Overview of Medical Rehabilitation in Natural Disasters in the Pacific Island Countries

Special Article – Disability and Rehabilitation

Phys Med Rehabil Int. 2016; 3(4): 1090.

Overview of Medical Rehabilitation in Natural Disasters in the Pacific Island Countries

Amatya B1,4* and Khan F1,2,3,4

¹Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia

²Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia

³School of Public Health and Preventive Medicine, Monash University, Victoria, Australia

4Committee for Rehabilitation Disaster Relief (CRDR), International Society of Physical and Rehabilitation Medicine (ISPRM), Geneva, Switzerland

*Corresponding author: Dr Bhasker Amatya, Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34-54 Poplar Road Parkville, Melbourne VIC 3052, Australia

Received: June 21, 2016; Accepted: July 05, 2016; Published: July 07, 2016


Pacific Island Countries (PICs) are one of the most natural disaster-prone regions in the world. Natural disasters in Pacific region are mainly due to meteorological (storm, typhoons), hydrological (flood, wet mass movement); and/or climatological (extreme temperature, drought, wildfire/bushfire) causes. This article presents a regional overview of medical rehabilitation status, and strengths and challenges for medical rehabilitation in natural disaster settings. In most PICs, rehabilitation medicine is still in infancy stage. In disaster settings, acute response and care protocols focusing on saving lives and treating acute injuries get most attention, whilst, rehabilitative needs are not prioritized in many cases. Operational/managerial factors seem to most impact rehabilitative care of disaster victims in PICs, these include: lack of systems and care protocols; limited provision of effective rehabilitation inclusive education, training and awareness-raising programs, funding issues, poor leadership, planning and communication, infrastructure, human resources, and poor institutional arrangement. Rehabilitation-inclusive disaster management plan is needed for longer-term management of disaster victims.

Keywords: Natural disaster; Rehabilitation; Pacific Island Countries; Disability; Disaster response


CRDR: Committee on Rehabilitation Disaster Relief; ESCAP: Economic and Social Commission for Asia and the Pacific; GDP: Gross Domestic Product; ISPRM: International Society of Physical and Rehabilitation Medicine; OCHA: Office for the Coordination of Humanitarian Affairs; ODA: Official Development Assistance; PICs: Pacific Island Countries; PHT: Pacific Humanitarian Team; SIDS: Small Island Developing States; ROP: Regional Office for the Pacific; SOPAC: Pacific Islands Applied Geoscience Commission; SNAP: Strategic National Action Plans; UN: United Nations; WHO: World Health Organisation.


The Pacific Island Countries (PICs) consist of 14 countries, divided into three zones: Micronesia, Melanesia and Polynesia [1]. The region has a population of about 9 million people, majority (about 80%) living in rural areas [2]. Of these, it is estimated 800,000 people have some form of disability [2]. The PICs are among the most isolated countries geographically with about 1000 islands scattered over an area across 180 million square kilometres of ocean (Figure 1) [3,4]. Further, small land areas and economies with low diversification, limited natural resources, poor infrastructure and limited capacity, paucity of human and financial resources, and significant distances to major markets have affected development and often led to a high degree of economic volatility [3,4]. The region is unique and diverse biologically, socio-economically and culturally. Papua New Guinea (PNG) is the largest among the group (population of > 6.7 million), while Niue, with an estimated population of 1000 being a smallest member. Amongst the PICs, Kiribati is one of the most remote and geographically-dispersed countries in the world, with 33 coral atolls spread over 3.5 million km2 of ocean (area larger than India), while Solomon Islands is scattered with almost 1,000 small islands and atolls [5]. Depending on their specific social, economic and environmental vulnerabilities, the United Nations (UN) have categorised all PICs as small island developing states (SIDS). In most PICs, agriculture and fisheries are the primary source of income. Many countries are heavily dependent on overseas support, with half receiving Official Development Assistance (ODA) exceeding 30% of their Gross Domestic Product (GDP) [5]. Five PICs (Kiribati, Samoa, Solomon Islands, Tuvalu and Vanuatu) are categorised amongst the UN’s least developed countries, reflecting low incomes, weak human assets (nutrition, health, education) and economic vulnerability (Table 1) [5].