Cook Islands Women Health Information

Namita Nayyar (WF Team)

13 years ago

Cook Islands Women Health Information

– Reported, April 04, 2012

The Cook Islands is a country of 15 widely dispersed small islands in the South Pacific Ocean. The population of around 18,000 people is mostly Cook Island Maori, Polynesian people indigenous to this part of the world. Just over two-thirds of the population live on Rarotonga, where Avarua, the capital and only urban centre is located. The land area of the Cook Islands is only 240 square kilometres, spread over almost 2 million square kilometres of sea. The distance between the islands is therefore very large, both in miles and the cost and other difficulties of travel that these miles translate into. It costs more to fly from Rarotonga to the Northern group, for example, than to New Zealand.
Despite the wide distance between them, and the inevitable disadvantages of isolation, all of the islands have a good standard of development. The islands of the Northern Group are most isolated by the cost of air transport and time of sea transport, and have relatively poorer access to health and
education services. The islands of the Southern Group are less dispersed and have more regular transport to Rarotonga.

Although the range of health services is narrower in small, remote communities, the entire population has access to government-funded primary health care services, including pre-natal and post-natal care. (There is a small and growing private sector-run health service, mainly on Rarotonga.)

For several reasons the good control of infectious diseases, the ageing population, changing diets and less physical activity there has been a rise in illness and death rates from non-communicable diseases, especially heart disease and diabetes. This type of disease is relatively expensive for health services and families to deal with. For example, the number of people with diabetes is quickly growing (figure 8). If uncontrolled, diabetes can lead to disabilities, even amputations, in adults.
Because of the changing cost and availability of different types of food, people now eat more imported foods high in fat and sugar, rather than their traditional staples. Cook Islanders also have high consumption of alcohol and tobacco. Although sports are popular, the level of physical activity has dropped. People nowadays are more likely to move about by car or motor-scooter than on foot. Motor vehicle accidents are a major cause of injury and death at all ages. Overall, however, the health status of Cook Island people, especially children, is good compared to other people in other Pacific Island countries where infectious illnesses are less well controlled.

Until recent years, the domain of Cook Islands women was mainly the household. Most family and community decisions were made by men, and it was considered culturally correct and proper behaviour for women to be passive enactors of these decisions (Kingston, 1999). Until recently, men generally
fared better than women in their access to higher education, paid employment, and access to credit and other productive resources, although women do not lag far behind. The attitudes and aspirations of women on the outer islands, however, are mostly more conservative than on Rarotonga (Kingston,
1999).
Both men and women in Cook Islands have high life expectancy, at 74.3 years for women and 68 years for men. Girls and boys have similar school enrolment, and almost equal proportions of women and men have had some secondary education. Beyond school, however, the gender gap widens. Almost
twice as many men have had tertiary education than women and more are in technical fields. The
gender gap is widest in employment.
In Cook Island tradition, women have equality with men in that they have more or less equal inheritance of land and rights of land use. The principle of no discrimination by sex is also enshrined in the Constitution and in family law. There is no legislation, however, that explicitly prevents discrimination
against women, such as any provision against gender discrimination in job advertisements or legislation or policies that prohibit sexual harassment at work. Nor are there positive discrimination initiatives in place to promote equality between men and women.

Another survey found that a very high proportion (75 per cent) of young people regularly smoke, including 71 per cent of young women in Rarotonga. Of those who smoke, 31 per cent said started between ages of 13 and 14, but around one quarter (26 per cent) began before the age of 11. Marijuana is also smoked by
young people. Although there is very little other information about illegal drug use, health and youth workers believe there is very little if any use of drugs other than marijuana.

Teenage pregnancy continues to be a major concern, although statistics have shown a gradual decline in numbers since 1998. The Cook Islands still has the highest teenage (ie 15-19 year-olds) fertility rate in the Pacific island region, of 47/1000 (SPC, 2004). The small decline may be due to health awareness and sex education programmes, but many young people are still evidently involved in unprotected sex. As well as the risk of unplanned pregnancy, this brings the risk of sexually transmitted infections (STI), including HIV and AIDS. Fortunately, as yet there have been no reported cases of HIV/AIDS in the Cook Islands, and the reported incidence of STI is low.

The mental health of young people is another concern. The youth suicide rate is moderately high. Are PaTaunga, the Cook Islands Mental Health and Well-Being Centre, was established in 1998 and provides services free of charge. Ministry of Health makes a contribution to salaries and operating costs. The
Ministry of Health, Police, Probation Services, Social Welfare and Prison Services refer people needing assistance with mental problems to the Centre. There are no similar facilities for people in outer islands.

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