Vanuatu hosts a Asia-Pacific Parliamentarian Forum on Global Health
Rather than being a threat to the Public Health, Hospitals and are essential
to prevent diseases and cure People, while being safe to the Environment
Waste Management and Sanitation conditions of a country are directly, and proportionally, linked with Health System Performance and its cost to tax payers.
Poor Waste Management and Sanitation means Poor Health.
Hospital Waste – Solid or Liquid – is particularly dangerous to the Environment, hence the People. It requires some level of expertise to deal with Waste. If the theme of MOH and WHO Parliamentary Forum is “Health Workforce“, it is important to notice that without proper building the capacity of health workers with specific Waste Management Skills, the Health System can become a real threat to the workers, patients, and broadly the Public Health. Safe Collection, Storage, Transport, Treatment and Disposal of Waste is fundamental to prevent contamination of the environment and protect humans from sharp, chemical, radioactive, and infectious hazardous waste. Some medical substances are expelled by human waste and remain in the water ways if not treated affecting the marine life, which then is consumed by humans.
The MoH has been receiving support and technical assistance from various donors who certainly, like WHO, have the expertise to advise. For example:
- regarding solid waste management, to use minimum standards to building a incinerator that should be built at a convenient distance away from buildings, so that any smoke or gas does not enter the buildings: 150 meters is the suggested minimum.
- on water waste management, 2014, Japan handed over new buildings for the Vanuatu Central Hospital (VCH), inclusive of specific infrastructure to deal with Waste Water from VCH. It was built and design for all buildings of the VCH, new and old, as informed by the Japanese ambassador to the Chiefs of Erakor. But the government never invested in making the connection from the other buildings. So, as of today, many of the VCH buildings keep their toilets and other waste, including blood, flushing directly a dysfunctional waste water treatment plant leaking to the Erakor Lagoons.
A visit to the Vila Central Hospital, incinerators and two waste water plants, would be important not only to local leaders but as part of the program of the visit of the Asia-Pacific parliamentarians. This way, local leaders could understand the challenges of VCH management and Vanuatu could benefit from the learning experiences from parliamentarians from other Asia-Pacific Countries and WHO experts. Maybe, this could assist Vanuatu’s to see waste management and sanitation as a development a priority, particularly for the Health Sector, as a way of reducing the Health expenditure on reduce waterborne diseases.
For many years Erakor Community, and the Council of Chiefs have been actively advocating for the Restoration of the Erakor Lagoons, specifically alerting various authorities for the fact that the VCH Waste Water Treatment Plan is not functional, affecting the Environment, People’s livelihoods and Health. This single ecosystem formed by 2 connected Lagoons is essential for People’s livelihoods and a breading zone for marine life.
2019 May prohibition to fish by Erakor Council of Chiefs to protect the fish population.
In 2020, the government started disclosing water quality reports and become evident the seriousness of the pollution at Fatumaru Bay – the cruise ship entry to Port Vila. No information was made publicly available on the Erakor Lagoon – the backyard of Port Vila – where all the hospital water waste and solid waste from various illegal dumpsites goes.
The Erakor Lagoons, being less exposed to the open sea, and not so able to dilute human pollution, made the community asked the questions: …what are the pollution levels of Erakor Lagoons? …where people swim for hygiene purposes and fish to survive.
The community decided to pay to a professional Lab, Engie, for 2 analysis. This was important to understand the situation and the status of the dysfunctional Hospital Waste Water Plant. The analysis results denounced the existence of dangerous bacteria Enterococci. “Enterococci are indicators of the presence of fecal material in water and, therefore, of the possible presence of disease-causing bacteria, viruses, and protozoa. These pathogens can sicken swimmers and others who use rivers and streams for recreation or eat raw shellfish or fish. Other potential health effects can include diseases of the skin, eyes, ears and respiratory tract. Eating fish or shellfish harvested from waters with fecal contamination can also result in human illness.” (USA Environmental Protection Agency).
The Chief of Erakor Bridge went to the media and shared the news
In October 2020, Department of Water that already knew about the pollution the Erakor Lagoons, and the link with the Vila Central Hospital is, ‘only’, considering a possible ban.
In November 2020, Vila Central Hospital recognized that needs to build a functional Waste Water Treatment Plant . In the same month, Vila Central Hospital was issued with Direction Notice to be supposedly fined by Department of Water: “Direct effluent discharge of sewage water into the lagoon is a breach of the Water Resources Management Act, said the DoWR. The act states “a person who without authorization pollutes any water, is guilty of an offence punishable on conviction for a penalty of Vt5,000,000”. No fine and no waste water plant fixed till today.
In December 2020, Director of Environment says “if the sea water is swallowed, whoever swallows it can get painful stomach aches and diarrhea, continuous diarrhea may cause children to be malnourished in future, for some it may happen quickly while for others it may take time, long term effects include damage to the small intestines. For those who swim every day, skin rash may form on their bodies” .(…) “Stunting causes kids to not grow well as they are meant to be, and this usually makes them shorter in future. According to Director Ham, stunting also causes slow development of the brain which will result in slow learning for the children who swim in this polluted lagoon. Ham also speaks against washing of napkins in the lagoon as she says this is also a major contributor to pollution. She says eating the fish, shells and crabs in the lagoon will also have the same effects as swimming in it as the fish have already been affected by the E. coli bacteria. But she says the infamous sewage plant of the Vila Central Hospital which leaked into the lagoon is currently being repaired*. However, she explains that after it is repaired it will take a longtime for things to get back to normal as the fish will also need to detox themselves which does not happen overnight.”
*the waste water treatment plant was never repaired and continued to leak till today.
Luckily, the Erakor Council of Chiefs already decided to make a fishing ban in 2019 expecting that this initiative would assist the government to act to defend the environment and Public Health. But then, it has became an awkward situation to assist to statements various responsible authorities blaming others on the Waste Water pollution of the Erakor Lagoons. The tragedy of the Lagoons is with so many authorities responsible for the Lagoons there is no clear accountability:
- Ministry of Health – Public Health Department
- Ministry of Health – Shefa Province
- Ministry of Health – Vanuatu Central Hospital
- Ministry of Agriculture – Department of Fisheries
- Ministry of Internal Affairs – Department of Urban Planning
- Ministry of Internal Affairs – Shefa Provincial Government
- Ministry of Internal Affairs – Port Vila Municipality
- Ministry of Climate Change – Department of Environment
- Ministry of Lands – Department of Water
- Ministry of Trade – Department of Tourism
- Chiefs of Erakor
In Feb 2021, many fish dye at Erakor Lagoons and the Department of Fisheries said that doesn’t have funds to make an assessment. No assessment was done till today after few years and opportunities to get funds to do it.
August 2021, Vila Central Hospital recruit Engineering Advisor for Hospital Waste Water Treatment and Engie / UNELCO makes a assessment and provides consultancy services to describe the technical specifications to MoH about how to fix the Waste Water Plant.
A tender contract was supposed to be launched in the same year, but never happened.
December 2021, People from Erakor become sick after consuming fish, with a direct link with sewage of the Vanuatu Central Hospital, as per health workers.
January 2022, Erakor Council of Chiefs invited all authorities and stakeholders to participate in the Erakor Lagoon Restoration Plan. Ministry of Health representatives didn’t participate and never responded to various letters regarding the waste water plant.
February 2022 – Erakor Lagoon Restoration Plan starts
April 2022 – Earth Environment Day – Erakor Lagoon Council of Chiefs invite the authorities to jointly identify the Lagoons’ Pollution Hotspots, shared with authorities
May 2022, Erakor Council of Chiefs were able to get Department of Water to endorse their fishing ban and have an instrument to ban fishing and swimming to protect People and Marine life with the main objective to tackle pollution, instruct polluters to fix leakages and fine them.
2023 January Council of Chiefs are ready to put Government in court due to inaction on fixing the VCH waste water leak into the lagoon
In February 2023, Government informs the Council of Chiefs that got 28mVT to fix the VCH waste water Plant, based on the assessment made by Engie / Unelco in 2021:A year lost with funds, no action and 20 to 25 trucks X 4000 liters X 365 days of waste water into the Lagoon.
October 2023, Chief of Solwota worried about harvesting of sea cucumber against the Erakor Council of Chiefs fishing prohibition participates in GLOBAL INITIATIVE AGAINST TRANSNATIONAL ORGANISED CRIME
23 January 2024, social media activist denounced pollution at Erakor Lagoon
25 January 2024, Director General (DG) of the Ministry of Health (MOH), Dr Samuel Posikai Tapo said that the Government has already allocated VT28 million to upgrade the Vila Central Hospital (VCH) Sewage Treatment Plant. Not being clear what funds, China or Vanuatu, were allocated, a year after with no action.
Minister ensured to the Public that there is no bacteria in the water which contradicts the Department of Water Resources data from https://coastalwater.vu/coastal-water-quality-data-base/ the reason of the Ban by both chiefs and government. He said the issue will be fixed in May 2024.
February 2024, Slow upgrade of VCH sewage system disappoints Opposition
April 2024, Erakor Council of Chiefs considers to lodge a court case against the authorities due to negligence to protect the Erakor Lagoons.
May 2024: As per DG MoH the new waste water treatment plan should have been operational
As of August 2024 this is the situation of the leaking of the Waste Water Plant with a flow equivalent to 20 to 24 trucks of 4000 liters of waste per day (equivalent to 1500 people) flowing into the environment for the last 37 years. Another year lost with funds and no action.
Apart from being non compliance with:
- Constitution of the Republic of Vanuatu
The Constitution mentions the use of natural resources or the environment. It imposes for every person a fundamental duty to him or herself, descendants and to others “to protect the Republic of Vanuatu and to safeguard the national wealth, resources and environment in the interests of the present generation and of future generations”. - Pollution Control Act 2013
The Pollution (Control) Act controls the discharge and emission of terrestrial and marine pollution in Vanuatu. - Waste Management Act 2014, Provides for the protection of the environment by encouraging effective waste services and operations. Establishes specific responsibilities for identifying waste, collecting waste, disposing of waste, planning, and reporting on waste management and managing hazardous waste. Also includes provisions on litter and waste disposal. These responsibilities are shared between the Department of Environmental Protection and Conservation, municipal and provincial councils, the Ministry of Health and Biosecurity Vanuatu. (…) The Ministry of Health has the responsibility to collect and dispose of all medical waste and on the request of the Director, is to prepare and submit a report relating to any aspect of waste management under its responsibility;
- Fisheries Act No. 10 of 2014. The purpose of the Fisheries Act is to a. conserve, manage and develop fisheries in Vanuatu to ensure their long-term sustainable use for the benefit of the people of Vanuatu; and (…)
- Public Health Act. The Public Health Act assigns the responsibility to the Provincial (Municipal) Councils to ensure (enforce) sufficient & safe water for all (sections 42, 43 & 44) and the authority to pass by-laws (section 116). The Minister may also make regulations for the control and maintenance of general environmental health quality in matters such as to prevent soil, water, noise and air pollution, amongst other things (section 113(y)). In addition, section 48 of the Public Health Act provides that “Every person who knowingly and willfully in any way defiles or pollutes any watercourse, stream, lake, pond or reservoir shall be guilty of an offence and shall be liable on conviction to a fine not exceeding VT 1,000,000 or to imprisonment for a term not exceeding 5 years or to both such fine and imprisonment.
- Water Resources Management Act 2002. s 37(2)(h)(i) – regulations may be made for ‘the control, regulation or prohibition of any matter or thing in connection with the diversion, taking, collection, storage, supply, disposal, or discharge of any wastewater’.
- Vanuatu Building Code 2000. NF HEALTH AND AMENITY. Performance Requirements. NF6 Sanitary Plumbing and Drainage. NF6.6 Resorts and Hospitals: The method, design and construction of the treatment plants and disposal facilities for Resort developments and hospitals shall be certified by an approved engineer and shall include disposal of effluent by means of irrigation onto land where sufficient land is available. NF6.6.1 Performance Standards. Effluent from sewage treatment plants referred to NF6.6 shall conform with the following performance standards: § Five Day Biochemical Oxygen Demand (BOD5) shall not exceed 300mg/l (one monthly measurement annual means not to exceed). § Suspended Solids (SS) shall not exceed 30Mg/l (one monthly measurement annual means not to exceed) § Faecal Coliforms (FC) shall be less than 5,000 MPN/100ml for 95% of the time. (Based on monthly measurements taken over an annual period). NF6.6.2 Prohibitions The following practices shall be prohibited: § Direct discharge of treated effluent to marine waters*.
(*there is no reason to have the waste water treatment plan so close to the Erakor Lagoons. It can be moved to another site)
any day of delay on fixing the VCH waste water plant has a significant cost for
The People, The Environment and The Future
As of August 2024:
Vanuatu to host Asia-Pacific Parliamentarian Forum on Global Health
The Ministry of Health (MOH) and the World Health Organisation (WHO) have announced that Vanuatu will host the Asia-Pacific Parliamentarian Forum on Global Health next week.
The forum is an annual event designed to engage parliamentarians on health-related topics. This is the first time it is being held in Vanuatu.
It will be hosted by the Parliament of Vanuatu with support from WHO and MOH, under the theme “Health Workforce.”
A statement announcing the forum highlighted that parliamentarians are a unique group.
Speaker of Parliament Seoule Simeon said, “To need health care is to be human. It is part of life. It begins with the antenatal care provided to our mothers before we are born. It continues with the vaccinations we provide to infants and school children, health checks, screening programmes, primary health care, and then more sophisticated and costly treatments provided by well-equipped tertiary hospitals and specialised care as we age.”
Parliamentarians play a decisive role in strengthening health systems in their countries, even if they are not Ministers for Health.
Vanuatu’s Minister for Health, John Still Tari Qetu, stated that health is everybody’s business.
Parliamentarians and advisors from thirteen countries are arriving over the weekend. They will attend a formal conference and also visit Saupia Health Centre at Paunangisu and Lelepa Dispensary to gain a better understanding of the Vanuatu health system.
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