Reorienting environmental health practice in Fiji: the potential in developing a National Environmental Health Action...

Environmental health policy and practice is in transition with a traditional focus on health protection merging with an increased focus on health promotion. In Fiji, the role of environmental health practitioners in this process has been pivotal. Practitioners in Fiji believe that the importance of the practitioner's role should be reflected through contributions to policy development. The domination of the health agenda by those with a curative, bio-medical mindset, however, often limited this potential. The practitioners themselves, therefore, proposed and undertook the development of a National Environmental Health Action Plan (NEHAP). This in turn led to the adoption of the health promotion concept of 'healthy settings' in order to promote health in a culturally sensitive and locally relevant manner: 'Healthy Islands'. Following a participatory action research approach, this study explores the role that NEHAP development played in the reorientation of the environmental health profession in Fiji. The journey is told through the eyes of the authors who, together with practitioners from Fiji as well as agencies such as the WHO, participated in a collaborative long-term approach to change. The results show that practitioner's assertion of their right to a policy voice has not only been an initial step in their own recognition as professionals, it had also served to give them a platform for placing environmental health on the national agenda. 'Healthy Islands', in particular, has provided practitioners with the opportunity -to reorient their practice and begin to transform national policy.