MINISTRY OF HEALTH
AITUTAKI HEALTH
CYCLONE ASSESSMENT
REPORT
Aitutaki Hospital, Doctor’s Residence and Community
Health - Public Health Inspectorate
Prepared by: BH Sinclair, Tata Vaeau and Charles Ingaua, Thursday 11th February 2010
AITUTAKI HEALTH CYCLONE ASSESSMENT REPORT
Departed Rarotonga at 9.45am enroute to Aitutaki via Mauke. Arrived
Mauke at 10.35am and had to await clearance before flight could
proceed for Aitutaki. Met by Dr Tauraii and staff and he took us on a
brief visit to the Mauke hospital and dental clinic.
We returned to the airport and departed for Aitutaki at 2.05pm
arriving Aitutaki at 3.45pm. Picked up by Dr Koko and Tereva and
driven to the Aitutaki Hospital.
Tropical Cyclone Pat has left the people of Aitutaki shattered with this
disaster. A lot of people left homeless with nothing, some residing
with families and friends, some still in shock trying to get over the
disaster.
We began the assessment of the Aitutaki Hospital and took notes and
photos of damages sustained to the Exterior part of the Hospital
Building and continued with assessment of damages sustained to the
Interior part of the Hospital Building.
Time did not permit us to carry out a complete assessment of the
Doctor’s residence and photos were taken on Thursday morning. We
assisted the staff with the cleaning of the inside of the hospital to
ensure that hospital services are maintained, despite the
circumstances.
Government Agencies Meeting
All representing agencies from Rarotonga gathered on Thursday
morning at 9.30am at the Aitutaki Power station for a quick overview
of the overall situation on Aitutaki. Agencies from Red cross, MOW,
Infrastructure, Telecom, Police, Health etc were split into teams of 4 to
conduct a full initial assessment of Aitutaki infrastructure, water and
sanitation and report back to the Disaster Team co-ordinated by
Charles Carlson. This assessment took days to complete and covered
the entire island. Priorities outlined in the meeting
- Shelter
- Power and communications
- Water and Food
- Sanitation
- Safety centres and schools
The following representatives inspected the hospital property and they included:
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Deputy NZ High Commissioner Ms J Afleck
Mr Charles Carlson, Disaster Management
Mr Patrick Arioka, Disaster Management
Mr Charlie Numanga, Red Cross
Hon Minister of Health
Hon Prime Minister and Cabinet Ministers
Eusenio – Representative from CIIC
OMIA, MOWEPP
Mr Bob Standby, Australian Red Cross
Mr Tai Herman, Mayor
Red Cross Water and Sanitation
Health and the Water Work personell (Tukua) met and conducted site
inspections with Bob Standby – Water and Sanitation Manager for
International Emergencies. A main concern for Bob’s visit was to
identify solutions to water safety in terms of drinking water and also
help assist in sanitation. However Health together with Bob conducted
a site visit to the Water Well, where we identified Vaipae Gallery as the
main source for palatable water for the people of Aitutaki.
- collected water samples from Vaipae Gallery Well (Sample 1)
- collected water samples from Vaipae Storage tank (Sample 2)
- collected water samples from Vaitau School.
The above samples will be tested for bacteriological and salinity and
the results will determine the plan of action highlighted below.
Bob had also advised us that a report had been conducted in late
2004, on water resource management on Aitutaki prepared by Sarah
Davies, Marc Overmars and Tasleem Hason.
The above named sample collection area was the only easy access to
get samples as power was not on during our time of visit. Based on
our findings, Bob has recommended that Redcross will need to import
into the country a water treatment system (ultra violet disinfection) for
treating water as the need for drinking water is of a high priority.
Possible chain of water distribution are = pumping of water from main
water well source (Vaipae Gallery) to the storage tank whereby water
will be channelled through the treatment plant onto a storage water
tank mounted on the truck, and has to be carted or distributed
throughout the island every 2 days.
Risk Assessments findings
Assessments was conducted throughout Aitutaki and our findings are
as follows
Water Supply
Inadequate water supply on the island for each individual households.
There is no running water from the main reticulation system as the
electricity is completely out. Water is dirty with regards to individual
water tanks (mostly plastic approximately 3,000lts) and is used for
daily chores as well as drinking. People have been advised to boil the
water to prevent gastro-enteritis infection.
Sanitation and Waste Management
About 70% of households on the island have crippled and inadequate
sanitation. Toilet facilities haves been damaged structurally with no
physical indicator of damaged septic tanks or leaking sewage and
people had somehow managed to use the same toilet or in worse
cases their neighbors. Currently sanitation in terms of sewage is not a
priority problem. Septage pond is not flooded, and a lot of debris from
the cyclone are currently in the pond.
Vector Control
A total of 4 stagnant water has been identified as potential breeding
sites for mosquito. Another significant breeding places for mosquito
are the low lying area around the island whereby flooding is very
evident. It is anticipated that mosquito larvae infestation will erupt in 5
days time, however there is insufficient stock available for the whole
island to complete.
Safety Cyclone Centres and Schools
Cyclone centres around the island has been damaged, roof tops blown
off by the wind, broken windows and doors including walls. The Araura
College is also damaged and currently not safe for occupation.
Food Safety
Food Outlets although appears to be damaged but they have resumed
selling products again from their intact side of building. The products
are still good and fit for human consumption especially canned, dry
products. In terms of food hygiene in the homes people were advised
during our initial assessment to be aware of cleaning and washing
hands (personal hygiene) and cooking utensils.
RECOMMENDATIONS
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Hospital Electricals to be thoroughly checked. Especially to areas that sustained
damages, ceiling ripped and exposed, and in some places have buckled. Power
points were also wet as a result of the leakage from the ceiling and rain that came
through from the windows
Hospital plumbing to be thoroughly checked and repaired, especially the repairs
and leaks to the water tanks, solar panels system and plumbing that run inside the
ceiling area of the hospital.
Tarpulins – in the interim to cover the outside walls that have been ripped.
However, the Outside Walls will need building materials to be repaired to avoid
further damages.
Electrical appliance such the washing machines and air condition units to be tested
and ensure that it is working.
Medical, laboratory and IT equipment that were thoroughly wet and confirm
whether they are workable.
Meanwhile, urgently liaise with Rarotonga Hospital to provide a Steriliser, an
autoclave and a haematology analyzer .
Request for an xray – service engineer to carry out servicing to xray equipment
that was wet. Dark room will also need to be checked.
Ensure sufficient supply of domestos, janola, sterile gloves, cleaning gloves,
handwash, paper hand towels, windowlene, etc
Request for crutches
Order stocks for larvicide
o 2 drums of diesl oil
o 24x500g Vectobac
Equipments
o 1x15lts knapsack
o 1x15ltr mistblower
Safety Apparel
o 4xoverall size Large
o 4prs of gumboot size. 2x Size 11 and 2x Size 12
o 2xrespirator
o 2xfacemask
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Request extra resource(2) personnel to help with Aitutaki
Health Aitutaki to continue to notify Public Health of any
communicable or notifiable disease for further monitoring and
surveillance to prevent an outbreak from occurring.
Liase with environment the disposal and management of fibrolite
Continue to implement awareness and hygiene to prevent
further occurrence of disease.
TEMPORARY MEASURES PUT IN PLACE UNTIL ELECTRICALS ARE CHECKED
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Refer all hospital laundry to Snowbird until electricals and power points are
checked by electrician, including checks to the Washing Machine
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Refer all deliveries to Rarotonga
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Refer all X-ray patients to Rarotonga
ANTICIPATION
As discussed with resident Medical Officers Dr Koko and Dr Lwin they anticipate an
increase in pharmaceuticals and consumables due to a rise in gastroenteritis infection,
and an increase in patients presenting with cuts, puncture wounds, abrasions and falls.
We will also anticipate an increase in patients presenting with diarrhea, vomiting, stress
etc.
The following captivates a summary report of the damages sustained to the Aitutaki
Hospital and Doctor’s residence:
DAMAGES SUSTAINED TO THE OUTSIDE OF THE HOSPITAL
AMBULANCE BAY
 A piece of the extension to the gutter is missing. Approx. ½ metre
HOSPITAL ENTRANCE
 Solar Panel (Solar Hart) missing including the plumbing fittings to the solar tank
 Water leaking and running continuously off the roof
 Outside wall ripped and torn away – approx 2.5 metres x 1 metres
 Top outside walls ripped – not sure of roofing iron if any has been ripped away.
Approx 3 metres x 1 metre (Above the storeroom and PABX room)
TOP OUTSIDE WALL ABOVE ISOLATION WARD
 Outside walls ripped – approx. 10 metres x 3 metres
 Spouting and gutter damaged
KITCHEN (facing Telecom)
 Facia boards over the back of the kitchen – ripped. Approx. 12 metres length
 Ridging on storeroom side - ripped. Approx. 6 metres
 Missing solar panel and fittings
 Roofing needs to be checked
LAUNDRY
 External back door – torn apart. Require replacement hinges: 3x 4” hinges
 Internal door. Require replacement hinges. Total: 3 x 4” hinges
 Washing machine to be checked - power cord still in point and dripping with
water.
 Check Electricals
PUBLIC HEALTH SHED (Opposite Telecom aerial)
 Completely destroyed and flattened
Items in storage exposed and includes chemicals, pesticides, old equipment, lawn
mowers, grass cutters, drums of diesel, mistblowers, knap sacks and other accessories
KITCHEN
 Main door – require replacement glass
 Little room adjacent to kitchen require replacement door for one side only.
Measurements TBA
 Standing Fan – wet and base bent. Please check before use!
 Industrial vinyl ripped
 Flooded towards the main door
 Main kitchen area – No damage
WATER TANK (Outside theatre)
 Missing 4 pieces of roofing iron – blown away
 Loose roofing iron
 Plumbing fittings and accessories destroyed
MATERNITY WARD (AT THE BACK FACING TELECOM)
 Gutter, spouting and brackets - damaged and missing. Approx 18 metres in
length
 Outside wall ripped 2 metres x 2 metres
 Hot Water Solar Unit completely damaged and panel missing
OUTSIDE THEATRE
 Water Tank Lid gone with the wind
 Plumbing accessories and spouting from roof damaged
 Boards damaged
BETWEEN THEATRE & ISOLATION WARD (Back door)
 Damage to outside wall – ½ metre
 Two benches broken and destroyed
BETWEEN ISOLATION WARD & MATERNITY
 Damage to outside wall. Approx. 6 metres
 Roofing iron ripped – can see 4 sheets missing (Need to check roof)
ABOVE THEATRE & MATERNITY WARD
 Outside walls ripped in two places. Approx. 4 metres x 3 metres & 1metre x 2
metres
BACK OF THE WARD FACING MAIN WATER TANK
 Entire gutter including the brackets destroyed and missing. Approx 54 meters
 Mosquito screens ripped. Total replacement. Measurement: TBA
BACK OF THE PAEDIATRIC WARD
 4x broken lourve blades – 24” lourve blade
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Ripped mosquito screens
Water Filter – ok
BACK AREA OF THE ISOLATION WARD, MALE, WOMEN’S AND PAEDIATRIC WARD
 Mosquito screens to be replaced
MAIN WATER TANK
 Plumbing connection requires glue for refitting
 Small filter netting for inside the water tank – torn (Require measurement)
 Water Pump House – back cover ripped. Approx. 1 metre x 2 metres
TOP WALL OUTSIDE SURGERY NO:1 & NO: 2
 Outside walls ripped. Approx. 2 metres x 1 metre
OUTSIDE THE OUTPATIENT (Facing the little green water tank)
 Outside wall ripped. Approx. 2 metre x 1 metre
 Water tank lid gone with the wind
 Require glue for plumbing fitting
HOSPITAL SIGNS
 Main hospital sign gone with the wind
 Others uprooted and can be put back into the ground
TRANSPORT
 GA189 – Damage to windscreen and Left headlight
 GA4436 – Damage to right hand rear view mirror
DAMAGES TO THE INSIDE OF THE HOSPITAL
OUTPATIENTS WAITING AREA
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Flooded
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Ceiling ripped
Surgery No: 1
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Ceiling ripped. Approx. 1.5 metres x 1.5 metres
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Room flooded
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Computer – UPS, Scanner/Printer/fax – all wet
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Desk – wet
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Cupboard – wet
Surgery No: 2 (Outside wall ripped above outpatients)
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Room flooded
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Computer – UPS, Scanner/Printer – all wet
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Desk – wet
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Cupboard – wet
OUTPATIENT TOILET
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Inside ceiling ripped. Approx. 4 metres x 1.5 metres
XRAY ROOM
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Flooded
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Developer room flooded
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Xray unit to be checked by service engineer
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Check electricals
PHARMACY
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Flooded
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Haematology Analyser Wet
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Air Conditioner Wet
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UPS – Wet
FEMALE WARD
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Ceiling ripped. Approx. 3 metres x 1.5 metres
SLUICE ROOM
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Flooded – no damaged
STAFF KITCHEN
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Flooded – no damaged
PAEDIATRIC WARD (Opposite Nursing Desk)
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Flooded
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Ceiling (above the Nursing Desk area) is buckled and needs to be checked
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Ceiling (across from the Nursing Desk) has ripped. Approx. 7 metres x 4 metres
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Ceiling Fan – check electricals
EMERGENCY ROOM
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Flooded, no damage
PATIENTS TOILETS
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No damage
MALE WARD
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Flooded, no damage
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Ceiling to be checked, along with electricals
MALE TOILETS
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Flooded
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Ceiling buckled – to be checked, along with electricals
CLEANING ROOM
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Flooded, no damage
ISOLATION UNIT No: 1 (Three beds)
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Flooded, no damage
PABX
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Ceiling buckled – to be checked
STOREROOM
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Ceiling ripped – to be checked for leakage
STAFF TOILET
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Flooded, no damage
STUDENT ROOM
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Flooded, no damage
ISOLATION ROOM No.2 (Two beds)
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2x bedside cabinets damaged
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Ceiling buckled – to be checked
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Flooded
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Electricals to be checked
ISOLATION ROOM No.3 (Two beds)
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Flooded
PASSAGE BETWEEN ISOLATION WARD AND MATERNITY
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Flooded
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Check Ceiling and roofing – Open to the universe
THEATRE
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Flooded, no damage
STERILISING ROOM
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Flooded
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All 3x autoclaves wet (Trident EA 625T, NT 85, HIRAKAWA
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1x Lourve blade broken. 27”
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Check ceiling & electricals
MATERNITY WARD
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No damage
ROOM BETWEEN MATERNITY AND DELIVERY ROOM
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Check roofing as there is leakage from solar panel into ceiling
TOILET AND SHOWER FOR MATERNITY
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Flooded - Leakage from Window
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Check electricals
DELIVERY ROOM
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Air Conditioner Unit wet
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1x broken lourve blade 23.5”
PUBLIC HEALTH OFFICE
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Flooded, no damage
DENTAL ROOM
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No Damage
MEN’S TOILET (At the back facing the water tank)
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Flooded, No Damage
ANTE NATAL
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NO KEY
DENTAL WORKSHOP
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Flooded, no Damage, just a ripped mosquito screen. Approx. 1 metre
VICTOR’s OFFICE
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No damage
MEALI’s OFFICE
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No damage
REPORT ON DAMAGES SUSTAINED TO DOCTOR’S RESIDENCE
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Solar panel missing along with fittings and tank damaged
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Carport Destroyed – Leaving a rather large crack exposed along the main outside
wall
Spouting to the water tank – damaged
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(Outside)
(Inside)
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Cracked along wall of the residence – adjacent to carport area
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Ceiling ripped in the toilet and iron roofing above toilet was exposed
(A temporary sheet of roofing iron was placed by Dr Koko but is subject to leaks)