Progress review of the Healthy Villingili
Island program in Gaaf Alif Atoll – Maldives
February 2004
Villingili Island
in Gaaf Alif Atoll, marks the first venue of the Healthy Atolls program
of action (healthy settings) in Maldives. The Villingili
Healthy Island Plan of Action was prepared at a workshop held on Villingili Island on 17 October, 2002 with participation
of major community groups; the representatives of the atoll and island
development committees, the assistant atoll chief, the women’s development
committee members, the business community leaders, teachers, youth, and
fishermen’s group representatives. Representatives of the Ministries of
Atolls Administration, Planning, Environment and Health also participated. WHO’s input to the workshop was as technical facilitator.
At the initial workshop in 2002, the Vision they
expressed for Villingili was: “That Villingili be an island that is completely free from the
nuisance of mosquitoes, flies, other environmental concerns, and be a
community that is working together in cooperative harmony in the pursuit of
island development actions”. The broad
Objective set for themselves was - to establish a well functioning
healthy atoll process in the Gaaf Alif Atoll. The process to be initiated
from Villingili island in 2002, begin expansion
to other islands of the atoll by the end of the first year, and complete
replication to the whole atoll by the end of 2005.
Thefollowing issues were identified at the
workshop: Personal hygiene – this
is a composite issue that people see as contributing to many health
issues such as ARI in children, diarrheal diseases,
skin diseases etc. The causes mentioned are the lack of awareness on how to
take care of children to protect  from getting colds and coughs,
lack of hand-washing, and general bodily hygiene and cleanliness. Some
environmental hygiene factors especially observed at the household level were
also considered here. Access to safe water - access to rainwater is
reasonable, but the quantities needed for a dry spell of about three months
have to be stored by the community and the households. Only then can this be
indicative of full community access/availability to safe water. Nutritional concerns – the community
concern here is the lack of access to and availability of adequately nutritious
foodstuffs, fruits and vegetables. There was not enough caloric intake and
also low consumption of fruits and vegetables in the diet. The causes were
the cost of food items, and lack of availability of fruits and vegetables in
the island (few households growing these), and also the lack of awareness of
a healthy diet for growth and development of children (physical and
intellectual). Nutritional disorders (clinical aspects would need to be
looked at subsequently). Solid waste disposal – in the context of a coral island,
with high water table, the issue of ground water pollution is a prime issue.
Also seepage to ground water from hazardous waste (batteries, and clinical
waste from hospital and health center) is also a danger. Flies nuisance - while this was seen as more of a
nuisance issue, the health implications are also evident. The fly breeding
occurs primarily because of the inadequate disposal of fish waste (fish
entrails, etc) on the beach. This is often the practive
by fisherman when they bring back the days catch to the island. There is a
fish purchase/ storage facility at a nearby island, but any leftover unsold,
is brought to the island. The fish that is brought is cleaned on the beach
and the inards left on the shoreline from where
they are beached further by the waves and left exposed to fly breeding. The
swarms that rise from these are found everywhere. While these flies are
indeed considered a nuisance, people have always lived with this as being a  part of life. Lately, a fish
drying/processing local industry is also thriving on Villingili,
and tons of fish are being processed daily and the entrails may not be well
disposed of in this case either. Mosquito nuisance - the major source of mosquitoes on Villingili island is its mangrove wetland bodies of water
(there are two). The wind then carries these swarms into the inhabited areas
of the island. This source and others from the wooded areas and garbage dumps
that hold anything that can harbor a pooling of water for breeding, unsealed
septic tanks may also be added to the sources to be eliminated. ARI – this includes the coughs and colds
of infants and adults that afflict the community periodically. For mothers,
this is particularly of concern because infants and children lose appetite,
lose time from school, and take away precious income to be spent on
medicines. Mother’s health – this
ismostly with respect to safe motherhood services (quality)
that is not available to mothers in Villingili.
Late stage pregnancy concerns such as eclempsia and
slow referrals were pointed out here. Also to be added here is the lack of
quality antenatal care and family planning practice advice. Tobacco use - there has been a decline in tobacco
use, but was flagged as an issue to be in line with national policy. The
focus here would be to prevent the teenager from taking up the habit, and
promote a smoke free school (teachers to stop smoking too).
All actions
were planned initially for completion in the first year (by the end of 2003).
A year-end review was also planned for during this initial process so that
the adequacy of progress and managerial issues may be assessed, lessons
learnt, and new targets set for the next phase of the program.
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