Medical Assistance Programme on Malekula
1. Kiwi doctors in action at Lamap, Southwest Bay and the Maskelynes
The Butterfly Trust had a fine team of four enthusiastic doctors in 2012. Each volunteered their services to provide medical care and training to the people of South Malekula. They were:
- Dr Fiona Bolden, GP Principal and owner from Raglan
- Dr Sarah Burling, Rural Hospital Medical Officer of Special Scale (MOSS) from Eketahuna
- Dr Claire Thurlow, GP from Nelson
- Dr Shaun Counsell, GP and Travel doctor from Porirua
The selection of all 4 doctors was overseen by Dr Peter Woolford, the Trust’s Medical Programme Advisor, and final approval was granted by the Ministry of Health in Vanuatu (‘MOH’).
The doctors came for a period of between 10 days and 3 weeks. Between them, they covered a range of health facilities including the mini-Hospital at Lamap, Dispensaries at Sangalai (Maskelynes) and Wintua (Southwest Bay) plus a number of village aid posts at Avock, Lawa, Melip and Lembinwen.
Patients were seen to with monitoring home visits and follow-up treatment or advice when necessary. Health checkups for schoolchildren at Lamap were carried out. Particular emphasis was placed on training local nurses, nurse practitioners and nursing students with the doctors often supervising patient visits while the health workers attended to the patient. In this way, they imparted some of their skills and expertise to the local medical services.
When not engaged in clinical work, the doctors facilitated and performed a diverse range of activities such as general and dental hygiene workshops for schoolchildren, group training sessions for nurses on specific topics, first aid training, clinic management and stitching up Blackie, a wounded dog!
They encountered various challenges – lack of medical supplies, equipment and diagnostics facilities, limited electricity and water, deteriorating buildings, the constant threat of malaria, transport over rough seas in small boats with very limited safety gear. Such conditions are faced by ni-Vanuatu health workers operating in remote outer island and inland communities most of the time.
The medical programme has expanded into Lamap where there is a mini-Hospital. The reason for this is the constant demand for medical services in other parts of South Malekula and it is ideal as a base for training. This is supported by the MOH.
The Trust has also begun discussions with Norsup Hospital in North Malekula, the largest health facility on the island currently staffed by about 20 nurses and nurse practitioners. The Trust may also be able to carry out some nurse training at Norsup in the near future.
2. Prioritising Health Education & Nurse Training
Staffing levels of health facilities throughout Vanuatu are a major concern. The latest estimate from th2011 Annual Development Report cites a current shortage of 400 nurses. The majority of doctors (30) are concentrated at the two regional referral hospitals at Port Vila and Santo. This makes the availability and standard of nursing care extremely important to rural communities where access to hospital care is difficult. The Trust has visited a number of health facilities in the outer islands where there has not been a nurse for months or longer. Many facilities are managed by sole charge nurses, some newly qualified, many run by overworked nurses and nurse practitioners past their retirement age, some voluntarily for a few days each week. Ni-Vanuatu nurses deserve due credit for working under challenging circumstances.
A major focus of the Butterfly Trust’s medical programme is on education and training. Providing on-the-job training and supervision to local nurses ensures that skills and expertise from volunteer medical professionals are passed on. All the Trust’s medical volunteers this year worked closely with resident nurses, nurse practitioners, nurse aids and a couple of final year nursing students on work experience at Lamap mini-Hospital. Lessons were gained in the areas of proper diagnostics and recognising symptoms, fracture management, suturing, wound care and appropriate doses of medications particularly with infants and young children. First aid training was also emphasised.
At Uliveo Island in the Maskelynes, Dr Fiona facilitated the setting up of additional first aid posts managed by volunteers with basic first aid training from the Red Cross. The idea was initiated by the Sangalai Clinic committee and supported by its nurse. First aid volunteers are strictly advised to tend to dressing minor wounds only and to refer the patient to the clinic for follow-up care as soon as practicable. The Sangalai Clinic also benefitted from the services of Sally Peet and Kay Adams, both registered nurses from Australia who spent 6 weeks assisting the clinic and working with the sole nurse in charge, Bambie Stephen. Dr Sarah and her husband Paul ran a couple of first aid training workshops. As well as her experience in rural hospital medicine, Sarah was a former territorial army medic. Paul utilised his myriad skills in farming, adult education and teaching as well as his expertise in outdoor pursuits.
A number of dental and general hygiene workshops targeting schoolchildren were run by Drs Fiona and Claire as well as retired nurse Dawn Robertson and disability support worker Beth Millar who both spent 3 weeks in the Maskelynes in August.
Minah William comes from Peskarus village in the Maskelynes. She gained acceptance into the 3-year nursing course at the Vanuatu Centre for Nursing Education (‘VCNE’) in Port Vila earlier this year. To help improve the long term skills base in the Maskelynes, Butterfly Trust will subsidise Minah’s nursing fees. The Trust wishes Minah all the best with her studies.
3. Dentistry an Unmet Need
Providing adequate dental care remains a major challenge for all levels of health facilities around Vanuatu. For a start there is a lack of necessary skills – only 5 hospital based dentists at Port Vila and Santo plus a small number operating privately mainly in Port Vila. Nurses are restricted in their ability to handle dental complaints other than administer painkillers or antibiotics. Many remote medical facilities do not have the equipment and the ones that have dental chairs and compressors face problems of installation, maintenance and adequate electricity. Individuals who can afford the cost of transport to a main hospital may receive treatment. Most risk infection and endure the pain and discomfort. There are a number of visiting dentists who volunteer their services to remote communities for varying periods of time each year. The Trust has contacted a number of these organisations and individuals in an effort to coordinate services. It is also discussing a proposed dental training programme with the Ministry of Health (‘MOH’). Dental hygiene education in schools is another core focus. The Trust thanks Dr Jim Coggan, retired Periodontist from the United States who assisted in an advisory capacity this year. We look forward to further discussion and possible partnership with Jim in the future.
Any experienced dentist who is interested in volunteering their services to assist remote communities in Vanuatu is encouraged to contact the Butterfly Trust. The Trust also needs more experienced doctors. We are looking for practitioners with 10 or more years of experience although exceptions will be made for particular skills.
Meanwhile, our focus on Education continues…………..
4. School Fee Subsidies for Maskelynes’ pupils
The Butterfly Trust has committed to subsidising the school fees for Years 9 and 10 students from the Maskelynes in 2013. This year, 24 out of a class of 28 Year 8 students from Sangalai Centre School in 2011 attended all three terms of Year 9. Each of these students received a fee subsidy of 22 500vt (approximately NZ$320) to supplement the cost of secondary education on mainland Malekula. Sending a child to senior secondary school can cost up to 70 000vt (NZ$1000) per year. Nationwide for the last 3 years, around 80% of students attained a minimum Year 6 education – a testament to the success of the Ministry of Education’s Universal ‘Fee-Free’ Primary Education policy supported and funded by the Australian and New Zealand governments. At secondary level, the attrition rate appears to be climbing steadily to around 44% in 2011. This is critical particularly in light of poor standards of literacy and numeracy overall.
The Trust believes that providing some financial assistance is one way of achieving better access to education. To be fair to each family, every Year 8 student from the Maskelynes will receive the same allowance. Current Year 9 students will also receive further support from the Trust’s fees fund. This component of the agenda is high on the list of priorities.
The Butterfly Trust applies 100% of donations received towards its projects. If you would like to support the Trust’s Education Fund, send an email to firstname.lastname@example.org
Students from Class 8 (2012) at Sangalai Centre school will each receive a fee subsidy to attend secondary school.
5. Supplementing Rural School Facilities
Namaru Solar & Sanitation Improvement Project
“The school really needs solar for classroom lighting, to run night classes, lessons on DVD, children’s shows and for the school computer, photocopy machine and printer. Toilets were our major problem in the school this year. Bush toilets are still being used which are not safe. The School Council and Avock Community Chief kindly request 3 permanent good toilets for students and teaching staff.”
Warren Christie, Head Teacher of Namaru School in an excerpt from a letter to the Trust
Like many rural schools in Vanuatu, staff and students at Namaru Primary School on Avock Island in the Maskelynes manage exceedingly well with relatively few resources, irregular and limited sources of electricity and poor sanitation. The school sits on a rise ‘out on a limb’ with foot access possible only when the tide is out. There are positive aspects – mosquitoes are not a major problem and the school was recently rewarded with a fiberglass water tank following application to NZAid, a major development partner. Unfortunately an application to another aid agency for classroom refurbishment was turned down this year. There are minimum infrastructure standards set by the Ministry of Education for classrooms, toilets and water facilities. Head Teacher Warren Christie is tenacious, dedicated and understands that improvements will take time. The Butterfly Trust has accepted the community’s request for assistance. The first stage of the planned solar power project will provide for 3 classrooms and the school office. According to government regulations, schools must have a minimum of 2 toilets. If you are interested in helping to finance the Namaru Solar & Sanitation Project, contact the Trust via email to email@example.com.
The Trust has also received requests for new and/or additional toilets from 3 other schools – Sangalai Centre School, College de Lamap and St Pierre Chanel Primary School. Meanwhile construction of the new teachers’ housing block at Sangalai School is now complete. When not used by teaching staff, the room unit will function as a simple guesthouse to supplement the school’s income.
Vocational & Trade Skills – 2013 programme
6. Solar & Electrical Skills Intensive
An introductory course combining electrical principles and basic skills in solar power installations and maintenance has been scheduled for July 2013 at the Uliveo Rural Training Centre (‘RTC’) in the Maskelynes. This 2-3 week intensive course will incorporate classroom sessions, practical demonstrations and site visits. It is designed to introduce core principles and working knowledge of solar to a group of around 25 participants representing several villages in the Maskelynes and South Malekula. Training will be conducted by 2 tutors from the Vanuatu Institute of Technology (‘VIT’) in Port Vila, an accredited training provider of fulltime and short term certified courses. Teaching equipment will be supplied by VIT and freighted to the Maskelynes by a combination of boat and air transport. Every attempt will be made to coordinate this workshop with the solar component of the Namaru School Project on Avock to enable participants the opportunity for field study. The main objective of the workshop is to impart a basic understanding of key principles and technical skills. Use of solar to generate power is becoming widespread among rural communities where the skills required to properly install and maintain equipment are still lacking. This structured course is intended to be an extension of last year’s solar skills practical in Peskarus Village which the Trust organised through Brian Basura, a visiting sailor from the United States. The organising committee consists of the Director of Uliveo RTC, Alick Masing (local community liaison), managing staff at VIT (course coordination and training) and the Butterfly Trust (funding and coordination).
News in Brief
Kicking the Habit – Stamping out marijuana use through football
Senior Sergeant John Henry Silas of the Lamap Police Post in South Malekula is hoping to reduce marijuana use among young people by diverting their attention towards sport. With the disused Lamap jailhouse as its office and equipment store, Senior Sergeant Henry set up the Sports Council this year. He also organised a successful 4-day football tournament involving teams from the south and southeast corner of Malekula. He has the support of the Lamap branch of Save the Children which organises drugs awareness programmes and outreach. The Council has asked the Butterfly Trust for assistance with gear and equipment.
In Port Vila, the Trust met the President of the Vanuatu Football Federation and Head of its Social Responsibility Unit to discuss the Trust’s work in health and utilising football to promote health education to children in South Malekula.
STAFF AND CURRICULUM DEVELOPMENT are core emphases in the Vanuatu Institute of Technology”s (‘VIT’) 5-year strategic plan according to Principal Kalbeo Kalpat. The Trust is looking at facilitating assistance in the area of upskilling trainers.
Anyone with experience in training trainers up to diploma level in areas involving trade, technical or vocational subjects, please contact Dave or Lynn in the first instance by email to firstname.lastname@example.org.
ARTISTIC SKILLS GENERATE INCOME FOR WOMAN BLONG AMBAE MO FUTUNA
Leiwia Tangou and Janet Markbie live on Uliveo Island in the Maskelynes. Both women are passionate about basket weaving, retaining the intricate and unique styles of their home islands of Ambae and Futuna. With the encouragement of the Butterfly Trust and Linda, Baz and the girls at Volcanic Earth in Port Vila, both women are supplying the organic skincare shop with colourful baskets and fans. It takes weeks for the pandanus fronds to be collected, sun dried, stripped and hand dyed before the weaving can begin. It is a labour intensive process with the women having to juggle weaving with daily chores – cooking on open fires, washing and looking after children. The baskets are popular with tourists.
NURSE SALLY ‘RETIRES’ – For the last seven years, Registered Nurse Sally Peet has travelled to Vanuatu to volunteer her time and medical expertise to communities at Sakao, Uliveo, Avokh, Okai, Akhamb, Naraminb and Lamap. Sally has worked tirelessly and passionately. For the past 3 years, she has assisted the work of the Butterfly Trust in various capacities. For all your help Sally, thank you from the Butterfly Trust.
Beth and Dawn – dedicated volunteers
Former cytologist Beth Millar works as a disability support worker in Invercargill, New Zealand. Together with retired nurse from Ngungaruru, Dawn Robertson, both women spent 3 weeks on Uliveo in the Maskelynes. Working through the Sangalai School, they organised and ran lessons in hygiene for Class 1 students and the 3 community kindergartens utilising dialogue, props, song and dance. Beth is keen to return to Vanuatu next year and provide assistance to the Vanuatu Society for Disabled People, based in Port Vila. While in the Maskelynes, she spent time with families of the disabled, including children. Beth found the families very receptive and with their consent, has passed on information collated to the Vanuatu Society for Disabled People. The Butterfly Trust thanks Dawn and Beth for their input and assistance with running the school workshops and for providing valuable feedback which will assist the Trust in planning future programmes.
JOEL MORSEN recently celebrated his 13th birthday in Auckland as he recovered from his heart operation at Starship Hospital. Joel had rheumatic fever as a child which affected his heart. The cost of surgery, airfares and living expenses for Joel and his father, Willie, were paid by the NZ government. While in Auckland, Joel captured the sights of Auckland with a camera donated by Helen Smith. Joel and Willie expressed their gratitude by making a donation to the Butterfly Trust. Thank you to all who offered to donate cameras in response to our email in May. The Butterfly Trust received 3 more cameras which have been donated to schools in Lamap.