Since 2020, the COVID-19 pandemic has brought many changes and challenges to our region, as the fight to stop the spread of the deadly virus continues.
There are nurses and doctors who have dedicated and sacrificed their time, knowledge, skills, and energy to fighting as frontliners during this pandemic.
They went above and beyond by working long hours to manage and ease the transmission while also caring for the critically ill Covid-19 patients.
Meet Dr Minado Paul, 42, from Vella and Marovo in Western Province, who has spent the last few years in Port Vila, Vanuatu.
She relocated to Port Vila in July 2008 after marrying in December 2007.
She is a Specialist Physician-Internal Medicine who has been working at Vila Central Hospital in Port Vila (VCH) since 2016.
Her ambition to become a medical doctor had come a long way as one of the brightest students in her class.
Throughout her primary and secondary school years, she had one goal in mind: to work in the medical field.
Her education began at Burns Creek Primary School, followed by Betikama Adventist High School (forms 1-6) and a year at King George Sixth School to finish her form seven science studies.
She received a scholarship as one of the top students in the country at the time and went to Suva, Fiji to pursue her tertiary studies, fulfilling her dream.
• MBBS from 2000 to 2005 at Fiji School of Medicine in Suva, Fiji; • Postgraduate diploma in internal medicine from 2012 at FNU, Fiji; and • Masters of Medicine, internal medicine from 2013 to 2015 at FNU.
She has been working at VCH’s Internal Medicine Department since 2016, and she is currently the acting head of the department.
“Right now, I’m working in the internal medicine department on the hospital medical ward.”
“I am currently the department’s acting head of department and a consultant physician,” she explained.
There are three doctors from the Solomon Islands working at Vila Hospital. Dr Boniface Damutalau is a specialist obstetrician and gynaecologist, and Dr Caleb Vangana is a specialist paediatrician.
Under a special recruitment agreement between the Solomon Islands Government and the Vanuatu Government, nearly 80 local nurses work in Vanuatu.
Dr. Paul, who is married to a Vanuatu doctor, has four children, ages 13, 11, 5, and 3. (only girl).
As a result, as a mother, she faces some challenges every day while juggling family life and work.
“For example, not having enough time to spend with children because the job is stressful and demanding,” she explained.
She also emphasised the unfavourable working hours, which include after-hours, weekends, and public holidays.
However, in her spare time, she would spend time with her family and participate in church activities and physical exercises.
“I spend the majority of my non-working hours at home with my nuclear family.” In addition, I am an active member of my local SDA church. I used to be very physically active, but I’ve been slacking this year.”
However, life and normalcy were soon disrupted when COVID-19 was declared a global pandemic in 2020.
Many countries imposed travel restrictions and other restrictions. Strict health protocols and measures were also followed.
This pandemic has also altered Dr Paul’s working methods. While performing her duties, she had to adjust to the ‘new normal.’
A number of actions were taken in Vanuatu to prevent COVID’s entry.
They were as follows:
International borders will be closed in March 2020. (air and sea travel)
limiting the number of returning residents who can enter the country
All inbound international passengers must undergo managed quarantine.
Strict IPC measures are enforced at ports of entry and MIQ sites.
Establishment of an isolation ward for covid positive cases discovered at MIQ sites;
Vaccines are being distributed to all provinces and eligible populations.
However, two months after Solomon Islands detected its first community transmission in January, Vanuatu received its share on March 4, 2022, when the first community transmission was detected.
The virus was most likely introduced by returning residents after flights resumed in February 2022. There were concerns about a quarantine breach.
Authorities are still investigating the origins of community transmission, according to reports.
When Vanuatu’s Ministry of Health sent specimens collected among the first locally acquired cases in Vanuatu to Australia for genomic sequencing in early March 2022, it was discovered to be the Omicron sub-lineage BA.1.
However, Omicron sub-lineages BA.1 and BA.2 were discovered among cases discovered at the border in February 2022.
Omicron BA.1 and Omicron BA.2 were discovered in additional specimens collected in early April from Port Vila and Santo.
The Ministry of Health confirmed that both sub-lineages are circulating in Vanuatu and that Omicron BA.2 will eventually become the main, and only, circulating sub-lineage.
To help reduce the spread, the Vanuatu government temporarily halted 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 a.m. to 6 p.m., which have now been lifted for provinces past peak incidence, mass gatherings prohibited, schools, churches closed but have since reopened, only essential businesses allowed to operate, inter-island and inter-provincial travel restrictions, strict IPC protocol enforcement, and all businesses, schools, and churches
A variety of measures have been implemented at Vila Hospital, including:
Restriction of hospital services to only emergencies—return to normal segregation of Covid and non-Covid patients.
Covid clinical management training, IPC measures, and PPE use
Adoption of updated relevant protocols.
Covid 19 patients are being cared for by the main team.
During the Port Vila outbreak, Dr. Paul was kept busy and had to take the lead in managing the Covid-19-infected patients.
“I was the clinical leader for the Covid 19 at VCH, responsible for patient clinical management.”
This work also presented a number of challenges.
“Having community transmission was actually a relief because it made dealing with mitigation rather than containment phase less stressful,” Dr Paul said.
She added that the work has been somewhat difficult due to the need to reorganise the department and relocate services outside of the hospital.
“Now we’re adjusting to the new normal,” she added.
She emphasised that in the early days, they were preoccupied not with more sick patients, but with setting up new systems, meetings, and dealing with the mental stress that comes with a new situation.
“Paradoxically, the overall number of admissions to my ward decreased, and we were able to spend more time at home as routine services were discontinued,” she explained.
During that time, medical officers can choose to stay at home or in hospital-provided housing.
“I stayed at home and commuted to work as usual.” Toward the end, all hospital staff were told to sleep at home and commute to work because VCH spent too much money on housing.”
She also spent one night in isolation prior to community transmission, which she thoroughly enjoyed. “Otherwise, I was never isolated during the entire outbreak.”
According to Dr. Paul, we must accept that Covid is here to stay.
She stated that the outbreak in Port Vila peaked in four weeks and that most things were back to “normal” within two months.
“I believe we were able to return to normal relatively quickly because both variants of omicron were circulating concurrently, causing rapid infection spread in the community.”
“Vaccination coverage was fairly good in Efate.”
Vanuatu, like the majority of the region’s countries, received external assistance from overseas donors and partners. The assistance included the following: 1. Deployment of an AUSMAT team for technical support; 2. Urgent supplies of RAT kits from donor partners; 3. Urgent supplies of oxygen concentrators, Airvo machines, and oxygen delivery devices from donor partners; 4. Urgent supplies of Covid 19 medications; and 5. Donation of vaccines.
The current vaccination rate in Vanuatu is around 40% as of early this week, and the rollout exercise for eligible population to get their jab is still ongoing.
As a result, most services are back up and running. The majority of schools have since reopened.
She described her experience as a local medical officer serving in Vanuatu for the past few years as having few challenges.
“It’s not particularly exciting to me.” Just difficult given our severe resource constraints.”
She thought about her family, friends, and the people of this country and wished she could also serve the Solomon Islands.
“Yes, my husband and I would like to raise our children in the Solomon Islands as well, so they can learn about their Solomon family and culture.” We’ve discussed working there, but nothing has been finalised.”
Her family’s most recent visit to the country was in January 2020. With the government’s recent announcement that international borders will reopen in July, there are plans for another surprise visit to the Solomons.
“Of course, we’d love to pay them a surprise visit.”
She also joins a team of Adventist health workers who go out to do medical work and church programmes because she works in a smaller hospital that is less busy.
“We have a Vanuatu Adventist Health Workers Action Team (VAHWAT) that goes out and does health screenings as well as running church programmes.” However, due to Covid-19, things have been rather quiet recently.”
There are currently no plans for any major additional studies. “I’m happy with where I’m at right now.” Perhaps only brief stints abroad or online to develop specialised skills.”
Although she has not worked at the National Referral Hospital (NRH), she believes it, like Port Vila Hospital, has room for improvement.
“I haven’t worked at NRH since 2008, so a lot has changed.” In comparison to VCH, I believe NRH is more advanced and has more resources and specialists. VCH is a small hospital with a capacity of 200 beds. NRH, like VCH, has a lot of room for improvement.”
She stated that there is a need to improve basic health care services and expand specialist services.
“I believe that the priority should be to improve and elevate the level of basic health care services provided while also expanding into more specialist services,” she said.
Let us wish her and her family the best in the coming years as she pursues her passion of serving the sick in Vanuatu.