We have a health facility in Melsisi that has been through a number of incarnations. At one point, it was a deemed a mission hospital and only people attending the church or the school were allowed to use it. (Since more or less everyone is Catholic, that wouldn’t have been a big restriction, though it may have been different then.) I’ve heard rumors that it was also a secular hospital during colonials times or perhaps just after independence. For the last at least 10 years it has been a “Health Center.”
The rankings are something like this: a hospital has doctors, several nurses and a wider scope of practice, the hospitals in Santo and Vila are the only ones that have the full compliment of what you might expect but the provincial hospitals can do a lot including surgeries; a mini-hospital has a doctor, a nurse practitioner, a midwife, a nurse, a maternity ward and dental as well as the other miscellaneous things; a dispensary has a nurse or nurse practitioner, a maternity ward and a minimum of drugs as well as limited beds for in-patient; an aid post has a village health worker (12 weeks training) and can do dressings and malaria tests.
After the French army renovated our Health Center, it is officially a Mini-Hospital. Of course, we don’t have a doctor yet, but we’ve been told we’ll have one when the group currently studying in Cuba and China finishes and comes back. I think that’s about three years away. They are also looking at increasing the staffing, but that may be all hot air. There is a serious shortage of trained health professionals in Vanuatu at the moment.
The renovations themselves include a new maternity ward with hot water in the delivery room, all new beds and new work stations; a dental room (though we have no one who can do dentistry); a new prenatal and postnatal room with proper baby scales and an icebox for vaccines; an “emergency room” that at the moment consists of a bed in a room without lights, equipment or anything else; a new pharmacy with a locking door that is separate from the rest of the buildings; and a hybrid electric system with 26 solar panels and a diesel generator that feed into a battery. That alone is probably worth more than the entire old Health Center was.
The other up side of this project has been the re-invigoration of the community. By outsiders coming here to put time, money and labor into this health center, it reminded the community that it is a special thing to have and we are lucky to have. There was a huge uptick in the number of patients during the renovations (which may have been due to the French doctor treating patients or due to the chance to watch the French work from close up) but the increase has been steady for the past week. People are remembering that the Mini-Hospital is a facility with the ability to improve their lives if they take advantage of it being there. I hope the trend continues and we see a general increase in public health and public health projects in this area because of it.