May 23, 2008

Dear Bill Jaynes
The Kaselehlie Press

A research paper apparently commissioned by UNICEF, based on data on intentional injury of children collected in Pohnpei, Tonga, and Vanuatu in 2000 and 2001 was finally released on April 30, 2008. It was erroneously entitled "Intentional Injury reported by young people in the Federated States of Micronesia, Kingdom of Tonga, and Vanuatu." No data was collected anywhere else in the FSM other than in Pohnpei.

They said "In FSM, surveys were conducted in Pohnpei state only because of its accessibility and the interest of stakeholders in collecting adolescent health information. Given the social and developmental diversity of the states of the FSM, the findings can therefore only be generalized to students in Pohnpei."

The report said that "intentional injury presents a threat to the physical and psychological well being of young people, especially in developing countries, which carry the greatest part of the global injury burden. While the importance of this problem is recognized, there is limited population data in low and middle income countries that can guide public health action. The present study investigates the prevalence and distribution of intentional injury among young people in three Pacific Island societies, and examines behavioural and psychosocial factors related to risk of intentional injury."

The research paper concluded that among boys and girls aged 14 to 17 years, 62% of boys and 56% of girls in Pohnpei reported that they had been intentionally injured. Of the three countries surveyed Pohnpei had the highest rate of intentional injury of children. The Kingdom of Tonga reported 58% of boys and 41% of girls admitted that they had been intentionally injured. Vanuatu reported the lowest incidence with 33% of boys and 24% of girls admitting to that type of injury.

According to the research paper the prevalence of intentional injury declined with age in Vanuatu and Tonga but there was little evidence that the number of incidences of intentional injury declined at all as the reporting sample got older.

It says that "across the three societies, the major source of intentional injury among boys were 'other persons' followed by boyfriends/ girlfriends and fathers. Mothers, boyfriends/girlfriends and other persons were primary sources of injury among girls." The report said that intentional injury was reported more often by those who had been bullied. It noted a statistical linkage for an increased risk of intentional injury in Tonga and Vanuatu for those in the sample that were regular smokers. They found a linkage in Pohnpei and Vanuatu for those who were "illicit drug users" though they didn't define what kind of "illicit drug" they were discussing.

The report came from population surveys with students aged 11-17 in the three countries. In Pohnpei, the sample size, or the number of people surveyed for the project was 1,495, while Tonga had a sample size of 2,808 and Vanuatu had a sample size of 4,474.

They concluded that "intentional injury was reported extensively in these three populations. Interventions directed towards the school environment and which take into account the role of bullying and drug use need to be considered."

The article said that health and education authorities in the three countries have agreed to collaborate with UNICEF in the development of a Lifeskills program for adolescents. They say that their report gives the opportunity to examine the extent of intentional injury in populations with high proportions of children and adolescents "which are experiencing challenges related to globalization, including economic changes and greater interaction between traditional values and western behavioural mores."

The report says that there was some variation in the age ranges used in each country. They said they surveyed 14 to 17 year olds in Pohnpei, 11 to 17 year olds in Tonga, and 12-17 year olds in Vanuatu. They said that they didn't include primary schools in Vanuatu or Pohnpei because of "varying literacy levels." They also said that all of the surveys were conducted in the local languages.

They pointed to a study conducted in the FSM in 1992 that said that harsh punishment by parents for particular behaviors, including disrespect and disobedience was acceptable provided that it was restrained and did not result in serious injury. They said that it was not possible in the study to determine whether injuries inflicted by a parent resulted in culturally acceptable levels of physical discipline, or whether the physically administered disciplinary actions exceeded that level.

Individual responses to the survey were closely guarded and extremely confidential.