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Pacific island nation is on the frontline of climate change but locals must fly to Fiji if they want to buy sunscreen

As the midday sun beats down on Tuvalu, a slim slice of golden sand in remote Oceania, locals seek shelter under palm trees by the lagoon’s edge or retreat to the dark interiors of their homes. There is little else they can do to escape the sun’s powerful rays because there is no suncream in the entire country, despite strident efforts by locals to obtain some.

Tuvalu is the fourth smallest country in the world and located halfway between Australia and Hawaii in the Pacific Ocean.

Classified as a developing country by the United Nations, Tuvalu is on the frontline of climate change, and is already seeing devastating effects, including sea-level rise, coastal erosion, droughts and hotter annual temperatures.

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A department of the Princess Margaret hospital in the capital of Funafuti has been devoted to climate change-related illnesses, which have risen in the last decade, according to hospital figures.

Locals complain that the increasing temperatures are becoming “unbearable”, and acting chief of public health Suria Eusala Paufolau says incidents of heat rash, heat stroke and dehydration are intensifying.

As locals do their best to cope by avoiding the sun when they can and wearing long, protective clothing, one of the western world’s most basic defences against sun exposure is completely unavailable – sunscreen.

Sunscreen was absent from every shop and supermarket in the capital of Funafuti when the Guardian visited in March. Meanwhile, products such as feminine hygiene wash, hair dye and baby cologne were widely available.

“We don’t have sunscreen,” says one shop owner. “We’ve never had sunscreen.”

Tuvaluans – especially women – say their only option for acquiring sunscreen is to purchase it from neighbouring Fiji – an expensive, two-and-a-half-hour flight away.

Half a dozen local women questioned in the town square of Funafuti said if sunscreen was available they would buy it, citing ageing skin as their primary concern.

“I am only 32 but I look older, we can’t get sunscreen here, we can’t get anything to protect our skin,” says one local woman, a housewife and mother of five. “Do you have any, can I please have some?”

Facebook Twitter Pinterest An aerial view of Fongafale island, the home to the Tuvaluan capital of Funafuti. Photograph: Sean Gallagher/The Guardian

According to the World Health Organization, shortages of many essential medicines are common in Tuvalu, and the country is one of the top importers of health supplies anywhere in the world, according to the BMJ.

Associate Professor Tony Reeder from the Otago University School of Medicine in New Zealand is an expert in skin cancer prevention and says it is alarming that sunscreen is not available to Tuvaluans.

“Not having access to sunscreen is quite critical, especially for people who are exposed to the sun for long periods of time,” says Reeder. “There are quite a few barriers to the use of sunscreen because it is often seen as a western product, and it can be prohibitively expensive.”

Reeder says subsidising the cost of sunscreen is one option.

“There are moves by some countries to reclassify sunscreen as a pharmaceutical protective product. Polynesians need sun protection as well, sun damage has been recorded among Africans with black skin. So all types of skin can be damaged from exposure to the sun.”

More pressing health concerns are the most likely reason sunscreen has been overlooked in Tuvalu, Reeder says.

A 2015 study of skin disorders in Tuvalu conducted by Taiwanese dermatologists – the first ever undertaken – concluded “there is a distinct lack of knowledge on the prevalence of skin disorders in Tuvalu”.

Elsewhere in the Pacific where sunscreen is widely available, some countries such as Palau and Hawaii have introduced a ban on the product, because some chemicals in sunscreens have been linked to deterioration of coral reefs.