Trouble in Paradise

Published on July 13, 2015
A 4-physician team lands in the remote islands of Vanuatu soon after it was hit with a massive earthquake followed by a volcanic eruption.

A rainbow emerges over one of the two small open boats used to traverse the Pacific Ocean between the team’s initial work location on the southeast corner of the island and their next work site, the southwest corner. Three primary population sites exist on the island, and they are isolated from each other by precipitous cliffs and a volcano at the island’s center.

Imagine black sand beaches, swaying palm trees, more than 80% of the population living in thatched houses, dense jungles, and a towering volcano at the center of a remote South Pacific island. A former English/French cooperative colony with a remote history of cannibalism, Ambrym Island in Vanuatu (formerly the New Hebrides) had an aura of mystery. Sounds idyllic, and the sort of place that Michener would use as a backdrop for his Tales of the South Pacific (which he did).

Now imagine the same setting after a magnitude 8+ earthquake followed, a day later, by a gigantic volcanic eruption with ash and acid rain fallout and, a week later, by Category 5+ Cyclone (hurricane) “Pam.” Not so pretty.

At least half the trees were down, coral pieces covered the beaches, nearly all the outhouses and at least half the thatch-covered household kitchen and houses were decapitated or destroyed, and the people who mostly survived on the vegetables and fruits they grew or harvested from their surroundings were starving. The most acute problem, however, was that their drinking water had been seriously compromised.

I entered the picture on March 23, a week or so after the cyclone. I arrived as a member of the small International Medical Corps team, via a 4-hour flight from Australia, in Port Vila, Vanuatu’s capital on Efate Island. Other non-governmental organizations (NGOs) and New Zealand, Australian, and French military units had already arrived and deployed to the well-known and hard-hit Tanna Island to the south. We were the only ones tasked to go to Ambrym and the smaller nearby Paama Island; no one had much information, since their communications were down.

A tiny plane delivered our team—four-physicians, a logistics/communications expert, one interpreter (Bislama is the main language)—and our equipment into the isolated southeast corner of the island. We later augmented our team with several local interpreters. More equipment, medications, and another logistics expert were coming via a 36-hour ferry journey. As soon as we arrived, we then sped off using the one unpaved path along that part of the coast to meet the Area Secretary, essentially the mayor for that one-third of the island’s population. Sitting in what remained of his thatched kitchen, he graciously offered us what was perhaps the last orange he had while welcoming us to the island. We couldn’t refuse his offer, although we desperately wished that he would save it for himself and his family.

Over the next two weeks, we helped deliver health care, distributed thousands of water purification tabs and plastic jerry cans, did some surgeries and dental extractions, and helped hone the skills of some of the local nurses and nurse aides who generally deliver care for the island—although they were often highly knowledgeable. We traveled in small open boats across choppy seas to Paama Island and the isolated southeast and north parts of Ambrym. Our sleeping accommodations were on the ground or on wooden platforms; our water was prepared by filtering and purification tabs, and our food was often locally acquired, including flying fox (bat), fish, yams, taro, island cabbage and, of course, coconut. We also tried (and did not enjoy) Kava, the traditional root-based drink. I won’t do that again!

As we left, we found that the New Zealand military was coming in to fix the water supply, an NGO was coming to fix the schools, and others would eventually arrive to help put the situation back on course.

Within 3 months, Ambrym will again have locally grown vegetables, a good clean water supply, and functioning schools. Bananas will be available within a year and the tops of the lopped off coconut trees seemed to be growing at least a foot every few days.

This was a rare opportunity to make a timely difference in a devastated environment with the International Medical Corps, an extremely knowledgeable, organized, and experienced organization. As a side benefit, it showed me an amazing place to come back and visit as a tourist in the future. Wonderful people and an awesome setting. That’s what practicing global medicine is all about.

Dr. Iserson is the author of “The Global Healthcare Volunteers’ Handbook: What You Need to Know Before You Go” 2014 www.galenpress.com and “Improvised Medicine: Providing Care in Extreme Environments” 2013, McGraw-Hill.

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