THE SKILLS OF OUR LOCAL ANAESTHETISTS ARE BENEFITING MEDICS ACROSS THE PACIFIC – AND SAVING LIVES. WORDS CARLA CARUSO MICRONESIA feels a world away from Townsville, even though it’s only roughly 4500km. Comprising 2000-plus islands and atolls scattered across the Pacific Ocean, the region has a total land area about the size of a large Aussie sheep station. It’s an isolated place Australians don’t often hear about, but it’s where Townsville’s Dr Stuart Lavender has visited since 2007 with fellow local anaesthetist Arthur Vartis. The pair island-hop every two years, running a five-day anaesthetic refresher course for local doctors and nurses – one of a number of Australian Society of Anaesthetists-funded overseas projects. Dr Lavender, who works out of Mater Health Services and Townsville General Hospital locally, was there most recently in April. “Micronesia is a remote area with very limited resources and access to basic medical care and surgery,” the UK-born anaesthetist says. “But you can’t have good surgical outcomes unless you have good anaesthetic outcomes. Basic anaesthetics training ensures the local staff do well and lives can be saved. We are very fortunate in the care we have here, so it’s just trying to give something back.” Rather than service provision – such as an overseas team sweeping in to perform surgery, then exiting – the courses up-skill the local medical population. “An appropriate analogy would be the difference between providing the community with fish or teaching fishing skills.” While there, Dr Lavender admits accommodation was fairly grim. “It was pretty basic in Pohnpei this time. I shared my room with a reasonable number of cockroaches. I left the light on at night, so they generally stayed under the bed. You do acclimatise.” In Chuuk, on his first visit, it was a slightly different experience. Chuuk is where the Americans paid the Japanese back for Pearl Harbour by sinking half the Japanese fleet. Its famed lagoon is now home to one of the world’s top wreck diving sites. “The accommodation wasn’t too bad because the diving resort was obviously set up for Westerners,” Dr Lavender recalls. “But we had armed guards and the hotel was patrolled. This is because there are youths in Chuuk who fashion barbed darts out of building reo, which they shoot at tourists and visitors using handheld catapults. We had to be a bit careful, but that’s unusual. Most other islands don’t have such problems.” Each centre has a hospital, though the standards and service do vary. “In Chuuk, the state hadn’t paid the electricity bills for a year, so the hospital’s power was on and off and there were more cats and rats in the ward than patients. There was also no running water, despite the fact they had these amazing tropical downpours. It was the worst I’ve ever seen.”
PRESENTERS STUART LAVENDER, LEFT, ARTHUR VARTIS, YOSHIKI NAKAJIMA, AND KAZU SHIMIZU
Like many developing countries, Micronesia is also plagued by the “curse of donation”. “Expensive, often inappropriate equipment is provided by well-meaning sources,” Dr Lavender explains, “but there is no ongoing maintenance and the necessary disposables [to keep them up-and-running] are unavailable. This very quickly turns the donation into a space-occupying doorstop.” Dr Lavender adds: “Other money has come from China, which has built a series of magnificent high-speed roads around the two main islands of Palau. And this has given the locals road trauma – something they didn’t have to contend with before. I would hazard a guess there will be little or no maintenance for these roads. At the other end of the spectrum, the roads in Chuuk are a series of muddy potholes and traffic rarely gets over 10km an hour.” Sometimes cultural issues impede things. “A talk on analgesia in [childbirth] on one visit fell flat,” Dr Lavender remembers. “As far as the delegates and obstetricians were concerned there was little requirement – pain was perceived as a necessary part of labour. Although, occasionally herbal remedies would be indulged in and pethidine given. Also we were reminded that such interference was contrary to the word of God who said ‘in sorrow thou shalt bring forth children’.” Despite the challenges, Dr Lavender says “it’s good to know our efforts are making an impact”. The team has also been instrumental in establishing the Micronesia Anaesthesia Society, and overall, he says: “This has achieved greater recognition for the speciality in Micronesia. We have larger numbers of people providing the services than ever before, and we now have a doctor in each of the major hospitals on each of the islands.” Not a bad effort, indeed.
“THE HOSPITAL’S POWER WAS ON AND OFF AND THERE WERE MORE CATS AND RATS IN THE WARD THAN PATIENTS.”
DR STUART LAVENDER
82 DUO MAGAZINE JUNE 2013 duomagazine.com.au
Published on May 31, 2013
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