A new study has revealed that inadequate water and sanitation facilities are significant contributors to acute watery diarrhea (AWD) in Fiji, with nearly 20% of cases directly tied to these deficiencies. The research underscores the pressing need for improved access to clean water and sanitation, particularly in vulnerable communities across the nation.
Conducted by researchers including Suliasi Mekerusa Batikawai and published in BMC Public Health (2025), the study analyzed national surveillance data on AWD from April 2016 to December 2021, focusing on Fiji’s Central and Western Divisions. The results indicated that children under five are disproportionately affected, a trend consistent with global data indicating that diarrheal diseases remain a leading cause of illness and mortality among young children in developing countries.
Interestingly, during the COVID-19 pandemic, Fiji experienced a temporary decline in AWD cases due to travel restrictions and lockdowns, but rates surged after restrictions were lifted, highlighting existing vulnerabilities in the country’s water and sanitation infrastructure. The study found that 17.46% of AWD cases were linked to unimproved water sources, with an even higher 17.80% associated with inadequate sanitation facilities.
The authors emphasized the critical need for investments in water and sanitation infrastructure, particularly in high-risk areas identified as hotspots for AWD, such as Rakiraki and Rewa, where poor infrastructure and frequent flooding exacerbate health risks. They noted a strong correlation between AWD cases in children and adults, suggesting households experience similar exposure risks.
The findings align with the ongoing concerns raised by local officials, including Ro Filipe Tuisawau, the Minister for Infrastructure, about the link between inadequate sanitation and water quality in Fiji. Only 17% of urban residents are connected to sewered sanitation systems, and efforts are underway to improve sanitation facilities in rural areas and informal settlements, bolstered by collaborations between the Ministry of Health and various NGOs.
The study calls for enhanced investments and the establishment of community-level resilience programs focusing on water, sanitation, and hygiene (WASH) to mitigate AWD risks. These ongoing initiatives represent hope for improved health outcomes and a commitment to ensuring safe water and sanitation access for all in Fiji, ultimately leading to a healthier and more resilient population. With sustained effort and collaboration, there is potential for meaningful improvements to Fiji’s public health landscape, underscoring the vital role of clean water and sanitation in safeguarding community health and resilience against climate change impacts.