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August 18th 2011
Published: August 23rd 2011
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Well everyone…it’s been a month since the last entry and a great deal has taken place. Of greater significance, however, is what has NOT taken place. Please try to remember folks, this is Vanuatu, and we first-worlders need to be able to roll with the punches.

If you’re not interested in the dreary prose, here’s the short version:

The construction of the Sele Clinic is being put on hold at the request of the Ministry of Health, but against my personal desire. I want to do what’s best for the greater good and most economically efficient for our donors, but I feel terrible about not finishing the clinic this year. However, what you want and how you feel are rarely in agreement.

If you’re strange enough to enjoy my ramblings, here’s the long version:

I’d like to preface everything with an update about the political happenings here in Vanuatu during the first half of the year. About the time I left (last year around Christmas), the parliament held a secret meeting while the Prime Minister was out of town and the opposition ousted him. Since then, the government has changed hands 5 times between opposing parties. With each new regime, a new set of Politicians is placed in charge of the various government ministries. Since they know their regime will inevitably be found unconstitutional and/or ousted by votes of no-confidence, each new Political Minister will ransack the various Ministry budgets they are currently overseeing.

Since I left, there have been several different Minister’s of Health.

The people who actually do the work for the citizens of Vanuatu are the civil servants. They are the ones that have to care for the populace, and with each new temporary politician at the helm they are forced to work with fewer and fewer resources.

It sucks, but it’s pretty par for the course in a developing nation.

Now that I’ve returned, I’ve had to change Project MARC's plans for the benefit of the beleaguered civil servants striving to do their jobs. What this means is: The Sele Clinic will not be completed this year. For me personally this is a kick to the gut, but the needs of the many are more important than the needs of the few (or feelings of one).

Two years ago the Ministry of Health asked me to build a dispensary on the West Coast of Espiritu Santo. This was their Priority One. Priority Two was a clinic in the Big Bay Bush near the village of Sele, those priorities have changed.

Two years ago the Samna Province Management was pushing for Infrastructure Development, like the building of new structures to access communities in remote regions. To facilitate this, we agreed to build two clinics over the course of the next couple years. All of our projects involve three participants: The Communities, Project MARC, and The Ministry of Health. Project MARC pays for the majority of supplies and transport required, the Communities provide labor and what supplies they can, the Ministry of Health hires a head carpenter and assists with supplies and transport.

Last year, Project MARC and the Communities surrounding the West Coast project site fulfilled their part of the arrangement. As per the agreement, the MOH was going to furnish the clinic and staff it with a Nurse before the beginning of 2011. Upon my return (July 2011) there was neither furniture nor a nurse in the clinic. Due to the year’s previous political turmoil, the MOH was not able to uphold their end of the bargain.

Likewise, the focus of the MOH has changed a bit as well. The goal now is to expand Human Resources before furthering Infrastructure Development. Simply put: We can build all the clinics we want, but what’s the point if there’s no staff to fill them up?

These two changes have forced Project MARC to change directions. We cannot justify continuing construction on the Sele Clinic until the MOH is in a position to fulfill their end of the agreement. If we were to finish the clinic in Sele it would be a horrible burden to the Samna Province MOH, and everyone knows that they don’t need any more of that.

Our resources are now being diverted to the Joseph Mape Limarua Clinic which we built last year. We are going to furnish the clinic for the Ministry of Health since their diminished budget will not allow them to do so. Upon completion of the furnishings, a nurse from the North District Hospital will be stationed there in an interim position until a full time Rural Health Nurse can begin work at the beginning of the next fiscal year.

The way I figure, it is better to have one unstaffed clinic rather than two.

A large part of me really just wants to bull ahead with the construction of the Sele Clinic. The flagship program for Project MARC this year was the Maternal Health Expedition, but for me personally it was the completion of this clinic. I started it last year, failed to finish it, but told myself and others that I’d be back to complete what we’d started. Donors gave large amounts of money, and the community poured so much work into the existing structure on the promise that the clinic would be completed and staffed within a year. NOT completing the clinic this year is a breach of trust to both the donors and the communities. Yet in the long run, it is the lesser of two evils.

If we were to complete the structure, there would be no nurse to staff it and no government support to maintain it. Anyone who’s lived here understands that an abandoned structure will be reclaimed by the jungle at a remarkable rate. We could finish the clinic now, but it would be a waste of our money and labor. We are better off to finish the construction when the provincial Ministry of Health is in a place to take ownership of the facility.

Now may be a good time to mention that a Rural Nurse’s salary for a year is roughly $11,000 USD.

And now, for the silver lining…

Project MARC’s flagship operation for the year has just wrapped up and it was a great success! We trained and certified three dozen Traditional Birth Attendants from villages along the West Coast of Big Bay. There were some tough times at the beginning but our team overcame and triumphed in the end. I’ll let the volunteers share their stories of this first MARC Expedition for 2011 (to be posted up soon with photos). It was their work that made it all possible and ultimately they should be the recipients of any accolades.

Thanks for staying interested everyone! The fun stories are yet to come.

*Having some issue with Travel Blog on this one. Not accepting photos at this time. Please check out the albums on Facebook for visuals of our work!


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