“A low-risk 10-bed Maternity Unit will be established in Makoi at a cost of $600,000FJD. This new facility will make this crucial health service more readily available to women living in the Makoi community, reducing the risk of maternal or infant mortality in this populous area.”
-Prime Minister Bainimarama announcing the 2014 Fiji National Budget
The expansion of the health center where I work has been the topic of conversation for quite a while now. I learned about it a couple of months after arriving at site while attending a Board of Services meeting one afternoon. At the time it was one of those “coming soon” type of plans. Everyone knew about it but we also knew how long it takes for something of this scale to move through local and government channels. Last November, PM Bainimarama announced that we would be getting the necessary funding for the expansion!
The 10-bed Maternity Unit will be built on a lot of land behind the current health center building. Right now the lot is just an overgrown space and like most unaccounted for open spaces here people have been using it to plant root crops. Construction on the Maternity Unit will begin…”soon”.
The bigger picture is that the new Maternity Unit will be a step forward in decentralizing health care in the Suva subdivision. This is a step in the right direction because the major hospital in Suva, Colonial War Memorial Hospital (CWM), is overburdened with patients and are working with a limited number of medical staff. Since Makoi is just outside of Suva the new extension will hopefully provide a much needed, and of course more convenient, service to the families in the area.
On a more day-to-day level, the staff and I are excited about the extension because it will alleviate one of the biggest problems we have at the health center– lack of space! When the health center was built in 2007 it wasn’t meant to take on the patient load and variety of services that it currently has. Over the years various factors like urban drift, the increase of NCDs in Fiji, lack of available facilities/equipment in other health centers, etc. has made Makoi Health Center work over it’s maximum capacity. Benches have been donated to the health center yet oftentimes chairs from the rooms have to be moved to the waiting area so patients can have somewhere to sit. When that doesn’t work, well patients stand and sick patients are given seating preference. This usually causes a crowd in the waiting area that extends beyond the front doors. Not to mention issues of cleanliness, safety, and productivity.
Staff at the health center feel the burden of lack of space and resources as well. The Ministry of Health provides equipment to the staff and furnishings for each health facility, but there are only so many items to go around. What you get is what you get. Maintenance of health center equipment leaves a lot to be desired and when something is malfunctioning or breaks it can take months to be replaced, if at all.
Each nurse gets a desk, a chair, and a cabinet to store their belongings. That means that that one desk, that one chair, and that one cabinet is claimed! It isn’t “the health center’s chair” it’s “my chair”. On many occasions I’ve seen nurses get into it because “their” chair was moved. A full on investigation ensues to find the chair and the poor soul who moved it. There are witnesses (“I last saw so-and-so with it in the zone room.”), there’s evidence (“This is so-and-so’s record book by the chair, they must have taken it.”), the confrontation (“You took my chair! No, this is my chair see it has my name on the back. You use your chair!”), and eventually the resolution (said chair is back in the presence of said nurse). It all seems silly until that fateful day when you’re the one that has accidentally used the desk/chair/cabinet without permission. Then shit gets real and for a split second you wonder why you joined Peace Corps (hahah kidding!). I can’t say I blame them though. When there’s a lack of resources it’s only human nature for people to guard what’s “theirs”, as disruptive as that might be for the work environment.
The lack of space and resources isn’t limited to the staff. My first week at the health center I was given a desk and a chair in the corner of the Sister’s Office, which is basically the main office. My second week at the health center the desk and chair were moved to another room where it was used to help the nursing staff. At first I was offended because I, too, had started feeling that sense of ownership; that it was “my desk” and “my chair”. I didn’t have a specific place to sit and over a year later I still don’t. At work I sit wherever there is available space. I take my laptop with me every day so when I can’t find an unoccupied desk I work with the computer on my lap. I’ve actually gotten pretty good at making myself cozy in whatever nook of space I can find. A few months before leaving for her rotation the previous Sister-in-Charge gave me a drawer in the file cabinet. It’s even got my name on it! Now I have somewhere safe to put my things :D
It might sound inconvenient but not having a desk/chair has helped me to be a more flexible volunteer. I don’t have a desk rooting me to one area of the health center so it’s easy for me to roam. Whichever staff member I’m helping that day, whether its in the pharmacy or the reproductive health clinic, I pull up a chair (after having asked nicely, of course) and sit. It’s also been a great way for me to build relationships with the staff because I get to spend quality time with them. Sure, I could make a fuss and demand a desk/chair and would be well within my right because volunteers are supposed to be provided somewhere to sit and work, but its really not a big deal to me at this point. Hey, a rolling stone gathers no moss, right?! I guess in this case it would be a rolling coconut :)
The Maternity Unit is slated to be completed at the end of this year well after my COS date. I won’t get to see it up and running but I already know it will be beneficial for the health center and the surrounding community.