Surgeon Professor Christophe Berney (centre) and medical student Tom O’Donell (rear) arriving at Sopas District Hospital.
This DAISI trip was the third to Sopas District Hospital, Enga Province in the remote Highlands of Papua New Guinea. This trip involved seven volunteers with the emphasis on further development of laparoscopic services and anaesthetic support.
The trip was led by Professor Christophe Berney an experienced GI, hernia and laparoscopic surgeon from Sydney. Building on skills already learnt from the previous March trip, various aspects of laparoscopic surgery and anaesthetics were taught.
Prof Berney was accompanied by anaesthetist Dr Arathi Rajan, counsellor Marina Berney, freelance photographer & film-maker Quentin Curzon, and seasoned DAISI volunteers/Notre Dame medical students Charlotte Ferrier and Tom O’Donnell.
As Sopas District Hospital does not have its own onsite anaesthetist, the other emphasis of this trip was teaching various anaesthetic techniques to the two Anaesthetic Scientific Officers (ASOs) Ronnie Kaum and Tom Wapulo who currently administer general anaesthesia at Sopas District Hospital.
Medical student Charlotte Ferrier uses a blown up glove to distract a child prior to induction anaesthetic. Anaesthetist Dr Arathi Rajan with Anaesthetic Scientific Officer (ASO) Tom Wapulo.
The DAISI team departed Sydney Saturday 18th May 8:20am, arriving Mt Hagen (Highlands, PNG) at 4:15pm. It was then a two hour four wheel drive trip from Mount Hagen to Sopas District Hospital, with the Hospital staff organising this.
The two hour 4wd trip from Mount Hagen Airport to Sopas District Hospital involves pot-holed dirt road for much of the way.
The DAISI team received the most hospitable and friendly welcome one could hope for from Sopas Hospital staff and community.
Notre Dame medical student Charlotte Ferrier welcomed by Sopas community. The man on the extreme right holds a machete, a customary accessory signifying manhood.
Head surgeon from Sopas District Hospital Dr Elvis Japhlet, and Surgical Registrar Dr Max Pangali (centre) giving DAISI volunteers a tour of Sopas Hospital (left to right: Marina Berney, Arathi Rajan, Christophe Berney, Charlotte Ferrier and Quentin Curzon). The blue building in the background is the volunteer’s accommodation.
Marina and Christophe Berney arriving at Sopas District Hospital, trying sago pancakes, a local delicacy.
A tour of the surrounding farmland and village, local river and waterfall.
The traditional housing that surrounds Sopas District Hospital.
Sopas Waterfall next to Sopas Hospital.
Anaesthetist Dr Arathi Rajan opening anaesthetic equipment brought from Sydney.
Prof Christophe Berney and Tom O’Donell in the volunteer’s lounge room sorting laparoscopic equipment for planned week of laparoscopic surgery.
Film-maker Quentin Curzon arriving at Sopas.
Quentin Curzon filmmaker from Sydney.
More than fifty patients arrived the first day for screening coming from near and far. More continued to arrive throughout the week. There were too many to treat on this one week trip so many were turned back.
The DAISI team spent one week volunteering at Sopas District Hospital from Monday 20th May until Friday 24th May.
Dr Elvis Japhlet doing laparoscopic appendicectomy with scrub nurse Noreen John.
Scrub nurses Rose Philip and Noreen John with Dr Max Pangali watching the monitor.
Sterile laparoscopic instruments ready for use.
Scrub nurse Noreen John gets the team ready for diagnostic laparoscopy. Anaesthetic Scientific Officer (ASO) Tom Wapulo watches on.
Dr Elvis Japhlet using laparoscopic graspers to mobilise inflamed appendix, with scrub nurse Rose Philip (left) and Noreen John (right). Senior registrar Dr Max Pangali (extreme left) watches on.
Dr Japhlet inserting 30 degree laparoscope via umbilical port after insufflating abdomen with carbon dioxide.
Rose Philip is Dr Japhlet’s assistant holding the camera steady.
The laparoscopic irrigator/sucker device is ready to clean the abdomen of pus.
Division of adhesion to right ovary and fallopian tube.
Diagnostic laparoscopy for chronic abdominal pain revealing classic features of adhesions due to chronic Pelvic Inflammatory Disease (PID). In this case dense adhesions are seen above the liver. Division of adhesion and washout of pus allowed this woman to be discharged home the following day on a course of antibiotics.
Anaesthetic training of the two Anaesthetic Scientific Officers (ASOs) Tom Wapulo and Ronnie Kaum was every bit as important as the surgical training, with these two professionals becoming more familiar with paralysing anaesthesia required for laparoscopic surgery.
Anaesthetic Scientific Officers (ASOs) Tom Wapulo and Ronnie Kaum with Anaesthetist Dr Arathi Rajan providing anaesthesia.
The trip was a great success with the surgical team building on skills already taught two months earlier. This DAISI trip, Sopas Hospital offered laparoscopic surgery to eight patients (three for appendicitis, two for undifferentiated abdominal pain, one for chronic cholecystitis, one for excision of urachus, and one for abdominal hernia). Non laparoscopic cases included two mastectomy, one nephrectomy, one prostatectomy, varicose vein stripping, and one minimally invasive thyroidectomy.
Just as important, this trip emphasised anaesthetic training for the two Anaesthetic Scientific Officers (ASOs) Mr Tom Wapulo and Ronnie (Roxie) Kaum.
Friday 25th May the DAISI members and hospital staff presented a shared Grand rounds in the conference room in Wabag, followed by a tour of Wabag.
In the evening the DAISI team were treated to a farewell dinner Enga style with Mumu (meat wrapped in banana leaves and cooked on hot rocks beneath the soil). I was a fantastic way to finish a week of hard work.
DAISI volunteers were then presented with gifts, an unexpected surprise.
Left to right: Dr Arathi Rajan, Tom Wapulo, Rose Philip, Max Pangali.
Left to right: Tom O’Donell, Dr Arathi Rajan, Charlotte Ferrier, Prof Christophe Berney, Marina Berney.
The Mumu pit is dug deep into the earth, with hot rocks at the base, with foil (traditionally banana leaves) acting as a barrier between the rocks and soil and meat. Then soil is placed over this to allow slow cooking. Once left for about 1-2 hours, the soil is removed, and cooked meat is ready for consumption.
Saturday 26th May was a tour of Lake Surinki.
Lake Surinki in distance with surrounding farmland on Wabag (Enga Province).
Trip to Wabag museum, where traditional sand painting unique to Enga Province is done.
A formal debrief was organised by Prof Berney & Dr Japhlet allowing all to give feedback and exchange ideas for further improvement. All volunteers were positive about the trip with plans to return.
Sunday 27th May hospital staff organised four wheel drive return of DAISI volunteers to Mount Hagen, with a brief stopover at the famous Kumul Lodge for bird watching with the beautiful “Birds of Paradise” arriving on cue.
A Bird of Paradise at Kumul Lodge during feeding time.
The DAISI volunteers departed Mt Hagen airport at 10am Sunday 26th May, arriving Sydney 7:40pm.
Farewell to DAISI team at Mt Hagen airport. Left to right: Charlotte Ferrier, Tom O’Donnell, Marina Berney, Prof Christophe Berney, Quentin Curzon, Dr Arathi Rajan & host Dr Elvis Japhlet.
DAISI would like to give special thanks to the operating theatre nurse manager sister Rose Philip, nurse Anna Japhlet & Noreen John and all the Sopas District Hospital nursing staff who worked tirelessly making this trip possible.
56 patients screened
18 operations performed:
6 minor (laparoscopic)
4 major (laparoscopic)
3 minors (open)
5 majors (open)