Among the Pacific island countries, Solomon Islands is the second largest country in terms of land mass, with total land area of 28 369 square kilometres (km2), and third in terms of population (456 800 projected for 2003).  According to the 1999 national population census, 93% of the total population are Melanesians, 4% are Polynesians and 3% are of other ethnic groups.  This ethnic distribution of population is reported to be the same for the projected population for the year 2003.

The country is a double-chain archipelago of more than 900 coral atolls, located in the south-west Pacific, about 1800 km northeast of Australia.  It is widely scattered over 1.3 million km2 (Exclusive Economic Zone) of the Pacific Ocean.  Most of the smaller islands are uninhabited.  On the larger, inhabited islands, 52% of the villages are on the coast, 15% are inland with sea access, and 33% are inland with no sea access and very limited road access.  The majority of the population, about 79%, live in the rural areas.

The maternal mortality rate in 2003 was 295 per 1000 live births as compared to 125 per 1000 live births in 1999.  The unfavourable effect of the ethnic conflict on the provision of maternal health care services is being mentioned as a major contributing factor to this notable increase. 

Estimated figures for 2003 indicated the following changes: life expectancy (63.6 years for males, 76.4 for females); crude birth rate (37.6 per 1000 population); and total fertility rate (4.05).  In 1999, the infant mortality rate was 66 per 1000 live births and the crude death rate was 9 per 1000 population.  The total population for 2003 was estimated to be 456 800 as compared to the census figure of 409 042 in 1999 and 444 564 in 2002.

The country’s economy was heading towards total collapse as a result of the ethnic conflict that peaked between 1999 and 2003. At the beginning of 2003, the main sources of the country’s economy – palm oil, fishing and fish-cannery; logging/timber, copra, cocoa, coffee, gold/silver mining and tourism – were either shut down or reduced to minimal production level.  The country’s poor economic situation was further affected by the temporary suspension of financial support by the World Bank and European Union.  Meanwhile, other countries such as Australia (AusAID), Japan (JICA), New Zealand (NZODA) and Taiwan continued to provide financial and technical support but on a well controlled and a regularly revised rate.  The poor economy disrupted and affected all government and public services (including health services), resulting in the following: unpaid wages, gross inadequacy of supplies and equipment, poor maintenance of health facilities, job redundancy and increased unemployment, alleged corruption among senior officers within the Government system, and poor morale among government employees at all levels, with several leaving the public/civil services.

During the same period, there was an almost total breakdown of law and order in most parts of the country, resulting in:  an increase in murders and robberies where firearms were used; alleged corruption practices within the government system; closure of major industries; illegal smuggling of goods; increased illegal activities committed by special constables; mishandling of funds before they reached the ministries, in particular, those funds that were earmarked for health and education.  More than one thousand internally displaced people (IDP) fled their villages in the Weather Coast area of Guadalcanal Province for fear of the notorious militant outlaw, Mr. Keke, and his followers. These IDP finally reached and settled in overcrowded, makeshift shelters in the capital city of Honiara.

As a consequence of the progressive decline of law and order and worsening status of the economy, Solomon Island was referred, in 2002 and 2003, as a ‘failing state’. Fortunately, the arrival in early July 2003 of the of the Regional Assistance Mission to Solomon Islands (RAMSI) comprised of soldiers and policemen from New Zealand, Papua New Guinea, Fiji, Tonga, Samoa and Cook Islands led by the Australian Army and Police not only helped restore law and order in the country, but also helped in the rebuilding of the economy and saved the country from becoming a ‘failed state’.  Moreover, WHO, in collaboration with the Ministry of Health provided the IDP in the Weather Coast and later at the temporary camp in Honiara with much needed emergency medical supplies and drugs.  WHO further collaborated with the International Red Cross and the National Red Cross Society to provide advice on environmental sanitation, personal hygiene, and counseling and health care services to the IDP.  WHO also supported the International Red Cross proposal to provide adequate counseling and medical (physical) examination to all IDP before they are returned to their villages in early 2004.

Although the implementation of WHO activities under its Programme of Assistance to Solomon Island for 2002-2003 were substantially affected during this difficult period, the decision by WHO not to close its office in Honiara not only further strengthened and revitalized its close ties and working relationship with the Government, but also assured the implementation of all WHO major activities.  This decision has been frequently mentioned and highly commended by the Government on several official meetings and gatherings.

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