Stories from the Western Pacific Region

Ageing and health is the theme of this year's World Health Day. The slogan of the day is "Good health adds life to years".

Over the past century life expectancy has increased dramatically and the world will soon have more older people than children. Older men and women can lead full and productive lives and be a resource for their families and communities.

Here are stories from the Western Pacific Region.

Malaria champion Yeang Chheang, 74

Age is no barrier to malaria field team leader Yeang Chheang. Neither is retirement an option. At 74, he brings a missionary zeal to his work in the emergency operation to contain and eliminate artemisinin-resistant malaria along the Cambodian-Thai border.

“I am happy with the work; I am happy in the village,” he says with a smile before gesturing to a mother and daughter to screen their blood for malaria in O Ro’El, a village in western Cambodia's Pailin province. One of Mr Chhean's responsibilities is to detect and treat hidden cases of malaria in such remote villages, even among people not showing signs of the disease.

Uncle Chheang, as his colleagues fondly call him, attributes his good health to working in the field. “It keeps me busy and makes my mind active. It’s like doing exercise,” he says.

Uncle Chheang miraculously survived the murderous rule of the Khmer Rouge from 1975 to 1979. Most other professionals were not so lucky. Since then, he has done his utmost to help the country overcome its knowledge deficit.

“I have taught a lot of people after the brutal Khmer Rouge occupation and passed on my medical skills,” he says.

In 1960, during the rule of Prince Norodom Sihanouk, Uncle Chheang was sent to study in the Philippines. He was then a 23-year-old entomologist technician at the Ministry of Health’s National Malaria Control Centre. Ten years later, in a tragic turn of political events, the prince's government was overthrown, and Uncle Chheang found himself forced into the army of Field Marshall Lon Nol in the civil war with the Khmer Rouge. “I was carrying guns instead of syringes,” he says, raising his hands in a shooting gesture.

Uncle Chheang's personal suffering under the Khmer Rouge was great. His wife died in 1976 at age 31. He also lost his youngest son, who was about one month old. “That period was the most difficult in my life,” he recalls sadly.

Before 1975, there were more than 500 medical doctors and other health personnel working on malaria in Cambodia. Fewer than 100 of them survived the Khmer Rouge. Only 10 returned to work at the National Malaria Control Centre, Uncle Chheang says.

Uncle Chheang managed to pick up the pieces of his life after the war. He married his late wife’s younger sister, Nong Bunny, who was then a lab technician in the National Malaria Control Centre. From that marriage he has one daughter who now works in the tourism industry.

His eldest son from his first marriage is a medical doctor in the United States of America, while his other son is a professor of Khmer linguistics at the Royal University of Phnom Penh.

In Pailin – a former Khmer Rouge stronghold and the current epicentre of multiple drug-resistant malaria – Uncle Chheang frequently encounters former Khmer Rouge fighters who surrendered to government forces and were granted amnesty.
When asked about this, he replies: “Forgiveness and compassion are the greatest human virtues. If we don’t help these people with malaria, we cease to be humans.”
Uncle Chheang says it is important for him to be fit because he has to provide leadership to screening teams. He works with health centres and village commune chiefs to ensure that all villagers appear to have their temperatures taken and blood analyzed by microscopy.
He also coordinates the quick transport, by taxi, of field blood samples to Phnom Penh for analysis in the Institute Pasteur Cambodia, using a laboratory technique known as polymerase chain reaction.

“We sometimes spend more than a month in the villages living in rustic conditions," he says. "I cannot afford to fall sick because the emergency work could be disrupted. For that reason I always make sure that I eat healthy food. Fresh vegetables and fruits are a must for me.”

It is critical that artemisinin-resistant malaria be contained and eliminated, since artemisinin is one of the most effective anti-malarial drugs. The project in which Uncle Chheang works is jointly led by the National Malaria Control Centre and the World Health Organization (WHO).

Uncle Chheang says he will continue working as long as he is strong and healthy. He wants his legacy to be that he passed his skills and knowledge about malaria to younger Cambodians.

Dr Miracle, alias Georges-Pierre Capuano, 76

Retirement? Georges-Pierre Capuano, aged 76, came across this word some time ago but he immediately relegated it to the cupboard. Although he officially retired in 2000, Georges-Pierre believes that age (he prefers to call it "experience") is an asset and in no way a limiting factor to his endless energy and enthusiasm.

In recent years, Georges-Pierre has been tirelessly working to bring together partners, including the Ministry of Health and the French Embassy in Fiji, the Pacific Leprosy Foundation in New Zealand, and the World Health Organization, to provide care and treatment to patients suffering from lymphatic filariasis. This tropical disease, commonly known as elephantiasis, causes infection of the lymphatic system by mosquito-borne parasitic worms. Among the most debilitating manifestations of infection are huge enlargements of the scrotum (hydrocele).

Known in the Pacific Islands as Dr Miracle, Georges-Pierre has operated on 120 people with lymphatic filariasis since 2009. He has brought back smiles to the faces of many men who were not only severely physically affected by this disfiguring disease but also suffered discrimination and stigmatization. “This is where I can make a difference,” he says. “Some men call me Dr Miracle; they tell me that, apart from being back to a normal social life, their private life with their wife is possible again, it’s like a miracle for them. That makes me really happy! I hope I can pass my knowledge and skills to a local surgeon during my next mission.”

"Oh yes, I was supposed to have retired in 2000 but, with 50 years of experience, I am at the summit of my art!” says Georges-Pierre, from the theatre at the hospital in Vunidava, Fiji, after providing surgical treatment to three men suffering from hydroceles. “I am in good health and I feel there is no time to waste in helping those who have not been as lucky as me," he says, before going to the surgical ward to see the patients he treated the day before.

Born and trained in Algeria during the country’s war of independence, Georges-Pierre spent most of his career working as a surgeon and university lecturer in France. Just as he was preparing to retire, the French Ministry of Foreign Affairs asked him if he wanted to go to Vanuatu, an archipelago in the Pacific Ocean, to give surgical support and training at the main hospital in Port Vila. The then 63-year-old surgeon, and father of three preschool-aged children, didn’t hesitate in saying yes. Since then, he has continued to provide his surgical expertise in the Pacific region, most recently for the lymphatic filariasis project in Fiji.

A “green” entrepreneur, Tsuneko Hariki, 89

At the age of 89, Tsuneko Hariki is busy thinking up new ways to use her computer and smart phone tablet to increase orders for her business. Tsuneko is a “leaf” entrepreneur. Since the late 1980s she has been collecting and cultivating decorative leaves that are sold to gourmet chefs to enhance the presentation of their cuisine.

Making a living has not been easy in the small village of Kamakatsu, nestled in a deep valley in the Tokushima Prefecture, Japan. A once-prosperous timber industry declined during the 1960s and a cold snap in the 1980s devastated a thriving mandarin production. Since then, Tsuneko has tried to grow strawberries, nozawana (a kind of vegetable) and sweet potato.

In 1986, Tomoji Yokoishi, a young adviser of the local agricultural cooperative, had the idea of selling leaves to Japanese restaurants as a way of revitalizing the community. At least there were lots of trees in the village ! Although most of the villagers were suspicious of Tomoji’s venture, Tsuneko joined the project as one of the founding members.

Business was not easy at first. Trees needed to be grown specially to meet the numerous demands of the market. Characteristics of leaves such as colours and shapes differ depending upon their location. These days, Irodori Ltd is a successful business that supplies as many as 300 different types of leaf and flower decorations to restaurants in cities all over Japan. The business employs about 200 villagers, many of them women over 65 years of age. Chief executive officer Tomoji advocates the creation of a society in which people are active throughout their lives. “Irodori is most suitable for the elderly,” says Tsuneko. “Leaves are light and do not require hard labour. Most of all, every leaf is beautiful. My work keeps me busy because it requires me to think about what I need to do to meet the demands of the market. Irodori keeps me healthy both physically and mentally.”

Tsuneko, who lives with four generations of her family, including her two great-grandchildren, rarely needs to see a doctor. Active involvement in activities such as Irodori is most likely providing health benefits to many of the older members of the community: per capita medical expenditure in Kamakatsu is among the lowest in the 24 municipalities in Tokushima Prefecture.