Welcome back to Contain This. We hope that you had a safe and restful holiday period and are looking forward to bringing you more insightful discussions.
This is Episode 22 of Contain This, brought to you by the Indo-Pacific Centre for Health Security is hosted by Australian Ambassador for Regional Health Security, Dr Stephanie Williams.
Today, we hear key perspectives on public health in Kiribati for 2021, in light of the COVID-19 pandemic.
Eretii Timeon, the Public Health Director in the Ministry of Health for the Republic of Kiribati.
Trained as a nutritionist, Eretii has been working with the Ministry of Health for the past 20 years. The ministry employs 580 people to look after the health and well-being of a population of 110,000 located on 16 islands.
For more information about the Indo-Pacific Centre for Health Security, visit our website https://indopacifichealthsecurity.dfat.gov.au.
Connect with us on Twitter via @CentreHealthSec and @AusAmbRHS.
Welcome back to Contain This. We hope that you had a safe and restful holiday period and are looking forward to bringing you more insightful discussions.
This is Episode 22 of Contain This, brought to you by the Indo-Pacific Centre for Health Security is hosted by Australian Ambassador for Regional Health Security, Dr Stephanie Williams.
Today, we hear key perspectives on public health in Kiribati for 2021, in light of the COVID-19 pandemic.
Eretii Timeon, the Public Health Director in the Ministry of Health for the Republic of Kiribati.
Trained as a nutritionist, Eretii has been working with the Ministry of Health for the past 20 years. The ministry employs 580 people to look after the health and well-being of a population of 110,000 located on 16 islands.
For more information about the Indo-Pacific Centre for Health Security, visit our website https://indopacifichealthsecurity.dfat.gov.au.
Connect with us on Twitter via @CentreHealthSec and @AusAmbRHS.
Please note: We provide transcripts for information purposes only. Anyone accessing our transcripts undertake responsibility for assessing the relevance and accuracy of the content. Before using the material contained in a transcript, the permission of the relevant presenter should be obtained.
The views presented in this podcast are the views of the host and guests. They do not necessarily represent the views or the official position of the Australian Government.
Eretii Timeon 0.04
We'll be requesting as well, the assistance as much as we can get. Because at the end of the day, the logistics in looking at our scattered islands, the training that we need, the resources that would be needed to ensure that these are well-secured distributions, we'll be needing assistance from our key partners, and development partners for assistance.
Dr Stephanie Williams 0.34
Welcome to Contain This. I’m Stephanie Williams, Australia’s Ambassador for Regional Health Security.
We are bringing you an important Indo-Pacific Health Leaders interview as we begin 2021, a year which will be dominated by the task of distributing COVID-19 vaccines, kick-starting the process of recovery from the global pandemic.
In my role guiding Australia’s Regional Vaccine Access Initiative for the Pacific and Southeast Asia, I have talked to leaders in 18 countries over the last three months about demand, supply and capacity to deliver vaccines.
Today I’m pleased to invite one of those leaders to talk to us - Eretii Timeon, the Public Health Director in the Ministry of Health for the Republic of Kiribati.
Trained as a nutritionist, Eretii has been working with the Ministry of Health for the past 20 years. The ministry employs 580 people to look after the health and well-being of a population of 110,000 located on 16 islands.
Eretii, welcome to Contain This.
It's terrific to be able to speak with you today and hear about your perspectives about public health in Kiribati for 2021. And to start, I'd really like to start on the question that's at the front of all our minds, around COVID vaccines and what this means for our countries and populations. Can I ask, how are you as Director of Public Health approaching the planning for vaccination amidst some ongoing uncertainty about supply timeframes for COVID vaccines? How is that going in Kiribati?
Eretii Timeon 2.19
Thank you for that question. And we are fortunate to have our partners in-country with us who have been assisting us along the way for technical advice and as well as ways forward. Now we lobbied and connect to GAVI where we've managed to confirm our application for the COVAX COVID-19 vaccine. We have WHO and UNICEF offices in-country, which makes things much easier for our lobbying and our communication in line with confirming where we stand and completing what the government of Kiribati through the Ministry of Health, what are the needs in line with our application and submission on time for the COVID-19 vaccine. From public health services, Stephanie, as I mentioned, since this we've seen our key role is to ensure that the public health is secured. And as for the COVID-19 vaccine, it has become a priority. Since the end of last year, we've tried to follow what GAVI recommends and what GAVI requests in line with our application to secure the portion that we'll need in line with the 20% that we will be given for COVID-19 vaccine.
Dr Stephanie Williams 3.58
It's an interesting time to have this interview, Eretii, because in the last couple of days, we understand, and GAVI has made public today, the point you just made around the initial allocation of the AstraZeneca doses to Kiribati through the COVAX facility, which is good news from an allocation perspective, although they did outline a number of additional steps countries needed to do in order to release the doses, some of which included a finished National Vaccine deployment plan. How is that progressing in Kiribati?
Eretii Timeon 4.40
It's timing well on that question, Stephanie. Because we've completed [the plan] since last week, but we just need clearance and endorsement, as a formality through the government. We will be sharing to our partners this plan by tomorrow, and we'll be requesting as well, the assistance as much as we can get. Because at the end of the day, the logistics in looking at our scattered islands, the training that we need, the resources that would be needed to ensure that these are well-secured distributions, we'll be needing assistance from our key partners, and development partners for assistance. So yes, the plan is in place, we'll be distributing it by tomorrow. And we'll be seeking the assistance from partners that are keen and interested to assist us to add on to what the government will be providing and is working already. So we are there, the plan is set to go. This is just in line with the 20%. But we will be working further on the 80% noting that the vaccine will be coming 100% but it will be coming for a certain population that it might be an additional 50 to 60% for Kiribati. So we are there, Stephanie, the plan is there, which is a matter of coordinating ourselves and communicating to our key partners for assistance.
Dr Stephanie Williams 6.19
That's great news. If I could ask about the population in Kiribati and their understanding or willingness to take a COVID vaccine. How are you already communicating with the public? Or how are you planning to communicate to the population about COVID vaccines and their importance in Kiribati?
Eretii Timeon 6.45
We've said already bit by bit, last year, lobbying to the parliamentarians, Members of Parliaments, because these are the main influences in their own constituencies in all the outer islands, including the Line and Phoenix, the furthest islands closer to Hawaii. So we've communicating. We've had a special conference, a one-day conference with them, sharing the details of the 20%. These are the tentative targeted populations that will be targeting and the reasons behind that and our way forward for covering, ensuring that we cover beyond the 20% that GAVI will be providing in the first phase. So we've started communicating with Members of Parliament as these are the key people and are key influencers in the community. We will be adding as part of the planning, we have plans to also communicate to church leaders who are also key influencers as well in Kiribati. I'm sure it's the same as well in other Pacific Islands as we move our way along to the community. We will not work in isolation. We will work with other NGOs as these are the key influencers in order to assist to disseminate the information. But we have to ensure that we have standard information that can avoid misleading interpretations of what will be occurring first in the 20%. And later on, if we are to add beyond the 20%.
Dr Stephanie Williams 8.29
That's terrific to hear. You've got that multi-layered approach to communication with standard quality information and different types of people in the community. Are you aware of any feelings of hesitancy amongst the Kiribati population at the moment?
Eretii Timeon 8.50
The only hesitancy that we received, Stephanie, is in line with a question and this is a major question. We haven't really started nation-wide but have started focusing on Tarawa first just to see how it goes, to disseminate the information on the vaccine, starting with the Member of Parliaments or MPs. The major question and the most repetitive question which has been communicated, is that why the 20% only? And what about the other percentages that will not be covered in this first phase? There is a need to really sit down together again, not only MHMS team, but to sit together with our other stakeholders. We have a skeleton of a national COVAX committee who should be confirming technical advice and ways forward to convey standard information to the public to reduce and/or avoid hesitancy issues. At this National committee, members are to ensure we sit down together and screen well detailed information to answer the questions of why 20%? What about the other percentage that are not covered?
In terms of not wanting or accepting the vaccine, this is quite rare, but we have to ensure we are ready to deal with this situation. For example, learning from the measles MR vaccination it's around one or two out of the many households we went to were reluctant to vaccinate their under five year olds. This indicated a crucial point to consider in line with standardizing the information so that those who are to receive the vaccines are well aware on what they will receive and what are the risks or side effects they might be experiencing. If we can deliver the information which is well-explained in a way that the targeted population can understand why 20%, the next move will be beyond this 20%, detailing and the impacts or the side effects that recipients might encounter if they have the first and second dose of this vaccine.
Dr Stephanie Williams 11.07
It's just so important what you say about the quality of standard information and tailoring that to the audience and the population in Kiribati. And Australia, as you know, is pleased to be able to support Kiribati through the Regional Vaccine Access Initiative to enable that broader coverage than 20% of the initial estimates. Can I ask you now to throw your mind back to 2020? I know that you led the health champions effort and travelled the country in March and April last year to raise awareness of COVID, using hand washing and social distancing. When you look back at 2020, from your experience as the Director of Public Health, can you reflect on some of the most important lessons you learned in terms of Public Health Leadership?
Eretii Timeon 11.59
One of the key challenges that we face is patience. You have to have it. During our campaigns and during our community visits, we encountered different community members with different understandings to accept or to receive information. Patience is one of the key challenges that have been faced with since COVID-19. There's a lot of questions and at times, they're not that relevant to what we were trying to introduce or share to the public but this stage requires a lot of patience to start with to try to answer and clarify, what is the main purpose of the outreach to the community? One of the main challenges, I don't know if it's the same with other Pacific Islands, but with Kiribati and i-Kiribati taking things not that serious. We can see that because there were questions raised as well as saying that if COVID-19 or Coronavirus is the same as other influenza type viruses, it's normally just a flu. So why are we taking this seriously? The fact is that they haven't really seen or have an experience while affecting in line with the seriousness of this. And including the way that we received this as i-Kiribati. And I'm sure it is the same in the Pacific countries not taking things seriously. Overall these issues require patience and time. Those were the challenges that I encountered, where most times I needed to sit back, think about how I provided responses and perform actions at the same time in line with Public’s demand and questions that were thrown during our campaigns in 2020, in particular, during the first time that COVID-19 was first introduced, or communicated.
Stephanie, that one good thing about our campaign was that measles [then COVID-19) one outbreak after another. Lessons learned from the measles MR campaign and the vaccination that we had been administrating with the nurses because we did work together with nurses in the community, was really helpful. We had been trying to be patient along the way to ensure that information and awareness were well communicated on time and well understood.
Dr Stephanie Williams 17.09
We are certainly in the COVID pandemic for years to come, I'm interested in how you personally keep up the energy and momentum in your busy job and what you enjoy most about your job, even if at a very busy time?
Eretii Timeon 17.25
Stephanie, it's about teamwork. It's not only myself who is doing most of the work. And we have to take turns. I have to ensure that my team together with the nursing and the hospital services and also the support services work together as a team. Because if we don't have that team spirit of teamwork, I'm sure by the middle of the year, even before the middle of the year, we'll all be exhausted. We have to strengthen our teamwork and communication so that at the end of the day, we can share the load and work according to what we will be planning so that not one or two or three people are to be affected but we work as a team. We have to take turns and share the load to ensure that we work together.
Dr Stephanie Williams 18.23
Can I thank you for your observations today, Eretii, on the importance of patience as a public health leader planning, as you are doing currently, for the COVID-19 vaccine and partnerships and teamwork. It's been terrific to talk with you and certainly as you go forward with the COVID-19 vaccine challenge in 2021, we in Australia look forward to working with you to meet that challenge. So thank you very much for your time.
Eretii Timeon 18.55
Thank you.