A recent study has highlighted the critical role that inadequate water and sanitation facilities play in the prevalence of acute watery diarrhea (AWD) in Fiji, linking nearly 20% of cases to these deficiencies. Conducted by a team of researchers including Suliasi Mekerusa Batikawai and published in BMC Public Health (2025), the research analyzed national surveillance data spanning from April 2016 to December 2021, particularly focusing on the Central and Western Divisions of Fiji. The findings are especially concerning as they reveal that children under five are disproportionately affected by this health issue, mirroring global trends that show diarrheal diseases as a leading cause of illness and mortality among young children in developing nations.
Interestingly, the study observed a temporary decline in AWD cases during the COVID-19 pandemic, attributed to travel restrictions and lockdowns. However, once these restrictions were lifted, a surge in cases occurred, emphasizing the vulnerabilities within the country’s water and sanitation infrastructure. The analysis found that 17.46% of AWD cases were tied to unimproved water sources, while an even greater 17.80% were associated with inadequate sanitation facilities.
The authors of the study underlined an urgent necessity for investments in water and sanitation infrastructure, particularly in high-risk areas such as Rakiraki and Rewa, where poor infrastructure and frequent flooding heighten health risks. They noted a strong correlation in exposure risks to both children and adults within the same households.
These findings resonate with concerns raised by local officials, including Ro Filipe Tuisawau, the Minister for Infrastructure, regarding the relationship between inadequate sanitation and water quality in Fiji. Currently, only 17% of urban residents are connected to sewered sanitation systems, although there are initiatives underway to improve sanitation facilities in rural areas and informal settlements, with cooperation between the Ministry of Health and various NGOs.
The study advocates for increased investments and the establishment of community-level resilience programs aimed at enhancing water, sanitation, and hygiene (WASH) practices to mitigate the risks associated with AWD. Such initiatives reflect a hopeful commitment to improving health outcomes and ensuring that all communities in Fiji have access to safe water and sanitation. With sustained efforts and collaborative actions, there exists a promising opportunity for meaningful enhancements in Fiji’s public health landscape, highlighting the indispensable role of clean water and sanitation in fostering community health and resilience against climate change impacts.