With water now flowing, toilets are next

This has been an exciting month in East Kwaio. Imbo School, a church-run primary school with about 100 children from Wyfolonga, Abitona and surrounding villages, has had three water taps installed. This is the first time the school has had running water for the students since its establishment almost 50 years ago.

Encouraged and supported by Mr Shayne Humphries, Manager of Capability Projects at Hunter Water (Newcastle, Australia), the school now has two taps and a basin for students, and an additional tap for public use.

“Ours is the first school in our district to have taps”, explained Chief Hensen from Abitona Village, “and we are very happy for our children.”

Following this success, a village meeting was facilitated by Atoifi Health Research Group leaders Chief Esau Kekeubata, Mr Tommy Esau along with the leaders of Abitona village last Sunday, 30 September.

Plans were made for student and staff toilets and wash facilitates that are easy to maintain, culturally appropriate and take into account the needs of all students, including senior girls who are menstruating. It was reaffirmed that education and appropriate toilet facilities were essential for both male and female students to allow the best outcomes.

The meeting was also attended by AHRG leaders Dr Michelle Redman-MacLaren, who facilitated discussions about needs of menstruating girls, and Mr Tommy Esau, who discussed toilet designs and resources required.

“It was excellent to have the specific needs of girls discussed in the meeting”, Dr Redman-MacLaren said. “Right now, some girls in East Kwaio don’t go to school when they are menstruating because there is no way to manage their periods.”

Since the meeting, a group has met, sketched plans and plans are now being made for the building of the toilets, with additional support from Mr Humphries.

For more information about this story, please contact Tommy Esau:

To read about the water, sanitation and hygiene situation for girls in the Pacific, you can read our published review for free here:

1) Chief Rex Silas with a student from Imbo school at the new basin and taps (photo supplied by Shayne Humphries)
2) Tommy Esau leading a community meeting about Imbo school toilets at Abitona village (photo supplied by David MacLaren)

Who is getting malaria, where and when? A new study underway

By Stephanie Wheeler*

The Atoifi Adventist Hospital staff knew that it had been a big year for malaria (so many patients presenting and so many slides to examine!), and communities had noticed more people becoming unwell in their villages too. Since the last malaria study at Atoifi in 2014, malaria data has been carefully collected, but not yet analysed.

With a sense of changing malaria epidemiology in recent years, a new study commenced in September to understand the current situation of malaria in East Kwaio. Data were entered electronically and analysed to describe who is getting malaria, where and when. Cases were also analysed by malaria species, and by number of hospital presentations for malaria.

As data only ever show a small part of the story, initial results were presented to key hospital staff and community leaders for input on the context of the findings. The group brainstormed many solutions and recommendations for next steps both within the hospital, and community-led initiatives.

We look forward to sharing the results soon!

*Stephanie Wheeler (RN, MIPH) is a Field Epidemiology trainee with the Australian National University and Hunter New England Health Protection in Australia.

To read the previous AHRG Malaria paper, please visit:

Photo: Stephanie and Dorothy Esau enter malaria data for analysis (photo credit Peter Massey)

Analysing data can be fun!

Learning quantitative analytical skills can be challenging.This can involve extensive time slaving over textbooks and worksheets. However there are fun and practical ways to gain the same skills using a ‘learn-by-doing’ approach.

In September 2019 Associate Professor Peter Massey delivered a series of ‘learn-by-doing’ workshops with final year students at Atoifi College of Nursing. Students worked together with coloured jelly beans to learn how to calculate disease rates, and investigate the prevalence of disease and disease outbreaks in different populations and sub-populations. Coloured jelly beans were used to represent different populations and sub-populations.

Students reported that they had increased their problem solving and analytical skills – and had lots of fun during the activities. Analysing data can be fun!

Sharing results for action: A Zika Survey on Malaita

By Mr Humpress Harrington

In May 2019 PhD candidate Mr Humpress Harrington and Associate Professor David MacLaren worked together with Atoifi Hospital Primary Health Care Department and community leaders to feedback results from the recent study to investigate the transmission malaria and aroboviruses in villages in East Kwaio.

The study, conducted in 4 villages, found 2 - 13% of people tested positive for malaria but did not have any signs or symptoms. Overall 45% of people tested positive for flavivirus (Dengue or Zika) and 46% tested positive for Alphavirus (Ross River or Chikungunya). The team also found that Aedes Albopictus, a mosquito responsible for arbovirus transmission was also found present in all 4 villages.

The result was firstly presented to the Atoifi Hospital and School of Nursing leaders. The results were then presented in open community meetings to the four communities in collaboration with the hospital Primary Health Care director Mr Chillion Fanuabae. Four nights were set aside in consultation with the communities to do the presentations.

Each night, presentation was given with Primary Health Care team followed by questions and answer session and a detailed discussion on what can be done by the communities and the hospital to control the spread of malaria and the arboviruses in the villages.

This is the first time that a community-level study has been conducted in East Kwaio to investigate arbovirus transmission. Therefore the results are very important for Atoifi Hospital, the Primary Health Care Department and the surrounding communities in planning to control vector bone diseases within the East Kwaio region.

The Atoifi Health Research Group wished to thank the James Cook University-led ‘Tropical Partners’ project and the Ministry of Health and Medical Services for making this survey possible.

For further information please contact Mr Humpress Harrington:
Photo: Mr Humpress Harrington sharing study results with villagers in East Kwaio