THE COVID-19 pandemic has a brought a lot of changes and challenges to our region since 2020 as the fight to contain the transmission of the deadly virus continues.
There are nurses and doctors who have dedicated and sacrificed their time, knowledge, skills and energy to fight hard during this pandemic as frontliners.
They went extra mile to work long hours to manage and help ease the transmission and looked after the severely Covid-19 ill-patients.
Meet Dr Minado Paul, 42, from Vella and Marovo in Western Province who is based in Port Vila, Vanuatu for the past years.
She moved to Port Vila in July 2008 after getting married in December 2007.
She is a Specialist Physician- Internal medicine and currently based at Vila Central Hospital in Port Vila (VCH) for the past six years since 2016.
As one of the bright students in her class, her dream to be a medical doctor had come a long way.
During her primary and secondary school years she already had one goal to serve in the medical field and she achieved that.
Her education journey started at Burns creek Primary, then on to Betikama Adventist High School (forms 1-6) and then a year at King George Sixth School to complete her form seven science studies.
As one of the top students in the country at that time she acquired a scholarship and went over to Suva, Fiji to undergo her tertiary studies and achieved her dream.
• MBBS- 2000 to 2005 at Fiji School of Medicine, Suva, Fiji
• Post graduate diploma in internal medicine- 2012, FNU, Fiji
• Masters of Medicine, internal medicine 2013 to 2015, FNU
Since 2016 she works at the Internal Medicine Department at VCH and currently the acting head of the department.
“I am currently working in the internal medicine department based at the hospital medical ward.
“I am currently the acting head of department for the department and also a consultant physician,” she said.
There are three doctors originally from Solomon Islands currently working at Vila Hospital. They are: Dr Boniface Damutalau – Specialist Obstetrician and Gyn ecologist and Dr Caleb Vangana – Specialist Paediatrician and Dr Paul.
There are close to 80 local nurses working in Vanuatu under the special recruitment deal between Solomon Islands Government and Vanuatu Government.
Dr Paul who is married to a Vanuatu doctor has four kids – 3 sons and a daughter, ages 13, 11, 5 and 3 (only girl).
Therefore, as a mother she also faces some challenges while juggling between family life and work each day.
“Such as not having enough time to spend with children as the job can be stressful and demanding,” she said.
She also highlighted the unfriendly working hours which include after hours and weekends and public holidays.
However, during her free time she would find time to spend with her family and also get involved in church activities and physical exercises.
“I spend most non-working hours with my nuclear family at home. I am also an active member of my local SDA church. I used to be quite physically active but have slacked off this year.”
But life and the normal way of living changed soon after when COVID-19 was declared as global pandemic in 2020.
Travel was restricted and restrict measures were also imposed in many countries. Strict health measures and protocols were also upheld.
For Dr Paul, this pandemic has also changed the way she works. She had to adjust to the ‘new normal’ while carrying out her duties.
In Vanuatu a number of actions were undertaken to stop COVID’s entry.
- March 2020- international borders closed (air and sea travel)
- Limiting number of returning residents into the country
- Mandatory managed quarantine required for all inbound international passengers
- Enforcement of strict IPC measures at ports of entry and MIQ sites
- Setting up of isolation ward for covid positive cases detected at MIQ sites;
- Introduction of vaccines to all provinces and eligible populations.
However, two months later after Solomon Islands detected its first community transmission in January, Vanuatu got its share when the first community transmission was detected on March 4 2022.
The virus slipped through most likely from returning residents after flights resumed in February of 2022. There were suspicions of quarantine breach.
Its understood that authorities are still conducting investigations on the origins of community transmission.
In early March 2022 when Vanuatu’s Ministry of Health sent specimens collected among the first locally- acquired cases in Vanuatu to Australia for genomic sequencing it was found to be the Omicron sub-lineage BA.1.
However, both Omicron sub-lineage BA.1 and BA.2 were found among cases detected at the border in February 2022.
Additional specimens collected in early April from Port Vila and Santo were found to be both Omicron BA.1 and Omicron BA.2.
The Ministry of Health confirmed that both sub-lineages are circulating in Vanuatu and that Omicron BA.2 will become the main, and eventually the only one circulating.
To help reduce the spread, the Vanuatu Government has taken steps by temporary placing cessation of inbound international flights which have now resumed.
Alert level raised to highest level: Alert level 3, ongoing vaccination drives to boost coverage, mask mandates, curfews imposed from 6 am to 6 pm which have now been lifted for provinces past peak incidence, mass gatherings prohibited, schools, churches closed but have since resumed, only essential businesses allowed to operate, inter-island and inter provincial travel restrictions, enforcement of strict IPC protocols and all business, schools and churches etc. tasked to develop strict IPC operational SOPs and protocols.
At Vila hospital a number of measures have been undertaken which included;
- Limit hospital services to emergencies only- now back to normal
- Segregation of Covid and non Covid patients.
- Training on clinical management of Covid, IPC measures, PPE use
- Adoption of updated appropriate protocols.
- Main team looking after Covid 19 patients,
During the outbreak at Port Vila Dr Paul was busy and had to play a leading role to manage the Covid-19 infected patients.
“I was the clinical leader at VCH for the Covid 19 responsible for the clinical management of patients.
“And this work also brought a number of challenges.
“Having community transmission was actually a relief as it has been less stressful dealing with mitigation rather than containment phase,” Dr Paul said.
She added work has been somewhat challenging in having to reorganize the department and relocate services outside of the hospital.
“Now we are getting used to the new normal,” she added.
She highlighted that during the initial days, they were busy not with more sick patients but just from setting up new systems, meetings and basically from the mental stress associated with a new situation.
“Paradoxically the number of admissions overall to my ward reduced and we were able to spend more time at home as routine services were ceased,” she said.
During that period medical officers have the option of staying home or going to hospital provided accommodation.
“I stayed at home and continued to commute to work. Towards the end all hospital staff were told to sleep at their own homes and travel to work as VCH spending too much on accommodation.”
She also spent one night in isolation prior to community transmission and she loved it. “Otherwise I never went to isolation during the entire outbreak.”
Dr Paul said, we have to accept that Covid is here to stay.
She said the outbreak in Port Vila peaked within 4 weeks and within two months most things are back to ‘normal’.
“I think we were able to return to normal relatively quickly due to both variants of omicron circulating simultaneously causing rapid spread of infection with the community
“There was fairly good vaccination coverage in Efate.”
Like most regional countries Vanuatu also received external support from overseas donors and partners. The support included;
1. Deployment of AUSMAT team for technical support;
2. Urgent supplies of RAT kits from donor partners;
3. Urgent supply of oxygen concentrators and Airvo machines and oxygen delivery devices from donor partners;
4. Urgent supply of Covid 19 medications; and
5. Donation of vaccines
The current rate of vaccination in Vanuatu now stands at around 40 percent early this week and the rollout exercise for eligible population to get their jab is ongoing.
Because of that most services are back up and running. Most schools have since reopened.
Being a local medical officer serving in Vanuatu for the past years she said it comes with few challenges.
“I don’t find it particularly exciting. Just challenging given the severe resource constraints we face.”
At times she thought about her families, friends and the people of this nation and wish she can also offer her service to Solomon Islands.
“Yes, my husband and I would love to raise our children in the Solomons too so they get to know their Solomon family and culture. We have talked about working there but nothing definite yet.”
Her family last visited the country in January 2020. Now with the latest announcement by the government that the international borders will reopen as of July, there are plans for another surprise visit to the Solomons.
“Definitely, we would love to pay them a surprise visit.”
Because she works in a small hospital that is less busy she also joins a team of Adventist health workers going out to do medical work and church programs.
“We have a Vanuatu Adventist Health Workers Action Team (VAHWAT), that goes out do health screening and run church programs. However, things have been rather quiet lately due to Covid-19”
For now there are no more plans for any major further studies. “I am quite content with where I am today. Perhaps just short stints abroad or online to develop some specialist skills.”
Although she haven’t work at the National Referral Hospital (NRH) she thinks there’s room for improvement just like Port Vila Hospital.
“I haven’t worked at NRH since 2008 so many things may have changed. I think NRH is more advanced and has more resources and specialist compared to VCH. VCH is a small hospital with 200 bed capacity. NRH like VCH definitely has room to improve.”
She said there is a need to improve on the basic health care services and expand on the specialist services.
“I think priority should be on improving and elevating the level of basic health care services provided whilst at the same time expanding into more specialist services,” she said.
As she continues with her passion to serve the sick in Vanuatu lets wish her and her family all the best in the years to come.
By MOFFAT MAMU