Tag: nutrition

• The Paradox of Paradise

  Look at the coastline in the screenshot below and you see the Pasifika we sell to the world: pristine waters, vibrant cultures and tranquil island life. Yet beneath this postcard image, lies a troubling reality. Life expectancy gains across our Pasifika is uneven, with Naoero falling furthest behind.

  Naoero’s decline is particularly sobering. In 1960, it had the third-highest life expectancy in the Pasifika. Today, it has the lowest. Its experience warns of how environmental destruction, economic vulnerability and a devastating NCD crisis can converge to undermine a nation’s wellbeing.

  But this is not simply Naoero’s story. The more important question for Fiji is whether we are heading in the same direction.

  The evidence warrants concern. The Devpolicy analysis identifies Fiji, the Marshall Islands and FSM among Pasifika countries, where life expectancy have fallen behind the regional average since 1960. While average life expectancy across the Pasifika increased by approximately 16 years over that period, similar income countries globally, gained around 23 years.

  The implications are that our people are living longer but our progress has not kept pace with the rest of the world.

  The Price of Paradise

  Our geographical isolation, small economies and exposure to external shocks create structural disadvantages. But geography alone cannot explain the growing health burden confronting us.

  The NCD crisis is one of our greatest challenges. As traditional diets and physically active lifestyles give way to processed foods, sugary drinks and increasingly sedentary living, diabetes, heart disease and hypertension are taking a heavy toll.

  Naoero represents an extreme case, with diabetes affecting more than one in five adults. Fiji faces its own serious burden of diabetes and other preventable chronic diseases.

  These are not merely medical problems. They reflect the environments in which we live, the food we can afford, the quality of primary healthcare and the effectiveness of public policy.

  We cannot continue celebrating the natural beauty of our islands while overlooking the deteriorating health of our people.

  For many, access to medical care is constrained by the absence of medical insurance. Remittances from our diaspora help sustain us and traveling overseas for specialist treatment can be lifesaving. But this option remains beyond the reach of many. Access to quality healthcare should not depend on whether someone has relatives abroad who can help pay the bills.

  We must therefore build a healthcare system that serves us at home, regardless of income or circumstances.

  That requires us to confront another uncomfortable reality: the treatment and working conditions of healthcare professionals. When skilled doctors, nurses and other health workers leave for better opportunities overseas, the loss is not simply a matter of staffing numbers. It weakens the capacity of hospitals, clinics and communities to deliver essential care. Those who remain; particularly in rural and maritime areas, can face heavier workloads, longer waiting times and reduced access to services.

  Retaining our healthcare workforce requires more than appeals to patriotism or professional duty. It demands fair remuneration, supportive working conditions, adequate resources and opportunities for career development. We cannot expect our health system to thrive while those responsible for sustaining it feel compelled to leave.

  Our objective must be clear: to enable Fijians to live healthier, longer and more dignified lives in Fiji.

  A Warning, Not a Destiny

  Fiji is not Naoero. Our population, economic structure, resources and institutions differ considerably. 

  Nevertheless, Naoero offers an important warning about what can happen when environmental damage, economic vulnerability and public health failures, reinforce one another over generations.

  Fiji must respond before preventable illness becomes an even greater constraint on national development.

  That means treating NCDs as a national emergency, strengthening primary healthcare, improving access to affordable, nutritious food, encouraging physical activity and investing in early detection and long-term disease management. It also means confronting the social determinants of health: poverty, inequality, food insecurity and education.

  Responsibility cannot rest solely with individuals. Personal choices matter, but they are shaped by household incomes, food prices, urban planning, commercial interests and access to healthcare. Government, communities, schools, churches, businesses and families all have a role to play.

  Ultimately, the measure of development cannot be confined to economic growth, tourism arrivals or the beauty of our coastlines. It must also include whether we can expect to live longer, healthier and more dignified lives.

  Paradise is not simply a place admired by visitors. It must also be a place where its people can thrive.

  Naoero’s experience is therefore more than a distant Pasifika tragedy. It offers a reflection for Fiji and our neighbours. We may share the same ocean and many of the same vulnerabilities, but our future is not pre-determined.

  The question is whether we recognise the warning in time to change course.

  2026.09.29

• Beyond the Burger: Confronting Fast Food and Health Literacy in Fiji

  A golden anniversary came with a golden arch. This past Monday, McDonald’s Fiji marked three decades of operation—training thousands, partnering with local suppliers like Rooster Poultry, and celebrating the “backbone” of its business: its people. Yet as we applaud this corporate milestone, a less celebratory statistic stalks Fiji. Non‑communicable diseases (NCDs)—diabetes, heart disease, hypertension, stroke—are our leading killers. To ignore the link between the rise of fast food chains and NCDs, is something that can no longer be ignored.

  Years ago, while residing in New York City, I tasted McDonald’s meals in midtown, in upstate New York state to stops along the I‑95 highway. And I observed. Mostly Black folks. Mostly families. Mostly obese. Not scientific—just my personal observation. But the image stuck. When I finally returned home, I saw how popular “Maccas” had become. I took my own grandchildren to various outlets, not once but on occasions. And I observed again. Not obesity this time—at least not yet. But then I started reading in the media about the slow creep of NCDs: the tiredness, the weight gain, the family members lost to diabetic complications.

  And let me be clear: this is voicing concerns about the rising fast‑food chains and outlets that have multiplied across our islands, selling the same calorie‑dense, nutrient‑poor meals.

  A thoughtful commentator recently pushed back. He asked: “Is Fiji’s obesity rate really ‘a consequence’ of McDonald’s as you assert? Was May 1996 really the major inflection point?” He pointed to Tonga—no McDonald’s, yet obesity rates are as high as ours. And to China, where McDonald’s is ubiquitous, yet obesity rates are a fraction of Fiji’s. He then defended the chain for its consistency: a black Americano tastes the same in York in the UK, Hong Kong, and even in Suva. That reliability, he argued, is a virtue.

  He has a point. But I believe he misses the larger one.

  The core business model of fast food is not about coffee or consistency. It is the mass production of what our nutritionists call “ultra‑processed foods”—items engineered to be high in salt, sugar, and unhealthy fats, yet low in fibre and essential nutrients. That “hot and spicy chicken meal” which Rooster Poultry proudly supplies, is emblematic. Whether you eat it in Nadi, Nukuʻalofa, or Changzhou, the metabolic damage is similar. So why the difference in outcomes? Because diet is a package: a Fijian who eats McDonald’s instead of ika vakalolo and dalo-ni-Samoa, will fare very differently from a Chinese person who eats McDonald’s occasionally as a treat amid a daily diet of vegetables, tea, and stir‑fried dishes. The problem is not one chain; it is the entire food environment. And in Fiji, that environment has shifted dramatically in three decades—away from fresh, local foods and toward cheap, convenient, ultra‑processed calories.

  The commentator is right that Tonga has high obesity without McDonald’s. That does not exonerate McDonald’s or fellow fast food chains; it merely shows that fast food is one driver among many. But when you add McDonald’s to an already vulnerable Pasifika population—genetically prone to insulin resistance, culturally shifting away from traditional staples—you pour fuel on a fire. China’s lower obesity rate reflects a different dietary baseline and far higher rates of physical activity in daily life. It is not a get‑out‑of‑jail‑free card for the golden arches.

  Then another thoughtful voice said: “My children eat it occasionally. They’re fit and healthy. The difference isn’t the food—it’s the choices around it, and the knowledge behind those choices. What we really need to talk about is health literacy.”

  That stopped me cold. Because she is right. A burger once a month will not kill you. A burger three times a week, washed down with sugary soda and followed by no exercise, very well might. The real crisis is not any single menu item. It is that too many Fijians do not fully understand what ultra‑processed food does to their bodies over time—or, even if they understand, they lack the resources and support to make different choices.

  She went further, and this is where the conversation must deepen. “As Fijians, we carry a cultural framework that sometimes locates illness in the unseen, in the spiritual, in forces outside ourselves. And when that’s your belief, seeking a doctor can feel almost beside the point. That’s a deep worldview. You can’t lecture people out of it. We also reach for herbal medicine, which isn’t wrong, but often without knowing what it can and can’t treat. So we use it for things that need clinical attention, and by the time we arrive at a hospital, it’s too late. And there is the fear—the very real fear of hospitals and doctors that so many of us carry. Once that fear is reinforced in childhood, it becomes natural to avoid doctors entirely until you’re knocking on death’s door.”

  How many NCD deaths in Fiji follow exactly that path? A family notices weight gain and fatigue. They try herbal remedies. Bobo. They pray. They wait. They fear the diagnosis. And by the time they walk into a health centre, the diabetes has already stolen a kidney or a foot. The fast food was a contributor, but the delay in seeking care was the finishing blow.

  So who breaks that cycle?

  The commentator answered plainly: “I think it’s the mother. She’s usually the one who notices symptoms, books appointments, decides what’s serious. She is the family’s first health system. If she’s empowered, if she’s confident in medical spaces and in her own body, that confidence spreads. It infects the whole household. It shapes how her children see doctors for the rest of their lives. Invest in her health literacy, and you don’t just help one person. You change a generation.”

  That is a powerful truth. We can argue about fast food regulation until our voices give out, but unless we also invest in grassroots health literacy—especially for mothers—we will keep burying our people.

  My point remains simpler and starker. Fast food is fast food, and it is now killing Fijians in numbers we can no longer ignore. Those who have lost relatives, watched cousins lose toes, or stood by children or grandchildren as they reach for a $9.95 burger combo instead of a fresh $15 ika vakalolo—have a responsibility to speak up. Not to ban fast food outlets overnight. But to demand that as they plan to “grow bigger and better,” they decouple their growth from the growth of our NCD wards. Health and nutrition experts who deal with these challenges will tell you that.

  That means genuine reformulation to slash sodium and saturated fats. Transparent calorie labelling. And a direct partnership with the Ministry of Health to fund community nutrition and exercise programmes. McDonald’s has proven it can train Fijians in customer service. Now can it retrain itself in public health ethics? And as the leader among fast food outlets, can it bring other chains along for a walk on the path to a healthier Fiji?

  But alongside corporate responsibility, we need a home‑grown revolution in health literacy. Let us equip our mothers with the knowledge to read a nutrition label, to recognise early symptoms of diabetes, to overcome the fear of the white coat. Let us integrate nutrition and NCD prevention into school curricula, community workshops, and church gatherings. Let us celebrate traditional foods—dalo, tavioka, fresh fish—as life‑giving heritage.

  The 30th anniversary of McDonald’s Fiji is indeed a milestone. But let us not mistake corporate longevity for societal health. A nation that cannot afford to lose its people to preventable disease cannot afford to celebrate an industry that accelerates those deaths.

  2026.05.11