System is already struggling – CWM Hospital doctor

The growing drugs and HIV crisis in Fiji is placing severe pressure on the Emergency Department at the CWM Hospital, with overcrowding, limited resources and increasing numbers of critically ill patients stretching the health system.

This was highlighted by CWM Emergency Department Registrar Dr Shiva Shankar while speaking during the Fiji Medical Association Mini Conference.

He says the first step to solving the crisis is recognising that the current health system is already under pressure.

He revealed that the CWM Emergency Department, which serves about 360,000 people in the Central Division, has only 15 bed spaces but operates at around 146 percent bed occupancy on any given week.

Dr Shankar says the department is constantly dealing with overcrowding, bed shortages, limited medical supplies and staff shortages while also managing rising numbers of HIV and drug-related cases.

He shared findings from a study carried out at the CWM emergency department, which identified 137 new HIV and AIDS cases over an 18-month period, with a 34 percent increase recorded during the final six months of the study.

He says most of the patients diagnosed were males between the ages of 20 and 49 who arrived at the hospital critically ill after delaying treatment.

Dr Shankar says patients often present with symptoms such as fever, chronic cough, weight loss and body aches, making HIV difficult to identify early.

He added that many patients also suffer from serious complications linked to intravenous drug use, including brain abscesses, tuberculosis, bloodstream infections and severe skin infections.

He says these patients often require lengthy hospital admissions, ventilators, surgeries and care from multiple specialist teams, placing additional strain on already limited healthcare resources.

Dr Shankar also raised concerns about increasing violence linked to drug use, saying emergency staff are regularly dealing with serious trauma and stabbing cases.

He stressed that temporary solutions will not solve the crisis and called for long-term investment, stronger healthcare infrastructure and greater political, financial and social commitment to address the growing burden of drugs and HIV in Fiji.

Dr Shankar says Fiji must now focus on sustainable solutions before the healthcare system becomes overwhelmed further.