Siaosi(George) Aho
Tonga is asmall island Kingdom in the South Pacific. It has apopulation of 10,000. About 40% of its population is under 15 yrs of age. Vaiola, the main hospital of 202 beds is in the main island of Tongatapu which serves 65% of total populatiopn. In this hospital there are 32 beds in the children's ward plus aspecial care nursery which can house 8 sick neonates. There are some 1500 deliveries per year in the main hospital which is neary60% of all the diliveries for the country. 90% of all deliveries is done at Ministry of Health facilities and the rest is at home where they are mostly delivered by traditional birth attendants.Threw are three smaller hospitals in outer islands-Vava'II,Ha'apai and Eua.
Total admission to Children's ward for 1995 was 1494 and 1039 of which were medical admissions. 58% of medical admissions were for respiratory conditions which were mainly pneumonia. Gastrointestinal conditions was next at 20% and these were primarily due to gastroenteritis. The third common conditions needing admission to hospital were that related to Central Nervous System. These were mostly frebrile convulsion plus afew cases of bacterial meningitis.
There is only one trained paediatrician for the country plus a junior colleague who together runs the Paediatric services for the main hospital which is also the referral hospital. Case fatality rate for our Children's Ward for 1995 was 1.1% and perinatal mortality rale was 17/1000. Of the 17 deaths that occurred in Children's ward 60% were in infants and 50% died of septicaemia within 2-5 hours of arriving in the ward. Two died because of TGA and VSD at least and one from biliary atresia Infant Mortality rate for the country was 22/1000.Life expectancy is 68 years.
Doctor population ratio for Tonga is 1/3000. In 1995 11.9% of the National budget goes to health expenditure. Immunization coverage for the six EPI target discases was 89.7% for the country in 1995.
