Cook Islands continue strong nursing ties with New Zealand.

From its earliest days, nursing in the Cook Islands had close ties with New Zealand, particularly during the 65 years when the stands were administered by New Zealand. It's a link that is stilt valued by Cook Island nurses, according to the School of Nursing principal nursing tutor, Upoko Takau Matapo.

The first hospital was opened in 1890 with 12 beds and staffed by European nurses on two-year contracts from Wellington. In 1906, Maori health officer Maui Pomare suggested Cook Island women be trained as nurses, but the absence of higher education in the Cook Islands and a reluctance by parents to allow their daughters to deal with sick bodies and human waste meant young men were trained as "hospital boys" instead.

In 1930 a primary school teacher, Pari Tamurua, was recruited to be trained as a nurse in New Zealand. She returned to Rarotonga as the islands' first nurse tutor. Student nurses started work at 6am and had lectures from 1pm to 3pm Monday to Friday, with one day off a week. locally qualified nurses continued theft post-graduate education in specialist areas such as paediatrics and public health nursing in New Zealand and Fiji.

From 1950 to 1965, candidates for nursing education were selected from Cook Island women gaining scholarships to attend higher education programmes in New Zealand. These women went to nursing schools in Whangarei and New Plymouth.

In 1965, Cook Island nursing marked the end of 65 years of New Zealand administration of the islands by issuing specially minted Cook Island nursing medals to all registered nurses (RNs) who had qualified since 1934. This was seen as a public proclamation of the coming of age of the Cook Islands' nursing service.

However, it was not until 1977 that the Cook Islands had the capacity to educate its own nurses. Between 1965 and 1970, Cook Island nurses trained in Fiji. In 1977 the Cook Islands' School of Nursing was established. Two years later, the World Health Organisation recognised its three-year comprehensive nursing curriculum. This programme has produced a small but steady stream of RNs since then, apart from a two-year disruption in 1996 and 1997 when the economic crisis affecting the country caused a severe loss of experienced nurses, including teaching staff, and the school was dosed. In 2001, the three-year basic programme was reviewed and upgraded to a three-year diploma of nursing. Post-graduate programmes are offered through distance learning with the Fiji-based University of the South Pacific. Last November, 18 first-year students were enrolled in the programme and a further 15 enrolled last month. The education programme is hospital-based.

In 2002, funding from New Zealand Overseas Development Aid was used to establish a six-month enrolled nurse (EN) programme for experienced hospital aides. Two EN groups have now graduated from this programme and are considered a vital part of the regulated nurse workforce. The Cook Islands plan to continue with both the Diploma in Nursing and the EN programme.

A BN programme is offered through Manukau Institute of Technology, and advanced education is available in conjunction with the University of the South Pacific.