Paradise lost, paradise found. A tale of health in the South and North Pacific
Traditional village life still exists somewhere in the world – Anetytum, Vanuatu
I’ve been lucky enough to contract to the World Health Organization in the South and North Pacific to take on work in the daunting area of non-communicable disease (NCD) prevention (obesity, diabetes, heart disease, etc). It’s been a privilege, but a task which has no easy solution. Here’s a tale of paradise and paradise lost. The two extremes of what I’ve seen in the Pacific.
The happiest place in the world?
Aneityum is a small island in Southern Vanuatu. It has several villages, each with its own chief and leadership structure. There are no roads, no cars and no electricity. Almost all of the food is grown locally or caught in the sea. There is a growing, but very small, local tourism operation; some cruise ships stop by for a visit, but they are confined to a smaller island, which the locals have given the tourist-friendly name of Mystery Island. So their sole income is from a small amount of tourism. Money is really only needed for education purposes, i.e. for children going to high school on Tanna, the biggest nearby island. There are both English and French schools on the island. Money is also needed for a small amount of clothing. Everyone has moved on from grass skirts and the like and wears Western-style shorts and T-shirts. One of the first things I saw when I arrived was an All Blacks hat. I’m not sure the guy who was wearing it had heard of the All Blacks, though!
The staple diet on Aneityum comprises fruits, vegetables, water, fish, coconut everything and an occasional small amount of imported rice. In terms of exercise, their system of community subsistence agriculture keeps them active all day. We walked four hours to the next village and back in a single day. Here, this is normal activity.
Do they suffer from lifestyle diseases? Very, very little! They’re primarily concerned with other health care, though they are pretty well organised with this, with a dispensary led by a local who is trained in nursing and other aspects of practical health care.
This is paradise found. Real food, real people, and real happiness. These are the happiest people I have ever met. Do they have problems? Yes, of course. Are they healthy specimens? Pretty much. Do they feel they are missing out on something in life? Absolutely not. Would they eat takeaways and sugary drinks if they could get their hands on them? You bet.
Do these people get diabetes easily when exposed to the industrial food diet? Yes, Port Villa, Vanuatu’s capital, is just starting to see the rise of the pandemic there. I just hope and pray that these guys stay as they are.
Happy, healthy kids. Two French speaking little boys give us the thumbs up!
A catch of flying fish and sea salmon. Just paddle your canoe out at night. Put your lantern on and the fish all leap into the boat. When it’s full, paddle in. Simple as that!
Time bomb: Kiribati
The sad state of Kiribati. Under-nourished kids play on the rubbish in front of a polluted lagoon. Underweight kids and obese adults with diabetes. If it’s calories in/calories out then are the adults too greedy and eating all the food? I don’t think so. This is why “the experts” need to travel and see this stuff for themselves.
Tarawa is the main island in the Republic of Kiribati (formerly the Gilbert Islands). It is right on the equator, about three hours flight north of Fiji, and is famous for the Battle of Tarawa in World War II, in which the US and Japanese smacked it out with huge losses on both sides. You can still see some of the wreckage. A coral atoll, with a maximum height above sea level of 2 m, the island may well cease to exist in a few decades because of global warming. It’s hard to grow food on a coral atoll, and local food supply is a massive issue for the 42,000 people who live on Tarawa, which measures just 40 km long and 300 m wide. Fishing is good (offshore at least), although the influx of foreign aid has meant that a lot of people no longer fish. In any case, the main lagoon is polluted to the extent that there is no inshore fishing or swimming possible.
This is pretty much the opposite of Southern Vanuatu. Staple foods are cheap imported products such as soft drinks, white rice, flour, sugar, tinned fish and instant noodles. We saw diabetes running at 60 per cent, the highest I have ever heard of. Out of hundreds of people that I measured, I think only one or two were not obese. There is a road that runs the length of the island and everyone rides in a car or minibus. Habitual walking and manual work have decreased.
The net result in Tarawa is paradise lost. Rubbish everywhere, NCDs out of control, with no solutions in sight. I measured the blood-sugar levels of everyone in my local health team. They all had diabetes. Fasting blood glucose was over 10 mmol/L for everyone. Remember normal is under 5.
The physiotherapy department at the hospital only deals with amputees from diabetes complications. That’s running between 5 and 15 a month.
Two islands in the beautiful Pacific. One on real food and a traditional lifestyle, the other on the cheapest energy available: processed carbohydrates. If you ever wanted evidence that processed carbohydrates damage humans, you should go to Kiribati and have a look for yourself.
Here we have the perverse and real situation that there are obese adults and undernourished kids in the same family. That’s what you get on a high simple carb diet. Its wrong and it’s not the fault of these guys. what do you think is happening here? Are the parents eating all the food and starving the kids? Of course not. It’s metabolic dysfunction from the carbs running riot.
I wrote this post because it was a turning point for me in understanding that it was nothing to do with calories in and calories out. It is metabolic and hormonal control. It’s fairly clear to me.
More pictures to give you a flavour of what we saw in the “Happiest place in the world”. The only dodgy thing in these places are the toilets, especially at night.
Sunset on Aniwa in Southern Vanuatu
The island’s health committee shows off their health monitoring techniques
Sunday village lunch after church at Futuna Island. Health checks conducted after service but before lunch. Real food is all you can get here!
I wanted to have a caption saying “Grant Schofield picking up a chick!”
No caption needed
A day’s physical activity on the island
Where else in the world can you walk up to the edge of an active volcano and breathe in poisonous gases. dodge flying lava, and all this with no health and safety regulations?! Tana Island
This was, no kidding, someone’s carry on baggage on a local flight! You slip your fingers under the gills to hold it as you walk on.
Lean, strong, and healthy in Vanuatu