In Abaiang, where the sea advances and resources are scarce, a woman is the main health reference for 6,000 people. Batiua is medical assistant, translator, counselor and caregiver. It faces the effects of the climate crisis every day, malnutrition and the scarcity of health care. Since 2024, Batiua has been supported by Médicos Without Borders teams.
Life in is deeply marked by the remote location, a high incidence of diseases and the aggravation of the effects of in this Pacific archipelago. The country’s health system is under immense pressure. And with the scarcity of health professionals, Kiribati depends on the capable and dedicated people within the community to provide care to those who live in the farthest islands.
In the heart of Abaiang Island, a 37 -kilometer -long dirt tongue and only 90 meters wide, Batiua has been the only medical assistant during the last six years to serve a 6,000 -person community with limited resources. Medical assistants are nursing staff with additional training on medical pathologies and forms of treatment, and may treat patients with the support of clinical professionals.
Along with medical staff , Batiua provides essential health care, with which it helps face problems such as malnutrition, infectious diseases and complications in pregnancy.
Patients greet Batiua as they reach the small cement structure of a single floor, surrounded by coconut trees, which acts as a primary health center in Abaiang. There, Batiua begins the morning by examining the first patient of the day and translates what is said, in the local language, the I-Kiribati, to the MSF doctor in English. It is the main point of reference for all patients, while the doctor provides him with support in the diagnosis and in the treatment planin addition to providing guidance on care to provide patients.
Nurses and medical assistants working for the Ministry of Health and Medical Services provide very valuable community care integrated in the Kiribati Health System, perform A vital role in the villages where they live, where there is not enough personnel and at the same time there is a high incidence of disease.
MSF medical teams have been supporting, since 2024, to nursing staff of the Ministry of Health and Medical Services in Abaiang.
“We focus here on our energies because there is a high incidence of maternal care from the farthest islands to the Central Hospital Tunagewhich is located on the main island of Tarawa ”, explains the medical coordinator of MSF KieraSargeant.
“We have identified that there is a need to support medical assistants and nurses through the establishment of a community -based care model,” he continues. This means that women can thus receive health care closer where they reside.
In 2024 alone, MSF teams traced up diseases not transmitted to 888 women in Abaiang. A room of them had Diabetes and almost 20 percent had hypertension disturbances in pregnancy. More than 60 percent showed signs of obesity.
And among the 514 tracked children, nine percent had recently suffered from diarrhea – which demonstrates the current challenges related to water and sanitation access.
High incidence of disease in kiribati
Of the five patients waiting for time that morning to be treated by Batiumthree were pregnant and two were children accompanied by the mothers.
Arrival the turn to meet Giannaten months, the mother, RuitiiAGACHA-SEE TO THE BABY SIDE. Batium INFORMA-A: “Our doctor says that the sound of her chest is better than yesterday, an improvement in relation to when it arrived the day before.”
Ruitii He nods and smiles. “My baby, Giannahad a very high fever, difficulty breathing and was not eating well. The MSF doctor and the medical assistant asked me to be admitted immediately. I was very worried. Now my baby is much better, it has started to eat. ”
The impacts of climate change make children and adults more susceptible to contracting communicable and noncommunicable diseases.
Disturbances in food systems aggravate Risks of poor nutrition, which can lead to overweight and obesity, increasing the danger of noncommunicable diseases, including pregnancy -induced hypertension and gestational diabetes. This is partly due to the excessive dependence of the population in food kiribati hyperprocessed And the lack of arable land that results from erosion and the high salinity of soils and water.
More than 15 percent of children under 5 in the country have atrophy; 3.5% of children with less than 5 Years are affected by cakexia (syndrome characterized by significant weight loss and muscle mass, often resulting from debilitating disease or chronic disease). AND 90% of children live in food povertywith access very limited to a diverse and nutritious diet.
Being malnourished, children become more susceptible to contracting infeciosas and other diseases. “Children are more affected because [a desnutrição] has direct impacts on development ”stresses Batium.
Increasingly sharp preference for people for imported and processed foods and the reduced ability to produce food locally are some of the factors which contribute to malnutrition and many of the non -transmissible diseases in Kiribati. In addition, extreme weather conditions and sea level climbing, related to climate change, threaten agricultural production and subsistence means.
“It’s a huge relief to the island when we have a doctor”
Climate change substantially affect mothers and children. Most patients in clinics on the remote island of Abaiang They are women.
Kiribati has one of the highest disease incidences in the Pacific region and, at the same time, one of the lowest rates of primary health care – which aggravates the vulnerability of pregnant women and children. MSF teams are helping women to have safer pregnancies through the work developed with local health workers to help them diagnose and treat diabetes and hypertension in pregnant women.
Cases, including those of high risk pregnancies, which cannot be assisted at the level of primary health care, are referred to the Central Hospital Tunagein the capital, Tarawa, on a trip of two to four hours per boat, or by plane (with flights once twice a week).
“Carrying patients in critical condition is always a big challenge,” says nurse Diana, who works at the clinic Takaranoin the north of the island of Abaiang. A single nursing professional or medical assistant is responsible for each clinic. “It’s a huge relief to the island when we have a doctor like Dr. Joseph, since he has more medical knowledge,” note Batium With a smile.
For Kiribati people, the climate crisis is a daily threat to health. The climb of sea level contaminates drinking water, increasing the diseases diarrhealand extreme climate events disturb food supply, aggravating malnutrition. Warmer temperatures facilitate diseases transmitted by mosquitoes such as dengue, and stress Thermal has impacts on people with heart disease and diabetes, as well as pregnant women.
All of these challenges, combined with limited access to health care, create an aggravated cycle of precarious health and vulnerability.
Improve access to drinking water
Accessing clean and secure water is a daily challenge for people in Kiribati. Drinking water mainly comes from underground groundwater that are contaminated with seawater, garbage and other waste. This limited access to a drinking water supply in primary health care puts a significant challenge, affecting both the care provided to patients and the sanitation conditions in the clinics. Without running water on the island, health clinics depend on the water of rain or water brought from nearby houses.
The Ministry of Health and Medical Services of Kiribati is working efforts to ensure water supply to the population. MSF has also been working with the ministry to test water quality in the island’s water table and analyze how it correlates with health conditions such as hypertension or diarrhea in pregnancy.
“We are also working on the geographical mapping of the various water wells, so that the community has more information about water quality in each well, and can make healthier choices on where to get water,” MSF medical coordinator needs, needs KieraSargeant.
The main freshwater sources are aquifer lenticular or the collection of rainwater. Groundwater wells may have seawater or be contaminated by bacteria.
The logistics of the remote islands
Kiribati faces unique geographical challenges that have impact on virtually all aspects From everyday life, including health care and transportation and waste management. Consisting of 33 atroes and islands of Recife, the country encompasses vast distances and limited infrastructures that make it difficult to transport essential medical supplies, have access to specialized health care and effectively managing waste.
Many of the peripheral islands depend on air or maritime media not frequent for the transport of essential supplies, and delays can lead to medicines shortages and limited access to health care. At the same time, the lack of a suitable structure for the elimination of waste implies environmental and health risks, with medical waste to accumulate many times under insecure conditions.
The remote location, the high incidence of diseases and the increasingly severe effects of climate change continue to exert enormous pressure on the Kiribati health system. More and more people face aggravated health challenges, including malnutrition, noncommunicable diseases and very limited access to clean water – so access to continuous medical support is critical.
MSF’s partnership with the Kiribati Ministry of Health and Medical Services aims to provide medical care, strengthen pharmaceutical management and improve sanitation efforts. Working with medical professionals at all levels, from the base to the tertiary, has been one of the pillars of this collaboration.
Nursing professionals and assistant doctors such as Batium They say they feel joy to help people. “My mission in life is to eradicate malnutrition in Abaiangespecially in children under 5 ”he says.
