When the news from Fiji started to filter through to communities on remote Tanna island in Vanuatu, the mood was sombre and the empathy palpable.
Less than one year earlier, Tanna and nearby Erromango had been devastated by Category 5 Tropical Cyclone Pam and today – almost a year on, the re-building continues.
Lenakel Hospital, which services a population of 32,000 people across Tanna and six surrounding islands, was hit hard by Cyclone Pam, with more than one million dollars (US) worth of damage sustained. Staff who were at the hospital when the cyclone hit, clearly remember the sight of nearby homes collapsing and roofing iron "flying around, just like paper."
While the cyclone damage is still quite apparent around Lenakel, the 43-bed hospital is fully functioning once more. In recent weeks the hospital has been a hive of activity, with the arrival of new equipment and the delivery of specialised healthcare waste management training on-site.
These activities are taking place through PacWaste – a four-year project funded by the European Union and implemented by the Secretariat of the Pacific Regional Environment Programme (SPREP) to improve regional hazardous waste management across the Pacific. Vanuatu is one of 15 countries participating in PacWaste, with activities taking place in the priority areas of healthcare waste, E-waste and asbestos.
PacWaste had previously visited Lenakel in March 2014, to conduct a survey of the existing healthcare waste management processes and facilities at the hospital. The survey identified the need for improved storage, treatment and disposal solutions for healthcare waste and noted some potentially hazardous issues with the hospital's two incinerators.
Ms Elizabeth Vanderburg, SPREP's PacWaste Project Officer, explains that the two incinerators in question are wood-fired and therefore do not reach the temperatures required to burn healthcare waste to a suitable standard:
"The issue with the existing incinerators is quite apparent. The old wood burners bellow out smoke, negatively impacting on the staff and public at the hospital. In addition it inefficiently burns the waste which results in toxic air pollutants being produced and leaving behind larger amounts of ash to dispose of after each burn. This poses a significant risk of human injury and also environmental contamination."
Through PacWaste, Lenakel Hospital is being equipped with a new high temperature incinerator that is specially designed to destroy healthcare waste safely and effectively. Importantly, the incinerator is equipped with two combustion chambers – one to safely burn healthcare waste and another to burn the smoke generated from the first chamber. This technology ensures that very few emissions are released as a result of the incineration process compared to the previous system.
Whilst in Lenakel, PacWaste is also delivering specialised training in the management and disposal of healthcare waste. The practical training programme, which has now been delivered at five separate sites across Vanuatu, has been tailored to build the capacity of hospital staff to safely manage and handle healthcare waste, from the point of creation through to treatment and disposal.
Lenakel Hospital Midwife, Ms Betty Simon, explains that the training was the most thorough she had received in her eight years at Lenakel hospital:
"I've had some basic training in the past, but nothing as detailed as this one. Today we have porters, drivers, nurses, laundry staff, cleaners, a radiographer, a pharmacy officer, lab technicians all at the training. It's good for all the people to be involved so that everyone at the hospital understands what is expected of them when it comes to managing our waste properly. For me, I have learned something here today about proper disposal of sharps, I plan to teach my nurses about disposing of needles properly."
Mr Jesús Laviña, Head of Section for Natural Resources and Infrastructure at the European Union Delegation for the Pacific, Suva explains that the provision of equipment and training at Lenakel hospital is part of a €2 million package of healthcare waste management assistance that will be implemented across 14 Pacific island countries, and Timor-Leste:
"The healthcare component of PacWaste has been designed to ensure that the region's largest hospitals can effectively and safely handle their healthcare waste, now and into the future. Investing in resources and training for the region's hospitals is an investment in the future health of communities across the Pacific," said Mr Laviña.