P ITCAIRN I SLANDS
1. CONTEXT
1.1 Demographics
The Pitcairn Islands, officially named the Pitcairn, Henderson, Ducie and Oeno Islands, constitute a
group of islands in the South Pacific Ocean about midway between Peru and New Zealand.
The only permanently inhabited island, Pitcairn, covers a total area of 47 square kilometres and is of
rugged volcanic formation with a rocky coastline with cliffs. The only access to the island is by cruise and
container ships, which travel irregularly between New Zealand and the Americas via the Panama Canal.
Ships can only divert for emergency need and a large diversion fee is payable. Pitcairn also receives a
scheduled supply boat, presently at approximately three-monthly intervals.
Of the total 63 people living on Pitcairn (April 2009), 17.3% are 0-14 years old, 61.5% are 15-64 years old
and 21.2% are 65 years and above. A total of 52 are permanent residents and 11 are expatriates working
as teachers, prison staff, health staff, etc., who also reside on the island.
Most dwellings are in Adamstown on the North side of Pitcairn; the island is small and no one is far from
the single administrative centre in Adamstown. A variable number of tourists visit Pitcairn, mainly from
October to March.
Two languages are spoken: English, the official language, and Pitkern, a mixture of an 18th century
English dialect and a Tahitian dialect. Pitkern is spoken as a first language by the population and is taught
alongside standard English at the island's only school.
1.2 Political situation
Pitcairn Islands is held by the United Kingdom of Great Britain and Northern Ireland to have come
under the jurisdiction of the British High Commission for the Western Pacific in 1898 and, in 1952, the
Pitcairn Island Order in Council transferred the responsibility for administration to the person of the
Governor of Fiji, following separation of the offices of Governor and High Commissioner. When Fiji
gained independence in 1971, the administration was transferred to Auckland, New Zealand, within the
jurisdiction of the British High Commissioner to New Zealand, who conjointly holds office as Governor
of Pitcairn Islands.
As such, Pitcairn Islands is the smallest British protectorate in the world and is governed from the
United Kingdom by an appointed Governor, whose office is in Wellington, New Zealand. As Pitcairn
Islands no longer have a Commissioner, the Head of the Pitcairn Island Office now handles most
ongoing, practical matters.
Pitcairn Islands is also notable for being the least populated jurisdiction in the world (although it is not a
sovereign nation). The United Nations Committee on Decolonization includes the Pitcairn Islands on the
United Nations list of non-self-governing territories.
Pitcairn Islands now has a new Constitution (2010), which aims to help protect human rights and was put
together after consultations with almost all people on the islands.
1.3 Socioeconomic situation
Pitcairn islanders exist on fishing, subsistence farming, handicrafts and sales of postage stamps. The
fertile soil of the valleys produces a wide variety of fruits and vegetables, including citrus, sugarcane,
watermelons, bananas, yams and beans. Bartering is an important part of the economy. The major
sources of revenue are the sale of postage stamps to collectors and the sale of handicrafts to passing
ships.
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Trade is restricted by the jagged geography of the island, which lacks a harbour or airstrip, forcing all
trade to be made by longboat to visiting ships. Occasionally, passengers from expedition-type cruise
ships come ashore for a day, weather permitting. In 2004, the island had a labour force of 15 men and
women.
1.4 Risks, vulnerabilities and hazards
While no specific data are available in the information sources listed, the vulnerabilities and hazards facing
Pitcairn Islands are similar to those of other tiny and remote Pacific island countries and areas.
Remoteness from each other and from trading/supply partners, with resulting high transportation costs,
raises the cost of social and protection services, as well as the cost of business.
2. HEALTH SITUATION AND TREND
Health care is easily accessible to all and is financed by the United Kingdom Department for International
Development (DFID) and the Government of Pitcairn. Emergency evacuation is by sea to Mangareva,
French Polynesia, then air transport to Tahiti, French Polynesia, or New Zealand. While the strength of
the health care system in Pitcairn is its advanced primary care, its weakness is isolation from secondary
care.
There have been three births and two deaths in the last five years. However, there were no infant, child or
maternal deaths in the five years to April 2009.
2.1 Communicable and noncommunicable diseases, health risk
factors and transition
In March 2002, a blood survey was carried out by the Pacific Elimination of Lymphatic Filariasis
Programme (PacELF) to detect lymphatic filariasis. The survey did not detect anyone with antigenaemia
and confirmed the Pitcairn Islands to be non-endemic for filariasis.
2.2 Outbreaks of communicable diseases
Outbreaks of respiratory and gastroenteric infection have occurred in the past six months.
2.3 Leading causes of mortality and morbidity
The five leading causes of overall mortality are likely to be cardiovascular disease, cancer, diabetes,
respiratory disease and accidents.
The five leading causes of overall morbidity are likely to be diabetes, cardiovascular disease, asthma,
degenerative joint disease and dental caries.
2.4 Maternal, child and infant diseases
No available information.
2.5 Burden of disease
No available information.
3. HEALTH SYSTEM
3.1 Ministry of Health's mission, vision and objectives
There is a subsidized national health system on Pitcairn and a purpose-built, fully equipped Grade 2
medical centre (1997) with a large reception area, a consulting room, a utility room, a small dispensary, an
X-ray room, a dental room and a two-bed ward with en-suite bathroom. There is good basic equipment
and a well stocked dispensary.
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P I T C A I R N I SL A N D S
The current medical officer is an expatriate general practitioner on a one-year contract. One Pitcairner
acts as facility manager and medical assistant. The medical officer is contracted to provide comprehensive
primary care on a 24-hour basis. One Pitcairner has basic training in dental and X-ray work.
The Pacific Public Health Surveillance Network provides infectious disease bulletins. The medical officer
gives public health advice to the Pitcairn Island Council.
3.2 Organization of health services and delivery systems
See section 3.1.
3.3 Health policy, planning and regulatory framework
No available information.
3.4 Health care financing
Health care is financed by the United Kingdom DFID and the Government of Pitcairn. Health
expenditure as a proportion of GDP is unknown.
3.5 Human resources for health
See section 3.1.
3.6 Partnerships
Authorities collaborate in regional initiatives for the prevention and control of infectious diseases with the
Secretariat of the Pacific Community, Pacific Public Health Surveillance Network (SPC/PPHSN).
3.7 Challenges to health system strengthening
No available information.
4. PROGRESS TOWARDS THE HEALTH MDGs
No available information.
5. LISTING OF MAJOR INFORMATION SOURCES AND
DATABASES
Title 1 : Pitcairn Islands Office website
Operator : Pitcairn Islands Office
Comments : No information on health aspects
Web address : http://government.pn/
Title 2 : Pacific Programme to Eliminate Lymphatic Filariasis – PacELF
Operator : PacELF and WHO
Web address : http://www.pacelf.org/regions/pitcairn.html
Title 3 : Samoa Commitment – achieving healthy islands
Web address : http://www.wpro.who.int/NR/rdonlyres/CE800376-BC67-45D6-
A3B9-01EDDE4FCB7B/0/Samoa_Commitment_2005.pdf
Title 4 : European Overseas Countries and Territories Needs Assessment
Operator : European Centre for Disease Prevention and Control Office
Comments : Completed by Dr Peter Cardon, Pitcairn Islands Medical Officer
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6. ADDRESSES
MINISTRY OF HEALTH
Office Address : Dr. Bruce Dixon
Medical Officer, Pitcairn Islands
Official Email Address : doc@pitcairn.gov.pn, mo@pitcairn.gov.pn
Fax : (872) 7623 37767
HEAD OF PITCAIRN ISLANDS OFFICE
Office Address : Mr Evan Dunn
c/o The Pitcairn Islands Administration,
Level 10, Reserve Bank Building, 67 Customs Street,
Auckland, New Zealand
Official Email Address : evan@pitcairn.gov.pn
Fax : (649) 366 0187
WHO REPRESENTATIVE IN THE SOUTH PACIFIC/DIRECTOR, PACIFIC TECHNICAL SUPPORT
Office Address : Level 4 Provident Plaza One,
Downtown Blvd,
33 Ellery Street, Suva
Postal Address : P.O.Box 113, Suva, Fiji
Official Email Address : who@sp.wpro.who.int
Telephone : (679) 3234 100
Fax : (679) 3234 166; 3234 177
Office Hours : 0800 – 1700
Website : http://www.wpro.who.int/southpacific
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