UNIFEM, all working for one purpose - to help the country move forward as an independent nation.
In global terms, the archipelago is one of our closest neighbours, but its health system falls far below international standards, as do many other aspects of its development.
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In 1999, tensions between the Polynesian and Melanesian populations erupted into internal conflict, which settled down when the Regional Assistance Mission to Solomon Islands (RAMSI) arrived. This included police and troops from Australia, New Zealand and other Pacific countries, which nine years on are still in place, acting as the Solomon's primary security force and supporting many other parts of its infrastructure, including health services.
Number Nine's new clinic, donated by the Taiwanese government, inspires scepticism in Element's guide; New Zealand nurse and volunteer Beverly Herbert. The islands are rich in minerals and gold, and fishing rights are
up for grabs. As in many developing nations, it's a situation that could easily be exploited. ?In the post-natal ward, on the other hand, the chart assigning beds is full. Pregnancy rates are rising, and in this impoverished country with a 98.5% paid-up churchgoing population, the Catholic Church still publicly frowns on contraception. Abortion is illegal. It's not unusual for a woman to give birth to eight or ten children, with obvious follow-on effects for her and the wider community.
At Honiara's Planned Parenthood Association - the country's only family-planning service and one of the few places condoms are freely available - director Dr. Michael Salini reports much of his staff's time is spent counselling women who come in asking for abortions, and again when they return after a botched backwoods abortion. ?Sixty seven percent of women give birth while still in their teens, and a whopping 59% of the population is now under 25 years of age. There's a steady battle going on to educate this youthful demographic, not only at school but in terms of sexual and reproductive health.
As a result, much of the work done by foreign aid agencies here focuses on the startlingly low status of the childbearing half of the population. In a recent Amnesty International report, director Michael Holmes described the issue of violence against women as "a human rights issue of epic proportions". Almost all (96%) women report problems in accessing healthcare, according to the latest Demographic Health Survey.
The UN Development Programme (UNDP), led by former Prime Minister Helen Clark also puts universal education, gender equality, and sexual and reproductive health at the centre of its Millennium Development Goals. This is not a niche issue, but the principle issue for the Solomons' social and economic stability, and over the long term, sustainable development.