On Pacific islands COVID-19 once spared, an outbreak accentuates inequality
By Hannah Beech
Festooned with hibiscus flowers and woven palm fronds, scores of guests gathered for a celebration during New Caledonia’s wedding season. The aroma of grilled fish and yams bathed in coconut milk wafted over the revelers on the island of Lifou, population 10,000.
The celebration on the atoll in late August seemed safe. For a year and a half, New Caledonia, a French territory in the South Pacific, had escaped the coronavirus pandemic. Quarantines and border controls kept the virus out, just like they had done during the worst of the influenza pandemic a century earlier.
But by mid-September, the delta variant was racing across New Caledonia, home to about 270,000 people. Of the nearly 13,300 people who tested positive within the span of a few weeks, more than 280 people died, a higher mortality rate than what the United States or France experienced last year.
“None of us expected COVID to come here,” said Marie-Janne Issamatro, 56, who spent 40 days in the hospital with COVID-19, after attending the family wedding on Lifou. “The doctors say I am the miracle lady because I wasn’t supposed to survive.”
Fueled by the omicron variant, the coronavirus is now reaching parts of the South Pacific that had avoided the pandemic for nearly two years. More than 1,000 people have been infected in Tonga, the transmission likely catalyzed by ships bringing in aid supplies after a volcanic eruption and tsunami in January. Kiribati and the Solomon Islands have contended with their first outbreaks. The Cook Islands reported its first case in late February.
Of all the South Pacific islands recently struggling with outbreaks, New Caledonia was among the most inundated, prompting the government to declare a state of emergency earlier this year. Less than 70% of the population has been fully vaccinated, despite plentiful supplies. (Few people here have died from omicron, compared with delta, and the surge has eased in recent days.)
A protest encampment on a coastal road in Nouméa, the capital, is decorated with hand-scrawled signs declaring “non” to vaccine mandates and health passes.
Serious coronavirus infections have disproportionately affected New Caledonians of Pacific Island descent, highlighting social inequalities in a territory that is agonizing over whether to break free of France.
An independence referendum in December failed in part because many Indigenous Kanaks, who make up about 40% of the population, boycotted the vote. They had called for a delay because traditional mourning rituals for those who died of COVID-19 precluded political campaigning. Paris, unmoved, forged ahead with the referendum.
New Caledonia’s health system benefits from the largesse of the French state, which heavily subsidizes the territory. Critically ill COVID-19 patients are warded in a state-of-the-art intensive care unit at the Médipôle Hospital near Nouméa, far fancier than many facilities in France. When cases spiked last year, about 300 medical professionals converged on New Caledonia, coming from France and its overseas territories.
But the strong social safety net hasn’t bridged the divide between New Caledonia’s population of Indigenous Oceanians and largely white migrants. Eighty percent of doctors at Médipôle are from France, hospital officials said. There are few Kanak doctors in all of New Caledonia, and none at Médipôle.
High levels of diabetes, hypertension and obesity among people of South Pacific descent have compounded New Caledonia’s COVID-19 crisis, doctors said. The territory may be one of the richest places in the South Pacific because of French subsidies and mineral wealth, but the income gap is wide. Most of New Caledonia’s impoverished people are Melanesian Kanaks and Polynesian immigrants from a pinprick French territory called Wallis and Futuna. European settlers, who make up about one-quarter of the population, tend to occupy the upper wealth rungs.
A scattering of islands strewed north of New Zealand, New Caledonia has long seen its history shaped by disease. Europeans arrived in the 19th century, bringing with them pathogens and toxic notions of empire. The French colonial administration herded Kanaks onto reservations and stole their land.
Diseases like cholera and smallpox proliferated. A campaign to force Kanaks to whitewash their homes led to high cancer rates from the asbestos in the white clay. Three-quarters of a century after their first contact with Europeans, the Kanak population had declined by about half.
But when the influenza pandemic began racing around the world a century ago, New Caledonia was one of the few places to emerge largely unscathed. A strict quarantine kept the virus out until 1921, by which time its virulence had diminished.
In January 2021, New Caledonia was one of the world’s first places to receive ample coronavirus vaccines. The territory had boosters available before much of France. Yet when delta hit, less than half of the population had been vaccinated.
“There is a closed island mentality, so people thought they were safe,” said Yannick Slamet, the health minister of New Caledonia. “People forget history quickly.”
By August, recent arrivals went to the courts asking to be exempted from New Caledonia’s strict two-week quarantine. While the local government wanted to obligate all people entering the territory to be vaccinated, Paris initially deemed that French citizens could not be bound by such a rule.
“They said, ‘We are all French so we can go anywhere in France,’ but we were a part of France without COVID,” Slamet added. “It was a pity.”
From one case to four to 30, the caseload multiplied quickly in early September.
“It was like a bomb hit,” said Dr. James Apperry, who endured the first wave of COVID-19 in Lyon, France, working sleepless weeks and months.
He later came to New Caledonia to help.
“It was crazy because we had vaccines and lessons learned from treating COVID, but it was like we were starting from the beginning again,” Apperry said.
Shortly before the COVID-19 spike last year, the New Caledonian government said it would be mandating vaccinations by the end of 2021. But the deadline for compliance kept getting pushed back.
After so many deaths from delta, some New Caledonians have been consumed by the Kanak rituals of grief, which unfold over a year.
“It started to feel like a natural thing, to go to the cemetery and mourn again and again,” said Charles Wea, a presidential adviser who had several family members die of COVID-19 last year. “But, you know, it’s not natural at all. It is a tragedy.”