Drugs, alcohol, child care and care of the elderly - not the sort of challenges that are synonymous with Atlantic island life. However, a new policy document drawn up by women from 16 offshore communities has identified these and other issues as priorities.
The document, which was presented to the Fianna Fail MEP, Mr Pat "The Cope" Gallagher, at the weekend, is the work of 106 women in places stretching from Donegal to Cork. Many of them have been participating in an EU-funded NOW (New Opportunities for Women) programme run by Comdhail Oileain na hEireann, the Irish Island Federation.
The result is one of the most comprehensive overviews of island living produced in the past decade, effectively banishing many myths. While the authors refer to previous studies, such as that compiled by an interdepartmental committee in 1996, they give valuable statistical information to bolster their case.
On the 12 large islands, for instance, there are only two resident doctors, so much of the pressure falls on public nurses. On five of the 12 islands, there is no childcare and not one of them has a full-time creche. On only one of the islands is there a day-care centre for the elderly, and 15 elderly people from Inis Mor are in nursing homes in Galway. A site and planning permission has now been obtained for a home on the island. Healthcare is among major issues identified in the 25-page report, along with education, employment, childcare, care of the elderly, and organised recreational activities for schoolchildren.
The report calls for health boards to participate in an islands health service plan which would ensure residents have access on a regular basis to the professional help enjoyed by people on the mainland. On many islands a two- or three-weekly visit by GPs is not considered sufficient. Nor are the GPs given adequate facilities. Doctors often have to see patients in public meeting rooms or libraries, where there is little privacy.
The report recommends that an adequately equipped health clinic be made a priority on each of the main islands. This clinic should be used for all aspects of healthcare provision, ideally by opticians, chiropodists, dentists, social workers, psychologists and practitioners in homeopathy, it says. Nurses should be given a proper support system, including information technology.
Maternity care has also changed little, with expectant mothers still having to spend a time on the mainland awaiting birth - at a cost in terms of accommodation. The report calls on health boards to draw up a maternity plan for island women aimed at reducing the emotional and financial strain during what should be a special occasion in their lives.
The document says island healthcare provision should include an awareness campaign on drug and alcohol abuse, and sex education, with advice provided to parents. It should also contain an emergency plan and designated emergency centre on each island. To give islanders adequate preparation, more first aid courses should also be run, it says.
Childcare, or the lack of it, and the need for better incentives are emphasised. The report says day-care centres for the elderly would reduce isolation and would give a choice to old people who might be forced to spend their last days on the mainland. It makes specific recommendations on education and training, including greater flexibility by the Department of Education on pupil/teacher ratios.
Tourism, information technology, the social economy, recreation, language rights and women in community development are other areas covered in the report, which highlights some strengths, such as the suitability of island economies for small-scale information technology. It is a study which gives women a voice. "If it hadn't been for the EU NOW programme we wouldn't have been able to do this - and now that we have, we don't want to lose the momentum," Ms Eilis Ui Chathain of the federation says. Under the new EU structural round, there are no specific funds for a similar initiative, and the Government has so far turned down appeals to allocate resources to continue the work.
"The women of the islands are a major human capital resource and they are now empowering themselves to play a full role in the sustained development of their communities," the study concludes.
A Policy for Ireland's Offshore Islands is available from Comdhail Oileain na hEireann on Inis Oirr, Cuain na Gaillimhe, at (099) 75096.