Storm surges, droughts, and saltwater intrusion have reduced the availability of fresh water and nutritious foods. To address the burden of non-communicable diseases (NCDs) and malnutrition affecting women of childbearing age and children under five, MSF implemented a community-integrated approach aimed at strengthening local health systems and providing people with a better understanding of the link between climate change and health.

MSF’s partnership with the i-Kiribati Ministry of Health and Medical Services is central to this initiative; we worked together to enhance the national healthcare system’s ability to manage the rising incidence of NCDs, including diabetes, high blood pressure, and obesity, alongside malnutrition. We supported nurses and medical assistants to improve recognition of health conditions, and use key innovations such as the CRADLE Vital Signs Alert system, a device designed to detect pre-eclampsia, sepsis, and other pregnancy-related complications in low-resource settings.

During health screenings for women and children in 12 villages, MSF teams identified a number of issues: most women with diabetes had poorly controlled blood sugar levels; there was a high prevalence of high blood pressure in women; and obesity was widespread, including among expectant mothers. They also saw evidence of poor water and sanitation conditions, and episodes of diarrhoea among children.

In addition to these activities, MSF supported the Ministry of Health and Medical Services in improving pharmacy processes; for example, the ordering and monitoring of supplies. We also assisted with waste management at Tungaru Central hospital and health centres on the outer islands, and tested well water for contaminants.

The MSF team frequently travelled between islands to conduct assessments and deliver medical care to remote communities, where access to health services is limited.