Finau S A
Pacific Basin Medical Officer Training Program, Pohnpei, Federated States of Micronesia.
P N G Med J. 1993 Dec;36(4):324-36.
Development in the Pacific has largely ignored the importance of health as a pathway and an outcome. This paper reviews the effects of development on health and health services in the region. It aims to highlight the plight of development that happens without considering the sociocultural and physical environments of the small island countries. The review shows that health and social conditions in the Pacific are deteriorating. The process of development has been externally controlled without community participation. Pacific leaders have been preoccupied with economic development and have not been cognisant of health and social consequences. During progress an enjoyable life can be achieved through sustainable development with community participation. However, indicators of economic growth in the Pacific do not correlate with those of health. The increase of rape, suicide, drug abuse, sexual promiscuity and crime suggests that Pacific islanders are increasingly disillusioned by the present developmental approach: they have ceased to enjoy life before death. It is suggested that decentralized development planning with community involvement, integrating health and social considerations, would be the way out of this dilemma.
太平洋地区的发展在很大程度上忽视了健康作为一种途径和成果的重要性。本文回顾了发展对该地区健康及卫生服务的影响。其目的是突出在不考虑小岛屿国家社会文化和自然环境的情况下进行发展所面临的困境。该综述表明，太平洋地区的健康和社会状况正在恶化。发展进程一直由外部控制，缺乏社区参与。太平洋地区的领导人一直专注于经济发展，并未认识到其对健康和社会的影响。在发展过程中，通过社区参与的可持续发展可以实现美好的生活。然而，太平洋地区的经济增长指标与健康指标并不相关。强奸、自杀、药物滥用、性乱交和犯罪率的上升表明，太平洋岛民对当前的发展方式越来越失望：他们在死亡之前就已不再享受生活。建议通过社区参与进行分散式发展规划，将健康和社会因素纳入其中，这将是摆脱这一困境的出路。
