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Pacific Island Orthopaedic Association (PIOA)

My Time in Papua New Guinea

I went to PNG to help my colleague and friend Dr Desmond Soares with his initiative - the Pacific Island Orthopaedic Association. This initiative took birth way back in 2012.  Dr Soares who in his former life before becoming an Orthopaedic Surgeon worked in Nepal looking after Leprosy patients.  He returned to Australia in the late 90's and trained as an orthopaedic surgeon in Queensland.IMG 1639

Pic 1- PIOA trainees with Dr Des Soares (Back far Left), Dr Darryl Teague(aust) , Prof Nik Friederich (swiss), Myself (seated L-R 4-6)

World inequality in healthcare is very obvious. A lot of us talk about it and acknowledge how terrible this is. We have ideas and thoughts of making a difference but to actually put it in practice is a mammoth task. This Mammoth task was taken on by Dr Soares and started the PIOA in 2012. Like any initiative that challenges the traditional models and threatens the existing systems faces resistance. Dr Soares faced the same from some within and some outside. He looked past it all and had a bigger picture in sight- the orthopaedic health of the pacific island inhabitants.

Dr Soares has now given up his very successful private practice in Brisbane and has decided to spend more time coordinating this training program. The enormity of obtaining funding and complying with rules and regulations of the participating nations and their trainees is no menial task. Dr Soares pays for every trainee to attend teaching modules from different pacific island nation. PIOA takes care of all travel and accomodation cost and brings together experts in their field to teach at these modules. These teaching modules are held 2-3(depends on cycle) times a year for a 3 week period

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Pic 2 Teaching Room

I was invited to teach at the Knee module recently held at the Kundiawa General Hospital in PNG. This experience was very humbling. I m from Fiji and have worked in Fiji and in India but PNG was another level. I delivered 2 days of lectures and helped out with operating on the 3rd day. 

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Pic 3 Prof Friederich and Dr Soares Demonstrating Knee Replacement Techniques

We did morning ward rounds and each trainee would present 3 cases that were chosen the night before. The tutors would teach on these cases during the round and then a group discussion would follow for the morning session. The Trainees were asked more questions and a management plan would be discussed. This plan would then be acted upon depending on the resources available.

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Pic 4,5   Teaching ward round

The afternoon session would begin with lectures on topics delivered by experts. Each module lectures are the same as what is taught to trainees in the Australian Orthopaedic Association training programme. In the evenings a Saw bone (plastic) practical with hands on practice for operative techniques would be carried out.

     Prof Nik Friederich showing arthroscopy techniques      IMG 20190802 160448975      IMG 6403

Pic 5,6  Practical sessions 

This programme runs for 4 yrs for each trainee. At the end of the 4 years each trainee has to sit a fellowship exam - set be external examiners from Australia or New Zealand. The examiners also come from Australia or New Zealand. These examiners are independent. If successful the trainees are presented with a Masters In Surgery (orthopaedic) from University of Western Samoa.

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Pic 7.8,9 Operating Theatre entrance, Helping with cases, with Father Jan (Polish Priest and Surgeon been in PNG 30yrs)

This initiative has the potential to transform Orthopaedic Care in the Pacific Island nations. Until PIOA, Australian and NZ surgeons would do outreach clinics on a ad-hoc basis and help perform operations on patients that presented during that time frame. Once the visiting surgeons would leave the system would revert to the same old system. This outreach programme do provide a level of service but is not self sustaining.

PIOA has the potential to train and uplift the Pacific Island systems to provide timely,safe and effective treatment. As i have shared before " give a man a fish he will feed for a day, teach him how to fish , he will feed for life.

Congratulations to Dr Desmond Soares on this very successful initiative. Wish you all the best and happy to help whenever required.

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Pic 10,11 Orthopaedic Ward