The situation: a whole island in Vanuatu was evacuated due to increased volcanic activity
“We were at church…and we noticed ash falling down. We thought ‘the volcano has fired up’. A man came to tell us that we needed to move to a village further north… That afternoon we moved… We thought we would only be gone for a short time so we only packed small bags… But then we were told that some ships and planes would come to take everyone off the island.”
On the 23rd of September 2017 the Government of Vanuatu increased the alert level of Monaro Volcano on the island of Ambae from level 3 to level 4. Due to the risks posed to residents, the Government made the decision to evacuate all residents from the island. During the first week of October, approximately 11,000 people were evacuated from Ambae to the islands of Maewo, Pentecost and Espiritu Santo. Of those evacuated, close to 6,000 were sent to Santo where 51 evacuation centres were set up. The Church of the Latter Day Saints on Santo was identified as an accessible location during the evacuation, and a number of people with disabilities, frail and/or elderly persons were housed there.
At the time of the evacuation, walking aid and wheelchair services were established only on the Island of Efate through a network of providers including Vanuatu Society for People with Disability (VSPD), the physiotherapy department at the Vila Central Hospital (VCH) and the Disability Desk at the Ministry of Justice and Community Services (MOJCS). Walking aids and wheelchairs donated by the Latter-day Saints Charities (LDSC) were stored and managed by VSPD in Port Vila. Both VSPD and VCH have staff trained in the assembly and provision of walking aids and wheelchairs. The week prior to the evacuation, Motivation Australia (MA) and VSPD had just completed a consultation visit to Santo, to discuss with stakeholders the expansion of mobility device services to Santo.
What was the response?
The need for mobility devices for people evacuated from Ambae was identified very early by those coordinating the evacuation.
The Ministry of Health (MOH) responded by deploying two physiotherapists to Santo who worked with the Health Cluster as part of their Emergency Medical Teams. The physiotherapists conducted screenings of individuals in Santo, providing an estimate of the number, type and sizes of devices required.
Initially VSPD staff and Motivation Australia provided remote support to MOH and prepared the necessary stock of mobility devices to ship to Santo. Due to the intensive workload required of the physiotherapists, personnel from VSPD and Motivation Australia travelled to Santo to provide support to them and other stakeholders.
All stakeholders including VSPD, MOH, MOJCS, Santo Provincial Government, the Vanuatu Disability Promotion and Advocacy Association (DPA), LDSC and Motivation Australia worked closely together with the Health Cluster and the Gender and Protection cluster to meet the demand.
On request, recommendations were also made regarding the most appropriate method of transfer and transportation for the repatriation of each mobility device user. Regular updates were sent to the both the Gender and Protection and Health Clusters to ensure all relevant stakeholders were kept informed.
What were the outcomes?
Through the joint work of all partners 56 individuals were assessed, including 33 women and 23 men. A total of 16 wheelchairs, 34 walking aids and one pressure relief cushion for an existing wheelchair were provided to evacuees in need of mobility devices. The needs of each mobility device user were considered using an assessment process, and devices matched as much as possible to the user’s needs. Every individual who received a device received user training in small groups. Only five individuals could not be prescribed a device due to the complexity of their postural needs.
Through a collaborative approach and providing the necessary support to those on the ground it was possible to implement a high standard of mobility device provision. This gives greater assurance that those who have now returned to Ambae have devices that better suit their needs.
Good records were kept, using standardised wheelchair and walking aid forms. This will be invaluable in planning follow up for those who received devices as well as reporting to donors.
What were the challenges?
- Time delay in response: Due to a number of factors, it took almost a week to be in a position to confirm the ability of local partners and Motivation Australia to respond to the need for mobility devices amongst evacuees. Some of these factors were out of our control, including the initial lack of data regarding how many people may need assistance and where they were being evacuated to.
- Equity of response: Limitations in the capacity of the available workforce and the short time frame meant that the response was inequitable as evacuees on other outer islands (including Maewo and Pentecost) did not get access to mobility device services through the response.
- Coordination: With a large number of Government departments, non government organisations and individuals working on response activities, along with an atmosphere of urgency at cluster meetings it was challenging at times to know who the most appropriate people were to liaise with, provide updates to, and seek information and guidance from on the ground.
- Complexity of need: A small number of individuals were identified with complex postural support needs for whom it was not possible to meet the needs for mobility and postural support with the available time and resources. This highlights the challenges associated with the lack of rehabilitation services and access to appropriate mobility devices for people living on Ambae and on other Islands in Vanuatu.
What did we learn?
Preparedness: The strength of the established wheelchair services in Vanuatu provided a sound basis from which to work. In addition, the availability of mobility device stock in Vanuatu meant that it was feasible to provide devices within a relatively short space of time. This highlights that service strengthening as a whole can improve the capacity of national partners to respond during an emergency situation. The following disaster preparedness strategies have also been suggested based on lessons learned from this situation:
- Having funding options in place to support the rapid mobilisation of personnel
- Guidelines for the ‘standard of provision’ of mobility devices during an evacuation to be agreed on
- Pre-training of those personnel likely to be called upon in early responses
- Simple tools available to assist including service forms and group training approaches
- Quarantining of some pre-positioned stock for immediate deployment for short term mobility options in the case of an emergency.
Wheelchair provision strategies: It was possible within the context of an emergency to carry out basic level wheelchair assessments and basic training for individuals in how to use their devices. Successful strategies for mobility aid provision included:
- Clustering of people with disabilities within one main location
- Screening which provided an initial identification of the type of mobility device required to assist in preparing and freighting stock
- Readily available wheelchair and walking aid assessment forms
- Use of group user training sessions.
Coordination: It was evident the importance of ensuring that the response was coordinated through the relevant clusters established as part of a humanitarian response.
Follow up: Throughout the response, Motivation Australia and partners ensured stakeholders were aware of the importance of committing to follow up of mobility device recipients. Plans have been made for VSPD and VCH physiotherapists to complete a joint follow up visit to Ambae in early 2018. Through the expansion of services to Santo, Motivation Australia will continue to work with partners to identify systems for sustainable and ongoing follow up for people living in the Northern islands of Vanuatu, including Ambae.
Motivation Australia acknowledges the following who we worked in close partnership with throughout the response: VSPD, VCH physiotherapists, Doriane Naliupus, Nellie Caleb (DPA), Health Cluster, Gender and Protection Cluster, the Latter Day Saint (LDS) Charities and the LDS Church in Santo. We also acknowledge Northern Provincial Hospital (NPH) and Save the Children for various logistical support. We thank LDS Charities for their ongoing support of mobility device services in Vanuatu and other Motivation Australia project funders including Australian Government through the Australian Non Government Cooperation Programme (ANCP) and the Morris Foundation.