The 2010 Global Burden of Disease study found skin conditions were the fourth leading cause of non-fatal disease burden. There are high rates of illness and death associated with skin disease in Fiji and across the Pacific islands but only four dermatologists live and work in the region. Pacific Dermatology has identified this as a critical health problem for the Pacific people, so aims to increase the number of specialist dermatologists, as well as provide training for general practitioners and nurses.

Specialised medical care and training is recognised as a health priority by the Fiji and other Pacific Ministries of Health. The need for specialist training has also been highlighted as a priority by Australian aid evaluation report “Strengthening specialised clinical services in the Pacific” published by the Australian Department of Foreign Affairs and Trade. However, dermatology training has not yet been included in an Australian Aid programme.

Fiji established a skin clinic in the PJ Twomey Hospital, Tamavua, Suva in 1977. The service has grown to seeing almost 500 patients weekly, at three morning clinics. Data collected at the clinics reveal high rates of illness in populations at increased risk such as children, the elderly and people with non-communicable diseases such as diabetes.

Since support has been provided by Pacific Dermatology Ltd, the Centre’s patient reach has grown from treating 800 patients per month in 2018 to more than 2,000 per month in 2024.

Developing post-graduate training in Dermatology meets two objectives of the 2015 Yanuca Island Declaration detailing decisions and agreements made by Pacific Ministers of Health: children are nurtured in body and mind, and people work and age with dignity. Post-graduate Dermatology training also addresses the United Nation’s Sustainable Development Goal 3: good health and wellbeing, and the World Health Organisation’s plans for addressing neglected tropical diseases including leprosy, filariasis and scabies.

On 8th February 2019, the Pacific Dermatology Training Centre was formally opened, beginning the journey towards the vision imagined by Dr Margot Whitfeld – access to specialised skin health care for all Pacific people wherever they live. The first four Diploma students graduated in 2019. Read about Dr Va‘a-Fuimaono returning to Samoa to start the first skin clinic there. The first Masters of Medicine in Dermatology students will graduate in 2024.

Our key goal is to train and graduate more doctors who are skin specialists, ultimately also supported by trained allied health specialists and nurses. However, we also aim to develop a more sustainable infrastructure for skin health in the Pacific. Examples of three future goals are:

• Building of a larger, well-equipped Pacific Dermatology Training Centre and patient facilities at Tamavua Twomey Hospital, Suva. This would enable expansion of the education program and better quality medical care for patients with skin disease, as well as facilities for improved pathology services, specimen evaluation,  and laboratory services.
• Development of a Master of Medicine in Pathology including a dermatopathology education program, incorporating scholarships for Pacific doctors. Dermatopathologists examine skin tissue samples and can then diagnose, for example, disorders of the immune system, infectious diseases, degenerative diseases, cancers and more.
• Development of laboratory services for dermatology, in particular, specialty fungal dermatology for identification and culture. Fungal infections of skin, hair and nail are estimated to affect one to two billion people worldwide; serious fungal infections affect 150 million people. Death from serious fungal infections is estimated to be similar to the number of deaths from tuberculosis.