At Vaiola Hospital in Nuku'alofa, doctors could see what Likiliki needed. They also knew they could not provide it. The cardiac procedures were not available in Tonga. Two other men were in the same position. Sione Aleamotua, 28, was a seasonal worker. Sio Lino, 45, a graphic designer who runs a print shop, had lived with pain for about seven months. The Tongan government agreed to pay for all three to be treated abroad.
Dr Annalisa Faanunu, an internal medicine specialist from Vaiola, went with them to Pacific Specialist Healthcare, a private hospital in Legalega, close to Nadi International Airport. It occupies two adjoining five-storey buildings, and it takes heart patients from Samoa, Kiribati, Vanuatu, Nauru, Solomon Islands and Papua New Guinea as well as Tonga. The three men were part of a larger group of Tongans there for treatment. Likiliki underwent angiography and angioplasty and received two stents. Doctors found a blocked artery in Aleamotua and fitted one stent. Lino received a stent too.
Likiliki thanked his government for covering the costs and praised the care he received from Fiji's medical staff. Aleamotua, the youngest of the three, summed up what they had learned: "If you have chest pain, don't delay — go to the hospital straight away."
The three men's illness is common in Tonga. The country ranks fifth in the world for adult obesity, and diabetes contributes to a third of its deaths from ischaemic heart disease. A WHO survey in 2017 found almost every Tongan adult at moderate to high risk of non-communicable disease.
Much of Tonga's heart care has long depended on help from outside. Australian volunteers with Open Heart International have made surgical visits to Vaiola since 1986. In May 2023, a New Zealand team fitted the first new pacemakers ever implanted in the country. Before that, visiting doctors had only replaced existing devices. Tonga runs its own government-funded scheme to send patients abroad, and a New Zealand programme adds to it.
Lino lived with his pain for seven months. Likiliki went to hospital the day his began. That is the difference the three men now want others to understand.