Monthly Archives

May 2016

by Dr Sepehr Lajeverdi

By | Medearth supplies make a real difference | No Comments

DAISI (Doctors Assisting in the Solomon Islands) is a registered Charity with the Australian Charity and Not-for-Profit Commission which endeavours to reduce disadvantage and make access to medical treatment a reality for the people of the Solomon Islands.

In Dec 2015, DAISI’s team of doctors and nurses travelled to Gizo Hospital in the Solomon Islands and took with them much needed medical supplies donated by MedEarth. These supplies were donated directly to Gizo hospital; which included consumables for the emergency department and the operating theatres such as dressings and sutures.

MedEarth’s donations were very well received by the staff at the hospital.

donation to greg jilini

The photo to the left shows these supplies being donated to Dr Greg Jilini, the Director of Gizo Hospital, by Dr Sepehr Lajevardi. DAISI’s team of doctors and nurses were also able to use MedEarth’s donations for the patients treated during the mission to Gizo hospital.

The donations had a direct and significant impact on the lives of patients receiving treatment, and DAISI’s mission would have been incomplete without the assistance of MedEarth. One particular case of note was a 16 year old boy who sustained a laceration to his dominant thumb while cutting coconuts. This young patient had cut the main tendon to his thumb as the result of the laceration – which could have led to a life-time of disability and loss of full functionality of the hand. Using the special tendon repair sutures donated by MedEarth, Dr Lajevardi was able to repair his tendon and return function to his dominant hand.

 

The photo below shows Dr Sepehr Lajevardi speaking to this young patient immediately prior to surgery.

TENDON REPAIR

As part of its charitable endeavours, DAISI was able to raise thousands of dollars in donations including school supplies, books, clothing and toys for the children’s ward, as well as nearby villages in the island of Gizo with DAISI members distributing clothing, books and toys to children in Gizo Hospital and the Babanga Village.

DAISI and MedEarth have now established a partnership for regular shipment of medical supplies to the Solomon Islands, with each surgical mission undertaken by DAISI.

 

Dr Sepehr Lajevardi is a plastics advanced trainee registrar from Sir Charles Gairdner & Royal Perth Hospital. He is committed to developing world surgery and plans to return to Gizo for volunteer for a surgical rotation in July 2016.

by a/Prof Hamish Ewing

By | Multi-Disciplinary Care for Breast Cancer | No Comments

FRONT ROW (left to right) Dr Paul Tauro, Dr Aaron Oritaimae, Dr Joseph Paahu (Radiology Registrar), Sr Maryleen (Surgical clinic nurse) , Assoc. Prof Hamish Ewing. BACK ROW (left to right) Dr Scott Siota, Dr Rooney Jagilly, Dr Roger Maraka (Pathologist) , Dr Dudley Ba’erodo, Dr Simon Wale (Radiology Registrar),  Dr Michael Buin (Surgical Registra), Dr Stallone Kohia (Surgical Registrar), Cancer Nurse ?, Dr Douglas Pikacha

As a recently retired General Surgeon with a special interest in managing breast cancer, it was wonderful to be invited by the Surgeons and Radiologist at the National Referral Hospital (NRH), Honiara, to deliver an educational package to the NRH doctors to help them understand the philosophy and practice of Multi-disciplinary Care for treating women with breast cancer. This was in the setting of increasing numbers of women presenting, usually late, with breast cancer. In addition, NRH had a new Mammography machine that they were keen to fully utilise.

Knowing the infrastructure circumstances that prevail in the Pacific, my first thought was that such a visit was inappropriate, but as I developed my ideas I recognised that this was a great opportunity to improve standard of care and initiate a development plan for future improvements. One of the most important elements of Multidisciplinary Meetings (MDM) is the bringing together of “a team” of Health Professionals to best manage cancer care. To this end, I was able to recruit the Director of Radiology at The Northern Hospital, Melbourne, Dr Paul Tauro, to join me on this trip. How better to demonstrate the MDM approach than by bringing an integral member of “our team”?

The most important factor for the success of our trip was to plan an educational package to best suit the requirements of the team at NRH. We exchanged many emails in the months prior to the trip which meant that thought we had the correct ‘recipe’. Our ‘well-planned visit’ got off to an unfortunate start as a result of our flight from Brisbane being cancelled and our arrival in Honiara delayed by 26 hours! This was in the setting of a tight programme and the doctors at NRH having cancelled clinics, operating lists, etc. to accommodate our educational visit. All credit to the NRH team, we drove straight from the airport to the Seminar Room, with USB-sticks in hand, and worked from 4.30 – 6.30pm and then met again at 8.00 the next morning so that we some important theoretical information could be delivered before the special Breast Clinic consulting session that had been teed-up ahead of time by the NRH doctors. I consulted in the Clinic while Paul worked with the Radiologist and his trainees to ‘work-up’ the women we were referring to them. This was a great vehicle to demonstrate how Paul and I work together to reach clinical decisions expeditiously. As a direct result of the demonstrations in ultrasound cytology biopsy techniques, NRH had positive cytology results available in 24-hours. The capacity to achieve this had  always been available but booking processes, needle biopsy techniques and follow-up clinic booking processes prevented streamlined management. Three simple steps made best use of skills already on-site at NRH.  This proved to be  really rewarding for all parties, including patients.

On the next day we held a demonstration MDM using patient case material we brought with us to demonstrate different clinical issues. We also discussed future developments for breast cancer care just ‘over the horizon’ as well as undertaking some Registrar training sessions.

On the final morning we were invited to make a presentation to the NRH Grand Round. This was a very well attended meeting with sixty doctors and nurses from all departments at NRH. This was a great opportunity to share the knowledge that we had all gained in the preceding three days. I also spent some time explaining the theory of MDM care and how the beginnings of this was  already  in place at NRH. Whilst delivering this Powerpoint  it  dawned on me that a Multidisciplinary approach was so very important for almost all conditions, especially the challenge that diabetes presents to Pacific nations. Where better to adopt a team approach than in diabetes?  Doctors, nurses, ophthalmologists, podiatrists, physicians, surgeons and, very importantly, district health workers, all combining for a co-ordinated and unified team approach to care. This observation resonated with the audience that happened to include the physician CEO of NRH.

Our last session was to run an MDM to discuss the women we assessed in the Clinic on Wednesday morning. This exercise was real and undertaken in real-time rather than being strung-out over weeks or months, as had often been the case. This was all achieved with staff and equipment currently available in the Solomons. I have been reassured to learn that Breast Cancer MDMs continue to be successfully undertaken once a fortnight.

This was a well researched visit that was delivered under the auspices of the Australian Government supported Pacific Islands Programme in response to a request by the Solomons doctors. This visit  also demonstrates the importance of Education, as much as Service Delivery, to advance skills and sustainability of a medical workforce in a developing nation close to our shores.

Assoc/Prof Hamish Ewing is a recently retired General Surgeon from Melbourne who obtained his FRACS in 1980.  He is currently Associate Professor of Surgery at The Northern Hospital, Epping and the Clinical Dean for the University of Melbourne at the Northern Hospital.  He has had an interest in surgery in the Pacific Islands for many year. In 2002, he first visited Dili, East Timor, as a relieving General Surgeon. This exciting, challenging and rewarding experience led to annual return trips to East Timor and subsequently Chairmanship of P.I.P. Monitoring Committee, External Examiner to University of PNG. M.Med(Surg) exams  and membership to the Rowan Nicks & International Committees of the Royal Australasian College of Surgeons.  A/Prof Ewing recently visited the National Referral Hospital (NRH) in Honiara to establish a multi-disciplinary team approach to the management of breast cancer.

 

 

 

by Nili Hali

By | Medearth combine forces with DAISI | No Comments

MedEarth has donated much needed medical and surgical equipment to the Solomon Islands.  DAISI secretary Dr Gary McKay (2nd from left) and his wife Roshini McKay (1st on left) met with MedEarth co-founder, Lara Garfinkel (2nd from right), and anaethetist and medical adviser to MedEarth, Dr Craig Garfinkel (1st on right), at the MedEarth warehouse (space is kindly donated by Panavision) in Lane Cove to see first hand all the donated medical equipment and supplies that MedEarth has recovered that is seeking a new home.  Lara Garfinkel and co-founder Laura Taitz founded MedEarth in 2013 and it is the only charity in Australia that recovers unwanted usable medical supplies and equipment from hospitals and redistributes it to those who desperately need it.  Lara adds, “This achieves our goal of protecting the environment whilst at the same time ensuring access to better health care for those in need in developing countries”.  The warehouse is full of fully functioning medical supplies and equipment donated by hospitals in Sydney during upgrades or refurbishments. In the absence of MedEarth, these items would have been discarded as waste and ended up as landfill. The ECG machine seen in the foreground was particularly requested by Gizo hospital emergency department in the remote western province of the Solomon Islands, as their current ECG machine is quite dilapidated.  With the aid of the Royal Australia Air Force (RAAF), DAISI and MedEarth, working in collaboration, will be able to transfer this much needed equipment to the Solomon Islands.  For More information on MedEarth please visit www.medearth.org

Nili Hali is a child protection lawyer with the NSW Government with previous experience in international law and volunteer work, having completed a secondment at the United Nations in The Hague, The Netherlands and more recently the Solomon Islands. She offers legal advise and assists DAISI on an ongoing basis, and continues to visit the Solomon Islands frequently on medical outreaches.