In the Solomon Islands, noncommunicable diseases (NCDs), including diabetes, are becoming the leading cause of premature death, accounting for 75% of all fatalities in the Pacific Island nation. Over the past three decades, Dr. Rooney Jagilly, head of the surgery department at the National Referral Hospital (NRH), has observed a dramatic rise in these diseases, a trend he believes threatens to overwhelm the country’s healthcare system.
When Dr. Jagilly began his medical career, diabetes was a rare condition. Today, however, it has become a public health crisis, compounded by its associated complications, such as diabetic foot disease. “The surge in NCDs, especially diabetic foot disease, is leading to severe outcomes for patients, including early deaths and disabilities,” he says. As traditional diets give way to processed foods and sedentary lifestyles become more common, diabetes rates in the Solomon Islands are expected to continue their upward trajectory, further straining healthcare resources.
The Impact of Diabetes and Diabetic Foot Disease
Diabetes is a chronic illness in which the body struggles to manage blood sugar levels, leading to high glucose concentrations that damage nerves and blood vessels. When poorly controlled, diabetes can lead to severe health issues, including lower limb amputations, kidney failure, heart attacks, strokes, and blindness.
A particularly dangerous aspect of diabetes is its effect on the feet. As blood flow and nerve function deteriorate, even minor wounds can become infected. If left untreated, infections can escalate, often resulting in amputations or, in extreme cases, death. According to Dr. Jagilly, 60% of surgery ward inpatients at NRH suffer from severe diabetic foot wounds, with many seeking medical attention too late, making treatment and prevention even more challenging.
“The burden of diabetic foot disease consumes significant time, medications, and staff resources,” Dr. Jagilly adds, stressing the unsustainable nature of the current situation.
In 2023, The Lancet labeled diabetes as “a defining disease of the 21st century,” warning that the global community has underestimated the social and health impacts of the disease. The publication noted that the next two decades will be crucial in determining how diabetes is managed, predicting it will shape global health and life expectancy for the next 80 years.
A Preventable Epidemic
Despite the dire situation, experts believe that diabetes and its complications, including diabetic foot disease, are preventable with early intervention. Theresa Ferani Mateaki, a nurse and national diabetes and diabetic foot facilitator, emphasizes the importance of regular foot checks and early treatment. “By the time most patients seek help, it’s often too late,” she warns. “Simple daily foot checks can save lives and limbs.”
In response to the growing crisis, the Ministry of Health and Medical Services (MHMS), in collaboration with the World Health Organization (WHO), launched a national diabetes program in 2024. The initiative aims to improve the screening, management, and prevention of diabetes and its complications, with a target of reaching 80% of the population by 2026.
The program includes two key components: healthcare worker coaching to improve skills, knowledge, and competency, and a quality improvement strategy to enhance health facilities’ capacity to address diabetes-related challenges. Over 300 health workers have been trained, and more than 20 nurse champions, including Theresa Ferani Mateaki, are at the forefront of the movement to improve foot care and diabetes management.
“We are seeing progress,” says Theresa, noting that more patients are now taking proactive steps in caring for their feet. However, Dr. Jagilly reiterates that prevention is paramount. “Once diabetes is entrenched, it becomes much harder to manage,” he says. “But with early action, we can prevent many of the devastating consequences, including loss of life and limb.”
The WHO has expressed gratitude to the New Zealand Ministry of Foreign Affairs and Trade and the Institute of Philanthropy for their vital support in the effort to combat diabetes in the Solomon Islands.
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