The Happy Planet Index has declared Vanuatu Archipelago ‘the happiest place on earth’ with its picturesque shoreline and friendly people. But unfortunately, Vanuatu - the Land Eternal- is a country with one of the highest disaster risks in the world.
On Friday 13th of March 2015 cyclone PAM hit Vanuatu's southern provinces of Shefa and Tafea, causing widespread devastation.
International Planned Parenthood Federation (IPPF), through its SPRINT initiative (supported by DFAT of Australian government), immediately responded providing life-saving reproductive health services with the help of its Member Association- Vanuatu Family Health Association (VFHA).
The VFHA team, with Vanuatu Ministry of Health and United Nation Population Fund (UNFPA), established medical and reproductive health camps in the islands (North Tanna, Epi, North Efate) and remote villages.
After the cyclone struck, the island people were left without any access to healthcare, leaving pregnant women especially vulnerable. Around the world, it is estimated that 60% of maternal deaths and 45% of newborn deaths take place in fragile contexts. So, many of these Vanuatu women and their babies are at high risk of maternal and neonatal morbidity and mortality.
Furthermore, violence against women and girls is a growing social and economic issue in Vanuatu. The Vanuatu National Prevalence Study of 2010 reports that at least 60 % of the women experience physical or sexual violence and 30% experience childhood sexual abuse while under the age of 15 years. During a crisis situation, this violence is exacerbated.
Aditi Ghosh, Acting Director, IPPF-SPRINT joined the VFHA team on their mission to the devastated Tanna Island.
“The journey to Tanna was along a long, rocky mud track through deserted woodland, called the land of wild horses. Finally, after two hours, we reached a small village called Launatke, which had a few thatched houses scattered around the forest. We were welcomed warmly by locals. They sang a cyclone Pam song for us in local Launatke tribal language “the power of the storm was so strong that it destroyed everything…”.
The VFHA team had turned a youth centre into a medical clinic. We listened to people telling us about the hardships they had faced during the cyclone.
Julia, a young women in early 20’s– a mother of four, told us that she conceived her second baby immediately after she stopped breast feeding her first and the same pattern was repeated with the following two pregnancies. Her youngest child was five months old and she was worried she would get pregnant again …… but the cyclone gave her the opportunity get advice from the VFHA nurses. Now, she said, she can focus on taking care of her four young children without the fear of an unexpected pregnancy. We heard many similar stories throughout the afternoon.
Next morning, we woke to thundering rain and a blanket of thick fog. We were headed for Labasilis village – a three hour trek through hills and forest.
The medicine and supplies were packed in a waterproof bag and we set off - a team of seven including two doctors and two nurses. Keeping balance in slippery mud was a real challenge, everyone decided to walk barefoot for better grip. I was relieved to learn that Tanna doesn’t have poisonous insects or snakes.
On our way, a team member told us that pregnant women have to be carried along this road, and then taken by truck the nearest clinic. How do these women survive through this journey?
Not surprising that most women prefer to deliver at the village with the help of local (and untrained) birth attendants. No sterilized knives to cut the umbilical cord, instead they use sharpened bamboo. We heard an amazing story of resiliance .. like the one about the woman who while working on her field suddenly felt labor pains. She came back home, delivered on her own, covered the baby with a cloth at home and returned to the field to finish her work.
After two hours we reached Loeala vama. I could see a few makeshift tarpaulin houses, a few damaged thatched houses. After providing some quick services in that village, we continued our walk along the slippery road towards our destination.
The fog has become thicker now, covering the whole area. It was difficult to see even the team members ahead of me. Finally, after another hour of we reached our final destination – Labasilis village.
There was an UNICEF tent, where we started to set up our outreach medical camp. Though it was an open tent, we partitioned a corner with a cloth for privacy.
Soon I could see a stream of people coming towards us, over the hills.
I was told that the surrounding villages had been informed about today’s camp and permission to visit given by the village chiefs.
That day we saw more than 190 clients – treating a range of ailments from cold, fever, wounds, pneumonia to pregnancy tests, newborn, antenatal and postnatal check-ups, plus family planning counseling and services. We saw many young parents- many with four or more children. Someone joked that here boys will have babies before they have beards. We could see for ourselves, how true that was.
I also noticed a young shy pregnant woman, with small baby on her lap, who quietly asked the nurse if she could talk to her in private. Her name was Natalie. She had been prescribed Jadelle (Long Acting Reversible Contraception), when she visited the clinic two months ago. But, when she returned to her village, people scared her by saying the medicine was for wild horses and somehow they removed the Jadelle implant from her arm. And now she is again pregnant, unwillingly.
Heading back to the airport in the pouring rain I thought about wild horses, old wives tales and how Natalie will cope with her new pregnancy.