Fiji Hub Achievement Report

January 2018
Dawasamu

The Health Project - Dawasamu District

Objective:

To assist local District Nurse on the health issues concerning the District of Dawasamu in accordance
with the Ministry of Health’s annual objectives for this District.

Summary:

The three key health areas identified by District Nurse in accordance with the Ministry of Health’s
annual objectives for this District. The following were discussed with GVI Health Scholar and an
action plan created to address issues within the communities;

1. The safe disposal of non-recyclable waste

2. Education on how to prevent malnutrition of children aged 0-2yrs and the importance of
Nutrition for breastfeeding mothers
3. Education on Preventative Health Measures and first aid
Report:
The start of the new health program saw our GVI Health Scholar begin to build a relationship with
the local District Nurse, and the people of the Dawasamu district which includes 9 villages and 2
settlements. A program had already been set in place by the Waste Management team whereby the
District had established recycling points in all of the villages and settlements, and education had
been given to the communities of these villages and settlements. The district Nurse had identified
the need, from a health perspective, to make sure the disposal of non-recyclable waste was done so
in a safe manner. The aim was to establish and implement a sustainable process for the education of
Dawasamu residents on the harmful effects of burning rubbish, and the process for the ongoing
monitoring of burn pit usage. The overall goal is to educate +60% of families within Dawasamu about
the harmful effects of burning waste and about responsible burn pit usage by mid-2018.
A meeting was held with the Community Health Workers (CHW’s) from each village and settlement.
They were given a short presentation of the overall program and a booklet on which to record the
number of burn pits in their own village or settlement on a monthly basis. This would empower the
CHW’s to start a conversation within their
own village to make a positive change for
their health. The CHW’s report this data to
the District Nurse every 3 months.

GVI began door to door surveys of an initial 6

villages to see whether waste in fact was
being recycled or if not, how it was being
disposed of. The survey included how soft
plastic, card/paper, food waste, glass, hard
plastic, tin, crockery, aluminium, and
batteries were disposed of. The families were
each given an education session and a laminated hand out on the correct disposal of non-recyclable
material and why it was so important for their family’s health. The laminated handout explained
how when hard plastic was burnt, the smoke would contain a chemical known as Dioxin which was
detrimental to a person’s health. Dioxin is known to cause breathing difficulties and in worse case
scenarios, it is known to cause cancer. It was also explained that by burning rubbish close to water
ways it would affect their oceans and streams. Furthermore, burying rubbish such as batteries could
release acid, which would affect the soil where their food crops were being grown. Education was
also given about the consideration of where burn pits were located in relation to homes and the
time of day burning occurred i.e. whether it was windy at the time. Most burn pits were situated
next to the houses and it was explained that due to the fact that the smoke was toxic it would be
ideal for the villages to have less burn pits, away from waterways and ideally everyone using a
communal incinerator with a chimney to funnel the smoke away from the houses. A second follow
up visit was done to 3 of the 6 villages to perform further surveys and also to ensure the CHW’s were
able to fill out their paperwork. The other 3 villages are scheduled to be visited over the next month.
It was decided to concentrate on 6 villages initially so that the visits are thorough and not rushed
through. The remaining villages and settlements will be surveyed over the next 3 months.

The second key area identified was the prevention of malnutrition for children under 2 years of age.
To assist in this area GVI began to attend the Mothers and Babies clinic at the Dawasamu Nursing
Station every Wednesday. A series of PowerPoint presentations were created and displayed centred
on the 10 key messages set out by the NFNC (National Food and Nutrition Centre) and the Ministry
for Health. Mothers would bring their children in for their maternal and child health check up with
District Nurse and after their check-up they could then be shown one or several of the PowerPoint
presentations in accordance with their child’s age. Education would be given on the importance of
nutrition for both them and their children to prevent malnutrition and also the importance of
nutrition for the mother so that she could continue breastfeeding which would in turn help to
prevent malnutrition of the child. The mothers were registered according to their village and an
attendance record is being kept with the date each key message was given, so as the education
sessions were not repeated to the same mothers.
The mothers were given the opportunity to ask questions and to think about any other health issues
they may like addressed in the future. Thus far, 50 mothers have been seen over a 4-week period. A
number of children have been removed from the malnutrition register in this time, however, it is too
early to see if there is a direct correlation between the education sessions and a removal of the
children from this malnutrition register.

“Improving children’s nutrition has been one of our child health challenges in the Dawasamu district
for the past year post Cyclone Winston. However, this year we are working with GVI to help educate,
support, nurture and facilitate mothers and children to achieve a malnutrition free community” –
District Nurse,Lavenia Merekula Raivono

Going forward 5 workshops are planned based around preventative health measures of common
conditions such as scabies and boils, as well as first aid training related to common issues such as
cuts, burns, bites and the importance of handwashing.