At the Maternity Ward of the Tungaru Central Hospital on Tarawa, in Kiribati, patients, health workers and nurses mingle freely with day-old babies the centre of attention; the older women fussing over them during visiting hours.
In the midst of these activities, staff nurse Makite Etekiera quietly goes about her work, the relative tranquility she's enjoying is abruptly cut short by a group of midwives conducting an emergency obstetric and neonatal care (EmONC) needs assessment survey.
Makite responds to their questions, based on two years of being stationed at the obstetric ward; she has 13 years of nursing under her belt and is also a midwifery graduate from the Kiribati Nursing School. That was a month ago when a United Nations Population Fund (UNFPA) team was in Kiribati for a training of midwives to conduct a national survey; the group has now started going out to the islands conducting a comprehensive EmONC survey.
This week however, Makite is with another seven nurses from the region for the annual Sexual and Reproductive Health Management Training Programme (SRHMTP), a four-month study stint at the Fiji National University's College of Medicine, Nursing and Health Sciences in Tamavua.
While the countries' ministries of health select participants, it is the individuals who decide whether they will do it or not - leaving their families and for most of them, their children, in order to up-skill themselves.
"I came here to study sexual and reproductive health management in order to help my country, serve my people, especially the mothers and babies, during ante-natal and post-natal periods," Makite said.
The UNFPA has been working with governments across the region to address sexual and reproductive health-related issues (apart from other areas in gender equality and reproductive rights, the population and development dynamics and sexual and reproductive health).
The sexual and reproductive health management training that the regional nurses are participating in is one of the many activities that hopes to upskill health workers so the population can receive better health care and services. The SRHMTP adds to and complements the nurses' clinical knowledge on sexual and reproductive health issues, but more importantly, the course includes socio-economic dynamics which links the nurses' work to issues people grapple with on a daily basis.
When formally opening the beginning of the training programme, UNFPA Pacific Director and Representative a.i Dr Annette Sachs Robertson urged the participants to develop a new sense of consciousness and a renewed social conscience; Dr Annette encouraged participants to look at their roles relative to the bigger picture of healthy societies whose youth reach their full potential because unintended pregnancy for example did not terminate their studies.
"One maternal death is one maternal death too many, it has to be absolutely avoided," Dr Annette told the class of 2013. "In each of your countries, you need to do something about ensuring that there is adequate comprehensive emergency obstetric care for the women that give birth and that there are adequate reproductive health services - that is why you are here."
Dr Annette discussed the 20th anniversary and the rights enshrined in the International Conference of Population and Development (ICPD) document and the targets of its Programme of Action; she reminded students that the region presently had an unprecedented largest number of young people, comprising one fifth of the region's total population.
"In the Pacific, it is these young people that we must particularly commit to in our areas of work," Dr Annette said.
"Our vision and commitment is ground in certain core values and principles that are embedded in the ICPD Programme of Action: that every person has the right to sexual and reproductive health, every pregnancy is wanted, every birth is safe, every young person has the education and services to grow up healthy, and every young girl is treated with dignity and respect, and violence against women should and can end."
Samoa's Enesini Timoti Milikini, 26, is the only male nurse in the 14th class of the SRHMTP. Acknowledging that sexually-transmitted infections have become an issue of concern in Samoa, Milikini is looking forward to the family planning component that includes training on the utilization of certain contraceptives that most regulations in the region only allow doctor to administer.
Tonga's Ebiline Tai who is based in Vaiola Hospital (Nukualofa) gladly accepted her selection because it was "really related to what I'm doing in Tonga as a community nurse". "I work through the community and I deal with everyone especially the teenagers, the single mums, and the parents and students ... I'm looking forward to learning more," Tai said.
Cook Islands nurse Rosie Tenari who is part of the Ministry of Health outreach team staff anticipates the "extra knowledge" she would gain from the course; she is particularly concerned with health concerns of teenagers.
"Very young people are coming in for family planning but they're under the age of 16 and they may need their parents' consent; however, they are too shy to approach their parents so I think that puts me in a place where I can advocate for the patient as well and for this young people," Tenari said.
The UNFPA Pacific-supported training programme has seen 276 graduates; the course includes non-clinical units like the principles of health promotion; reproductive health commodity; health information system; epidemiology; and health management systems.
Programme Coordinator Alumita Bulicokocoko says the programme which started in 1999 addressed the the lifecycle of a woman; she believes the programme's holistic approach is what makes it a successful one.
Bulicokocoko was referring to the Fiji Ministry of Health's decision to train 34 nurses from the Western and Northern Division in 2010 and 2011, apart from this UNFPA-supported regional programme.
"We also trying to look at our attitudes as medical people especially as nurses trying to look at what do we do what can we do and where to from here ... (the students) look at their values, attitudes and they look at human rights," Bulicokocoko said.
"We think that we are training middle-level managers so that when they go back, they are also equipped with leadership qualities and management issues so that they could go back and lead, and educate and advocate and also give services to the their populations in their countries."
