Merita Monteiro is part of the Indo-Pacific Centre for Health Security's STRONG TL project, which is designed to strengthen communicable disease surveillance and control in Timor-Leste.
What is your current role?
Currently, I am taking a short break from being a GP and Head of Communicable Diseases Department at the Ministry of Health in Timor-Leste to study a Master of Public Health at CDU through Menzies School of Health Research. It has been my dream for the last five years.
What drew you to work in health security?
I am interested in public health and health security because I want to improve the community's health and well-being. I found many issues and challenges related to public health when working as a GP in one of the municipality hospitals in Timor-Leste. It made me think that health extends far beyond just a treatment; it is also about prevention - how do we prevent our community from illnesses, detect diseases early, provide health education and respond as early as possible so people can live a healthier life.
How does your work impact people’s lives?
My work experience as both a GP and Head of Communicable Diseases together with my public health knowledge will provide me a solid foundation to better understand the issues that cause population health problems, the environment where people are living, their behaviour, culture and their perception of health and also the health care system available to them. These experiences and understanding reinforce my commitment to help people to live healthier lives.
What are some of the challenges you face in your work?
The most challenging thing I faced when working as a GP was that the community's perception of health was very poor in Timor-Leste and the healthcare system in place did not adequately respond to the community's needs. There are also limited studies on disease prevalence and other public health issues. Therefore, I think it is essential to also invest and collaborate with partners in ''Research'' to provide evidence on current population health conditions to support designing better health programs and policy making decisions.
What is the most rewarding thing about your work?
To me, the most rewarding thing about my work is how I helped people through my job as GP and then then as the head of communicable diseases. This made me feel that I had contributed a tiny part to society. Helping others creates an extraordinary feeling inside me.
Access to clean drinking water is critical to public health. Natural disasters such as cyclones and flooding often reduce the quality of drinking water so our Watershed Interventions for Systems Health in Fiji (WISH Fiji) project has acted quickly after recent tropical cyclones. Instances of heavy rain and resulting flooding can cause contamination of water from livestock waste, human sewage, chemicals and harmful contents of soil runoff.
Once contaminated, drinking water can become a hazard to human health and efficiently transmit deadly water-borne diseases such as typhoid fever and leptospirosis, and also cause diarrhea. Standing water that pools after flooding also becomes a breeding ground for mosquitoes and can increase the occurrence of diseases transmitted by these insects, such as dengue fever.
On 17 December 2020, a Category Five Tropical Cyclone (TC) Yasa, made landfall with heavy rain and strong winds up to 250 kph in the Northern Division, leaving behind a massive trail of destruction for residents of the Province of Bua. The cyclone damaged the homes and livelihoods of people, including schools and other significant community buildings. Many communities have also suffered damage to critical water and sanitation infrastructure, which can lead to poor health outcomes if left unattended, including outbreaks of water-related diseases. Fiji was additionally buffeted by TC Ana on 31st January 2021.
In support of the efforts of the Ministry of Health and Medical Services to strengthen water quality assessment capacity in communities post natural disasters, WISH Fiji has conducted a five-day refresher training for the health inspectors in Northern Division. The training was part of the project’s collaborative response to protect public health post TC Yasa, building the knowledge and skills of the participants in conducting water quality tests in remote communities using Wagtech PotaLabs (portable laboratories).
The participants learn how to conduct chemical and microbiological (bacteria) tests with the use of the portable laboratory kits to:
- determine if the drinking water is safe for consumption;
- identify sources of contamination; and
- recommend interventions to reduce the risks of water-related disease in the affected communities.
The WISH Fiji project manager, Timoci Naivalulevu said, “As partners in the arena of public and environmental health, it is our responsibility to ensure that drinking water is not only available to the communities but is safe for consumption and does not prompt waterborne diseases especially after disasters.” “For instance, several communities in Bua Province are already recognized as hotspots for leptospirosis, typhoid, dengue and diarrhea (LTDDs) after TC Yasa. The water quality assessments are critical to ensure that the risks of disease transmission are detected quickly, so we can enact preventive measures.,” he added.
The five divisional health inspectors will prioritize these high-risk areas to conduct water quality assessments after the training. The MoHMS Macuata Sub-Division Health Inspector, Pranit Kapoor said, "It is important to add water quality analysis to our water sampling work. This enables us to make quicker decisions on what interventions are needed in high priority communities. We can also develop water quality profiles for high risk communities within the sub-divisions."
During the last two days of the training, the participants conducted water assessments in the six communities in Dama District in the Bua Province. The WISH Fiji project has spent over a year working with communities in Dama and four other watersheds to identify the factors that are contributing to water-related diseases and affecting human health and the many services provided by the environment. Since then, the WISH Fiji, through its Water Safety and Security Planning workshops has identified multiple interventions that will be implemented to improve the water and sanitation infrastructure and wisely manage human activities within their village and watershed environments to help reduce the transmission of water-related diseases. WISH Fiji has so far completed two water infrastructure interventions in Tavulomo Village in Dama District in Bua Province and Bureta District on Ovalau Island in Lomaiviti Province.
The portable laboratories were previously supplied by WHO (another WISH-Fiji partner) and have recently been serviced by the WISH-Fiji team so that they are fully operational for the training and TC response. This project is also supported by Bloomberg Philanthropies.
Banner Caption: WISH Fiji conducts WagTech PotaLab refresher training for the health inspectors in Northern Division, Fiji.
Read about the WISH Fiji project and job openings under the new Vaccine Access Initiative.
The Daily News Alert.